Cancer seems to run in Sandy Nga Lee’s family, and so she ran for them last year — or rather, walked, in the first annual UCI Anti-Cancer Challenge. She joined the challenge’s 5K walk to honor her sister, who survived endometrial cancer that struck 15 years ago, and her mother, a survivor of colon cancer.
Lee walked again in the 2018 Anti-Cancer Challenge, but that time it was for herself, too.
After the June 2017 walk, Lee was diagnosed with stage 2 breast cancer. The highly personalized treatment she received has made her grateful for the UCI Health caregivers who discovered cancer in both her and her mother. It also has made her determined to ensure that her own daughter grows up informed about the risks of cancer but not afraid of it.
Lee, a UCI graduate and young alumni engagement manager for Alumni Relations at UCI’s Paul Merage School of Business, has long volunteered for health and service programs for Asian elders. So it seemed natural to help out at the healthcare conference put on several years ago by the UC Irvine’s Chao Family Comprehensive Cancer Center for Orange County’s Chinese community. Lee, whose ethnic Chinese family came from Vietnam, encouraged her parents to join her and in 2013, they finally did.
Screening for colon cancer
“At one of the booths people were handing out the FIT [fecal immunochemical test] kit for early detection of colon cancer,” Lee said. Her mother, Anh Ha Quan, took the home screening test and sent her fecal sample for laboratory testing, which was offered by the cancer center for free. The test detects traces of blood in the stool, an early warning sign for colon cancer.
“It came back positive,” Lee said. That triggered a colonoscopy and a finding of cancer. “Stage 1. Her doctor said, ‘If it weren’t for this test, your cancer wouldn’t have been found this early.’ I felt as though it was meant to be that she agreed to come with me that year.”
Five years later, Lee’s mother remains cancer-free, as does her sister, Anne Lee.
Dense breast tissue hiding cancer
Last year, Lee discovered that she had breast cancer despite a routine mammogram that had come back clear. But her mammogram report noted her dense breast tissue, which is fairly common, and that she had a 16 percent elevated lifetime risk for breast cancer.
Lee’s primary care doctor, UCI Health internist Emilie Chow, MD, suggested an MRI. Even before that test, Lee found a lump in her left breast through self-examination. In the spot where Lee had felt the mass, the MRI detected an area of denser tissue. Her radiologist, Dr. Freddie Combs, immediately performed an ultrasound and a needle biopsy, which confirmed the mass was malignant.
Lee then met with breast cancer specialist Dr. Karen Lane, who diagnosed the tumor as stage 2 invasive ductal carcinoma. She ordered a BRCA gene test to determine whether Lee had a higher risk of developing additional breast cancer; when it came out negative, a single mastectomy was recommended.
Checking for chance of recurrence
For the mastectomy, UCI Health doctors used sentinel dye to determine whether her fast-growing tumor had spread to her lymph nodes. One node was positive for cancer cells, so Lane and her team took out 12 more nearby to be safe. Fortunately, those were clear.
During the same operation, plastic surgeon Dr. Keyianoosh Paydar reconstructed Lee’s breast.
“Dr. Lane removed a mass that was 4.9 centimeters — nearly two inches in diameter — and that was almost double the size when we initially discovered it,” Lee said. The size of the tumor and the fact that it had spread to a lymph node, led her to expect to undergo chemotherapy, radiation and hormone treatment.
“Then my oncologist explained the numbers and the risk factors. He said, ‘I don’t want to do chemo if we feel your risk factor is low.’ ”
instead, the physician requested a tumor-profiling test called Oncotype DX on a sample of her tumor, which showed her chance of recurrence was low.
'A holistic approach to everything'
Lee skipped chemo but she did undergo six weeks of radiation therapy supervised by UCI Health radiologist Dr. Jeffrey Kuo. She is now taking tamoxifen, an estrogen-blocking drug used to prevent her type of cancer from spreading, and she continues to see her oncologist for follow-up care.
Lee’s life has barely skipped a beat. “I was able to work full-time and stay involved in all of my daughter’s activities the entire time that I was getting radiation treatments,” she said.
“I wanted everyone around me to know that this cancer will not take over my life — I am stronger than cancer and can be in control. My positivity has been the best medicine to overcome every stage of my treatment.”
Lee is emphatic about in her gratitude for her caregivers.
“The doctors and staff at UCI are so great; they work so well together, with a holistic approach to everything,” she said. “It has been such an amazing, positive experience.”
Educating her daughter about treatment
That may not be how most people view cancer treatment, but Lee wants others to know that it can be. And that includes 10-year-old daughter, Kailee Kwok, who was informed about every step of the testing and treatment and even joined Lee at some of her appointments.
“I don’t want her to grow up and be afraid of cancer,” Lee said. “I told her, ‘Mom has cancer; it happens. But it’s not going to bring me down. I’m going to live through this.’ She and I are so close, and I feel that being open and positive means that if anything like that happens to her or her family in the future, she won’t be afraid of it.”
Lee’s radiation treatment ended just a few months before the 2018 UCI Anti-Cancer Challenge, but she took on the five kilometer walk with no trouble. Participants can run, walk or bike the distance.
All proceeds benefit research
The best part, said Lee, is that 100 percent of money raised goes to cancer research — the kind of research that produced the FIT kits that detected cancer so early in Lee’s mother and finely tuned tests like the ones that helped personalize Lee’s cancer care.
Many of Lee’s siblings —she’s the youngest of 11 — will sponsor her fundraising walk, as will friends and co-workers on the Merage School Cancer Crushers team. Her husband, Simon Kwok, and Kailee will walk alongside her. And her mother will be cheering them on from the sidelines.