Today, we’re going to talk about metastatic breast cancer, or Stage IV breast cancer. Metastatic breast cancer is breast cancer that has spread beyond the breast to other organs in the body – most often the bones, lungs, liver or brain. Although metastatic breast cancer is not currently curable, it can be treated. Today, it’s estimated that at least 154,000 people in the U.S. have Stage IV, or metastatic, breast cancer. Treatment focuses on ensuring a high quality of life, and living a better life, longer.
Janet St. James goes by many titles: longtime broadcast journalist, healthcare executive, public speaker, wife, mother of 3, and breast cancer patient.
Janet worked as a television journalist for 25 years, 18 of them at Dallas ABC affiliate WFAA-TV, which she joined in 1996 as a general assignments reporter, covering a wide variety of stories from the Oklahoma City bombing to Hurricane Katrina. She covered the medical beat from 2000-2015 and was the first to break the news of positive Ebola case in Dallas in 2014.
Janet left WFAA in March of 2015 to pursue a new career as Asst. Vice President of Strategic Communications for Medical City Healthcare, which includes 14 North Texas hospitals. In the week before starting that job, she was diagnosed with stage 2 breast cancer. In November of 2018, she was diagnosed with metastatic breast cancer for which there is currently no cure. She regularly blogs about her cancer ordeal on social media, hoping to educate and empower others about treatment and how a healthy attitude, education and honesty can make a difference.
Adam: [00:02] Today we’re going to talk about metastatic breast cancer or stage four breast cancer. Metastatic breast cancer is breast cancer that has spread beyond the breast to other organs of the body, most often bones, lungs, liver or brain. Although metastatic breast cancer is not currently curable, it can be treated. Today it’s estimated that at least one hundred and fifty-four thousand people in the US have stage four or metastatic breast cancer. Treatment focuses on ensuring a high quality of life and living a better life longer. To help us learn more about that and how to live a better longer life with metastatic breast cancer, let me introduce Janet St James.
[00:40] Janet goes by many titles, longtime broadcast journalist, healthcare executive, public speaker, wife, mother of three and breast cancer patient. Janet worked as a television journalist for twenty-five years, eighteen of them with Dallas, ABC affiliate WFAA-TV, which she joined in 1996 as a general assignments reporter covering a wide variety of stories from the Oklahoma City bombing to hurricane Katrina.
[01:06] She covered the medical beat from 2000 to 2015 and was the first to break the news of positive Ebola case in Dallas in 2014. Janet left WFAA in March of 2015 to pursue a new career as assistant vice president of Strategic Communications for Medical City Healthcare, which includes fourteen North Texas hospitals. In the week before starting a new job she was diagnosed with stage two breast cancer.
[01:32] In November of 2018 she was diagnosed with metastatic breast cancer for which there is currently no cure. She regularly posts about her cancer ordeal on social media hoping to educate and empower others about treatment and how a healthy attitude, education, and honesty can make a difference. Janet, welcome to the show.
Janet: [01:52] Thank you so much for having me. I’m very happy to be anywhere right now, so that’s good.
Adam: [01:57] Well, listen your bio is so prolific. You’ve obviously done so many amazing things. You’re doing amazing work and you’re doing it really just in spite of, I guess and in light of your circumstances. Is there anything you want to add to your story?
Janet: [02:14] Sure. Well, first of all, my philosophy is you just keep going until you can go no more. Right? Isn’t that what we all do? So the whole idea of being brave or something like that, that’s foreign to me because you just go until you can’t go. I’ll tell you a little bit more about my story because I think the background of how I was diagnosed is a little interesting because as twenty-five years as a journalist, sixteen of those covering health and medicine, the irony of being diagnosed with breast cancer right after I left journalist that’s not lost on me. And being diagnosed with metastatic breast cancer subsequently is also something that I think sometimes people have a hard time being able to comprehend, how is it me?
[02:58] I was initially diagnosed in the week before I started this job as Assistant Vice President of Communications at Medical City Healthcare. I really didn’t know about staging until the Friday before I showed up for this job. My cancer was found by my gynecologist who initially thought it was a cyst and since my health insurance expired the next day I had to get in immediately for an ultrasound that showed breast cancer that was clear it had already spread to my lymph nodes. So at diagnosis, we knew that it had already spread to the lymph nodes, that does not make it metastatic.
[03:30] But a few weeks after starting the job, I had a double mastectomy followed by chemoradiation because my cancer is highly hormone fed. I had a complete hysterectomy. I’ve had nine surgeries in three years and unfortunately, none of that was enough to stop my cancer from returning. So I was diagnosed with metastatic breast cancer in November of 2018 and I think people are always surprised to know that it’s happened to me because I’m pretty educated and there was no big lump or anything.
[04:06] And even with metastatic breast cancer, it’s not like suddenly I fell down and was like, it’s back. I had some minor but persistent spine pain for some time. I’m in really pretty good shape. I exercise, my oncologist didn’t think it was serious, but I insisted on some scan. In part because I had a cold that I was struggling to recover from and I just felt like that wasn’t quite right for me. I usually like it when I’m right, but not that time.
Adam: [04:31] Yeah, that’s not the kind of thing you want to be right about, right? So, of course, metastatic breast cancer is breast cancer that’s spread beyond the breast, right?
Janet: [04:39] Yes and beyond the nearby lymph nodes so it’s beyond the lymph nodes.
Adam: [04:44] Okay, correct, yeah, yeah of course. Thank you for that. So talk a little bit about how you’ve coped with that diagnosis.
Janet: [04:52] How I’ve coped with it? I think that some days are better than others. It’s hard I won’t lie. mentally it’s hard. Sometimes physically it’s hard. Treatments may work for some time, but nobody really knows for how long they’ll work while none of us is promised tomorrow. It is frightening and it’s humbling to know that you really do have to live for today so the mental game is a tough one at times.
Adam: [05:16] Yeah, yeah I can totally imagine that and what has been the most helpful to you to kind of create a community of support around you during this time?
Janet: [05:25] I’m very blessed and I’m honored to have a very large family and many friends, many kinds of people that I’ve never even met support me through social media where I do video blogs. Social media can be good, not always bad. In my case, it’s been very good for coping with this. Well, I’ve always lived my life as an open book and I don’t intend to change that and I think people count on me being open and sometimes that uncomfortable honesty that you’re going to get from me.
Adam: [05:53] I love that. I love people that you know where you stand and you know where they stand. The worst is to ask somebody how they’re doing and they give you a fake answer. So I love that you can give an honest answer and you gave an honest answer when we started talking even before this interview and I appreciated that.
Janet: [06:09] Of course.
Adam: [06:10] Well, so describe if you would what’s your current regimen of treatment and how are you taking care of yourself right now?
Janet: [06:18] I don’t like to talk about the specific medication that I’m on because with metastatic breast cancer that could literally change at any moment. I’ll tell you that I’m on a powerful medication right now called a CDK four inhibitor that works to try to stop the cell division of cancer cells. Some people may call it a chemo pill. I don’t know that it really is technically that, but I’m also on a powerful hormone blocker because my cancer is almost 100% hormone fed.
[06:45] I shouldn’t have any hormones left in my body, but I apparently do and I take a hormone blocker. And I also receive infusions to strengthen my bones because my cancer has spread primarily to my bones and they are at high risk of fracture. I also did two weeks of radiation on my lower tailbone not long ago because it was causing so much pain I could hardly sit down, but as you’ve already pointed out, metastatic breast cancer is not curable. So that radiation wasn’t designed to cure it, it was just designed to target one small area so that there would not be any pain.
Adam: [07:23] Yeah, wow, I like your perspective on this. I like that you’re continually pressing through, but it sounds like a really challenging regimen that you’re working through.
Janet: [07:38] But as I said, you just do until you can’t do anymore.
Adam: [07:42] That’s right. That’s right, so peaking of doing and, and support what are some sources of support for people that are living with breast cancer? So where do you recommend they look for support?
Janet: [07:55] It depends on your comfort level, you know, family and friends they always want to help. My advice to others that have any sort of cancer, breast cancer, metastatic breast cancer, any sort of cancer is if friends and family want to help, my advice is to let them. I’ve also found that there are a lot of support groups for women with breast cancer, but many of them are attended by women that are very early stage. That’s truly a different mental game than a stage four metastatic diagnosis and I’ve been a part of both support groups under both circumstances.
[08:27] But I found a wonderful closed group online that’s just for women with metastatic breast cancer and if I ever have a question or some ache or pain or something, someone in that group has experienced it and may have an answer before I get one myself from my doctor.
Adam: [08:42] That’s fantastic. Yeah, I mean, and it’s like you talked about earlier, social media in these particular circumstances certainly does have the power to do a lot of good in our lives.
Janet: [08:52] Absolutely.
Adam: [08:53] What are the best recommendations you have for living a better, longer life with metastatic breast cancer?
Janet: [09:00] I wish I had the answer to how to live longer. Every one of us with metastatic breast cancer wishes that we had that because that’s really the thing, right? It’s not up to me. We need better and we need more research. I think I read somewhere that less than 5% of funding for breast cancer research is spent on metastatic breast cancer even though 30% of breast cancer cases become metastatic, that’s almost one in three women diagnosed with breast cancer. Their breast cancer will become metastatic breast cancer. It’s metastatic breast cancer that kills.
[09:34] So we need more research into life-extending life-saving treatment, so really the best recommendation that I have is that we need to contribute more to breast cancer research that comes up with better and longer-lasting treatments. Personally, I try not to live with guilt about that diagnosis. Could I have had done anything differently? I’ve always been a workaholic, very tough [inaudible 09:59], so I’m, I’m trying not to feel guilty about that.
Adam: [10:02] Yeah, I love that. I love that and I love your focus on research. I agree it’s a very important area where more research needs to take place in order to improve longevity and quality of life. So that’s really great.
Janet: [10:15] It’s incredibly important for those of us with this disease, you know when one medicine runs out you have to rely that there’s going to be something else out there and the treatment options are pretty limited right now. So right now when the treatments that are on the market run out, you really do have to go to a clinical trial and for some of us, that happens very quickly. All too quickly.
Adam: [10:37] So tell me a little bit about how Susan G Komen has helped you in your breast cancer journey.
Janet: [10:43] As a longtime medical reporter, I was already pretty educated and I felt like I was on top of things where breast cancer is concerned. I had thought in advance because I had done so many stories about which doctor I would go to, what treatment, all that sort of stuff, but I have to tell you that this diagnosis can put anyone in a tailspin and it is tough to think straight. Komen, you know, there’s Dr. Google, everybody turns to Google once they’re diagnosed with cancer, you can’t help it and there is lots of answers out there. But not all of them are reliable and I found that Komen really did provide reliable resources in a sea of sometimes contradictory literature.
[11:24] And when I was first diagnosed I thought I would know all the questions to ask, but it’s so stressful. I was just so relieved to be able to print off the Komen list of questions to ask my doctor and that was big for me, that I knew that I could go back to that list and know that I had taken good enough notes to have answers to those questions that were important for me. And I’m also thrilled that Komen is donating to metastatic breast cancer research because my tomorrow depends on that research.
Adam: [11:52] That’s right, that’s right. Well, that’s great. Well, this has been great. Janet, do you have any final thoughts you want to share with our audience?
Janet: [11:59] I just hope everyone will be educated with their own bodies and their own health. Early detection is obviously key. I don’t want anyone to end up with stage four metastatic breast cancer so getting those mammograms, knowing your own breast health is incredibly important that can help catch cancers very early before they have a chance to become deadly.
Adam: [12:22] That’s right, that’s right. That’s really, really good advice. Janet. This is great. I love your attitude. I love how you approach life and just thank you for continuing to press forward and thank you for sharing your journey with us on the show.
Janet: [12:36] I am happy to be asked.
Intro and outro music is City Sunshine by Kevin MacLeod. The Real Pink podcast is hosted by Adam Walker, produced by Shannon Evanchec and owned by Susan G. Komen.