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Race for the Cure holds new meaning for breast cancer survivor

Carrie Persing with her son, Ryan

When Carrie Persing crossed the finish line at the Susan G. Komen Race for the Cure in 2015, the event held a completely new meaning for her.

Despite having participated in the breast cancer awareness fundraiser for the previous five years, that was the first time she had taken part since she underwent surgery for breast cancer.

In May 2014, Persing was informed that she had breast cancer just four days after completing the Race for the Cure in support of her friend. She received a biopsy on Friday, finished the race on Saturday and was diagnosed on Wednesday.

Persing felt total shock when she first received her diagnosis, accompanied by a general sense of fear, both for her family and for her own unknowing of what lay ahead.

Following suspicious results from a biopsy several years prior, Persing had been getting biopsies on a six-month basis to keep a close eye on her health. This was supposed to be her last one before being downgraded to an annual biopsy barring any setbacks. 

After she was told that she had stage 1 breast cancer, Persing decided to receive a second opinion at VCU Massey Cancer Center because a friend of hers, who works at VCU, recommended that she visit physician-researcher Harry Bear, M.D., Ph.D., Director of Massey’s Breast Health Program.

Bear confirmed the original diagnosis, determining the tumor was small in size and had not spread to any of her lymph nodes.

“Dr. Bear was very informative and told me all of my options. He explained the cancer to me in ways that I could understand it. He also advised me as to what treatment he would suggest, but ultimately he let me make the decision,” Persing said, adding that Bear is an “awesome” doctor and she wishes he would never retire.

Because the cancer was still in the first stage, Bear’s initial recommendation was that Persing move forward with a lumpectomy followed by radiation therapy.

However, a past familial experience with breast cancer persuaded Persing to opt for an alternative procedure. Persing’s aunt had previously been diagnosed with breast cancer, and after undergoing a lumpectomy, she was diagnosed with another form of cancer in her other breast 19 years later.

“I always knew once I started getting mammograms that if I was diagnosed, I was going to go forward with a double mastectomy,” Persing said.

A double mastectomy is the total removal of both breasts compared to a lumpectomy, which is a partial removal of the cancerous breast.

This procedure of removing the opposite breast without any clear signs of cancer is called a contralateral prophylactic mastectomy (CPM). The surgery is proven to reduce the risk of breast cancer in that breast, however it remains unclear whether this risk reduction translates into longer survival for the patient.

Despite the lack of evidence supporting increased survival rates, the use of CPMs more than tripled between 2002 and 2012, according to a study published in the Annals of Surgery.

For her reconstructive surgery, Persing chose the Deep Inferior Epigastric Artery Perforator (DIEP) Flap technique, performed by Massey surgeon Santosh Kale, M.D.

The DIEP Flap is an advanced surgical procedure where skin and tissue are removed from the lower abdomen, sparing the six-pack muscle, the rectus abdominus, and used to reconstruct the breasts. The blood vessels supplying blood to that tissue must be temporarily disconnected and then reconnected once the tissue has been moved to the chest.

“Relatively speaking, it’s a fairly rare procedure. Tissue-based reconstruction, across the United States, is less common than implant-based reconstruction mostly because of the technical complexity of the operation. Therefore, there is a smaller percentage of plastic surgeons that can perform the DIEP Flap,” Kale said, where he is the only surgeon capable of performing it at VCU Health, and one of less than five in the Richmond area.

Despite the complex process of the DIEP Flap reconstruction, Persing opted for it over implants because the procedure harbors more natural results, and she also didn’t want to deal with getting implants replaced multiple times.

In total, Persing’s surgery, including the CPM and DIEP Flap reconstruction, lasted for 15 hours because of the advanced nature of both procedures.

For the month leading up to her surgery in June 2014, Persing was gripped by the fear of whether she made the right decision, if the surgery would be successful and if the cancer had metastasized.

Relief washed over Persing during her first follow-up appointment with Bear, in which he informed her that the cancer had not spread to any lymph nodes, and she would not need chemotherapy or radiation therapy.

In 2016, and in good health, Persing looks back on her decision without a moment’s doubt or regret.

“There’s a peace to it for me because I don’t worry as much. I still worry every time I have an oncology appointment hoping that the cancer didn’t come back, but it’s not the daily anxiety that I think I would have had if I had chosen the lumpectomy,” Persing said. 

For other women who may be faced with the same situation, Persing said that, at the end of the day, the choice is in the patient’s hands.

“Talk to physicians and other people, of course, but it’s a very personal, individual decision, and just know that whichever decision you make is right for you,” Persing said.

Persing called her overall experience with Massey “amazing,” citing the center’s high levels of comfort and trust.

“I knew Massey was the place I needed to be…Cancer is a tough thing to have to go through, and everybody that I came into contact with has just been very kind and understanding. They take the time to sit with you and talk with you about things,” Persing said. “I had one nurse who sat with me and held my hand. She had gone through a similar situation, and talked me through some of the things to expect. You don’t usually get that elsewhere.”

Now, with two post-operation and cancer-free years in the rearview, taking part in the annual Richmond Race for the Cure with her son, Ryan, has evolved from the original tradition it once was of supporting her aunt and others affected by breast cancer into something entirely different.

“For the first time when I went to pick up my race packet in 2015, instead of a regular shirt it was a survivor t-shirt. It kind of hit me all at once that I am now a survivor instead of walking for other people,” Persing said, tearing up briefly as she spoke.

In light of her experience, Persing shies away from claiming the same survivorship status as other later-stage breast cancer survivors around her on that day.

“Sometimes I don’t look at myself as a survivor because I had my surgery and my cancer went away, where I look at somebody who had to go through so much more as the real survivor,” Persing said.

Regardless of what Persing thinks, the pink t-shirt she wore during the 2016 Race for the Cure signifies her as one among the nearly 3 million breast cancer survivors alive in the United States, according to the American Cancer Society.

Persing is a teacher at the MathScience Innovation Center in Richmond, which provides STEM-based educational programs and services to thousands of students in the Central Virginia region.

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For more information related to breast cancer and treatment options, visit the Massey website.

Written by: Blake Belden

Posted on: November 16, 2016