What You’ll Learn

In this intimate interview, a woman shares her personal experience of being diagnosed with breast cancer during pregnancy, surviving addiction, and navigating motherhood while coping with mental illness and smoking addiction

VIVO: Could tell me your story beginning before your pregnancy?

Interviewee: Certainly. I never smoked cigarettes or anything of that nature all the way through high school. When I entered college, I had maybe a one-month period during one year of college where I casually smoked cigarettes when I maybe had been drinking out. And then one day out of the blue I woke up about a month after doing this, and they made me incredibly nauseous. Never touched them again until… I’ve had some drug abuse issues in the past. I graduated from college, didn’t smoke or anything. I did smoke marijuana sometimes. I eventually, unfortunately became a cocaine addict. When using cocaine, I also started to roll combined cigarettes, either roll my own cigarettes or combine tobacco and marijuana in cigarettes. That’s the point where I first started using tobacco a little more regularly and I would’ve been about 23 by that time.

The real kicker that got me fully addicted to just straight cigarettes is I went to rehab in 2008. I went to my first rehab. Originally, I was meant to be residential, unfortunately due to a roommate situation where my roommate threatened me the first night, I was told to just commute up and back because I was close enough. The interesting part was at the time, I still only smoked marijuana and tobacco combined. I’m now in a rehab program for cocaine and marijuana and the only way you’re allowed smoke breaks where people could go smoke cigarettes outside. And it was like, well, I want to be outside, so I guess I’ll smoke. I want a break outside.

I picked up smoking just straight rolled cigarettes at the time. I will say I did not put filters in them. They were just straight rolled cigarettes. They were probably pretty harsh and not very healthy. That was at the age of 26. I didn’t become a full-time, committed cigarette smoker until age 26 when I entered this rehab. From the age of 26 onward, I’ve been a full cigarette smoker except my pregnancy. Although I have had other issues with drug addiction after that, the cigarettes have always been my constant. At this point, I use medical marijuana and I have a medical marijuana card for some disorders I have and I was given it when I was doing chemotherapy, had the nausea. But the cigarettes are the one thing that I can’t give up.

I have tried a lot of things. I’ve tried Chantix. Unfortunately, because I have a history of bipolar, it did cause psychiatric concerns and suicidal ideations, so that did not work as a medication. The nicotine patches and gum didn’t prevent my cravings in any way, shape or form, and I found myself smoking while wearing the patch, which is considered dangerous. The lozenges and gums, same idea. They didn’t reduce any cravings. I’ve tried to slowly cut down. I can get to five cigarettes a day but never… I eventually will increase again. I have debated about going to a hypnotist at times but I have yet to do it but I’ve tried a lot of things. And keep in mind, I’ve now been to drug programs three times.

I’ve been to rehab three times. Ultimately, I have been fully clean from cocaine. That was my abused drug. Now, since 2017, and I am fully committed to that, which I’m proud of but the cigarettes are like no one saying that I can’t. Given that my family has a history of lung cancer, I’ve had lung cancer screenings in the past. This is going to sound horrible. When I was diagnosed with breast cancer, when I was pregnant, the joke I made to people was, “See, and you all thought it’d be lung cancer.” Because we all did. We all figured if I got a cancer, it’d be lung cancer. I’ve been a heavy smoker on and off. And I have a family history of it. My only successful quit was the day I found out I was pregnant.

I’ll be honest, I’m somebody who even then was… When I first found out I was pregnant and I told my husband, after I told my husband, he goes, “No more cigarettes.” And my first thought, as horrible as this sounds, was I should have a cigarette and then told him. That’s how bad it was. But at the same time, I was very aware, I just can’t. There’s no way. I’ve even had people who say, “Well, you can. I mean people do it. My mother smoked when she’s pregnant with me at the time.” But that was the one thing I felt like that’s not fair to my child and it wouldn’t be fair to my husband who would never want it for our child. However, I will say I think I always knew I was going to go right back to smoking as soon as she was born.

And then certainly, once I was diagnosed with breast cancer when I was eight months pregnant, I was diagnosed at the end of November of 2022, and she was born a couple weeks later. She was induced two weeks early in the middle of December, and then I started chemo two weeks later. I will say, once I got that news, I think I used it as an excuse to be honest, to say, well, now I’m going to smoke. I think I already planned to go back to smoking or didn’t think I’d be able to prevent myself or stop myself. But this certainly removed any possibility of even attempting to stay quitting. It was like, no, I’m sorry. If I’m going to be dealing with all of this, then this is my stress reliever. This is how I cope and deal with life.

VIVO: You found out you were pregnant and then you just quit cold turkey?

Interviewee: I did. I literally that moment threw the cigarettes out. I think it helped, to be honest, that initially I had bad nausea and they were not able to get that morning sickness under control right away. It took about a month before they found a prenatal vitamin that helped with the nausea. I will say, the one other reason, the only other thing that ever prevents me from smoking, and I can have a sore throat, I could have strep throat, I could have bronchitis, and I’ll still smoke. The only thing that I can’t smoke is when I’m nauseous. When I’m nauseous. If I take a drag of a cigarette, I’m likely to increase that nausea if not end up throwing up. I think that might’ve helped but I think it was the knowledge that’s just not right to the unborn child and it’s not right to my husband. I will be honest, I had other women saying, if you have to smoke, you just do it. It’s life.

These are people who I would’ve never thought, as mothers would say that to me. They were saying that there are worse things in the world than if you had a cigarette with your child. But even then, it was like, I just can’t. I just shouldn’t, I can’t. Then once I got over a big enough hump, I think that first month, by the time the nausea calmed down, as much as I knew, oh, I would love to have one, it was do it for the time and then you can assess how you feel after she’s born if you want to go back or not. I think I would’ve had a greater commitment maybe trying to stay quitting. But once I got that news, it was like… I’ll be honest, I gave birth, we came home, I walked in the door. My husband held her for a moment, and I went directly outside to have a cigarette. It was that compelling.

VIVO: What led to the diagnosis when you were pregnant?

Interviewee: For the breast cancer? I had no symptoms that would’ve been outside of typical pregnancy symptoms. The discovery of it was completely random. I do not check for lumps normally. I happened to have taken a shower when I was about eight months pregnant, middle of November, and as I’m pulling the towel down, I can feel a huge, hard mass under the towel. And then I feel it and I’m like, “Hmm, that’s odd. I’ve never noticed that before.” It was large enough to just from the wiping down, you could feel the large mass.

I happened to have an appointment a couple days later with my OBGYN for our last couple checkups. She felt the lump and she said, “It’s probably pregnancy milk duct related but let’s just be certain.” You can’t have a mammogram, so they did ultrasound. They were concerned, they biopsied. Of course, all along the way, everyone keeps saying… And this all occurred within a week. I found out right before Thanksgiving that… November 18th, I got the ultrasounds and everything, and then I had the diagnosis, I believe by the 28th or 29th of that month.

Once they did the biopsy, they determined there were two types of cancer. There was DCIS in the ducts and then there was also an invasive tumor and it was triple negative, which happens to be, I guess, the most aggressive type. My daughter was already going to be induced one week early because I was already at the age of 39 when I was pregnant with her. They already considered me an at-risk pregnancy, so they just induced her an extra week early and she was born December 13th. I began my chemo December 21st. And then I had, I think, four months of chemo and then what ended up being five surgeries in the end for double mastectomy to just ensure it didn’t occur in the other breast because my mother had breast cancer, separate breasts, nine years apart. We didn’t want that to occur to me.

VIVO: So you have a one-week-old baby, and you go in for chemotherapy. What was the process there?

Interviewee: It was three different types of chemotherapy drugs. They did the first drug, which I believe was Taxol and it was the ACT combo that they do for breast cancer. The first one was Taxol. It was the mildest but it did make my hair fall out. They told me my hair would fall out, so I shaved my head because I didn’t want the horror of being in the shower with huge chunks. I shaved my head. I lost my hair. I did the Taxol for I think two months. I came in every week.

Once a week I would come in on Wednesdays. It would be a four-hour chemotherapy bout that one wasn’t as bad, it’s the A and the C that are worse. After two months of those, I did two months of the A and the C. Those you do every other week because of how harsh they are, and you also end up getting… After each treatment, you come back the next day. I’d still come in on a Wednesday but after each treatment, I’d have to come back on a Thursday and get a… it was some sort of medication to re-boost my white blood cells‚ÄîNeupogen, I believe. I’d have to come in the next day. That one was much harsher in terms of things but at least it was every other week. I did that for about two months, I believe. I ended my chemo. I did chemo from December till the very end of March, and then I started my surgeries. I had a double mastectomy in June, and this would’ve been June of 2023. Unfortunately, I had a number of different complications over the time. The first surgery, I ended up with a hematoma that night and had to have a second surgery, an emergency surgery in the middle of the night to evacuate the hematoma.

Then they did two separate surgeries. One to put in the expanders, a separate one. They didn’t do it at the time of the initial mastectomy because of the amount of tissue they had to remove and they didn’t feel healing might be ideal because I’m a cigarette smoker, which is an issue. And they would repeatedly tell me, “Please try to cut down, please stop.” And I told them time and time again, “I’m taking my chances.” I am aware that some of the extra unfortunate outcomes of having extra surgeries was likely because I continued to smoke. I’ve had multiple infections.

One of the breasts became encapsulated. They had to go in, scrape all the scar tissue, remove it through surgery again, replace the breast implants. Over the time, I’ve had five surgeries. And at this point, I’ve had multiple infections in both breasts that had to have been dealt with through very strong antibiotics multiple times. I don’t have any nipples. They were never able to reattach the nipples because of lack of oxygen. I have very large full scars across. One has a huge indent. They’re not well-matched. There’s been a lot of issues and I am aware that smoking contributed to those issues. And I’ll be honest, my body is ravaged enough, I’m having my cigarettes.

People are like, “But you have a baby at home.” And I was very good about… I had my smoking clothes I would change into. I would wash my hands. When she was younger, she was nowhere even near the door I would be leaving to smoke outside. She really was minimally exposed, if ever. I know people would also say, “You have cancer.” And I would be the person who would pull up outside of chemo, have my cigarette, walk in and do my chemo, come out and light my cigarette as I was walking out. And I used to say to the nurses, “I’m sure the only one.” And they would always say, “You have no idea. You’re not. There are so many.” I used to sit with the nurses and make a joke about building a smoking section in the chemo unit as horrible as that sounds.

I know people are looking at you like, what? You have cancer. And it’s like, that’s the point, I have cancer. I’m trying to deal with this. This, unfortunately, is maybe not an ideal coping mechanism but it’s my coping mechanism.

Once again, as horrible as it sounds, but when I’m exhausted, at my wit’s end, I need a break, stepping outside, I know it’s not the ideal coping mechanism, but it got me through everything. And the reality is I know smoking’s not ideal and neither is alcohol, but people equivalently cope by having a glass of wine. I know cigarettes are viewed very differently than alcohol.

I was doing my best. I will say one thing is I have a bad history of bipolar. I have a bad history of suicidal ideation, no interest in acting on it, nothing of that nature. But I am not somebody who enjoys being on earth, I will just state it that way but I’m also aware I’m here and I’m not going anywhere. In my mind I find life very stressful, very tiring, not something I would choose to be a part of but I know I have to, and I don’t enjoy very many things at all, I’ll be honest.

I see the bad in the world 99% of the time, so it’s very hard for me to find any joy. And a cigarette is that smallest amount of, I wouldn’t say joy, but moments where I can let things go a little bit that I need. I look at it as if I have to be here, which I do, and I have to deal with life as it is, then I’m going to take this little, teeny bit of… I’m not trying to call it joy but at least awareness of the bad, I don’t know, or just moment of relief.

And also, my daughter has brought a lot of change perspective to the way I used to look at the world, and now I realize, okay, once again, I’m here, let’s make it the best for my daughter. I had a wonderful childhood but once I became 18, I feel like a switch changed in my head, and I was like, wow, the world’s not what I thought it was, this happy, happy place. The way I also cope with that is children should have childhood, true fun childhoods, and so I’m very big into let my daughter enjoy herself. She needs to learn and not live in a bubble, but also have that moment because you’ll get to be an adult soon enough.

VIVO: You said the ACT treatment and that the T was easier. What were the A and the C? Do you know what the A stood for?

Participant: The C was cytosine, I believe. And the A, I think, is adriamycin. The red devil. That was interesting because it was so talked about as such a toxic thing, and then you see the red… But it was interesting. This might sound horrible but the whole chemotherapy experience of what I thought it was going to be and what it ended up being were so starkly different because my perspective of chemo was when my aunt was going through it back in the early-nineteen nineties when it was way rougher. I’ll be honest, I went in thinking I’d be throwing up every day nonstop, and now they have medications to control that.

I went in thinking it was going to be horrifically worse than it was. I’m not saying it was a walk in the park but that helped in a way to go, wow, okay. Yes, I feel nauseous a lot of the time but I’m not throwing up all the time. I was surprised. I also, at that point, I will say I have a very high pain tolerance because I have fibromyalgia as well so things like the needle going in every time. It was just like, eh, okay.

VIVO: For a woman, especially one who’s just gone through all the changes of pregnancy anyway and your body’s already changing back from pregnancy afterward, then all these changes. Can you talk about your experience with that?

Interviewee: I realized when I chose to do the double mastectomy at the time I got that first surgery, my breasts had not fully changed back from pregnancy. I realized even if they did just the breast that had the cancer, this breast would never match. It would be slowly still returning from pregnancy. Either way, to match, I would’ve had to have some sort of additional surgery on the other breast to match it to the implant, either way. Unfortunately, because the breast surgeries have not gone so well, it’s interesting because my image… Growing up, there were two things I always wanted. I was very flat chested as a child. I always wanted bigger boobs, and then I finally got that as an adult and I loved my breasts as an adult, and I loved my hair as an adult.

Those were the two things I always loved. And it’s funny because the two things I lost were the breasts and the hair. My hair is now growing back. It’s way darker. I was a total blonde before. It’s way darker. It curls now at the end. I can’t use the same shampoos or anything. I can’t use conditioner anymore because follicles react differently. I don’t like my hair at all anymore.

Interviewee: I don’t like my breasts at all anymore either. They look funny, they’re lopsided a little. One, I’m telling you, has an indent. I call it a moon crater in it. I’m like, okay, that one’s got an indent there. In some ways, I feel like I should be horrified, like, oh my gosh, the two things I always waited a long time to love about myself, I’ve now lost. At the same time, I’m like, I barely bathe. Who am I? I don’t care what people think. I don’t leave the house incredibly often. I’m not a social person. I have bad social anxiety. I avoid social occasions even with my family to a certain extent. I’m a very big introvert, homebody. I don’t care what people think of me. It makes me laugh sometimes when I do get looks from people. I remember walking into a Target when I was bald and this little boy was running out of the Target and he saw me bald and he screamed and ran to his mother crying. Funny, hilarious to me.

When I was bald, I had posted a picture of myself and my daughter in somebody’s comments because my mother-in-law reposted the picture and one of her friends, her female friends commented, “Oh, is that her uncle?” Meaning me being the uncle because I was bald. In some ways, it was like, are you kidding me? And in some ways, it was like, that’s the funniest thing I’ve ever heard in my life. I jokingly call myself uncle mom. That’s a joke I do. I’m like, “I’m uncle mom.” There’s a point at which it’s comical. It’s just funny. I don’t care about my image enough to care anymore. I’ve come to realize, I am who I am. Take me or leave me, and I’m not looking for you to take me because I’m not interested in forming those relationships.

To be honest, I could care less about my image anymore. I think I didn’t care too much before that but now it’s even like, the two things I doted on and was like, at least my hair looks good and my boobs look good, not anymore. We’ll let it all go. That’s where I’m at in terms of self-image.

I will also say, I don’t think I’m ugly or anything like that. I know I’m not a runway model beauty, I never was. That’s fine, I’m not looking for that. I also know I’m not intelligent level of Albert Einstein. I’m realistic but at the same time, I also know I can feel beautiful still if I want to and make myself what I consider to be looking my beautiful. It doesn’t faze me, it gives me a great laugh.

Humor is one of those things that has gotten me through a lot of parts of life, especially the chemo. We used to sit there, to be honest, me and the nurses just cracking up because if I’m going to be here… I don’t believe in happiness but I do believe there are moments of joy and laughter is a guaranteed, in my mind, moment of joy. I do look for humor and laughter all the time, and I do have a sarcastic, dark humor with it.

VIVO: What do you mean you don’t believe in happiness?

Interviewee: I think the idea of happiness and the word happy is false. What does that mean? I think we have moments of, like I said, maybe joy. I just feel like happiness is this vague, overused term that means nothing. I think there are too many problems and concerns in the world, even for first world individuals who have great lives, to say like, I’m happy, I’m not happy. I think we have ups and downs and there are moments of elevated joys in their ebbs and flows. But the closest thing I consider happiness is humor. It’s the only moment where I look at other people and what they seem to describe as happiness or a moment of happiness or joy for them. The only one I can equate to that is when I’m laughing at humor.

Other than that, I’m not sure I know what that feeling is. I know what the feeling of not caring or not having a worry at the moment but I would not say that’s happiness in other people’s mind. I’m not sure I know what happiness is, so I’m not sure I feel like it exists.

VIVO: Are you planning on getting screened for lung cancer? 

Interviewee: I believe I was screened previously and I do plan to. I’ve had various X-rays done. I’ve had various CTs, MRIs that have been of the chest cavity area as well to ensure that I don’t, because I have had some… Because of the diagnosis of fibromyalgia taking a number of years and then coming right before the onset of pregnancy and then cancer, figuring out what different things have been, whether they could be the cancer having spread versus fibromyalgia, they’ve covered my whole body in terms of ongoing cancer screening. I will continue to get lung cancer screening given that I continue to be a cigarette smoker.

VIVO: What do you want to make sure your daughter knows as she’s growing up? In 50 years when she says, my mom always said this, what’s yours?

Interviewee: That is a good one. Well, one big thing I want her to recognize is empathy. Empathy and kindness. But I believe the best quality any human being can have, and if you can only have one quality, it should be kindness or empathy. There’s too much hate in the world. We got to realize that we don’t know others. And most of the time, we tend to want to blame others. Blame gets us nowhere, be kind. I’ve become aware of that, to be honest, after giving birth to my daughter. There’s so many moments where I’m at in that moment where somebody could just say the wrong thing at the wrong time, and I’m thinking it’d be so nice to just be… And then it’s like, why? I wouldn’t want somebody to do that to me. I wouldn’t want somebody to do that to my daughter. Just be kind. That’s a big one. I would say, have fun. Enjoy what you can.

And that’s my big thing with my daughter is because a lot of people have made jokes, to be honest, like, wait till one day she says, “You gave me breast cancer.” I said, “I plan to never say that to her.” I have no doubt that at some point somebody’s going to phrase it that way, unfortunately, whether it’s a joke or some other kid to be mean or somebody to be mean, unfortunately.

But breast cancer or not… I’ll be honest, I also am now in menopause. I can’t have any other children. My husband even said, he was joking, but I wouldn’t be surprised if one day when my daughter asked why she doesn’t have siblings, he goes, “I’m going to tell her because you gave your mother cancer and she went into menopause and she couldn’t have kids after you.” I don’t know if he was joking or not. I don’t care if he was joking or not. Bottom line is she did nothing. She came along and was the greatest thing ever. If the only way I could have had her was alongside breast cancer, I still would’ve had it. Breast cancer was nothing in comparison to life in general. Life can be way worse than breast cancer when you’re pregnant. It just can be. She’s amazing. She’s nothing but happy, if that’s what people want to call it, joyful, smiley. I just want her to stay that way as long as she can.

Participant Profile

• • Female breast cancer survivor
  • Geographic location: Evanston, Illinois (outside Chicago)
  • Medical history: Triple-negative breast cancer diagnosed at 8 months pregnant; underwent ACT chemotherapy and multiple mastectomy surgeries
  • Comorbidities: Bipolar disorder, fibromyalgia, history of substance abuse (cocaine, now in recovery since 2017)
  • Current tobacco use: Active cigarette smoker since age 26
  • Family history: Mother had breast cancer; family history of lung cancer
  • Living situation: Lives with husband and 2-year-old daughter
  • Notable challenges: Multiple surgical complications attributed partly to continued smoking; currently in menopause due to cancer treatment; unable to have more children
  • Key priorities: Daughter’s wellbeing and childhood experience; finding moments of joy through humor