Thankful for every day

It does not discriminate, does not know gender, age, ethnicity or beliefs. Yet some people think they just cannot contract cancer.

The attitude is usually, “I’m young. I don’t have to worry about that for a few years. Plus, I don’t smoke and I’m healthy.

I’m safe.

Well Josane Williams at age 23 found out otherwise.

Williams was first diagnosed with stage two colon cancer three years ago and just last year, she was diagnosed with stage two triple negative breast cancer - a rare and aggressive form of cancer.

“I want to let people know that cancer DOES affect young women and the numbers have increased over the years. Young women need to be conscious of their body and any changes that may occur. I want a lot more young women to get involved - to know their bodies, know what tests are available to them, and get them done because lot of young people, when they DO get diagnosed, the cancer is at a late stage because they may have noticed something but they just didn’t take it on,” she stressed.

At the time of her initial diagnosis, Williams was a medical student at St George’s University, Grenada. During her second year, she began to have “unbearable” abdominal pains so she visited a doctor who gave her antibiotics but the pains did not improve. In addition to the pains, she began to feel fatigued, the bowel movements changed, and finally she saw blood in her stool.

The doctors suggested she return to Trinidad and Tobago to see a specialist, which she did in October 2013.

A colonoscopy was performed and the gastroenterologist found a tumour. Three days later she was sent to a surgeon for tests and a consultation to have a laparoscopy.

Both doctors had suggested that the tumour may have been cancerous but initially, she was just relieved to have found out the reason for her pain, and happy that there was a way to fix it.

“I don’t know what happened but while he was explaining what the surgery entailed, I started to cry.

I guess everything sunk in then and I just broke down,” she said.

One week after the surgery, she received the results of the biopsy of the tumour. They told her the tumour was large, that he had to remove a lot of lymph nodes, half of her colon and her appendix, and confirmed that it was cancerous.

The good news, however, was that the cancer had not spread.

“There was no indication at all as to why I got the cancer. I have no family history of colon cancer.

They said this kind of cancer affected mostly older people, I did not eat red meat, and after I did some genetic testing it confirmed I had no genetic syndromes for it,” she said.

Her oncologist gave her the choice of chemotherapy, explaining it would increase her chances of survival by three percent.

Thankfully, her treatment consisted of simply taking tablets in cycles for about eight months.

She had no hair loss and had relatively mild symptoms compared to the intravenous method.

“The most difficult thing for me was the fact that I had to take leave of absence from school. It was affecting the course I had planned out for my life,” she said.

After her treatment, she got the all-clear to finish her studies. She returned in August 2014. “I was a bit apprehensive at first because that would mean I had to leave all the doctors here, go back to Grenada, and I would be on my own until the next school break.

But then I realised that staying in Trinidad would not have prevented the cancer from returning so I might as well go back. So I went,” she said.

Everything was back to normal, relatively, with Williams, except that she was much more alert to any changes in her body. Despite this awareness, when she noticed a lump in her left breast in April of 2015, she did not immediately rush to a doctor.

“I mean, it was painless, I was young, and I thought the chances of me having breast cancer as well as colon cancer was slim.

I had one more month to finish off the school year so I decided to wait and check it out when I got home,” she recalled.

When she returned, she scheduled an ultrasound. The technicians saw a mass that looked “highly suspicious.” “My mom was outside. I had to think of how I was going to tell her this news.

It was bad enough for me but for her... she didn’t take the first diagnosis that well and to have to hear this again...” she said.

Her mother suggested she contact her oncologist and surgeon, which she did. She had another ultrasound and a mammogram with the same result, and her doctors suggested a biopsy of the mass.

“Surprisingly I was really calm throughout. I had no emotions.

I don’t know if my mind and my body were not connected but I just dealt with everything. I just remember praying and hoping that this was not because my colon cancer had spread and gone to the breast,” she said In July 2015, Williams started intravenous chemotherapy. She told Sunday Newsday the plan was to do all her chemotherapy before surgery. She recalled that during her first infusion, the port which carried the drugs to her veins began to leak so she had to have an emergency removal.

“Imagine I was just finished with my first chemotherapy so I was weak and then my body had to be subjected to general anaesthetic to get this thing removed.

After that surgery I was shaking, I was vomiting... it was terrible,” she said.

Then, after two cycles she began to feel pain in her fingers, and could not walk without pain in her feet. The doctors decided to stop chemo, remove the mass, and later resume chemo as well as radiation therapy.

She decided to have a modified radical mastectomy instead of a lumpectomy. She made the decision after finding out that she had a susceptible gene to breast cancer even though she had no family history of it. This meant that, if she left most of her breast intact, chances were high that she would have a recurrence, especially as the type of cancer she had was very aggressive.

“Thankfully, it was not the case that the colon cancer had metastasized.

It was a totally different thing and that was a good thing,” she said. Also, after the first two bouts of chemo, little to no cancer was left in the tumour. However, that was where good news stopped.

The new chemo drug she was to take was called “The Red Devil” by patients as the drug itself is red in colour and the side effects are “horrible.” She lost all her hair, she was very sick and weak, she developed mouth sores so that she could not eat, back pains so that she could hardly sleep, and her throat, chest and stomach burned as if they were on fire.

“The only way I made it through was by prayer and family support including my dad, brother and nephews but especially my mom. I know it was tough for her but she would always be strong for me. She was there with me for every chemotherapy infusion, she would make me as comfortable as possible. I just knew she was there and I didn’t have to worry,” she said.

Williams, now 26, said the ordeal was also an emotional challenge.

She said she would ask herself why she had to face this again but eventually decided to use the experience to help others rather than feeling self-pity.

“It was a very tough time but I tried to keep myself uplifted.

I wore wigs and head scarfs. I dressed up. I told myself that a lot of women were facing this and it was nothing new. I didn’t want to feel like a victim,” she said.

She also made the decision to have radiation therapy as well as a prophylactic mastectomy (the removal of breasts to reduce the risk of developing breast cancer) on the unaffected breast and is scheduled for breast reconstruction surgery.

After all this, Williams tries not to plan for the future and now “lives within the moment.” Despite not knowing what the future holds for her, she would like to one day complete her medical training and specialise in oncology.

In the interim, however, she is thankful for every day she is alive and tries to enjoy it to the fullest.