She knew her annual exam and mammogram were overdue.
But, her excuse seemed valid.
Sara Stevens-Stehl of Bertrand was tired of doctor’s visits. She had spent the last several years taking her teenage son, Riley, to specialists to determine the cause of his health problems. He was eventually diagnosed with POTS (Postural Orthostatic Tachycardia Syndrome), an illness that causes extreme fatigue and dizziness, among other symptoms.
“Once we had gotten him (Riley) through the pain program, and he was back on his feet, I scheduled my annual exam,” Sara said.
That was in November 2016, and it had been three years since her last annual women’s exam. Sara had no concerns going into the appointment and admitted that she hadn’t performed regular breast self-examinations.
During the appointment, her doctor found a suspicious lump that she thought at first might have been caused by Sara drinking too much caffeine. But, a mammogram the next day and an ultrasound the following day showed something far different.
“From all of that, the doctor said she was 95 percent sure it was cancer,” Sara said.
She found out the diagnosis as her husband, Kevin, was in the emergency room preparing for surgery on his hand after he accidentally sliced it while butchering a deer. They shared the news with Riley and their then 19-year-old daughter, Shelby, that night.
“I’ve never cried so much in my entire life,” Shelby said.
While the diagnosis was difficult, Sara said staying focused on the next action step helped her.
“Through the whole treatment process, my focus was on the action,” Sara said. “This is not my nature. I’m thinking this was in God’s court. When I knew what the next step was, I could go do other things. I wouldn’t get completely emotionally consumed like I thought I would. God gave me the ability to focus on the next step.”
Sara’s next step was meeting with a surgeon in Hastings, and a biopsy was scheduled. Sara considered getting a second opinion at the Mayo Clinic in Rochester, Minn., since she was impressed with their care and collaboration among doctors in the diagnosis and treatment of Riley’s disease. The Hastings surgeon supported her attempt to schedule with Mayo and said if she could get into Mayo quickly that she should do it.
“And, that is exactly what happened,” Sara said.
A biopsy was completed in Hastings on Friday, and by the following Tuesday, the surgeon confirmed that Sara had cancer. She called the Mayo clinic the next day (which was the day before Thanksgiving) and somehow secured an appointment the following Tuesday.
Doctors at the Mayo Clinic ordered a breast MRI for Sara before determining her treatment options. A breast MRI captures multiple images of the breast while the patient is lying face down with the breasts hanging below. It is typically performed after a biopsy that has revealed cancer.
The breast MRI revealed a network of smaller tumors in Sara’s breast and changed her plan from a lumpectomy to a mastectomy.
Doctors originally diagnosed her with Stage 2 cancer but changed the diagnosis to Stage 3 after a lymph node biopsy. “This was definitely my most emotional day,” Sara said of the day she found out her cancer was Stage 3. “It was a shock, and it sounded way more frightening than Stage 2.”
Sara chose a skin-sparing mastectomy (a technique that preserves as much of the breast skin as possible and doesn’t require implants) to begin her treatment. At this point, they removed 25 lymph nodes and testing revealed cancer had spread into 19 of the 25. The next step was 20 weeks of chemotherapy, which she did in Hastings with oversight from her Mayo doctors, followed by 5 weeks of proton radiation at the Mayo Clinic.
Sara said standard radiation goes through the entire body. Proton radiation uses protons rather than x-rays to treat cancer. According to the Mayo Clinic’s website, a proton beam can be more finely controlled so higher doses of radiation can be more safely delivered to tumors with less risk to healthy tissue. With the procedure, they were able to radiate the lymph nodes under the breastbone that they weren’t able to remove (because they would have to break her breastbone).
Initially, the proton radiation wasn’t approved by Sara’s insurance company, but her radiologist (who happened to be from Nebraska) appealed the decision, and it was approved.
“I didn’t cry very much through this process, but that’s one of the days that I did,” Sara said of learning that her proton radiation was approved.
Sara was grateful for the breast cancer educational classes offered at Mayo’s and for the collaborative effort between surgeons, radiologists, oncologists and other doctors in setting treatment plans. This turned out to be a blessing for Sara as she had a “complex” case of cancer.
“It makes such a huge difference in stress level when you know that these multiple brilliant minds get together and come up with what they agree is your best plan,” Sara said. “The biggest thing for someone who is diagnosed is to find the people you trust to take care of you, wherever that is because feeling good about your medical team is a huge part of getting through it.”
The Mayo staff gave Sara a binder of information and told her that if she wanted to research breast cancer on the internet to only go to these approved sites: American Cancer Society (www.cancer.org), National Cancer Institute (http://cancer.gov), Mayo Foundation (www.mayoclinic.com), Susan G. Komen Foundation (www.komen.org), American Society of Plastic and Reconstructive Surgery (www.plasticsurgery.org), National Lymphedema Network (www.lymphnet.org), Y-ME National Breast Cancer Organization (www.y-me.org) and Young Survivor Coalition (www.youngsurvival.org).
In August 2017, Sara completed her cancer treatment, just a few months before her 53rd birthday.
While the main treatments were over, Sara said cancer will always be part of her life as she has a high chance of reoccurrence due to the advancement of her cancer before it was detected.
“I don’t think it’s ever over,” she said. “They will never say that I’m completely cancer free because of the advancement in the lymph nodes. Emotionally, I don’t think it’s ever over for someone who had cancer.”
Sara said throughout the process, she was grateful for the help of a licensed mental health counselor.
“It made a huge difference for me to have someone to help me who cares about me, but someone who has a little more distance to help me process it all,” Sara said.
The counselor helped her deal with the dark thoughts so her family wouldn’t have to confront those with her.
At the time of her diagnosis, Sara had worked as an independent Aflac agent for three years.
“I am not only an Aflac salesperson, but we are also now an Aflac poster family,” Sara said.
When she first started working for Aflac, she purchased a heart policy due to her family history of heart disease.
“It took me a year of telling people that one of two men and one of three women will have a cancer diagnosis in their lifetime to decide I’d better buy a cancer plan, too,” she said.
She added a cancer plan, a hospital plan and an accident plan, and it was a good move on her part because as she was trekking through the trenches of cancer, her husband had his emergency hand surgery, a heart catheterization, back surgery and shoulder surgery.
“The Aflac policies paid enough that I didn’t have to worry about working,” Sara said. “It made a huge impact for us.”
And even now, each time she travels to Minnesota for a medical reason, she is reimbursed $450.
Besides her job, she was also grateful for friends who offered her a place to stay, those who brought meals or offered to clean her house or wash dishes and for the thousands of prayers offered on her and her family’s behalf. “I advise people to think about what would be most helpful to them as they begin treatment, so that when people offer help they can respond with the type of assistance they would find most helpful. It’s different for everyone.”
“I was so blessed with support that one of my missions in life from now on is to support people in difficult situations in life,” Sara said.” I’d like to think I’ve always been a compassionate person, but I am more compassionate now. I want to be able to support people because I will never be able to pay back the people who supported me. It’s definitely a pay it forward.”
For now, Sara’s medical treatment continues with visits to an oncologist in Hastings every three months, visits to the Mayo oncologist every six months and a once-a-year visit with a Mayo radiologist. Since her tumor was fueled by estrogen, she also travels to Hastings for a monthly shot to suppress her estrogen.
Sara is back to work with Aflac part-time now, but she still suffers from low energy levels.
Those looking from the outside would never know as Sara seems to be the ball of energy that she has always been. She recently tackled organizing the Spirit of Grace Church Spooktacular event (that attracted 1,000 people) and did so with love, enthusiasm and her favorite cat pants!
Sara said she is now taking her health more seriously by exercising more and making healthy food choices.
“The hardest thing is learning to be vigilant about my body without becoming a paranoid hypochondriac,” Sara said.
And, she promises herself that she won’t get behind on her annual exams again.
Her daughter, who is now 21, agrees and is reminded of that every time she walks by a poster at her job in Oshkosh where she works as an EMT.
“Early detection saves lives, and it saves a lot of heartaches,” Shelby said.
Sara agreed. “Mammograms are not fun, but they are way less hassle than advanced cancer. If I had scheduled my annual exam a year earlier, my treatment would have been much simpler,” Sara said.
Now that Sara is on the other side of her cancer treatments, she’s had some time to think more about her life.
“Why did I survive?” she said. “I feel like God has a purpose for me. I think that purpose might be to support others as they go through similar things or listen or share my story. So many did these things for me.”
If you would like to visit with Sara about breast cancer (or her love of cats and cat socks!), please connect with her on Facebook at https://www.facebook.com/sara.stevensstehl