Facing Death, Finding Hope: Young Mother’s Battle with Metastatic Breast Cancer
Nicola Heart experienced unimaginable grief when she held her newborn babies as they passed away. She believed life could not present a greater hardship. However, in 2020, at the age of 37, she received a devastating diagnosis: stage IV metastatic breast cancer. Doctors informed her that she likely had less than a year to live. A tumor, the size of a tennis ball, had developed in her chest, previously dismissed as a benign cyst by her OB/GYN months prior.
Missed Warning Signs
In retrospect, several indicators were overlooked by both Ms. Heart and her physician. These symptoms included:
- Changes in breast color and texture
- Small lumps in the armpit and near the collarbone
- Intense abdominal pain
- Nipple discharge
- Unexplained and significant weight loss
- Excessive sleep, needing 13 hours daily
- Prolonged recovery from common colds
Last Resort Treatment Offers Renewed Life
After multiple cancer medications proved ineffective, Ms. Heart’s final option was Enhertu, an innovative targeted chemotherapy drug. This treatment is designed to specifically target cancer cells, delivering medication directly, reducing tumors, and limiting damage to healthy tissue.
The experimental medicine has exceeded expectations. It alleviated her pain, reduced cancer spread in her lungs, diminished liver swelling, and slowed tumor growth.
Nicola Heart initially thought the loss of her newborn twins was the most profound pain she could endure. However, a stage IV metastatic breast cancer diagnosis at 37 presented an even more daunting challenge.
Her symptoms included nipple discharge, changes in breast size, armpit lumps, skin texture alterations such as dimpling, unexplained weight loss, excessive sleep, and difficulty recovering from common colds – all potential breast cancer symptoms.
Embracing Life After Near-Death Prognosis
Feeling stronger than she has in years after her initial year of Enhertu treatment, Ms. Heart is now planning travels with her eight-year-old son. These adventures include hiking through the jungles of Belize and Kauai.
“Those moments are when I feel most alive – being able to explore cave systems with him when just a couple of years ago I was told I had less than a year to live,” she stated.
“I went from being placed in hospice care to where I am today – capable of pursuing most of my desires and living without pain,” she added.
Breast Cancer in Younger Women
While breast cancer is more prevalent in older individuals, with approximately half of diagnoses occurring in patients over 60, Ms. Heart emphasizes that younger women are also susceptible.
“This experience is entirely new to me. It becomes very dark, I won’t deny it. But I consistently remind myself that I will overcome this, and brighter days are ahead,” she expressed.
Ms. Heart, a resident of Dana Point, California, received a diagnosis of stage four metastatic breast cancer, a condition associated with a five-year survival rate of approximately 31 percent. The cancer had aggressively metastasized to her bones, liver, and lungs, causing severe pain and complications.
Her condition deteriorated to a point where hospice care was recommended.
“I have been grappling with the reality that I have reached my final treatment option,” she explained.
However, her health decline has slowed, and her condition is showing signs of improvement thanks to the cancer treatment.
For years, she utilized Penguin Cold Caps to preserve her hair during chemotherapy. These caps minimize blood flow to the scalp, reducing chemotherapy exposure and protecting hair follicles.
Enhertu’s Positive Impact
Despite reaching her last available medical intervention – Enhertu treatment initiated three months prior – Ms. Heart has experienced significant positive changes. Her pain has subsided, lung metastases have disappeared, her liver is shrinking, and tumor markers are decreasing.
Enhertu functions like a targeted missile, identifying cancer cells, delivering potent medication directly to them, and aiding in tumor reduction while minimizing harm to the body.
Ms. Heart now enjoys increased quality time with her son, which was challenging during extensive procedures like port placement, liver and bone marrow biopsies, and numerous blood transfusions.
At one point, critically low blood counts prevented her from starting chemotherapy.
“I’ve been frequently hospitalized, battling transfusion fevers and excruciating pain,” she recounted. “It’s been a blur. Much of it is a hazy memory.”
“The past weeks have been exceptionally difficult – managing chemo side effects and cancer pain. Adding to this, it appears I will lose my hair. I’m upset. Losing my hair at this stage feels particularly unfair. I don’t want my son to remember me without hair,” she added.
Hair Loss and Acceptance
She had successfully preserved her hair for years using Penguin Cold Caps, a scalp-cooling method that temporarily reduces blood flow to the area, limiting chemotherapy drug exposure and protecting hair follicles.
However, she now faces the almost certain prospect of hair loss, likely permanently.
Ms. Heart was exceptionally healthy before her breast cancer diagnosis. Her diagnosis in her 30s underscores that breast cancer in young women is a reality, despite being more common in older women.
Since beginning Enhertu treatment, her last hope, three months ago, Nicola Heart’s pain has vanished, lung metastases are gone, her liver is shrinking, and tumor markers are declining, allowing her to cherish time with her son.
Despite Enhertu’s targeted nature, its potent chemotherapy component causes hair loss that even cold caps cannot prevent. While effective with older chemotherapy drugs, the aggressive nature of drugs like Enhertu can overcome the cold caps’ protective effects.
“There are countless ‘cute wigs and short hairstyles’ suggested – but that’s not me. I won’t recognize myself in the mirror,” she lamented.
Living in the Moment
Yet, with her positive response to this final treatment, she is determined to make the most of her remaining time.
“I started making plans to travel with my son, to take him hiking through the jungles of Belize and Kauai. Those moments are when I feel most alive – being able to crawl through cave systems with him when just a couple of years ago I was told I had less than a year to live,” she reiterated.
Having lost twins in 2018 and unable to have more children due to cancer, she says her eight-year-old son is her greatest inspiration.
“He loves sports, and watching him play gives me such joy. He keeps me going,” Ms. Heart shared.
“I’ve accepted that I’m not in control of this disease. I choose to live in the present moment.”