A cancer diagnosis is probably one of the most debilitating events that can happen in a person’s life. How do you pick yourself up after? Where do you find strength when it seems like the world is falling down on you? Sharing a story of hope, Sarah E. McDonald is an inspiration who not only kicked one but two cancer diagnoses in the teeth. In this episode, she joins Tina Fornwald to talk about her journey through cancer, overcoming twice the odds at the same time. With her book, The Cancer Channel, Sarah relays the many realizations she had across the events surrounding her year of cancer treatments. Sarah also touches on her father’s battle with prostate cancer, how she learned a hard lesson when a loved one is having a health issue, and going through the grieving process. Across all the pain and challenges, Sarah lets us in on her experiences to highlight the power of our stories and how we can turn them into beacons of hope and strength for others. Let this conversation inspire you to advocate for yourself and show up for others.
Thank you for viewing this post. I am not a licensed therapist or professional life coach.
I am sharing my experience of loving the same man for 32 years, a mother to two adult children, a retired military officer, a breast cancer survivor, and my connections with others.
Anyone experiencing suicidal thoughts should reach out to a suicide hotline or local emergency number in their country: https://www.psychologytoday.com/us/basics/suicide/suicide-prevention-hotlines-resources-worldwide
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Kicking Cancer In The Teeth Twice: A Story Of Hope With Sarah E. McDonald
Our guest is Sarah McDonald. We met some time ago, years when I was enduring breast cancer, and we’re going to have a conversation with her about her journey through cancer, a book that she’s written, and, unfortunately, her dad and his battle with cancer. Let’s get into the conversation now.
Our guest is Sarah McDonald. She is someone I’ve known for a lot while but have not spoken to in ages. As we know, the widowhood conversation is about every part of that hood, whether it is a parent, a spouse, or someone close to you that is no longer in this world. We are having a conversation about that. As we talk about grief, it expands past, unfortunately, the passion of someone we love. Sarah can talk about all those different things. We’re going to have a conversation about her, her journey, and anything else that comes up. She probably drills me because we have not talked in a long time. We’re going to get right into it. Welcome, Sarah.
Thank you, Tina. I’m thrilled to be here.
She’s a one-liner, but this lady is out here making big gains in this world. Sarah, tell us a little bit about professional Sarah and personal Sarah.
Professional Sarah has done a number of different things. When I first met you and your brother, I was working at eBay. I had been there for fourteen years. I had become a senior person at eBay. During that time, I had cancer. That’s the reason I’m talking to many people on podcasts these days because I had that tough experience, and I’ve written a book about it.
From a professional standpoint, I left eBay at the beginning of 2019. I went to work at a small 120-person startup as the COO. I ended up leaving that a few years later during the pandemic and decided to become an executive coach. While I was going through my executive coach certification, I had been writing this book about my cancer experience. I decided that with the time that I had, I wanted to finish the book. If my time was short in this life, one of the things that I would regret most, Tina, is if I didn’t finish the book.
While I was getting my certification, I finished writing my book, The Cancer Channel. Since that time, I’ve been an executive coach, coaching a number of C-level executives at startups. I am now a published author who is speaking at corporations, TV, radio, and podcasts. Podcast is my favorite medium by far. It’s much more relaxed and real. I’m working at a small startup again. I live in Northern California in the Bay Area. It’s hard to live in the Bay Area and not participate in the startup phenomenon.
There’s a couple of things there. Thank you. People, we’re all on the same page. What is a COO and C-level?
A COO is the Chief Operating Officer, and generally, that is the second in command after the CEO, who is the Chief Executive Officer. The way we described our roles, for those of you who have been in the hospitality space, he was the front of the house and I was the back of the house. I made sure that the company was running well, efficiently, and effectively, and we were meeting our goal. The CEO and I paired on that. When I say C-level, those are people who have the word chief in their title. That would be the CEO, COO, CMO, which is the Chief Marketing Officer, or Chief Product Officer, which is the CPO. I’m talking to people who are in the hot seat, Tina.
Thank you for breaking that down for us. We’ll make sure everybody understands. They’re probably like, “Look at that. What is that word?” I make sure they’re all good. Cancer, how did that start? I know the book is written, but what is the onset of that in types of cancers, and how did that go for you?
This is something you and I talked about several years ago. My cancer story started when I had been at eBay for several years. I was running a big department. I was asked to interview for a role called the Chief of Staff to the President of eBay. Tina, I’ll be honest. Similar to C-level executives, I had no idea where the chief of staff was. I know your family has a military. I have greater awareness. I do not come from a military family. I come from an academic family. I was like, “What is a chief of staff? Would I even know how to do that?”
I went and interviewed with the President of eBay. His name was Devin Wenig. He asked me to become his chief of staff. I went from running this big team to being in charge of myself and occasionally trying to manage Devin. With this extra time I had before things heated up in the chief of staff role, I decided to see some doctors I hadn’t made the time to see when I was running a large team. The first thing I did was I went to see the dentist. I hadn’t been to the dentist in three years. She did one of these thorough cleanings that is awful.
It is like deep descaling and that kind of stuff. Your mouth is open and your jaws are sore afterward. This is where they say, “Take antibiotics before you come.”
After all of this descaling, I felt this lump in the floor of my mouth. I thought, “She must have poked the floor of my mouth. I must have gotten an infection.” I called the dentist. I was like, “I think I have an infection. Can you prescribe some antibiotics?” She said, “Can you come in and see me immediately?” I did. She felt around and said, “Sarah, there are a number of things this could be. At one end of the spectrum, it could be the infection you think it is. On the other end of the spectrum, there’s this rare form of cancer. I’m sure that’s not it, Sarah.”
She said, “I want you to talk to this other specialist.” I saw a number of other specialists. Spoiler alert. It turns out that I had the rare form of cancer she didn’t think I had. It was salivary gland cancer, or, to use the medical term, adenoid cystic carcinoma. It’s rare. Only 1,200 people a year are diagnosed with it. It’s considered an incurable cancer.
How was that information delivered to you?
Sadly, it was delivered over the phone by one of the specialists I had seen, who had also told me, “Sarah, you’re making a big deal out of this. This isn’t cancer. I can’t feel anything that feels like cancer, but I want to have you do an FNA.” It’s a Fine Needle Aspiration, which is a type of biopsy where they take a needle and poke the offending tumor or cyst. They try to take some cells that they can analyze and determine what is in the lump.
He had me do this fine needle aspiration. He called me a week later on the phone and said, “Sarah, I know I told you that it’s not cancer, but it’s cancer. It’s a rare form of cancer.” Tina, you can imagine I had all sorts of questions for him, like, “What is the prognosis? What are the statistics? Is this going to kill me?” He didn’t have answers because he wasn’t an expert in this kind of cancer.
He picked up that phone and delivered that message.
He didn’t know a lot about it. He said, “I’m willing to refer you to a specialist.” I was like, “Can we call him on the phone now?” He is like, “No, I’m going to write a letter of recommendation for you.” Tina, do you swear on your show?
You talk how you talk.
I said, “A mother f***** letter?” I did not say this out loud to the guy, but that’s what I’m thinking in my head. I’m like, “It’s 2012. We’re going to write a letter of recommendation?”
I cannot even imagine. I’m expecting them to have said, “I have this person in the room. We’re going to have this. I want to let you know they’re not going to be part of this conversation.” “You have shaken my entire world and I’m supposed to wait for a snail mail. Tell me it’s in our office mail, at least.” I am sorry. That is hard.
I asked him, Tina. I said, “Where can I learn more about this?” He was like, “I’m reading off the internet now.” He was googling it on the internet. He said to me, “You’re a smart girl. You’ll figure it out.” That is a verbatim quote.
I’m not sure if I’m more offended by the girl part.
He was condescending in all kinds of different ways.
We’re going to move past him.
That was tough. Someone referred me to a specialist at Stanford. I ended up seeing a specialist at Stanford who was helpful. I’m happy to share that story because it’s a happier story. I had another doctor at Stanford refer me to this specialist. I called his office to try to set up an appointment. They said, “He doesn’t have availability for six weeks.” I was going to have to wait six weeks to talk to a specialist. I’m six weeks sitting there in purgatory. I’m not sleeping and not eating. I’m going crazy, but the referring doctor called him and said, “Will you please call her?”
On a Friday night, at 5:30, this head and neck specialist from Stanford called me. My phone rings and it says Stanford Medical. I thought, “Who’s calling me?” He was like, “This other doctor asked me to call you, so I’m calling you. Tell me what you know about your cancer. When are you coming to see me?” I said, “In six weeks.” He said, “Maria, my nurse, will fit you in on Monday. I’ll see you on Monday.”
You can imagine. I hung up the phone and all of the grief and terror that I had been holding in came out in gulping sobs. I melted to the ground in a fetal position, sobbing because after months of trying to figure out what this was and in a couple of days of living with it, “It’s a rare, incurable form of cancer.” I did go to the internet and the words that described this cancer were words like relentless. The statistics were not good. To know that there was someone that was going to be on my side was tremendous.
I ended up working with that doctor. I did the surgery. I met with him on a Monday. I spoke with him. I had the surgery two weeks later. Two weeks after that, I met with him to talk about what other treatments were available to me. The answer is only radiation. With this particular cancer, they haven’t found a chemo that works against it. Your options are surgery and radiation. There are some new treatments that have come out, but those were the options at that time.
I went to that doctor’s appointment to talk about the radiation with him. I brought a long list of questions for this doctor. One of my last questions to him was, “Several years ago, I found a lump in my breast. We biopsied it. I was told it wasn’t cancer, but is it possible that this is metastatic adenoid cystic carcinoma? Is it possible that it has spread? When they went looking for cancer, they were looking for breast cancer in my breast. It was the salivary gland cancer.” He said, “Sarah, adenoid cystic carcinoma when it metastasizes, it goes to your lungs or your brain.” It made me feel great, Tina. He said, “It doesn’t metastasize to the breast.”
If you have cancer in your breast, it’s most likely breast cancer. We never see it in someone young to primary source unrelated cancers. If it would make you feel better, you should pursue it with your OB-GYN. I went to my OB-GYN, and she said, “She can see you in six weeks.” I emailed her directly. I said, “Deb, what are the chances you can see me?” She did. She said, “Has this grown?” I was like, “No.” She said, “Aren’t you doing mammograms?” I said, “Every year since you and I found this lump.” She said, “You do have dense breasts. Sometimes tumors don’t show up in mammograms with women who have dense breasts.” I thought to myself, “Why am I hearing about this for the first time?”
I reminded her that we had done a biopsy on this lump. I showed her the scar. She said, “Sarah, have you ever noticed how far away this biopsy scar is from the lump? I’m not sure they biopsied your lump.” I had electricity going through me. I thought, “I have breast cancer too.” I went and saw a number of different specialists. I had tests done and they diagnosed me with stage three breast cancer.
In a weird way, my salivary gland cancer saved my life from breast cancer because honestly, in my mind, I had been told, “You don’t have breast cancer.” I had accepted that I was lumpy. This was a cyst in my breast and I didn’t pursue it anymore. It turns out that it had been slowly growing. By the time they went in to remove the breast tumor, I had lymphatic involvement. Two of my lymph nodes were infected. The cancer was slowly but surely progressing. That is how I came to have two forms of cancer at the same time. I started being treated for both of them at the same time.
There are a few things I want to circle back on. Thank you. It’s not your first time sharing that at all. I want to go back to the person delivering that information and getting to a specialist. Going through what you’ve endured, what would you recommend for someone who is in that situation where they’re receiving this vital data in such an off-putting way, how to handle that, or how to be their own advocate to move forward past that to get to what they need?
The point you make is that we all need to be our own best advocates. There is no one who cares more about your health than you, even the doctors. If I learned anything from this experience, doctors make mistakes. It turns out they’re human. I did not get treated at the medical center that originally misdiagnosed me. I went to Stanford, but I believe in my heart of hearts. No one at that medical center was trying to hurt or harm me. They just made a mistake.We all need to be our own best advocates. There is no one who cares more about your health than you. Click To Tweet
They are practicing medicine. I know they’re well-trained and educated, but you can only be as much as you can be as a human being. There is no ill intention. Being your own advocate, did you have anyone going to treatment or doing anything with you? Did you intend that all individually?
I wanted to say about being your own best advocate. Once I had it in my head that the doctors were human, I said, “We’re a team together. We need to work together. I need to give them all the information I can so that they can make the best decisions they can. I need to follow up and remind them of things because they’re not going to remember my personal case as well as I am.”
I also believe when people are going through something like this, do get a second or maybe even a third opinion. When you get a cancer diagnosis, it feels like you’re going to die tomorrow so you need to see everybody. Certainly, work with urgency, but you have enough time to see other doctors and urgently ask for second and third opinions because you want a treatment plan that’s going to work for you. You want to work with a doctor that you believe in and who you believe believes in you. The first guy who diagnosed me, there’s no way I could have worked with that jackass. I would’ve been miserable seeing him all the time. His condescension and how flip he was with me would’ve been hell.
That would’ve impacted your healing, ability to recover, peace of mind, solace, and determination. He didn’t seem like he was on team Sarah to make this and be productive. You need to pick your players on the A-team and rock with them.
That’s true because you are putting your life in their hands. You have to believe in them and that you can work with them. When we later talked about my dad, that was one of the places where my dad and I had differing opinions, and that was hard. My dad and I chose to do cancer differently, and that’s hard. You asked the question, “Did I go to everything on my own?” I didn’t.
I was lucky. I am married to a lovely man named Jeff. We were newly married. We had only been married a year and a half when I was diagnosed with cancer. We were going through fertility treatments when I was first diagnosed. We were about to do an IVF, In Vitro Fertilization. We were about to have an embryo implanted. I was diagnosed a week before we were about to do IVF. Sometimes, I think about what would’ve happened had I gotten the cancer diagnosis a week after the IVF.
In this life, timing is everything. My husband, Jeff, traveled with me to these meetings for almost every doctor’s appointment. I had a number of friends who wanted to come with me to radiation or chemotherapy. I did a lot of those with friends. That would give Jeff a break and allow him to continue to work.
You also did a blog. You were informing people.
I found it quickly overwhelming trying to tell all the important people in my life what was going on and keep them informed and up to date. I was losing track of who I had told what. Frankly, things were changing so often that I didn’t know how to keep in touch with everybody. I had a friend suggest that I start a blog on CaringBridge.org, and that was tremendously helpful. It allowed me to keep everyone apprised of what was going on and what was coming. It was my first experience playing around with blogging and writing regularly. It was so much fun. I tried to make it humorous so that people would come back. I have a background in business, specifically operations. I put KPIs, Key Performance Indicators, in place for my cancer treatment.
As I went through and would hit certain KPIs, I would celebrate. At the end of my cancer treatments, I announced via my blog that I had met or exceeded all of my key performance indicators. Therefore, I felt that I had earned the President’s Club award, which is something that salespeople win at many companies. My husband needed to take me to Mexico to a resort, and he did. It worked out for me.
It was a ton of fun to write the blog. It was when I was writing the blog that a number of people said to me as they do, when you’re writing a blog, “You should turn this into a book.” I thought, “That’s interesting.” I started to write a guidebook for the newly diagnosed because what was happening is, on the heels of my cancer diagnosis and treatment, as my friends and friends of friends knew people who were diagnosed, they would refer them to me. I was spending a lot of time talking with people who were newly diagnosed, sharing my story, asking their stories, sharing with them the information I had, and answering the oftentimes awkward questions that people don’t know who to ask.
I started writing this guidebook for the newly diagnosed because I found, with cancer, it was a whole new language. If you don’t grow up in the medical field, the business field, or the military, all of these places have their own language that you don’t know and understand. I was having to make choices and decisions about my health when I was the most stressed out I had ever been in my life. You’re having trouble thinking clearly. Frankly, I didn’t always understand what they were talking about. I didn’t always feel like I had the best information or knew the best questions to ask.
That’s why I started writing a guidebook for the newly diagnosed. That’s the first book I wrote and tried to get published. The publishing industry also has its own language. I was told by people in the publishing industry, “No one is ever going to read a guidebook from someone who’s not an expert. Guidebooks are written by doctors. You’re not a doctor, but you have a good voice. You’re funny. You should write a memoir.”
That’s why I wrote the memoir because what I was trying to do was write a book that would help people who were newly diagnosed. I thought, “If my stories can give people hope in the long dark tunnel that is a cancer treatment and I help a couple of people, it’s terrific and worth it.” That’s why I went back and wrote the memoir, the book that I wrote during the year I was doing the executive coaching certification. I wrote the memoir, published it, and now have been talking with people.
If your book is what you gave me in our conversations, it is much worth the read and the understanding. I want to come back to some things. I want to talk about how important it is to have someone to go with you. Sometimes, people receive a diagnosis of cancer and they want to keep everything internal. They don’t want anybody to know because they are afraid that this may be the end of their life. They don’t want to disturb their family or friends. I know everybody does their journey the way that they do. What are some pros and cons you see in that as people are trying to deliberate what they should do to give them something to feed on for that?
I had the benefit of two cancer diagnoses. With the first cancer diagnosis, I wanted to be private. Obviously, I told my husband. There was going to be no hiding it from him, nor did I want to hide it from him, but I didn’t want to tell people at work. I didn’t want them to perceive me as weak. I don’t know if you had this experience. I felt somehow embarrassed because I didn’t want to talk about something personal such as my health or possibly my death.
There was a strange shame that I had in being diagnosed like I had done something wrong. All of which I know is not true, but I felt like I had done something wrong. I was private with my first cancer diagnosis. What I hoped would happen is I would go through treatments, get past it, and return to my normal life. It was going to be a little bump in my life with this cancer thing.
I got a second cancer diagnosis, Tina. I was like, “Cancer is coming for me. All bets are off.” The doctors sent me to the genetics team at Stanford because they’re like, “Is this part of a larger cancer story?” I do not remember what gene it is, but there are some genes that they can test you for. I ended up calling it the cancer all-the-time gene. There are people who get cancer after cancer until cancer takes them down. The doctor is worried that that’s what I had. Thankfully, I did not.
I also didn’t have the BRCA mutation, which is the breast cancer mutation, and now they have another one. I decided I was going to be public. Getting back to the question of not wanting to be a burden on your family or who you tell, there are a couple of things. One of the things I observed was when I went to doctor’s appointments, I had so much adrenaline pumping through me.
I’m a reasonably intelligent person, Tina, but that doesn’t mean you can always hear. I was doing a lot of reading about cancer. I understood their terminology better. I was asking better questions, but I didn’t always hear everything because of all of that adrenaline. You think about the times in your life when you are aroused and you’ve got all this adrenaline pumping. You can’t always hear everything that’s being said.
It’s almost like that Charlie Brown teacher thing going on. You’re hearing a word and a walk. You’re thinking about my life. You’re thinking about what’s going to happen. How am I going to feel? You’re fading in and out of the conversation. You’re almost stunned because I’m like, “I know how I handle things at work and how many tasks I can handle, but I’m having a challenge focusing on this one person and conversation.
That’s where bringing another set of ears to the meeting can be helpful. You want to choose somebody who you think can remain calm. Don’t bring the family member who’s going to freak out even more than you are. Many medical centers have patient advocates who can go to the meetings with you, take notes, help you ask questions, and help you coordinate with your doctors or your insurance company.Bringing another set of ears to the meeting can be really helpful. Click To Tweet
I suggest to people to bring somebody else to your meetings and when you go for treatments. Both radiation and chemo are the symptoms aggregate. They are cumulative. When you’re going through radiation or chemo, you’re getting more tired. I did have a couple of chemo and radiation appointments that I went to on my own. I would often have to pull off on the side of the road on the way home and take a nap. At that time, I was in some of the best shapes of my life. I was working out regularly, but the treatments can be exhausting, even for somebody who’s strong.
Before I had the cancer diagnosis, my son and I would go out and run in the morning. He’s blazing ahead, but I was keeping up and able to do that. At the same time, when the cancer diagnosis came, I had a list of friends to take me to treatment. I remember talking to them afterward in the gym. Five minutes in, I was asleep. It was done. There was no way that I could be able to do that. My treatment location was 90 minutes one-way from Memorial Sloan Kettering.
I can relate to having to pull over because when you’re dealing with chemo, they are burning off the bad cells, and new cells are trying to be created in every aspect. In talking about the treatment, what did that look like? Different people have experiences with things not staying on our bodies. What did that look like for you?
I’ll share all of it. A friend was diagnosed. It’s a friend’s father. He was in the Vietnam War. He was exposed to Agent Orange in the Vietnam War. He developed bladder cancer and not a good type of bladder cancer. Not that there’s good cancer out there, but some bladder cancer, sometimes they can take the cyst or the tumors out, and you can keep going. His was more involved and they were asking me about side effects. I said, “This is the interesting thing. They tell you what all the side effects are. That does not mean your body is going to choose to do any of those. They’re giving you the most common ones, and every body is different and reacts differently.”
I was lucky with the chemo. I had some nausea and dryness, and I was tired, but for the most part, I didn’t have debilitating symptoms with the chemo. I did chemo and radiation to my mouth at the same time because they were trying to treat my two cancers in parallel. They didn’t want to ignore one cancer and let it kill me while they were working on killing the other one. I had had surgery for the mouth. I was starting the radiation for the mouth. That’s when they started me on the chemo for the breast. It turns out chemo intensifies radiation. I did six weeks of radiation to my mouth. Two weeks in, we were starting to see the symptoms they normally see at the end of six weeks.
I started to have mouth bleeding and developed mouth sores and sunburn in my entire mouth. They would make decisions. I would sometimes skip chemo. My doctor would say, “We’re going to skip chemo this week because your mouth is too toxic.” What they were afraid would happen is my mouth would have many sores that I wouldn’t be able to eat. I actually wasn’t able to eat for about three weeks because I had so much pain in my mouth. They had me on oxycodone and put me on morphine for a while, but that made me barf so I had to go off morphine. I lost 35 pounds. Mind you, Tina, I have found all 35 of them. Don’t feel too sad for me, but it was tough.
The radiation chemo combo for me was toxic. The radiation was done. I continued to do chemo. What was tough was that every time I did chemo, my body was reminded of the radiation. I would get something called radiation recall. I’d be like a month or two out from having finished the radiation. The sores were supposed to be healed and they would come back because I was doing chemo. That was lame. I didn’t like any of that. I did about six months of chemo. I lost all the hair on my body, which made me look like this skinny newt. All of my lady stuff was gone. It is like the biggest Brazilian waxing you’ve ever had.
When my hair eventually came back in, it came in curly like I had a light afro. It did not look attractive to me. My hair was like cotton candy. It is wispy and curly. I decided to try dying platinum, and it straightened my hair, Tina. My hair went from curly to straight, and I had this platinum blonde short haircut for about five years. I was damaging my hair. I decided to grow it out again. I was like, “It’s only hair so I’m going to do purple.” I’ve done purple, green, blue, pink, but I’m a purple gal.
Isn’t it amazing how these situations in life changed our perspective of things in a way that never would’ve happened before? It’s like one of the small gifts that you receive after surviving, endurance, and hardship. I want to circle back to something else. You talked about you guys were trying to have children before the cancer diagnosis. How did that go for you? Where did that go from there?
We got the first diagnosis, and two months later, is when I got the breast cancer diagnosis. About a week after that diagnosis, my breast oncologist called Jeff and me back into the office. She said, “Can you both come back in?” I said, “Okay.” She walks into the room. She’s like, “You guys have been processing a lot.” I said, “Yeah.” She said, “I understand you were seeking fertility treatments here at Stanford when you were diagnosed.” I said, “We were about to go through IVF.” She said, “What have you heard about your fertility?’ I said, “If I make it through the cancer treatments, my understanding is in two years’ time, I’d be able to try having a baby if I survived these two cancers.”
My doctor looked at me, Tina, and she said, “Sarah, after we get through the chemo and the radiation and the surgeries for your breast cancer, I’m going to put you on an immunotherapy called Tamoxifen. This is a medication that will block estrogen and progesterone because those are the hormones that your cancer is feeding on. You need those hormones in order to nurture a baby. I would have you on this medication for ten years until you’re 54. At that point, you would not be a candidate for IVF. Unfortunately, you will not be able to bear a child.”
It’s amazing for Jeff and me to think about it because even though we weren’t sure I was going to survive the year and we were focused on that, somehow, we had this crazy idea that I would have a baby. I know they are incongruous, but it had been such a hope and a dream for us, having gotten married late. I was 42 when I got married.
I looked over at Jeff and he had tears welling up in his eyes. He was like, “This is all too much.” We began mourning and processing the fact that we were not going to have a child. Two years after I finished all the treatments, I was back to the important treatment for breast cancer. Do you make it through the treatments? They care about the second year, the fifth year, and the tenth year. If you make it past in ten years, they say, “We’ve cured you.” Here I was at my second year of treatment. I’m meeting with my doctor. I said, “I’m starting to feel optimistic that I might live.” We’re starting to explore finding a surrogate to have a baby. We have all these embryos on ice. We’re wondering, “Can we find a surrogate to bear the child?”
She said, “I am glad you bring this up because there have been these studies done in Europe where they tracked Belgian and German women who had breast cancer, were on Tamoxifen, and willfully and against their doctor’s orders went off the Tamoxifen in order to get pregnant. They got pregnant and had babies. They went back on the Tamoxifen. They haven’t shown a higher incidence of recurrence.” I was like, “What does that mean?” She said, “If you want to try having a baby, let’s do it.”
I went to Jeff and I said, “I have terrific news.” He said, “Do you have to go off your cancer meds to do this?” I said, “Yeah, I’m going to have to go off the cancer meds for three months and then we could do the IVF. I’ll be off the cancer meds for the time of the pregnancy while I’m breastfeeding until I stop breastfeeding, and then I would go back on the cancer meds.” He is like, “I don’t want to do it unless they can give a guarantee that your cancer is not going to come back.” I said, “We never have that guarantee.”
What we need to think about is, “How do we want to live?” The way I want to live is I want to experience everything I can, which includes having a baby. If I can have and carry a baby, I want to, so I did. At 48, I gave birth to Rory Elizabeth McDonald, and she turned seven in 2023. She is fiery, fierce, and occasionally feral. She is tough.We never have that guarantee. What you need to think about is how you want to live. Click To Tweet
I wonder where she gets that from.
We feel lucky to have her. It was exciting.
One more question. I know we have a couple of things to talk about. How did you develop the questions that you came to the doctor with? How did you go about doing that?
Jeff and I would both brainstorm them together. I would try to do all the reading that I could. I come from a family of academics. When you don’t know something, you read about it. You find the encyclopedia, or in this case, Google, or lots of books. Most of the books I was reading were written by doctors, like the people who told me, “Nobody is going to read a guidebook by somebody who is not a doctor.” I was reading books by doctors who were explaining this is why cancer happens.
I was asking various questions like, how is this going to impact that? The different medications I’m taking, how are they going to interplay? What can I expect from my side effects? It was the curiosity that I had not known anything about things and that I was developing from the reading. I was 44 when I was diagnosed, and I knew very few people who had had cancer. Now I’m in my 50s and I know a lot more people who have cancer, but it was out of our curiosity.
The other thing I will tell you is that neither my husband nor I have a background in medicine, but we both found the stuff we were reading utterly fascinating. We would often joke with one another. If this wasn’t involving my potential death, this was fascinating stuff. I’m reading about how the body works. I’m embarrassed and want to apologize to my mom. My mom was a professor of Biology, Anatomy, and Physiology and was the advisor to the potential medical students at her university. None of her kids went into science. None of us did. I developed an interest in science later on due to my diagnosis.
The questions came out of curiosity and wanting to understand more. I wanted to be the best patient I could be because I thought to myself, “I want to adopt everything the doctors are telling me. I don’t want to do things wrong.” I tend to be a rule follower in general. Whatever the doctors were telling me, I believed them. I adopted whatever they told me to do.
I’m going to shift to your dad. You talked about how you and your dad handle cancer differently. Do you want to go down that road?
My dad had been diagnosed with prostate cancer when he was 62 or 63. At that time, the treatments for prostate cancer was surgery, which had some bad side effects, potentially radiation, where you could radiate the area or do nothing. They say that if men live long enough, they will develop prostate cancer, but it might not be what kills them.
If a man develops prostate cancer in his 80s or 90s, often, the doctors will say, “It’s not worth going through the treatments because prostate cancer is slowly growing and you’ll likely die of something else before the prostate cancer can get to you. Dad was 62, which is young. He didn’t want to do the surgery because it could lead to incontinence and impotence. He was like, “I don’t want to be wearing diapers. I don’t want to do it. What I’d like to do is ignore it.” I’m like, “You’re too young.” He opted for radiation.
What ended up being tough is, with cancer, it only takes one rogue cancer cell to start duplicating. Along about the time I was getting diagnosed with cancer, my dad’s cancer came back. He had a recurrence and they found it in his bones. It had metastasized. At the beginning of this episode, you were talking about people wanting to be private. My dad felt very strongly. He didn’t want anyone to know that he had cancer. He was embarrassed by it. He didn’t want to talk about it. He didn’t want anyone to know.
When prostate cancer has metastasized to the bones, a lot of what the doctors want to do is chemotherapy to try to erase the steps or the footprints that cancer may have taken in your body. The chemo is what can try to eradicate the metastatic prostate cancer in the bones. Dad didn’t want to do it because he said, “I’d lose my hair. Everyone would know I had cancer.” His privacy was important, and keeping it not public was important to him that he wanted not to do the treatments that the doctors were recommending.
I said, “Dad, don’t you want to do everything you can to save your life?” He said, “The doctor said to me, Sarah, that on a scale of 1 to 10, he asked me how I was feeling and I said four.” He asked the doctor, “Can you get me back up to 8 or 9? I want to feel that good again.” The doctor said, “I can get you to a six, but I don’t think I’m not going to be able to cure you.” My dad was like, “Is it a life worth living if you’re feeling lousy all the time?” He did end up deciding to do chemo, but at that point, it was late. That was tough. I had to respect it because it was his life and choice. I had to respect his decision not to do chemo as long as he had that decision.
You chose to respect. You could have been overbearing. On the outside, you were respecting him, but what was going on in your heart?
I did try to be as respectful as I could be. Like older people, often, there are combinations of health issues. He had some heart issues plus cancer. I asked, “Are you telling both of them that you’re being treated by the other one? Do you know that the medications won’t cause issues with one another?” He said, “Sarah, how dare you question the doctors?” I said, “Dad, what I know is that doctors can make mistakes. If you don’t give them all the information, they’re more likely to make those mistakes.”
I suggested this whole idea of a patient advocate. I said, “Dad, what if you employed a patient advocate to help you coordinate between the doctors?” He thought that that was the height of rudeness. The language was, “How dare you question the doctors?” I had to apologize for making the suggestion. I told him I would respect his opinions.
I didn’t get combative. I was trying to be urgent. I argued with him in a way that he could hear me, but it made him feel that I was questioning him and his doctors. He was angry with me, Tina. A hard lesson to learn is when a loved one is having a health issue, and they’re not listening to their doctor, they’re being cavalier about their health issue, they’re not doing all the things the doctor tells them, or they’re not being as urgent about it. A lot of people get health diagnoses and they put their heads in the sand because they don’t want to believe that it’s true.
I said to my dad, “I love you. Selfishly, I want you around. I’m willing to fight whomever I need to fight to keep you around, but I don’t get to make these decisions for you. It is your life and choice. I will respect it, and I will love you. After we got through that hump, that was the approach I took. It was clear at that point he was not going to be winning his battle with cancer. It was a matter of riding it out with him.
When you’re going through cancer, I found it freaky to be around my father because I kept thinking, “Is he the canary in the coal mine?” I’m watching how this cancer is ravaging his body and how his body is reacting to these treatments. They’re different, but he’s my father. We have similar bodies. It was hard to lose him because he became my little cancer buddy. He was the person I spoke to every single day that I was going through cancer treatments. We both weren’t working while we were going through the cancer treatments. We could call one another at any time and talk about things that maybe we couldn’t talk about with our spouses.
If I’m hearing you correctly, your dad did eventually succumb to cancer and passed?
He died in October of the year that I had cancer. I was diagnosed in January and he died in mid-October. It was hard because I had my first breast cancer surgery and I flew down to spend time with him. It was while I was down there, and he was quickly declining. My brother and I both flew down there. My sister lived near my mom, so we’re all around my dad. While I was down there, my doctor contacted me and said, “We didn’t get clean margins on your surgery. You need to fly back up. We need to do another surgery.” I said, “My dad is dying. I need to stay down here.” They said, “No, we need you to come back up.” I flew back up and he died. The next day, I went in for my second surgery, which was the right decision, but it was hard.
There’s such a loss for someone who has been in your entire life in their absence. How has your family coped with that loss?
We were all close to him. I wasn’t living near him. There is something about somebody that you see and you’re in touch with every day. I missed talking with him but I was only seeing him every other week. I wasn’t seeing him every day. We’re several years out now. We had the anniversary in October. For mom, it’s still a daily struggle. I don’t know about your mom, but it’s hard.
They were together for how many years?
They were married for 49 years, but together, it was 50 years. She was funny. She was like, “We almost made it to 50.” I was like, “Mom, making it to 49 is freaking cool.” She still struggles.
Does she ever open up to you guys? How do you see yourself helping your mom being that widow?
She does not like to go into the emotions. There are some people who, for self-preservation, stay on the top. That’s why, several years later, she’s still struggling because she has not plumbed the depths. Grief is super interesting. I have observed grief to be something that’s like a wound on the skin. You think it’s healing and sometimes something will touch it. It bleeds again. You’re like, “What the hell? That’s painful.” I’m sure that happens for you with Mark. It catches you sometimes because it’s non-linear. There’s no set path or steps you can go through to heal your heart and soul. It catches you sometimes.
My mom is not someone who likes to delve deep and that is part of her self-preservation. I speak to her every Sunday night. She talked about how much she missed Dad. I let her talk. I’ll ask questions, but she doesn’t wallow in it. There’s part of me that thinks she would be well served to dip in a little bit, but I don’t know.
I never correlated the two as we talk about cancer, someone receiving that diagnosis, wanting to put their head in the sand, and the magnitude of the grief that you experienced by the death of a loved one. If you cannot dive into the deep part of that, this concept or mindset won’t impact me if I don’t deal with it. I have found in conversations with people that, whether it’s the cancer diagnosis and you leaning in, becoming educated, finding out these answers to the questions, getting this right path, and fighting the fight, it may endure life longer.
Sometimes, people are afraid if I get into it a little bit, it’s going to take me over, and I’ll never be able to come out of it. I have found those waves of grief happen. When I lean into it, it subsides quicker than not because now I’ve faced it, but it is hard either way. My mother’s age and her era were not something you talked about. We’re going to talk about grief, and people are like, “What are we doing?”
My mother was the second person on my show. It wasn’t something that she was thinking that we would do. There’s something about releasing that out of you, whether it’s blogging or writing, but connecting with other people. There’s a way of empowering you to have a life differently, but I understand the challenge.
I’m thinking about diagnoses and the grief you go through. I went through all those stages of grief. I ended up doing something called Guided Imagery. I don’t know if I ever talked with you about it but it was my fertility doctor who suggested it. She said, “I don’t know if you believe in the connection between mind and body, but I do.” Guided imagery is like guided meditation, where somebody has you envision something. You close your eyes and envision like walking through a forest and this woman with this soothing voice to say, “Notice this and notice that.”
Tina, it is no joke. I was sobbing. I am thinking about walking through a forest and this weird woman is talking. I don’t know what happened but all of this grief came pouring out of me. When I first started, it allowed me to grieve viscerally. I did it a couple of times a day for three months because I was stressed out. I have to envision this happens when you lose your husband. You’re so panicked. You’re like, “He’s gone. What is my life meant to be?” There’s so much panic. This allowed me to grieve and plumb the depths.
What I found was the anti-anxiety medication that I asked my doctor to prescribe to me because I was freaking out. I was like, “I am going to have a heart attack before either of these cancers can kill me unless I get this under control.” I did three months of listening to guided meditation every day. It was so awesome. As I’m talking to you, I’m thinking I never suggested that to my mom. I don’t know that she would’ve done it, but maybe it would’ve helped.
The week after he died, I offered to come down and help her because she went into project management mode. She’s like, “We need to go through his closet. We need to get everything out.” I’m doing that. She’s holding it together. I’m not seeing her cry at all. I ended up having to take her to the emergency room because she had this excruciating pain. This woman who’s not crying is screaming and writhing in pain. I take her to the emergency room because she’s like, “I’m dying.” The doctor was like, “This is grief. This is your body.” She got some muscle relaxants. I was like, “This is what happens when you’re not processing this.”
There are two things you talked about. We had someone who was a heartfulness person. They are licensed. They talked about the relaxation method and yoga. We have a mind, body, and soul. We’re connected. We may not be able to see it all, but one doesn’t particularly operate independently of each other. It is important to be able to sit with yourself, exhale, and see yourself healed or in a different state. It’s never too late to do something like that.
As you were sharing your mom’s story, it was similar to my mythology. My brother Jesse was the first person to be at the house when my husband passed. I remember being in that fog. I was like, “How did you get here?” In my mind, he teleported because I was in shock. My husband died in front of me. He said, “I flew here, Tina.” He started saying, “She is not who she normally is.”
There was a project management mode. All the things that I needed to get done for his service, I got rid of clothing that week. There were people in the house that fit my husband’s clothes and looked in his closet. It made me go through this imagination that he would wear it again, and I could not allow myself to even hover in that spot. I took his clothes out that I knew I wanted to keep into a different room.
Jesse was with me for two weeks and then a cousin came. They rotated out. We were going to get up at 2:00 in the morning to take Jesse to the airport. My cousin was there. We got her the night before. I was full-on freaking out. I had never had a panic attack. Mark died of a heart attack. I thought I was dying of a heart attack.
My cousin, who had gotten to Pennsylvania the night before, was now driving Jesse to the train, not knowing where she was going. My daughter was taking me to the emergency room. Mark and I were together for 32 years. That person was ripped apart and you are trying to process it mentally. I know people die, but my person died. What does that look like in the mind trying to reconcile? I can relate to the project management mode because this is a safe space. I can control this. This is what I control then I will deviate from that. It is quite the thing.
I remember your brother calling me when he was with you. He was like, “Sarah, he died.”
Jesse and and Mark were close. He was like Uncle Mark. It shook the fiber of our family in a way that you did not even see coming because he was just 54.
The thing is this was after you have been dealing with cancer.
In October, I had a complete hysterectomy because they thought the breast cancer was now turning into uterine cancer. I was at a coworker’s desk. We were talking. I work on a military installation. We hear something go, “Tap, tap, tap.” I’m like, “Do we have to duck?” I look down and there is blood everywhere. My period came on in a rush. That was the look on my face. I’m like, “I’m glad I was talking to a female.”
I call my doctor. They say, “Come in immediately.” They’re looking at the way the cells are changing. I was like, “I am 51. We don’t need anybody else babies. We got what we got at this point.” It went from that conversation to the next week, I was having a complete hysterectomy because it was altering and about to change.
In October, I had to complete a hysterectomy. In November, Mark left Pennsylvania, took a job in Virginia, and passed that fall in March. I was getting my head on straight. As crazy as it is, when he passed, everybody was going, “Tina had cancer.” All of my family showed up strong and have continued to be supportive as life changes and you continue to live. I have a couple of questions for you. What gives you hope now, Sarah?
I have a little girl. The work I’m doing now feels important. I am talking with a lot of corporations about how we show up for one another in crisis. What’s interesting to me is that the companies want to talk about it. My friends who are running senior leaders at companies say, “We need to talk about this. We need to help our managers know how to talk to employees who are going through crisis.”
A crisis isn’t a cancer diagnosis. It’s the loss of a spouse or a child. It’s a divorce or a financial hardship. Crises take all different forms. We need to be able to talk directly about it and talk about the hard things so that we can show up for one another. People ask, “What do I say to someone who is going through a crisis like this?”
I say, “There are two sentences. You say, ‘I am sorry you’re going through this. It must be hard.’” That applies to all different kinds of things. You open up the resonance space. You say, “It must be hard,” then you show up for the person. I don’t know if this happened to you with cancer or with Mark’s death. There are people who are afraid of contagion.
They’re going to say hello to you and they’re going to get cancer. They’re going to say hello to me and my husband is going to die. That’s not how it works.
People end up saying nothing because they’re terrified of saying the wrong thing. They fear becoming overwhelmed when they’re with the person so they avoid the person. What that does is isolate people who, at their greatest time of need, need us to lean in. I started out saying at the beginning I wrote this book to be helpful for people who have cancer. What I discovered is the book was helpful for people who loved people who had cancer and who didn’t know how to show up for people who had cancer.
I honestly thought all I was going to do was write a book and get it out into the universe. People were like, “What are you going to say?” I was like, “I don’t have anything to say.” I realized, “I have a lot to say.” A lot of it is talking openly about it. I joke when I do the corporate talks. I say, “We’re going to talk about the hard stuff.” It is because everybody talks about it that way, rather than, “Tina had cancer. Tina is beyond that now. Tina is a stronger and more resilient person now. Tina lost her s*** for a while there because all of that is real.”
What I hope to do is talk openly and honestly about all of it. Talk about the hard stuff and say to people, “Lean in. Don’t isolate this person in crisis. Help them.” I have found, having been through it, I still make mistakes with people. I say, “I’m sorry I made this mistake. I’m trying to show up for you.” I was speaking to a woman whose husband had stage four lung cancer.
She asked me something about the year. I said to her, “It was a hard year. During my year of cancer treatments, I learned a lot. It wasn’t all bad.” She looked at me. She’s like, “How dare you say that to me? How dare you say that it’s not the worst possible year. You don’t understand I’m about to lose my husband.” Tina, she’s right. I said, “I’m so sorry. I did not, in any way, shape, or form, mean to be disrespectful of you.” She was in a fragile place. I would still say I did learn some stuff from the year. Not everything was terrible, though I wouldn’t wish cancer on anyone.
I could say the same. There were people I never accounted on showing up. The amount of love of people I’ve connected with still stayed in contact over the years, and life does provide some gifts in these challenging situations. We do have to be open to embrace them. I have had friends who have lost their parents. I’m watching them care for them until their last breath. Life is something to be appreciative of and cherish. If you were to speak to younger Sarah, what age range would she be, and what advice would you give her?
It’s interesting as now I’m raising a girl who is fiery, fierce, and feral. She had some friends over, and I was like, “They are feral.” What I’m trying to do with my girl is I want her to be successful and smart. Above all, I want her to be kind and brave. I’m 55 now and I like myself better than I’ve ever liked myself. In part, I am more thoughtful, kind, and brave. I would’ve wished all of those things on myself when I was younger. I don’t know if I had to go through various life things to get me to that place.
I was listening to a Brené Brown podcast and she was interviewing Daniel Pink. They were talking about the importance of regret in your life because people say, “Live with no regret.” Daniel said, “I think that’s dangerous. We should live with regret because it is a teacher.” Don’t wallow or beat yourself up, but say, “I made a mistake. How am I going to do it differently next time?” It is beautiful. What I would tell the younger Sarah is to be more thoughtful, kind, and brave. It’s all going to work out. Don’t spend a lot of cycles trying to make everything perfect. It’s going to work out the way it’s supposed to work.Be more thoughtful. Be more kind. Be more brave. It's all going to work out. Click To Tweet
If someone was interested in purchasing your book, you being a coach, or coming to speak at their company, how would they contact you?
My book is called The Cancer Channel. I have a website for it called TheCancerChannelBook.com. They can email me at Sarah@TheCancerChannelBook.com. The website has information about me as a speaker. I had some headshots of me. As far as the book, you can purchase it on Amazon. I published it on Amazon, but I also registered it with Ingram, which is where independent bookstores and libraries get their books.
You can go to an independent bookstore, which I highly recommend. You can ask them to order The Cancer Channel. There is a paperback and a hardcover. I’m in the middle of doing an Audiobook now. I’m on chapter 7 of 17 chapters. It turns out that doing an Audiobook is hard because you have to say it word for word. I’m enjoying it, though.
Anything else you’d like to say before we wrap up? I leave it to you.
Tina, I appreciate the opportunity. This is brave of you. I appreciate you showing up for people who are going through this and creating the space for them. It is a beautiful gift. I know you didn’t know how to podcast before starting this. You have a beginner’s mindset. If I can draw a parallel similar to me, you’re saying, “Let me take hardship and the things I’ve learned and let me share it with others so that maybe I can soften their journey.” That was my goal with the book. That’s your goal with this show. You are adding your voice. That’s beautiful. Thank you so much for inviting me on. I appreciate it.
Thank you so much, and you have nailed it. It is wanting to take this situation and make it purposeful because we cannot change it for someone, but we can let them know they are not alone. They can pluck nuggets out of every conversation to create their own journey and know that it is something that they can have a life not only existing, but have a life they enjoy. Thank you so much for being here.
Thank you, Tina.
Widowhood, thank you for being here with this conversation with Sarah. As we know, grief comes in many different forms, whether it is us grieving, a loss of expectations, unfortunately, a spouse, or a family member. I chose the word widowhood because it encompasses our entire group. It may be the daughter or the son of a widow or a widower. You may be part of that hood because you are a friend of someone who is grieving. I hope that each one of these conversations will help you pluck a nugget out that will be helpful for you and what it takes to either support someone who is grieving or as you are going through your own grief journey.
I am sorry for the person or the grief experience that you have endured that has brought you to this conversation. At the same time, I’m glad that you found us, and I’m welcoming you to our hood. Feel free to email us. Go to our website. If you want to share your journey and story with us, I look forward to hearing from you soon. Bye.