Four days after being diagnosed with HER2+ breast cancer, Beth Brubaker learned she was pregnant. An initial diagnosis of Stage Zero Ductal Carcinoma In Situ resulted in a lumpectomy and the second diagnosis required a mastectomy and a chemotherapy regimen of Adriamyicin, Cytoxin and eventually Taxol, Herceptin and Perjeta, Beth Brubaker achieved survivorship and gave birth to a healthy daughter, Harper.
Beth Brubaker of Alexandria, Kentucky first realized something was wrong when she noticed an ulcerated sore on her left nipple. When continued to bleed, she sought medical attention. That led to a diagnosis of Stage Zero Ductal Carcinoma In Situ, which meant that the cancer was confined to the breast ducts. This called for a lumpectomy, also known as breast preserving strategy.
However, when after six weeks the ulceration was still, Beth’s breast surgeon ordered an ultrasound-guided needle biopsy. Her diagnosis was changed to HER2+ Invasive Ductal Carcinoma, presenting as Paget’s Disease, a diagnosis that required a mastectomy and a chemotherapy regimen, all while Beth was carrying a child.
When Beth Brubaker was 20 and a half weeks pregnant, she began an aggressive chemotherapy regimen of Adraimyicin and Cytoxin. Incredibly, she didn’t experience the vomiting and nausea that are often associated with chemotherapy. After four rounds of this combination, she had to do an additional twelve weekly rounds of Taxol.
Meanwhile, not only had to juggle the enormity of cancer and pregnancy, she continued going into work as a schoolteacher. Beth Brubaker praises the administration at her high school for hand-selecting students who would be sensitive to her plight, which included good behavior and sanitizing their hands before entering her classroom.
When Beth Brubaker began her third trimester, she temporarily halted her chemotherapy regimen until Harper was born, a successful, uneventful birth. Harper came screaming into the world at five pounds, four ounces, her small size attributed by the care team to her being exposed to chemotherapy. Beth then resumed intake of Taxol, then transitioned to the targeted treatments of Herceptin and Perjeta for the next several months.
On August 1, 2019, Beth Brubaker celebrated taking her final round of breast cancer medication. She can now concentrate on raising Harper, who in 2024, turned five years old. Beth says Harper is smart, funny, witty and creative.
From this tumultuous experience, Beth and her husband, Jason, wrote a book, “25 Months.” It begins with Beth having a miscarriage, being diagnosed with ductal carcinoma in situ breast cancer, her cancer treatment and the birth of Harper. The story from the alternative perspectives of Beth and Jason. It is available on Amazon.
By way of advice for anyone diagnosed with ductal carcinoma in situ breast cancer while pregnant, Beth Brubaker says to find the best medical team you can, and do not be afraid to ask questions, and to remember that there is life after cancer.
Additional Resources:
Book: “25 Months” by Jason and Beth Brubaker
A portion of the profits from “25 Months” go here:
Harper’s Fund through the Karen Wellington Foundation - https://secure.givelively.org/donate/karen-wellington-memorial-foundation-for-living-with-breast/harper-jaye-brubaker-living-fund
Transcription:
Beth Brubaker…
Bruce Morton: This is the Cancer Interviews podcast, and I’m your host, Bruce Morton. For our guest, it wasn’t enough that she learned she had HER2+ breast cancer. Not long after that, Beth Brubaker of Alexandria, Kentucky, found out she was pregnant. As it turned out, Beth stood up to both, and went on to tell her story in a book. Now, she is going to share her story with us. Here she is, and Beth, welcome to Cancer Interviews.
Beth Brubaker: Thank you so much for the privilege to be here.
BM: Beth, obviously you have a life over and above breast cancer and pregnancy. If you would, tell us a bit about yourself, where you are from, what you do for work, and what you do for fun.
BB: So, I am from Alexandria, Kentucky, which is fifteen miles south of Cincinnati. I grew up in Cincinnati. I am high school English and journalism teacher in one of the river cities in Northern Kentucky. For fun, I have an almost five-year-old daughter, so she keeps my husband and I incredibly busy, but I also am an avid reader, and I just love spending time with my family.
BM: For all of us who are cancer survivors, there was that difficult juncture when something about your health let you know that something wasn’t quite right. For you, how did that abnormality manifest itself?
BB: I noticed I had an ulcerated sore on my left nipple. I thought maybe I had cut myself several months before. Unfortunately, that ulceration did not heal, and of course I went to Dr. Google, and everything that came up with that was cancer. I let it go another month or so and noticed there was bleeding from that ulceration on my left nipple and decided it was in my best interest to call my OBGYN. From there, fortunately my OBGYN took my concerns pretty seriously. She knew that my grandmothers were both two-time breast cancer survivors. I had gone through genetic testing and tested negative, so everything was pointing to the fact that this wasn’t anything to worry about, but my OBGYN just wanted to make sure, so she sent me for a diagnostic mammogram. This was September of 2018. I went for that mammogram and fortunately the radiologist saw what are known as calcifications and that 70 percent of the time, this is nothing, but she wanted me to undergo an ultrasound-guided needle biopsy in that area. The radiologist thought this was probably nothing to worry about, but the biopsy revealed I had Stage Zero Ductal Carcinoma In Situ, with a presentation of Paget’s Disease, which means it is breast cancer that has invaded the skin.
BM: So, what happened next?
BB: From there I was referred to a breast surgeon and she said we needed to do a breast MRI, and we need to do it as soon as possible. She also said there was a possibility that I might be pregnant, and as a result, I had to do a pregnancy test before we get to the MRI. So, I found out I had breast cancer on September 26, 2018, which was a Wednesday and I found out on September 30 that I was pregnant with my daughter, and it was the biggest rollercoaster of emotions you could ever imagine in that moment. It was awful. We had experienced the loss several months previously, so this was our first time really trying to get pregnant again.
BM: We’re confident you will be able to learn some tips and tools to help you through your cancer journey, but first we’d like to invite you to please give a ‘like,’ leave a comment or review below and share this story with your friends. Kindly click on the Subscribe button and click on the bell icon, so you will be notified when we release our next cancer interviews. And if you or a loved one are facing a cancer diagnosis, please click on the link and Show Notes below to check out our free guide, “The Top Ten Things I Wish I Knew When I First Got Cancer.”
So, Beth, let’s talk about when you first got cancer. There was that gap of a few days between your cancer diagnosis and you learning you were pregnant. Let’s start with that. It is never an easy time for anybody, but with all the variables that went into this diagnosis, what went through your mind?
BB: Unbelievable. At the time I was 31 years old and young people aren’t supposed to get breast cancer. I had done everything correctly. I had gone through genetic testing regarding my family history. I had been doing self breast exams. This was not supposed to happen to me, but when you are diagnosed with cancer, you go into ‘fight or flight,’ and went into Fight Mode. We knew we had this pregnancy on top of the cancer diagnosis, and that Wednesday my breast surgeon was able to see me. She sat me down, she held my hand and she said, “We can do both of these things. You can be happy that you are going to have a baby. We are going to figure this out, and we can do this together.” Even though I was absolutely terrified, afraid I would not see this baby go to kindergarten, those words from my doctor gave me a little bit of ease that we were going to get through this. At that point, I was only four weeks pregnant.
BM: Now that sounds like it was a significant source of support, but your husband, Jason, how was he as a source of support?
BB: I have the most wonderful husband on the planet, I really do. He always is a person that likes to attack things head on, and so that was the mood he went into as well. He said are going to get through this, and we have incredible family support. So, on September 26, the day of my diagnosis, we sat on my porch, made some calls and my family said they would be with us every step of the way, and you cannot buy that kind of support from family, and fortunately, we have phenomenal co-workers. My co-workers knew that I had to go in for additional tests, they had been covering for me, making sure I got what I needed.
BM: It sounded like you had great support from Jason, from your extended family, and you got words of encouragement from the doctor who was spearheading your care team, but here were you and Jason dealing with this two-headed monster and there were very few people who fit the profile of dealing with cancer and pregnancy at the same time. How did you deal with this when you had no experience in this area and there were few outside sources who had that experience?
BB: I will tell you throughout my pregnancy, it was probably until my second trimester which was December of 2018 that I felt at ease about this pregnancy, given that we had had a loss beforehand. Our focus at the beginning was my health, and making sure that I was safe. Fortunately, that was one of the questions I did ask my breast surgeon was if she had experience with pregnant cancer patients. She said it had been about two years earlier, but she did have that experience. That brought us a little bit of peace of mind that it was possible to handle both of these things.
BM: I want to talk about the two tasks you faced, but I want to talk about them separately, so I want to set aside the pregnancy and talk about your cancer journey. If you would, tell us about the treatment regimen you and your doctor agreed upon. Tell us about that.
BB: Initially I was diagnosed with Stage Zero Ductal Carcinoma In Situ, which means that the cancer itself was confined to the breast ducts. Initially my treatment was going to be a lumpectomy, called breast preserving surgery. The breast would be preserved, and they would just take out the cancer. I would lose the ability to breast feed on that side, but it would still preserve most of the breast tissue and the other part of that would be radiation after the baby was born. In November of 2018, we did the lumpectomy, but my breast surgeon was still watching the ulceration, it was not looking any better after six weeks. So, she wanted to biopsy it. That is when everything changed. She biopsied it and saw that it was HER2+ Invasive Ductal Carcinoma presenting as Paget’s Disease. When you have HER2+ breast cancer, you will have to have chemotherapy. Because of where I was in my pregnancy, I couldn’t have chemotherapy until my second trimester, so I had to do a mastectomy immediately to get rid of the cancer in the left breast. That lumpectomy changed everything.
BM: When did you start with the chemotherapy?
BB: I started in January 2019 when I was 20 and a half weeks pregnant. It is amazing to me that there are types of chemotherapy that are filtered through the placenta and are safe during pregnancy. Two of those drugs that have been studied with pregnancy and cancer are adriamyicin, also known as the ‘red devil,’ which is one of the harshest chemotherapy regimens you can have, and then cytoxin. I did four rounds of them as a combo. Typically that’s given every two weeks, but my oncologist felt very comfortable about spreading out to once every three weeks, thinking Beth’s body could rebound okay and she was absolutely correct. I did not have problems during chemotherapy, I had very few side effects. It is typical to experience vomiting and nausea and I had none. A large part of that, my oncologist thought, was due to my pregnant because the female body does amazing things trying to protect the baby. After those four rounds of chemotherapy, I would need an additional twelve rounds of taxol, which is usually given weekly, then had a month off, then Harper was born on May 21, 2019.
BM: It sounds like the chemotherapy regimen you were on was not as grueling as it was for others, but it was still chemo. It can affect your energy level, it can affect the way food tastes. Meanwhile, you still need to devote the energy you need to devote to your pregnancy. At this stage, how did you juggle the two?
BB: It was very challenging because not only was I going through chemotherapy, but I was working normally in my teaching job. I felt fine the day after I went in for chemotherapy. I would go in for chemotherapy on Thursday, work on Friday, and then Saturday and Sunday I would be in bed all day. I would not get out of bed because of the exhaustion. That was one side effect from the chemotherapy that hit me hard, which I also think also went in tandem with being pregnant as well. That was really challenging, but I was really committed to working as normally as possible. I am a teacher. It is something I am incredibly passionate about, and so I think having that normalcy was really important, so I was juggling doctors appointments for chemotherapy, and I was in the high-risk clinic for my pregnancy, so I had a nurse that worked specifically with me outside of the OBGYN group as well. I would have additional screening. They were checking baby’s heart rate near the end, just making sure everything was smooth. I am of the belief that you do what you have to do, so juggling all those things, I did it because I had to do it in the moment, and we were trying to maintain some normalcy prior to Harper being born.
BM: I don’t mean to make light of this, but you already had a two-ring circus with chemotherapy and pregnancy, but now here is a third ring, as you try to teach high school. We all know that in any classroom setting it can be stressful because kids can be unruly. How did you deal with that additional layer of stress?
BB: I will tell you I am still in touch with kids who were in my classes at that time and have since graduated, I truly believe each of the students that I had in my classes were handpicked for me to have that year. They were wonderful. My school district made sure that my kids were sanitizing between classes, making sure they washed their hands to keep me healthy, and my students that year were incredible. They were absolutely incredible. They made sure that I had as normal of a school year as possible, in light of everything else, and to this day, I am still incredibly grateful.
BM: Your chemotherapy regimen, it didn’t go on forever. Eventually it came to a conclusion, and I am hoping that right around that time that with respect to the cancer journey, is it fair to say that not long after the chemo was done, and you could see some metaphoric light at the end of the tunnel?
BB: Yes. Once Harper was born I still needed to finish my chemotherapy, so I went through ten additional rounds of weekly Taxol, and they also started two drugs that are very specific to HER2+ breast cancer that basically have changed what HER2+ breast cancer is in the community. It used to be that that was almost a death sentence, and then came the drugs Herceptin and Perjeta, which are targeted treatments that go with chemotherapy. I had to take them because I could not take them while pregnant, so I started on them in May of 2019 after Harper was born. I finished chemotherapy and continued with the herceptin and the perjeta for another several months, but I will say August 1, 2019 is one of the top five greatest days of my life because that was the last time I had to have any taxol or any sort of chemotherapy and we celebrated big. That date is also significant because that was the date my oncologist got to hold my daughter for the first time. She had worked so hard to keep Harper safe that, talk about light at the end of the tunnel, it was the biggest celebration you could ask for.
BM: Beth, I am sure people watching this, and listening to this, as we have talked about your cancer journey and your pregnancy are very curious. Giving birth to Harper. How did that go?
BB: Minus breast cancer, my pregnancy was pretty average. Everything went well. She was healthy the entire time. I was induced at 37 weeks. She was a term baby. The only was that she was small. They said that was common for babies that are exposed to chemotherapy, but she was five pounds, four ounces at 37 weeks, which was small, but she otherwise came screaming into the world like you would expect from a typical baby. I had a typical vaginal delivery, unremarkable pregnancy if the cancer journey had not been a part of it.
BM: So, there was a successful childbirth and you have gotten past breast cancer. I don’t know if triumphant is the right word, if it isn’t, feel free to substitute a better word, just how did that feel to successfully bring Harper into the world, and get past your cancer journey, or at least the worst part of it?
BB: You worry for nine months. People can tell you all the time that the baby is going to be fine. Then you see that the baby actually is fine. Beyond gratitude, I don’t think there is a strong enough word, and I am truly thankful to God, I don’t think those words are strong enough for that moment in our lives.
BM: A phase of your story we brought up very briefly at the top, but now we want to get into it in a little more detail is that you have chronicled your journey in a book. If you would, tell us a bit more about the book you wrote.
BB: The name of our book is “25 Months.” I wrote it with my husband, and we wrote it with alternating perspectives, so you get my perspective, then you get Jason’s. We named it 25 Months because that for us is where our journey began. That was with our miscarriage prior to becoming pregnant with Harper, and so in the span of 25 months, we had a miscarriage, we had cancer while pregnant, we went through some other trials regarding our five-year-old nephew and COVID. So, it spans from April of 2018 to May 21, 2020, and May 21 is my daughter’s birthday. That is also when I had my final dosage of cancer-related medication, so that is what the book details. We wrote the book really to have something written down for Harper is what we started with, then it evolved from there, once we realized there is not a whole lot out there for your breast cancer patients, and there is even less out there given from the perspective of the cancer caregiver, because we truly believe cancer is a family diagnosis.
BM: And I think, Beth, just as people wanted to know how childbirth went, they want to know, how is Harper doing today?
BB: She is awesome. As we speak, she is upstairs playing. She will be five, as of May 21, 2024. She is going to kindergarten next year. She is incredibly smart, funny, witty, creative and you met her on the street, just met, you would have no idea what that child went through to get here. She is thriving, and I am just very, very grateful to be here to see that.
BM: Beth, we are going to wrap up now, and we want to ask the question we always when we conclude. Imagine you encountered someone diagnosed with HER2+ breast cancer while pregnant. You may have many things you would want to share, but if there is one point you would want to drive home, what would it be?
BB: I would say find the best medical team that you can. Do not be afraid to ask questions. Also, just know that there is a life after cancer and that there is a light at the end of the tunnel, and that cancer is not forever.
BM: Excellent. Beth, thanks so much for sharing this story. It is going to be an inspiration to a lot of women, and you mentioned that cancer is a family thing, so it is an inspiration to these families, too. So, Beth Brubaker, thanks very much for sharing your story, thanks for being with us on Cancer Interviews.
BB: Thank you so much for the opportunity.
BM: And we will conclude as we always do, reminding you that if you or a loved one are on a cancer journey, that you are not alone. There are people out there, just like Beth, who have a story that can inform and/or inspire. So, until next time, we’ll see you on down the road.
Additional Resources:
Book: 25 Months by Jason and Beth Brubaker
A portion of profits from 25 Months go here:
Harper’s Fund through the Karen Wellington Foundation - https://secure.givelively.org/donate/karen-wellington-memorial-foundation-for-living-with-breast/harper-jaye-brubaker-living-fund
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