In late fall of 2020, as leaves covered the sidewalks in Charlotte, Jane Flasterstein approached a new season of her own. It commenced with a sharp pain in her breast (or mastalgia). It only happened occasionally, but her husband, Jacob, thought she ought to get it checked.
“He knew about my grandma,” Flasterstein said, explaining that her maternal grandmother had breast cancer twice, ultimately succumbing to the disease at 47.
She begrudgingly agreed to see a doctor to put her husband at ease. But that reluctance didn’t last long.
“I realized there was a tiny, little lump on my breast. It was small, and I could only feel it if I laid a certain way, but it was definitely there,” she said.
At 39, Flasterstein was a year younger than most women who get a yearly mammogram. And even though the lump could be a cyst (most of which aren’t cancerous), her primary care physician thought she should get one. “Just in case,” they agreed in January 2021.
Her mammogram led to a biopsy. Then came the diagnosis: stage 2 triple-negative breast cancer. As scary as the news was to hear, Flasterstein knew the only way out is through. She just had to decide where to get treatment.
A hunch
The family lived in Charlotte at the time. Jacob worked in finance, while Jane helped out at their daughter’s elementary school. But they were getting ready to leave. Jacob had taken a new job with a large financial services company based in Florida. It was an exciting opportunity, she said, so their family agreed to relocate to Boca Raton.
All this happened as they were preparing to move. Knowing she needed treatment, Flasterstein had a decision to make. She liked Novant Health, but their plans were already in motion, so they checked out another health care system there.
She hated it. Left and right, she got a bad feeling about the place. One example: she said team members wouldn’t engage with her and often didn’t look her in the eye. She got the vibe that patients were just another number.
She trusted Novant Health. It felt warmer and Flasterstein liked all the resources available to people battling cancer. Especially the nurse navigators.
And just like that, they put the move on hold. The whole family would stay in Charlotte so she could receive treatment at Novant Health Cancer Institute. “It was just a hunch,” she said.
‘An angel on earth’
She found “an angel on earth” in Vicki Davidson, a Novant Health nurse navigator, who helps patients
understand their diagnosis and treatment options, while coordinating their care.
“Vicki is brilliant,” Flasterstein said. “She organized
everything, every aspect of my schedule. And I could always reach her when I
needed to talk.” Just as helpful, she added, were all resources – outlined
below – that Davison encouraged her to use.
Nurse navigators, provided free of charge by Novant Health, are available to
patients battling cancer, recovering from stroke, or facing women’s health
issues.
A glimmer of hope
Just as integral was her oncologist, Dr. Kimberly Strickland of Novant Health Cancer Institute – Elizabeth, who Flasterstein described as
thorough, caring, and responsive – someone who sets the bar on what a doctor
should be.
“Dr. Strickland was so kind to me and my family. I know we asked her
the same questions over and over, but she was patient with us. She always took
the time to make sure we understood,” Flasterstein said.
She was equally impressed by Strickland’s knowledge of the latest breast cancer research and clinical trials. “I knew any
decisions she made were well informed, so I trusted her," Flasterstein said. "I felt like I was
getting the best care I could find,"
And for the first time since her diagnosis, she began
to think, 'I’ve really got a chance at beating this.'
Survival mode
It didn’t make the next five months of chemotherapy any easier. Treatment became her new full-time job and the toughest part of the experience.
“I remember being so foggy. And so tired. I could barely get out of bed,” Flasterstein said. “I was in complete survival mode, just trying to get through it.”
She finished chemo on July 7, 2021, a date burned into memory.
Going flat
Six weeks later, Flasterstein received a double mastectomy. She had no desire to get a breast reconstruction, explaining that she’s proud to be flat chested. “And sick of doctor’s offices,” she added.
“Going flat” – a phrase adopted by patients who opt not to get a reconstruction after losing either one or both breasts to cancer – has made national headlines in recent years.
And experts say it’s becoming increasingly common among breast cancer survivors. About 25% of double mastectomy patients choose to stay flat after surgery and 50% of single mastectomy patients do, as well.
Targeted therapy
After her double mastectomy on Aug. 17, 2021, Flasterstein got the following news from her oncologist: Strickland said, “We found residual disease in your breast."
Residual disease is not the same as cancer growth (evidence the cancer had spread), however, "Jane had a higher risk of recurrence because of that,” Strickland said. “As a result, she received one year of olaparib, a targeted therapy that kills a mutation that caused her cancer."
Olaparib is taken orally, twice daily, so it didn't require the frequent doctor's visit that Flasterstein experienced with chemotherapy.
BRCA1 mutation
Around the same time, genetic testing revealed that she inherited a BRCA1 mutation, linked to higher rates of breast and ovarian cancer. Flasterstein “wasn’t surprised,” which brings us back to the other reasons she got a mammogram in January.
Her primary care physician knew she had a family history of breast cancer, with Flasterstein's maternal grandmother being diagnosed at an early age (23). They also considered her heritage. Ashkenazi Jewish women, who trace their ancestry to central and Eastern Europe, are more likely to inherit a BRCA gene mutation.
In addition to higher rates of breast and ovarian cancer, a BRCA1 mutation is associated with an uncommon but aggressive type of uterine cancer. To reduce her risk of ovarian and uterine cancers, Flasterstein got a full hysterectomy on Dec. 27, 2021.
Breast cancer survivor Dr. Kellie Schneider, a Novant Health surgeon who specializes in treating gynecological cancers, removed her “ovaries, uterus, fallopian tubes – everything,” Flasterstein said. “I was like, ‘Yep. Whatever. Take it out.’”
Mind and body
In addition to the support she received from her Novant Health care team, family and close friends,
Flasterstein credits the following with keeping her somewhat sane:
- Counseling provided through Novant Health Cancer Center Buddy Kemp Support Center.
- Physical therapy, which helped her recover from a double mastectomy.
- The Cancer Exercise Wellness Center (formerly called Strides to Strength), a team of exercise physiologists, registered nurses and more.
- Integrative Medicine, a part of Novant Health Cancer Institute, which aims to optimize health and healing through complementary care that includes nutrition counseling, meditation and mindfulness, acupuncture, massage therapy and more.
Cancer-free
Once she finished treatment, Flasterstein got the news she’d been waiting for. Strickland said, “You are cancer-free, and of course there are no guarantees, but right now, you are cancer-free.”
The family finally moved to Boca Raton, Florida, in 2022. Jacob is still working in the role that relocated the family south. And they recently celebrated their twins’ 13th birthday.
Flasterstein returns to Charlotte every 3 to 4 months for continued care, meeting with Strickland and Dr. William Ntim, a Novant Health cardio-oncologist who helps cancer patients prevent or manage heart disease.
Despite some lingering brain fog and memory issues (referred to as chemo brain) and body weakness, she feels stronger and more appreciative for having experienced breast cancer. “No matter how cliché that sounds, it’s true,” she said.
