RACHEL MARTIN, HOST:
It has been nearly five years since Kate Pickert found out she had breast cancer. She had just moved to Los Angeles with her husband and toddler to start a new chapter in their lives when, all of a sudden, she found herself searching terms like young women, breast cancer, death rate. Before she lived through cancer, she reported on it, as a correspondent for Time magazine, so it was a subject she was very familiar with as she went about weighing possible treatments and outcomes. Kate Pickert writes about her own ordeal in her new book, "Radical: The Science, Culture, And History Of Breast Cancer In America." Here's her conversation with Noel.
NOEL KING, BYLINE: Tell me how you found out that you had breast cancer.
KATE PICKERT: The thought of being diagnosed with breast cancer had honestly never occurred to me. I was only 35 at my diagnosis, and I realized that something was wrong because I had some nipple discharge. And I had recently stopped breastfeeding my daughter so I didn't really think that much of it. And I even waited a few months to go to a doctor and get checked out. And of course, as soon as I went to the doctor, I got into the diagnostic cascade, which took about a month to sort of really nail down the diagnosis. But that was the first sign.
KING: Is that normal - I mean, based on the research you've done - for a doctor to be able to tell you, here's what you've got and here's what you're going to need to do? It sounds agonizing.
PICKERT: It was agonizing. I think that that's probably a little bit longer than is typical. But remember, I was only 35. So I didn't fall within the typical group of women diagnosed with breast cancer who were in their 50s, 60s and 70s. So it was a little bit of a mystery at first. I initially had an ultrasound that didn't show much. And then I had a mammogram, which showed that I had a kind of pre-cancer but didn't show any invasive disease.
So at that point, I knew that I was going to have surgery but I didn't think that my life was at risk. And it was only two or three weeks after I initially went to the doctor and had an MRI that my doctors discovered that I had two invasive tumors and that the breast cancer had spread to my lymph nodes. And after that, I had a series of scans to figure out if the disease was metastatic, if it existed in other parts of my body. And lucky for me, it did not.
KING: But you were in a very perilous position at that point, once you had the final diagnosis. What was going through your head? What were the things that you were worried about? What did you decide not to worry about?
PICKERT: I mean, I was extremely worried about my family, as I think many breast cancer patients are. I had a 3-year-old daughter. I was in the midst of a great career, and everything in my life seemed to have a lot of really forward momentum, which really paused for the year that I was in treatment. But because I was a health care journalist, I started reading and researching like crazy from the very beginning. So in short order, I really began to understand the science behind the treatment that I would get, and I really had a lot of faith in that science. And so I felt pretty optimistic beginning my treatment.
KING: Can you walk us through the choices that you had and the choices that you made - what you said yes to, what you said no to?
PICKERT: Yeah. I mean, like a lot of women diagnosed with breast cancer, particularly at a young age, I was very scared, of course. And I gave into the temptation to kind of throw the kitchen sink at my disease. So there were a few choices to make early on. One of the most interesting was whether I wanted to enroll in a clinical trial. I think people have this idea that women diagnosed with early stage cancer and breast cancer aren't the kind of folks needed for clinical trials because they're not dying. They're not sort of at the end of their rope. But in fact, we really need early stage breast cancer patients to enroll in clinical trials.
And one that was offered to me was testing a new drug against a standard treatment therapy that has a lot of data behind it and works really well. So it was, did I want to enroll in this trial and take the risk of being randomized to a new drug, or did I want to go with the regimen that is sort of tried and true? And in the end I...
KING: Not a small decision, by the way. I mean, you know, I got chills as you were - in the book as you were talking about how you were going to decide what to do. I was like, God, I hope she makes the right choice. But that was your real life.
PICKERT: Yeah. It was really difficult. I had a couple of weeks to decide, and I emailed my oncologist almost every day, (laughter), asking more questions, asking for more data, trying to dig up previous existing science related to the drugs that were being tested. And in the end, I decided to enroll in the trial. It's certainly the case that the good, tried and true regimen would not exist if women had not enrolled in clinical trials, very risky clinical trials back in the 1990s. And I knew that, and it was in the back of my mind, and I really felt the debt to those women and wanted to be a part of science.
KING: You ended up having a double mastectomy. Not an easy - well, let me ask you. Was it an easy decision to make?
PICKERT: Yeah. I definitely had a choice of what kind of surgery to get. I for sure needed a mastectomy because my disease and the DCIS that I mentioned earlier was so widespread, a lumpectomy was not really on the table. But in terms of the decision about whether to remove my other breast, the one that didn't have cancer, it was really tough. As a health care journalist, I had written about this particular decision over the years. And I knew that on paper, my chances of survival were the same whether I had a single or a double mastectomy.
And I think this is a really personal decision, and I would never criticize a patient's choice. But for me, I just felt like even if I was diagnosed with breast cancer in the other breast, it would be caught early and it would be treated well, and that's why the survival is the same. But I really couldn't stomach the idea of sort of going through cancer treatment again. And also the idea of being screened on a regular basis in the years to come just really ramped up my anxiety, just the mere thought of it.
KING: Did the cancer change you permanently? Did it change who you are as a person?
PICKERT: I think it's definitely the case that I really appreciate all the small moments. And when it comes to my daughter, I really don't miss things. I really don't miss anything. If it means rescheduling an appointment or taking the morning off from work, I do those things to be there with her. And I think, you know, just knowing that things don't last forever and how important sort of all of these little things are and building memories with her - I think it's definitely true that I've become a little bit more of an emotional mother, I think, in the wake of my breast cancer experience, and really want to be present for as much as possible because I understand that life is finite.
KING: Kate Pickert's book is called "Radical: The Science, Culture, And History Of Breast Cancer In America." Kate, thanks so much for taking the time.
PICKERT: Thanks so much, Noel. Transcript provided by NPR, Copyright NPR.