SURVIVOR SPOTLIGHT

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Christina Chavez:
The Story of a Sister’s Greatest Gift

By Genevieve Branco

Even as I approached Christina Chavez as she was sitting at the patio Starbucks table, I had a hunch it was her from the pink embellishment on her cap. Although I hadn’t had the opportunity to meet Christina in person before this day, I instantly felt connected as she gave me a big hug. She is one of those people that you find yourself opening up to, even though you just met her. I suppose that’s one of the many reasons she makes such a great mentor in the Links for Life support groups. Fortunately, Christina’s passion for helping other women in their medical journeys has boosted her willingness to share her own story – and here it is.

Christina’s story began on November 5, 2019.  This is not the day that Christina found a lump in her breast, nor was it the day she had a positive mammogram or a breast cancer diagnosis in herself. November 5, 2019 was the day her older sister, Josephine (Jo), used a Facetime from her home in New Mexico to share with Christina and their other sister, Becka, some devastating medical news. Jo was 44 years old and was telling her sisters that she had been diagnosed with HER2 positive breast cancer, over a video with her own adult daughter by her side.

Fast forward to February 2020, when Christina went to see her OBGYN for a regular visit. Christina spoke to her doctor about her sister’s diagnosis. Despite the fact that Jo’s genetic testing was negative, the doctor did explain to her that as a direct relative to someone with breast cancer, she was eligible to begin her mammogram screenings up to 10 years earlier than the family member’s diagnosis age. In this case, that would have made Christina eligible at 34, but she was already 38, so she wanted to do her due diligence and have a mammogram. Since she had a one-year-old and had just finished breast feeding, the doctor advised her to wait six to seven months before undergoing the screening, so she set her mammogram appointment for August 12, 2020.

In March 2020 the world nearly shut down due to the COVID pandemic. This affected Jo’s treatment because it prevented either her older sister, Becka, or her younger sister, Christina, from coming to help her during her treatments. With a compromised immune system, the doctor advised against it, so her primary caregiver during her treatments was their mother, who lived close and could be part of her inner circle, taking necessary precautions. Christina reflects now on how Jo would routinely comment that if her diagnosis somehow helps even one woman, she would know why she went through this. Jo never felt sorry for herself, she always believed that all things happen for a reason, and she never questioned why she got it.

When Christina went to her mammogram screening in August, she had a unique experience. Do you remember when I told you that Christina is the kind of person who people just open up to? Well, here we go. The screener (we’ll call her Betty, to keep her own privacy) shared her personal breast cancer story, that her two sisters had both had breast cancer as well. One had passed away from the cancer and the other had lived. Christina felt that they had a moment during that screening – almost like a bond because both of them had sisters who had breast cancer. But never did Christina think that she was going to have a positive diagnosis herself. Christina was only 38! Surely she was just doing her due diligence by getting an early screening! When they parted ways, Betty told her, I didn’t see anything of alarm, but if we notice anything, I’ll call you. Christina joked that she liked Betty, but she didn’t want that call.

But the next day, Betty called. Christina said that as soon as she heard the words, Hi Christina, this is Betty, she had a feeling that was hard to describe. Almost instantly and as if Betty spoke the words herself, Christina heard the Holy Spirit’s voice say, “Jo’s breast cancer was to save your life.” Betty’s voice said, we saw an area of concern and we want to get a second look.

Christina only told her husband and a single friend at first. The thought of putting her family through another cancer diagnosis was not one that she wanted to think about. She underwent the second mammogram. At this point, her sister Jo was about nine months into her treatment. She had finished her chemotherapy and her double mastectomy, and was getting ready to start targeted therapy. So when she first decided to tell a sister, it was Becka that she told first. Amazingly Becka had also had some signs and symptoms of breast cancer, but fortunately her screenings were all clear.

After the second mammogram showed signs of cancer, then Christina underwent a guided biopsy. Because our world was still vastly affected by COVID, she had to go her appointment alone, but she had Becka on the phone. She was told that her cancer was DCIS. DCIS is also called intraductal carcinoma or stage 0 breast cancer. (For those of you who aren’t aware, DCIS is a non-invasive or pre-invasive breast cancer. This means the cells that line the ducts have changed to cancer cells but they have not spread through the walls of the ducts into the nearby breast tissue.) Her doctor referred her to two oncologists to get a treatment plan and more information. It’s also interesting to note that neither Christina, nor her doctor, ever felt a lump in Christina’s breast. She speculates that it was because of the placement of the lump being so near to her chest wall that she couldn’t feel it. But it certainly does underscore the need for people to be diligent with recommended cancer and health screenings.

At this point Christina made an appointment to visit the first of the two oncologists. This time she would have both her sisters on the phone, having finally told her full family. The first oncologist got straight to the point, showing Christina what looked like a decision tree of treatment options. Christina felt a little mixed feelings about it all – on one hand, the oncologist made her feel like her cancer was minimal and she didn’t have to rush to make a decision. On the other hand, she felt a little like the doctor may have dismissed the devastation of the diagnosis too quickly. Just because it was stage zero, doesn’t mean it wasn’t an enormously life changing situation for Christina, and something with that first doctor just didn’t feel right. 

When she went to the second doctor, things felt better. The surgical oncologist spent time getting to know Christina and wanted to hear about her life and help her understand her diagnosis. When Christina asked what her treatment options were, the doctor encouraged her to slow down. She said she had more tests to run before she could really advise about treatment options. Her approach seemed more like what Christina needed and she was glad that she got a second opinion. The first doctor might have been a perfect fit for some, but for Christina, a different approach was better.

Christina was scheduled to have an MRI and a second look ultrasound with a possible biopsy. Turns out that the second doctor’s methods were best for her, since they did find the presence of another breast cancer in a lymph node. Almost overnight Christina went from thinking she had isolated stage zero, to hearing it was in her lymph nodes and she would need more tests to ensure that it wasn’t anywhere else in her body as well. That’s when the pace picked up – things really started moving fast.

Now, we have to back up just a minute to when Christina first was diagnosed. Perhaps because of the voice of the Holy Spirit that came upon her, or perhaps because of her initial diagnosis, Christina says she never had any fear. She knew she would be ok. She never thought of death as a risk. Suddenly, with this new news, while she waited for the results from her pet scan, she reflected on Betty’s story during her very first mammogram, and she wondered, what if I’m the sister who dies?

She remembers that the nurse navigator called her at nearly six o’clock on a Friday night to discuss the results of her tests. Christina told her she should be off for the weekend, not worried about calling people about tests, but the nurse navigator wasn’t going to let Christina wait a whole weekend without her results – a caring person indeed.  The verdict was that Christina had HER2 positive breast cancer in her lymph nodes, stage 2B-3A. The same cancer type as her sister, Jo. It’s interesting to note that Christina’s genetic testing was also not positive for any genetically known cause, but what the geneticist told her was that we only know what we know today, and perhaps in 10 years there will be a new discovery, which is why continued research is so important.

Because HER2 positive breast cancer is very aggressive, Christina began chemotherapy almost immediately. She underwent 6 rounds of chemotherapy spread over 18 weeks. Each session lasted about six hours. She was so fortunate that her sister Becka was able to fly to California and be with her and her kids during the sessions. This not only distracted the kids with the positive news that Aunt Becka was coming, but it also allowed Christina’s husband to be there by her side during the sessions. Amazingly Christina chose to keep working through the chemotherapy treatments, a choice she made because she felt she needed the distraction. Plus, a benefit of the pandemic was that she was still working at home and had some flexibility in how she could schedule her days around her good days and bad days of chemo side effects. Other family visited as well, and she had a great support system. She recalls that her third chemotherapy session was just one day after Jo’s last targeted therapy treatment, so for about nine weeks the sisters were both actively undergoing their treatments simultaneously.

After Christina’s chemotherapy was completed, she underwent surgery. She had always thought she would opt for a double mastectomy and just be done with it, as she put it. But after a lot of her own research she surprised herself and opted for a lumpectomy with the effected single lymph node being removed. She had always told her husband, from her initial diagnosis, that she was prepared to do the most aggressive treatment necessary (and he was very supportive), and so her decision was a well thought out and researched decision.  Then, she underwent 33 rounds of radiation treatments and another year of targeted therapy treatment which she finished on December 10, 2021.

Christina regrets that she didn’t get involved with Links for Life until near the end of her treatment because she appreciates the importance of talking to women who underwent what she herself went through. Seeing that women have already gone through it helps to be forward thinking at a time when you’re consumed with what’s happening right in front of you. She has become a mentor in the newly diagnosed support group and encourages others that they can get through it, despite the ups and downs.

Christina’s story comes accompanied by so many lessons. From the importance of screenings, to the value of trusting your gut, to the importance of being an advocate for yourself. Christina learned first hand that it was so important to find a practitioner that fit her needs, and that it was ok to be assertive in taking control of her own health care decisions. In fact, she says today that one of the things that has changed most in her life is her ability to place her own health in a priority position in her life. Intentionality was a word Christina used quite a bit. Since cancer, she is now intentional in so many areas of her life, from the way that she chooses her priorities to the way she kisses her kids goodnight as if it could be the last time. She openly hugs her coworkers and isn’t afraid to tell them that she loves them. She adjusts her work schedule to be present for her kids big moments at school, no matter what. Christina learned that when you face your own mortality, all of the little things that seemed like rituals suddenly become full of meaning and take priority. She says she’s not the same person that she was before cancer changed her physically and emotionally.

Today Christina boldly speaks to anyone about bareast cancer. She wears her pink bracelets and her survivor shirts to intentionally spark conversation with strangers about health and wellness. She encourages screenings and encourages patients to be advocates for themselves. The most amazing part of Christina’s story is that the story isn’t just hers alone. Christina says that she firmly believes that Jo’s cancer diagnosis saved her life. Perhaps Christina’s openness and honesty about her story will save another. In the meantime, when Jo says that she hoped her cancer diagnosis would save at least one life, Christina can say, Jo, it was mine.