It’s not the kind of surprise anyone wants: You have breast cancer – times four.
But attitude is everything, and so is knowing where to get the best healthcare. Longtime UCI Health patient educator Marra Williams has an abundance of both. And they saved her life.
“I joked with my friends, ‘I don’t recommend surprising your doctors. But if you do, make sure you’re at a university medical center because they’re the only ones who can handle the surprise.’”
“I had heard the UCI Health Breast Cancer Services Program was amazing. I didn’t know how amazing it was until I was in it.”
As the first patient health educator at UCI Health, Williams has spent 20 years helping patients and the larger community improve their health by changing their habits. From smoking cessation to weight loss to post-treatment care, she has changed lives one step at a time.
“Knowledge is power. When it comes to health, it’s a whole different language for people. Part of my job is to translate that into plain language, so that it’s understandable to everyone,” Williams says.
“My goal is to make it not scary and to empower them so they know they can do this.”
‘Crappy cancer vacation’
In 2017, Williams’ own life changed dramatically when she detected an unusual lump during a routine breast self-exam, something she’d been doing monthly singe age 16.
Her husband Jason also felt it. A mammogram, ultrasound and biopsy confirmed her first thought: It was cancer. And it had spread to the lymph nodes in her armpit.
Without any family history of cancer (which genetic testing proved), Williams embarked on what she calls her “crappy cancer vacation.” Ever the optimist, her new motto was: “I caught this, I got this.”
Choosing UCI Health for treatment
She already knew she would get her care at UCI Health.
“I learned about UCI Health’s Breast Care Services at one of our Super Saturday community health fairs and flu clinics [which Williams organizes]. We’d had the Athena and the Wisdom studies come to our events over five years ago. They were raising awareness about breast cancer and letting people know we had research programs that would help everybody. That’s how I learned they have the best program around.”
After her diagnosis, three different colleagues asked, “Are you going to see Dr. Lane?” So Williams scheduled an appointment with surgical oncologist Dr. Karen Lane.
Neoadjuvant therapy: ‘Chemo first, cut second’
Williams’ original diagnosis was Luminal B HER2 negative, and Lane chose to start with neoadjuvant therapy, which means a course of chemotherapy to shrink the tumor first to make it easier to remove. “Chemo first, cut second,” says Williams.
After the first full course of chemotherapy, a tumor that had been the size of an egg had shrunk to the size of a quarter.
During surgery, which included a mastectomy, Williams was injected with a “glow-in-the-dark medicine.”
“Basically, that was how Dr. Lane was able to get all the cancer out.”
Cancers in hiding discovered
The pathology showed that Williams’ Luminal B HER2 type cancer had switched from negative to positive, which occasionally happens after neoadjuvant therapy.
“But the big surprise was that they found three other cancers we didn’t know about: Paget’s disease and DCIS (ductal carcinoma in situ), which is a fairly aggressive one. But the one that pulled the rug out from under me was triple negative.”
Triple negative breast cancer refers to the lack of hormone receptors and makes it a type of breast cancer that is harder to treat, although it does respond to chemotherapy, according to the Centers for Disease Control and Prevention (CDC).
“My oncologist, Dr. Robert Carroll, refers to triple negative as a ‘bad actor.’ It does not like to work with treatments, and that’s why it is still considered fatal.”
Because of the hidden cancers, Carroll pivoted Williams’ post-mastectomy treatment from condensed radiation to a full course of radiation and a full course of chemotherapy – this time with pills instead of infusions.
“Dr. Carroll said, ‘If my mother or my sister had this, this would be the course of action I would recommend for them.’ I said, ‘That’s good enough for me. Let’s do it.’”
‘I love my doctors’
“I love my doctors. My doctors are fabulous. They are the best doctors I’ve ever had. They’re the only reason I’m still here. I don’t believe any other doctors would have been able to handle this.”
Williams also appreciated the human side of her care: “I have an amazing relationship with all my doctors. Very blunt, very transparent, very frank.”
Carroll didn’t sugarcoat his answer when Williams asked: What are the outcomes for a patient like me? He paused, sat back, looked her in the eye and told her 25% to 30%.
Williams told him, “I’ll take 31%.” But later she thought, “If only 25% to 30% of women survive, then that means that 70% to 75% of women in my shoes don’t survive. Oh, that’s not right!”
A village of support
Survive she has. But besides the innovative approach to her breast cancer treatment, Williams also attributes beating the odds to her “village of support,” including her doctors, nurses and all healthcare practitioners she encountered.
“My support was off-the-chart incredible. Everyone should be able to have this treatment. That way they know they can return to their life as they know it. And their life can be even better.”
“Not only did I survive, but I’m thriving now. That’s why I want to try to help others create their own village, so they can survive whatever critical time it is. Whether it’s a health, financial, emotional or whatever kind of crisis, with support, they can make it through.”
Her village included constant support from her husband Jason and sons. Friends and colleagues kept her company during chemotherapy and recovery, laughing during movies, bringing her family food and even creating a “Box of Sunshine” full of 30 little scrolls with inspirational quotes and joyful photos, which she opened whenever she was having a difficult time.
Eventually, she says she changed her motto to “I caught this. We got this.”