Dear Kayla and Christopher: A Mom With Breast Cancer Documents Her Battle for Her 2 Young Children

It was 2 days after her very first mammogram when Lisa Vance got a call from her physician’s office requesting that she come in to discuss the results. Even so, it never occurred to her to be worried. Instead, the 40-year-old mother of 2 was reassured by her physician’s assertion that he’d be “very surprised if it turned out to be anything at all.”

Lisa had undergone an initial lumpectomy and then another to obtain clear margins. Still relatively confident, she went alone to discuss the pathology results with her surgeon rather than having her husband, Chris, take a day off from the steel mill. But she soon questioned that decision. “I heard the word cancer, and that was it,” she recalled. “The rest was basically, ‘Blah, blah, blah.’”

What Lisa heard only vaguely in the din of her panic were the words “ductal carcinoma in situ” and “mastectomy.” Her relative calm now a distant memory, she recalled feeling like “a nervous wreck” and immediately started thinking the worst.

A Journal for Her Kids

Lisa’s thoughts turned to her husband and 2 young children, 3-year-old Christopher and 1-year-old Kayla. She knew that Christopher was old enough to at least understand that his mommy was sick and needed to go to the hospital to get better. But Kayla was just a baby and Lisa wondered how she could help her grasp what was about to happen.

Powered by what she now believes was a healthy dose of denial, Lisa picked up a journal and began to write to her children.

Dear Kayla and Christopher, I just found out that I have to have a mastectomy. I’m really scared and don’t want to do this but I want to be here for you to see you grow up. I’m going to fight this. I’m strong and I can do this! I have support from my wonderful husband and my great family and friends. This is just another bump in the road.

While Lisa certainly is not the first mother to document a fight with cancer for her children, her reasons for doing so were somewhat unique. “I don’t think I started writing in anticipation of not being there for my kids,” she said. “Instead, I wanted them, especially Kayla, to understand at a later time what they couldn’t possibly understand at such a young age.”

Lightning Really Can Strike Twice

Still trying to catch her breath, Lisa, this time with her husband, Chris, arrived at the surgeon’s office to discuss her upcoming mastectomy and undergo preoperative testing. She said, “I was just starting to wrap my brain around what was about to happen in 2 weeks, but there’s no way I could have prepared myself for the next 2 minutes.”

Just as the nurse began to take Lisa’s vital signs, Chris, in what Lisa describes as an almost apologetic voice, began to complain of chest pains. Within hours, Chris was undergoing triple stent placement as Lisa sat in disbelief in the hospital’s surgical lounge. (A fourth stent was inserted just 4 weeks after Lisa’s mastectomy.)

Dear Kayla and Christopher, Daddy was admitted to the hospital. The doctor said he had a heart attack and needs four stents in his heart! Kids, I’m so sorry you have to see Mommy and Daddy sick like this!

"In a strange way, Chris’ heart attack gave me something to focus on other than my own issues,” said Lisa, who immediately switched gears to resume her usual role as caregiver and nurturer. “I had 2 weeks to prepare for my mastectomy, but I also had a sick husband and a son who was absolutely devastated that his daddy couldn’t come home.”

Dear Christopher, You’re taking this very hard. Your daddy is your best buddy and you don’t like to see him sick! It breaks my heart to see you cry but we’re going to make sure mommy and daddy get the best care and get better!

Will Mommy and Daddy Be OK?

To Kayla, the days that followed were much like any other, with the exception that many more family members were nearby to make a fuss over her. With 4 siblings each, Lisa and her husband had no shortage of family support. But Christopher was having a hard time dealing with the reality of his father’s hospitalization and his mother’s upcoming surgery. “He was a question machine,” said Lisa, who recalled a constant barrage of queries, such as, “Will mommy be OK?” and “Why is daddy sick?”

Lisa and her husband tried their best to answer each question honestly, and they took their cues from their son’s questions rather than sitting him down for a formal talk. Even so, Christopher seemed better able to comprehend his father’s situation than his mother’s. “Christopher could see that his daddy was sick,” said Lisa. “But Mommy just looked like Mommy to him, and it was hard for him to grasp some abstract concept about something that had yet to happen.”

With Chris now home from the hospital, the couple found it somewhat easier to reassure their son. In the end, Christopher seemed comforted to know that “Daddy’s heart was sick but is better now” and “Mommy has a boo-boo but the doctors are going to make her better.”

Hair Loss and Hot Flashes

On March 25, 2009, Lisa underwent a total mastectomy of the right breast with immediate reconstruction at Parma Community Hospital in Cleveland, Ohio. Her cancer was designated as stage I, but lymph node metastasis necessitated 4 rounds of chemotherapy. The estrogen-sensitive malignancy also required treatment with tamoxifen and goserelin, and Lisa now deals with the onset of medically induced menopause.

With “no time to fall apart,” she saved her “breakdowns” for her sisters and mother. “I know it sounds like a cliché, but I wanted to be strong for the kids,” she said. “At some point, the journal will show them that their mom really did cry and that crying is OK.”

Dear Kayla and Christopher, It’s very hard on all of us. It’s breaking my heart that you kids have to go through this. We just have to remember that this medicine will make mommy get better.

But like so many women who share the diagnosis of breast cancer, Lisa glossed over the description of her recovery from surgery, and even the chemotherapy, and cited her hair loss as “the worst thing of all.” I knew I was going to lose my hair but it didn’t hit home until it started to fall out in clumps,” said Lisa, who had always taken pride in her short, spiky cut. It was then that she, with her family in tow, embarked on her extreme hair makeover—with Christopher taking the first turn with the clippers. “I wanted to involve him and let Kayla watch what was happening,” said Lisa. “It was a bad day, but it gave us all a little sense of control.”

Dear Christopher, Today, you were mommy’s hero and protector. We were at a basketball game and a little boy asked you why your mommy has no hair. You told him that your mommy had a bad booby. That was so cute and such a good way for one child to tell another that his mommy has cancer.

At first, Lisa wore scarves and baseball caps. But when she finally invested in a wig, it was her son who made the ultimate decision. Dear Christopher, Today I went to get my wig cut. Kayla just looked at mommy and giggled. But you looked at me and started to cry!

Christopher’s sobbing continued as he ran into his room and slammed the door. Between sobs he pleaded with his mom to go back to wearing baseball caps.

Dear Christopher, I hope my hair grows back fast, buddy! But for now, I’m taking my wig off because I think it’s scaring you. You told me you just wanted me to wear a baseball cap all the time. I’m going to do what you and your sister wish!

Hopes for a Bright Future

On July 9, 2010, Lisa went for her last round of chemotherapy. She will follow up with semiannual and then annual blood work, and she continues her regimen of goserelin injections and tamoxifen. Her second, and most recent, mammogram revealed no sign of disease, and Lisa’s oncologist has declared her cancer-free.

Dear Kayla and Christopher, Well, kids, this is my last treatment. Yes! I can’t wait until this is over. I’ve been feeling very emotional and crabby. You kids and Daddy have been great! I’m sorry Mommy has to be this way. I’m going to be strong for all of you!

“In one way, I still don’t believe I ever had cancer,” she said. “But on the other hand, there’s a part of me that’s convinced the cancer still isn’t really gone.” Despite her oncologist’s pronouncement that a recurrence is unlikely, Lisa said she has yet to experience a day when she is not fearful of the cancer returning.

Even so, she does not want her cancer, or even her survivor’s status, to become her identity. She said, “It’s part of my makeup but it’s not who I am.” And this, says Lisa, is what she has tried to impart in her journal. “I want my kids to understand that something bad happened to us all, but that we were able to make it through and come out even stronger.”

Sure enough, Lisa and her husband, who had been married only 7 years when their world came crashing down, feel closer than ever. “We know this kind of thing can make you or break you as a couple,” she said.

As she did for 8 years before her diagnosis, Lisa continues to walk in annual Susan G. Komen “For the Cure” events with her sisters and friends by her side. Chris, who walked in the first event after his wife’s diagnosis, decided his first walk would be his last. “It was just too emotional for him,” said Lisa, who plans to one day take her children, if they express a desire to join her.

When asked if he remembered his mom and dad being sick, Christopher, now age 6, remarked, “When you get to the end of the story, it’s good.” As for Kayla, her mom plans to show her the journal when she turns 16. “I want her to know how much we love each other and how hard we fought to stay together,” said Lisa. “I guess, in its truest form, the journal is simply a love letter to my family.”

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Laura Bruck is a Cleveland, Ohio-based freelance writer and editor who has specialized in healthcare reporting since 1987.