Balancing a career and breast cancer: Tiffany’s story

At the time of her diagnosis, she was dealing with several challenges in her personal life, including the loss of a long-term relationship and the need to reestablish herself in the US, after working in China. And, she had just started a new job.

Tiffany had routinely worked long days and barely touched her paid time off; in her own words, she hadn’t “set great boundaries” with work. Now, however, she needed to focus on her health. Having only been at her job for two months when she was diagnosed, Tiffany had to figure out how to handle communication about her diagnosis at work during a great deal of uncertainty. She was so overwhelmed that when she finally received a call from the doctor saying she could schedule surgery for the following week, she balked, thinking about work-related issues. A trusted colleague had to remind her that her health was the most important thing.

Now, Tiffany wants to share her story because she wants you to know that you CAN handle breast cancer and workplace issues, because she DID. Learn about Tiffany’s experiences and how she learned to prioritize what really matters as she narrates her story and then chats with Jean Sachs, LBBC’s CEO.

Listen to Tiffany's story below or read the read the transcript.

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Transcript

Tiffany (00:01):

Your health matters. Like your life matters. Take care of yourself first, right? Like the job stuff will work itself out. I feel like I've been, you know, privileged enough that I've worked hard enough and I've built strong enough relationships that if anything were to happen, I can go get another job. I can't get another me.

Jean (00:23):
Welcome to Can and Did conversations: candid conversations with young women diagnosed with breast cancer. I'm Jean Sachs, CEO of Living Beyond Breast Cancer. I want to thank you for listening to these authentic and inspirational stories. In this episode, Tiffany shares her story about being diagnosed with early-stage breast cancer at the age of 36 and how this impacted her professional life and changed her perspective on what her life priorities should be. She talks to us from her home in Washington, DC. Afterwards, I will take a few moments to chat with Tiffany. Now let's listen to her story.

Tiffany (01:12):
My name is Tiffany, and I was diagnosed with stage IIB hormone receptor, HER2-positive, estrogen positive, and progesterone negative breast cancer. I was diagnosed in August of 2018, at the age of 36. Prior to my diagnosis, I had moved to China in April of 2016 and had moved back to the states in April of 2018. So I actually found my lump while I was in China.

(01:47):
Having to one, find a doctor, right? I found an international hospital over there and went and explained like, hey, I felt a lump. I've been feeling some short pains and also trying to explain the fact of like, I have a history of breast cancer in my family. Both my maternal grandmother and aunt were diagnosed with breast cancer and my aunt was actually I think 36 when she was diagnosed as well. And unfortunately both of them, you know, have since passed. So, you know, trying to explain and kind of be an advocate of saying, Hey, like I have this going on, only to be told that hey, it's probably a cyst, right? And if it gets bigger in six months, come back to see us. But I knew for me, in six months I was actually going to be returning to the states.

(02:39):

I had actually gone to China with my partner at the time and that relationship ended. So, I came back to the States. Yeah, I think that was April of 2018. And so I was actually still working for a Chinese based company when I came back. I do marketing as my career, so I was leading kind of their global marketing efforts at that time. But coming back to the US having kind of this medical thing in the back of my mind, now I have to reestablish myself now around the time of my diagnosis, I definitely had a lot of elements happening, right? Personal life, sort of grieving a long-term relationship, the loss of that, figuring out how I was going to reestablish myself in the US and then also dealing with kind of this medical issue kind of lingering in the back of my mind. And then I actually started a new job probably June of 2018. And then I finally found some doctors in and went and had the lump checked out and, and then eventually I'm going to a slew of doctor's appointments and scans and markers and biopsies. And so I got a call, it was August 28th, the doctor called me and said, you've probably figured it out by now it is cancer.

(03:59):
I had started this new job in June and so literally like two months and a few days late after that I was now diagnosed. And so I did tell my manager, I, again, I don't remember when, but I also had two people that I really trusted that I worked with. So I, I told them about my situation and was very thankful that I had them, they had been at the organization for years. So, they gave me very sage and sound advice on who to talk to internally and HR and, and benefits. Again, I was 36, I was single, I don't have kids. So it's like, oh well if you want to freeze your eggs, here's a pamphlet on fertility, you know, try to fit that appointment in there and, you know, and so there are so many decisions and appointments.

(04:47):

So, I had to tell my manager about my situation and, and at that point I didn't know like when my surgery was going to be, I didn't know when things were going to start or if I was going to go out or anything. But I did have to tell her, you know, I have this situation, I have doctor's appointments and then, you know, I'll just have to keep you up to date as I get things solidified. But needless to say, that's not a conversation you want to have like 60 days in. It was a tough conversation to have and, and my direct manager wasn't like, you know, we're still building a relationship, still getting to know each other. I think I was lucky enough because I did have a couple of people I trusted to help me to have those conversations, but it was still difficult. I was at lunch with, you know, one of my coworkers or colleagues, one of those trusted folks I mentioned and I got the call from the doctor saying, Hey, we can schedule you for surgery on Tuesday.

(05:44):

And so this is a Friday afternoon. And I'm, like, hold on. What? Wait, I'm still trying to figure out what I need to do, like internally, I don't know, well what I can put for leave, I haven't been here 90 days. So I hang up the phone and my friend looks at me, she was like, this is your life. So I had someone at that point to also remind me of what was important, right? Because I'm still like, I just started a new job. I can't go out, I can't do this. But I had someone at that point to say, Tiffany, this is what matters. Call them back, tell them yes, we'll figure out everything else, right? It's just a job. I call him back, I get it scheduled and then I have to go into, you know, complete like, oh crap. I need to tell my boss, I need to call benefits and get everything straight. Like, what paperwork do I need to do? Like at that point I had to, you know, make the final decision on what surgery and what option I was going to do. So, it was definitely a lot and I wasn't sure it was going to completely work out. I literally had surgery on my 90th day of work.

(06:56):

I think my benefits kicked in, and I was literally going under the knife on the same day. So, I wasn't a hundred percent sure that like my short term because I ended up taking short term disability to really focus on like my surgery and my treatment and you know, and, and getting through that, which was something I've never had to deal with before. I've just never been that person that's had to ask for special like accommodations or request. I barely call out sick. When I left my jobs, you know, I would have over a month of like time off that I never took right? I was that person. So, to now have to like I start a new job and to say Hey, I'm actually going to go out and focus on my health was a complete foreign concept to me in many ways.

(07:47):
I work in a pretty demanding field with marketing and I've worked in different industries and sectors, but it's a career that's allowed me some great things, you know, to be able to travel the world. But you know, it's also a very demanding job. I definitely didn't set great boundaries. I would say <laugh> between work and life, but I don't think I had enough confidence to stand up and to set those boundaries. It was just more so of like, okay, I, I have to put in the work, I have to show up, I have to be seen as a certain way. I wanted to always be seen as like a hard worker and things of that nature to this day everyone's like, so are you here? Are you going here? Are you around? But it's because I was always on the road, I was always traveling, I was always working.

(08:32):

I think I remember a time when I traveled for six weeks straight and only came home for like a day to do laundry and pack my suitcase and leave again. My me time would be kind of a tag onto like the work trips. I feel my form of self-care was, was much more of a check in a box versus it being true self-care. It was the idea of like, okay, like I, I booked a massage, or I booked a spa day or you know, I'm going to stay an extra day or two in this city because I enjoy the city to like see it for myself,

(09:08):
I had a pretty aggressive form of chemo. I was on Taxifare Carboplatin. And then with the HER2 positive ISO had those targeted treatments of Herceptin and Perjeta. And so I was getting all four of those treatments for the first five months. And so during that time that's when I didn't work and really just focused on the treatments and getting through that. And then once I stopped the Taxifare and the Carboplatin and I was just on the targeted treatments, that's actually when I, I went back to work and from home like limited capacity because the treatments weren't as taxing on me and I know everyone doesn't have the luxury to do it. But what I think helped me to be able to tolerate was the fact of not having that added stress of having to work during that time.

(10:05):
I truly was able to, to focus and to heal. I would go in for treatments on Thursday and I think by Saturday I would sleep all day. That's when it would hit me. And then by the time you regain your energy, you're back in treatment again. So for me I think not having that added stress of work or I don't have kids so I didn't have kids to take care of and at that point I didn't have a relationships. All I had to do was focus on my health and it was both mental and like getting through treatment. So I, I think not having that added layer helped my body to tolerate the treatment in a way that it wasn't completely affecting my quality of life through my cancer center. We actually, they had a social worker though I took advantage of meeting with the social worker to kind of talk through like what I was feeling. What I'll kind of say is that I think at that time emotionally I was kind of processing more of the loss of my relationship. Who am I now? Who am I going to be? I did a lot of work around like what my values are and I was thinking a lot about work. Like that was a big part of like my life and it's like when I come out on the other side of this, what do I want like my life or my work to look like

(11:31):
During that time? Meditation was a huge part. The breath work and the, the ability to be mindful. These are all things to this very day that if I feel like that anxiety creeping up or if I feel like I'm having a thought that just keeps going, I now kind of have those tools to be okay, take the moment, breathe, come back, you know, to the present moment.

(12:03):
Yeah, I really did take advantage of the social worker and then I eventually the hospital system where I had my surgery, they also have something called life with cancer and that support groups and restorative yoga, gentle yoga classes and things like that. Those group meetings and those classes gave me a safe place to go because everyone there is aware obviously of you being immunocompromised or just kind of your limitations. But it gave me an outlet so I wasn't just, you know, sitting at home sort of wallowing in what was going on. It gave me, you know, something to do as well to sort of help with the mental aspects of going through treatment and knowing that you're not alone. Especially those support groups. I went to one for young women but even within that most of the women were, were married or were coupled or many of them had had children. There were only a couple of us that were single and that comes with its own sort of unique situations. So for the first five months I didn't work at all and then I went out in September in mid-February is when I went back to work and at that point I went back remotely. I came back to a different situation,

(13:29):

My position. So while I was out, my team was restructured in my position. I was demoted almost when I came back to work. Not in title or pay because I don't know if that they could have even legally have done that. But my responsibilities and my role had completely shifted when I came back before I was bleeding a global team and I was responsible for the strategy of our global events and conferences. And when I came back, the person who like who was my counterpart, I was now reporting to her and then there were people on my team who were reporting to me who were now my equals. So they completely shifted the scope of my position, like it was supposed to be much more strategy and leading and became a, a more tactical, I was still leading in a team, but the complete focus shifted. I was still going through treatment at that time, so now I have to adjust to a completely different role in job and, and knowing that at this point in time, like I can't leave and now I have to like figure out how I show up in this job with these new roles and responsibilities that I didn't sign up for initially. So that was definitely a hard transition coming back

(14:53):
And even just managing my energy levels and focus, having to come back and be present and focused for work for eight plus hours or, or what have you. It was definitely hard to kind of come back and try to be at somewhat of the level I was at before diagnosis and before going through treatment I was always on top of everything and coming back I don't feel as sharp <laugh> as I used to, right? I don't have the ability to just kind of recall information. I have to be much more methodical of writing things down and, and being very specific in how I write things down. When I first came out of treatment, my energy was pretty low and even now I think my baseline of energy is a lot lower than what it was. I feel like I kind of run out of gas a lot faster <laugh> and a lot sooner than what I did before, and I don't push past that anymore.

(15:56):
I think before, even if I was tired or burnt out, I could always find some extra lever to kind of keep going. And now I think it's both physical but also like what matters and what's important. When I feel like I'm done for the day, I kind of shut my laptop <laugh> down, I'm like, okay, that's what I have to give for today and we'll get back to it tomorrow. The way I approach work has definitely shifted. I continued to get stuff done, but what I think shifted also for me was that level of confidence and insane what was on my mind. So I became I think more vocal from that perspective where if something had bothered me before, I might not have expressed the concern. I now no longer have this irrational fear of like, I'm going to be fired because I've set a boundary.

(16:51):

It's just having that conversation with my manager or like I have skip levels with my VP in my department and just kind of being open around like what matters to me. I'm obviously going to show up and do my job, but I'm also going to do those things that matter because if, if I'm not taking care of myself, then I'm not going to show up to work as my best self either. If I'm constantly draining myself to get work done, that's not beneficial for you and it's not beneficial for me. I haven't really been met with too much resistance in terms of setting those boundaries. But if I were then I think it becomes a matter of, if you've had like that hard conversation, then we all have choices to make, right? Then you have to look and say, okay, is this a place where I want to be anymore? Right? We all have choices to make.

(17:46):

As someone who has now had two jobs since being diagnosed and treated, it's like, do I check a box to say I have a disability or, and I think I have once and didn't the other time. Do I have to bring this up in the interview or when do I bring it up? It's definitely a vulnerable place and for me it's being authentic. It's having a level of freedom. And with that, I mean there's risk, there's fear, but I also realized that I know how to do my job. I thought about, okay, how do I bring this up? Do I need to bring this up, you know, with my managers? And I didn't do it right away and either of my jobs. I kind of do these gut checks and there just came a point where I'm like, okay, I think this is the right time to share that I'm a breast cancer survivor.

(18:38):

But again, I had to sort of feel out like my new managers or my coworkers and I did it when I felt comfortable. I mean it was still a very vulnerable place to be in my current job. I haven't been there quite a year yet, but I think I was in a one-on-one with my VP and we were just talking about something. I'm like, well I have something to share. And then I think at that point I shared that I was a breast cancer survivor. I had recently become a young advocate volunteer with Living Beyond Breast Cancer and just kind of shared that it was also kind of from a perspective of what matters to me currently and, and how I show up at work. But for me, I just feel like this is a part of my purpose of being a survivor and how we show up in the world.

(19:28):

It's definitely a vulnerable place to be, but I would encourage folks to share with if they feel comfortable and when they feel comfortable. I no longer work regular 12 and 14 hour days. I took a position recently because it meant less travel. It allowed me to have that time back to myself. I go to yoga, I go to boxing, I put that on my work calendar as well as that reminder of like stop and go, you know, do the things that are part of your peace and are part of your joy. Or if I have a dinner scheduled with a friend, I put the those things in my work calendar as well as that like visual reminder of there's more to life, right? So I try to do things like that to help set boundaries and to also be reminders to myself of like, no, go spend that time on yourself.

(20:19):

Right? Go do those things that are important. Go meet up with your friend, be present for your family. Those little cues have helped me to like maintain those boundaries between work and life where again, before I probably would've powered through or said, no, I can't meet you tonight because I have to get something done. I no longer do that. I prioritize those things that are important to me now. Right now, I feel like I'm the most Zen that I think I've ever been in my life. Like I have a lightness to me.

Jean (20:58):

Tiffany, thank you so much for sharing your story and I'm so happy you're joining me for a quick conversation. How are you?

Tiffany (21:06):

I'm good. Thank you for having me back to chat with you a little further.

Jean (21:09):

Of course, I can tell in listening to your story that this diagnosis was a shock and it's that way for most young women. You were clearly in the middle of your life living in another country dealing with the ending of a long-term relationship and clearly really building your career. And I found it so interesting that your diagnosis was what helped you reprioritize your life goals, maybe moving away from working such long hours and finding more balance. And while I think that's great, it was probably not the best way to learn that lesson, right?

Tiffany (21:48):
Yes, <laugh> I would say it's something that I was working on for sure, trying to figure out that balance, but obviously like being diagnosed it really just put things into perspective even more so. I feel like I was pretty tuned in on that before, but going through it personally really put that focus on self and making sure I'm putting my physical health, mental health and spiritual health at the forefront. The diagnosis definitely made that very clear for me.

Jean (22:19):

I think a lot of people feel that way and of course they always say, I wish it wasn't cancer that made this happen. But good for all our listeners to know that it is an opportunity to re-look at your life and reprioritize. So I just had two questions I wanted to ask you. They really are tied together, but since a lot of people that are probably listening to this are single and have had breast cancer and we know that can be a hard road, particularly if you're dating or interested in dating. So I just wondered if you had any tips to share about how you're managing it?

Tiffany (22:58):
One of the things that was a huge, I guess help for me is my support system. I can say I have a wonderful tribe from my family to my friends, but something outside of that that was really helpful was the cancer center that I went to had a support group for young women. So I really tried to take advantage of going to that support group and being able to share what I was going through. Some of the decisions I had to make, some of the things that I was thinking through and being able to share that with other people that were in a similar position. So really taking advantage of that and actually through that support group is how I was introduced to living and beyond breast cancer in the survivorship program. And so even being able to take it a step further and really talking through like some of those differences, right, of being single when you're young I did find a lot of the people in my support group were married or were partnered in a lot of ways, but there were a few of us that were single.

(23:57):

And so you're having to navigate this, I wouldn't say alone again, like if you have like your support group of family or friends, but you know, having to make these decisions without having a partner or you know, having a face, do I freeze my eggs? I'm not in a current relationship. That's something I haven't thought about. These are now decisions that kind of come to the forefront. So, I think really looking at some of those support groups, whether it's online or in person, through your cancer center, through your local hospital, through living beyond breast cancer and other organizations was really helpful for me.

Jean (24:31):

Good. I'm glad we were able to be helpful. And I think it's hard because when you have a partner or a family, there's a lot of motivation. Hopefully you're in a good relationship and when you are single, you do need to navigate this more on your own and then as you meet new people, share information that might not typically come up in the beginning of a new relationship.

Tiffany (24:56):

Exactly. And I actually, I just had a friend who was recently diagnosed and who's also single. So like we had very candid conversations around this and was able to share with her around some of the reasons why I made the decisions I did. And it was, some of that was obviously based on the fact that I was single and when it came to a point that I was comfortable with like dating again, like how do you bring this up? Or again, there are certain aspects of that like that you kind of take in into effect with maybe the types of surgery you want to do or again, like your reproductive or fertility things. So there definitely are considerations that you think about when you're not partnered and diagnosed in going through this.

Jean (25:38):

So I want to make sure everyone knows you're not alone and there's lots of ways to get support and living beyond breast cancer is one of them. I did want to ask just one question that's tied to that. I know you mentioned when you were first diagnosed that fertility preservation was brought up, but I wasn't sure if you actually followed through with that.

Tiffany (25:57):
So once I was diagnosed, I, you know, I went in and spoke with my surgeon around my different options and as part of that conversation it was also getting my genetic testing. It was more so like a, a leaflet of like, here you go in terms of fertility, so like scheduling all of these appointments, you know, with the plastic surgeon. So I was given a pamphlet, but I did not follow through with the fertility preservation options because that was my personal choice. But it was something that was brought up as we were exploring my treatment options. It's not something that I necessarily went into depth on, but for me I think that is definitely like an opportunity for healthcare providers to ensure, you know, that they are having that conversation.

Jean (26:42):

Yeah, I really just wanted to bring it up to say that we know at Living Beyond Breast Cancer, when you're diagnosed young and you're making decisions about how to save your life, to then be asked the question of do you want to preserve your fertility? And if you don't have a partner and how overwhelming that would be. And I totally understand that you might have just said, I don't have time to figure this out.

Tiffany (27:05):

Yeah, and to that point, right? I was diagnosed August 28th. I had my surgery September 18th and I started chemo October 10th. And so in between September 18th and October 10th, I would've had to, to sort of squeeze in getting my eggs, the fertility aspect of it, right? So, it really was a lot. And outside of just the actual like process of it, it's also the cost, right? Many insurance plans don't cover it. And, if you don't have those additional resources, that could also be a barrier.

Jean (27:38):

Well, I just want to thank you again for sharing your story and sort of giving that glimpse of being a, someone building their career and then things really shifting after a breast cancer diagnosis. And we certainly feel so happy that you have found more balance in your life and, and even feeling more Zen. And we just wish you lots of good health.

Tiffany (28:00):

Thank you. And again, thank you to Living Beyond Breast Cancer for providing the support and these safe spaces to be able to share our stories and to be able to have these conversations. It's really been a huge part of my support system, so thank you.

Jean (28:15):
Well, thank you too. Can and did Conversations is a production of Living Beyond Breast Cancer. This episode was edited by Adriana Lecuona and produced by Jonathan Pfeffer. Listen to our other episodes on Apple Podcasts and Spotify or on our website LBBC.org. Do you need support? LBBC's Helpline Volunteers are ready to listen. Visit www.LBBC.org/helpline to get connected. Many thanks to the Center for Disease Control and Prevention for their support of this series.