The News from Dr. Hake - April 22
Wednesday afternoon was filled with a swirl of emotions I can’t fully put into words. As we walked into the upper level of the Greenwald Center in Mukwonago, my eyes landed on the sign: Cancer Center Entrance.
In that moment, I was transported back 11 years—to standing in this very place with my hands raised in the air, just after completing one of the hardest years of my life. Six months of chemotherapy (including the “Red Devil”), two surgeries including a double mastectomy, and 37 rounds of radiation had brought me to that finish line.
And yet here I was again.
Walking back through those same doors brought a wave of questions I wasn’t ready to answer. How am I back here? What does treatment look like this time? Is this my breast cancer returning? And what does this mean for my long-term prognosis?
Everything felt familiar—but also completely unknown at the same time.
 |
| Last Radiation Treatment June 2015 |
As we walked toward the clinic doors, I stopped. There, painted on a rock, were the words: "Be strong and courageous. Do not be afraid; do not be discouraged, for the Lord your God will be with you wherever you go." (Joshua 1:9). I took a deep breath, whispered to myself “we got this,” and stepped inside.
Once we were back in the exam room, Dr. Hake came in shortly after. As he walked through the door, tears were already in my eyes and I stood up to give him a hug. He held me as I cried, and for a moment there were no words—just the weight of everything settling in.
We began by going back through the last several weeks, retracing the changes and symptoms that had brought us to this point. Then he gently explained what the imaging was showing: this was my breast cancer, now metastatic to the bones. He reassured us that it was not in any organs and not in my brain.
Next, he walked us through the PET scan. The images showed areas of concern throughout my spine, with more concentrated involvement in the lower back and hip. When the scan was shown in contrast, the tracer highlighted the cancer activity even more clearly—those brighter “hot spots” indicating where the disease was active. As he explained it, I could feel the reality of it settle in. It wasn’t just a few areas—it was widespread. Some spots were small, but they were everywhere.
When he finished, I asked the question I was afraid to ask out loud: “How long do I have?”
He was honest, but also steady. He explained that there are many treatment options for metastatic breast cancer, and we would start with one approach and adjust as needed. Some patients live many years—sometimes a decade or even two—but ultimately, this is something that will one day take my life. Hearing those words made everything stop. I am 46 years old… and I was being told I may have one or two decades. My mind struggled to catch up as emotions came crashing in and I felt myself beginning to hyperventilate. After a few moments, we slowly continued the conversation.
Andy began asking more detailed questions about treatment options, and Dr. Hake walked us through how much has changed since my first diagnosis. Medicine has advanced significantly, and there are far more tools available now. Based on my current cancer profile—still estrogen and progesterone positive, with HER2 status pending—they would begin with a multi-pronged approach.
The plan includes monthly zoledronic acid infusions to strengthen my bones and reduce fracture risk, along with an ovarian suppression injection to medically induce menopause. I will also start a daily aromatase inhibitor (letrozole) to lower estrogen levels, essentially cutting off the fuel that feeds the cancer—slowing growth, stabilizing disease, and in some cases shrinking tumors.
We are still waiting on the final HER2 (FISH) results, which could adjust the treatment plan further if positive. In addition, the Next Generation Sequencing (NGS) testing will look at the cancer at a genetic level—analyzing its DNA to identify what is driving it. This can reveal targeted treatment options, including specific pills or therapies designed to attack certain mutations or pathways. It’s one of the most important pieces of information in guiding next steps.
Dr. Hake discussed using Targeted Therapy—essentially a 'smart' pill that carries chemotherapy directly to the cancer cells. This treatment follows a cycle where I take the medication daily for 21 days, followed by a seven-day break to let my body rest. If needed, additional chemotherapy or a port could be part of future treatment depending on how things respond. There are still multiple options available if one approach stops working, and ongoing research continues to bring new developments.
Dr. Hake also recommended I meet with Dr. Weyers early the following week to discuss whether radiation might help with areas of focal bone pain.
As the visit was coming to an end, Dr. Hake reassured me once more that a solid plan would be in place. He encouraged me that he expects I’ll be ready to hike on our Tennessee trip in August, even be back to running, and that returning to teaching in the fall is very much within reach—which he strongly supports. Before I left, he gave me another big hug, again reminding me that once all the final results are in, we’ll move forward with clarity and direction.
Shortly after, one of my nurses from 12 years ago stopped in. She wrapped me in a familiar hug, and we shared a few very emotional moments together. Another nurse then came in to go over the plan for my first treatments—Lupron injections to shut down ovarian function, along with a zoledronic infusion for bone strength, both scheduled for Friday of this week.
The nurse navigator also visited, offering steady support and helpful resources for our family as we continue to navigate my cancer diagnosis.
Andy left feeling reassured, and my mom kept reminding me that there are many treatment options ahead. But in my mind, one sentence kept replaying, louder than everything else:
“Eventually, this will take your life.”
