Janet Klein: Living a Good Life With Stage 4 Breast Cancer Thanks to Palbociclib
Sherman Oaks, California
I was diagnosed with stage 4, recurrent breast cancer in April 2009. After surgery, I was offered the chance to participate in a phase I clinical trial testing a new drug for exactly the type of breast cancer I had—stage 4 estrogen receptor–positive breast cancer. I jumped at the chance and have been taking palbociclib (Ibrance) and letrozole ever since. Within 9 months of starting the trial, there was no evidence of cancer in my body. My quality of life is extraordinary and I continue to do everything that I want to.
It all started in October 2005, with a phone call from my gynecologist a day or two after my annual mammogram. I was always vigilant and made sure to have annual mammograms because my mother survived breast cancer twice, the first time 40 years ago. My sister also survived breast cancer. I had always assumed that it would eventually be my turn and hoped that the mammograms would detect it early. I was fortunate; the diagnosis turned out to be stage 1 estrogen receptor–positive breast cancer.
Right after my diagnosis, I met with a number of surgeons to learn about the options for my surgery. I chose a surgeon at UCLA because she was able to do reconstruction surgery at the same time as a bilateral mastectomy [surgery to remove all of both breasts]. I was back at work just four weeks after surgery, traveling and living my life.
I then met with an oncologist and started a five-year course of tamoxifen therapy. I also chose to continue having yearly mammograms, even though this was not standard of care at the time, which is lucky because this is how my recurrence was caught.
About four years after my initial diagnosis, I received a phone call a day or two after a mammogram to tell me there was something suspicious. I was told to come back for another mammogram immediately, which I did. At that point, it was decided there was no immediate concern and I was offered a follow-up mammogram in six months. But I wasn’t satisfied with that and took the mammogram films to my surgeon who said there was no need to wait and that I should have a needle biopsy straight away.
So that is what I did, and sure enough, I had a recurrence of the breast cancer in the small amount of breast tissue left after the mastectomy. A PET scan and bone biopsy revealed that the cancer had metastasized to my left iliac bone. I had a lumpectomy and bilateral oophorectomy [surgery to remove both ovaries] before meeting with my oncologist to plan the next steps in treatment.
The first thing my oncologist told me about was a phase I clinical trial testing a new drug, palbociclib, together with letrozole. Once a radiation oncologist had agreed that it was OK to just watch the bone tumor, I was cleared to participate in the clinical trial. There has been no sign of cancer in my body since January 2010, about nine months after I started on the clinical trial.
I will take letrozole every day and palbociclib on a four-week cycle for the rest of my life, as long as it keeps my cancer at bay. Right now, the quality of my life is extraordinary—if you saw me walking down the street you would never imagine I was a stage 4 cancer patient.
One of the reasons I choose to talk about my experience with cancer, rather than keep it private, is because I think it is critically important for women to know that you can go through stage 4 breast cancer and come out the other end. For more than five years there has been no evidence of my cancer, and all I do is take a pill and live my life.
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