Fast facts (if you don’t have time to read the full post): Once again, I am happy to report that my most recent scans show I am NEAD, despite the turbulent first five months of the year. With that peace of mind and a DVT-free calf (for now… and hopefully moving forward!), I gave myself permission to finalize a surgery date for a third attempt of breast reconstructive surgery. I also had my second opinion appointment and I am left with more questions than I am with answers, but I received the clarity I sought. I quit Verzenio (bye bitch) and I am back on Lynparza. Poison is my friend. Oh and I also went to Japan. LOL. Who the fuck am I?
Countdown to reconstructive surgery: 15 days
TO THE LONG VERSION!
Growing up, my bedroom had mirrored closet doors, installed after a suspiciously persuasive campaign to replace the original brown ones. I don’t know how I convinced my parents, but once they were in, those mirrors became sacred real estate. Every friend who visited was invited to sign their name and leave a message in dry-erase marker. The pubescent graffiti would line the edges of the mirrors, leaving plenty of room for iconic Myspace selfies and outfit checks.
But the same mirrors that acted as my guestbook were also my biggest bullies. I’d stand naked in front of them, tugging at the soft edges of my hips, stretching the “muffin tops” toward my back to picture what I’d look like with a flat stomach. No matter how many laps I swam, how little I ate, or how tightly I trained my body to stay sucked in, my stomach was the enemy. I was obsessed with my belly button, too, convinced it was too big, too oval, too wrong. I’d stretch the skin around it upward, silently bargaining with the skinny gods for a flatter stomach and a cuter navel.
My body dysphoria has worn many faces over the years, evolving through adolescence and adulthood like some shape-shifting shadow. But it shattered the night I shaved my head after my second round of chemotherapy. In that moment, the cruel little voice went silent. For the first time, I saw myself clearly. My body was no longer a project, a performance, or a problem to solve. It wasn’t shaped by trends or peers or some imaginary version of who I was supposed to be. My body was dying, and I was trying to save it. Since then, I’ve never looked at it the same way.
But acceptance isn’t a straight line. Some days I feel grounded in my body, at peace with my scars and flat chest. Other days it’s like I’ve time-traveled back to the first few months post-mastectomy: raw, disoriented, and unsure of who I am in this skin. That ebb and flow is something I’ve learned to live with.
Still, I’ve been moving toward breast reconstruction. For many breast cancer patients, it’s described as a return to normalcy, a reclamation. A quiet (or not-so-quiet) fuck you to cancer. You took my breasts? I’m building new ones. It’s defiant, healing, complicated.
Vanity feels different now. I’m not as focused on how I’ll look in a top or what others will think. What occupies my mind is the healing: the cut that will run from hip to hip. The weeks of recovery and the stop in my routine. The permanence of a body altered again. I worry about what it will feel like to see my new scars and if I’ll recognize myself when I do.
And then there’s the belly button.
I’m losing it.
A body part that’s been with me since birth, proof of a life-giving connection to my mother, the soft center I once poked and pulled at in front of those mirrored closet doors. It’ll be gone. Removed and remade. Technically, I’ll get a new one. Surgically sculpted. But it won’t be mine. And so many patients have complained that their belly buttons look like little fucked up cat butts. There’s something deeply strange and a little sad about saying goodbye to a body part so ordinary, so permanent, so… primal. And one that I thought was ugly for like majority of my life. And now I could end up with a more fucked up one?!
Sometimes I think about my childhood self, tugging at her stomach in the mirror, convinced that changing her shape would change her worth. It’s surreal to now be preparing for a surgery that will literally reshape my stomach in order to build new breasts. I can see myself clearly now: scars, strength, all of it, but I’d be lying if I said I wasn’t scared. Scared of what this decision might do to my mental health. Scared of making a change for the wrong reasons. Scared of letting go of the version of myself who has been visibly, unapologetically a cancer patient.
This surgery feels like the final step in not looking like someone with stage IV breast cancer. When I’m dressed, no one will know. No more sideways glances. No quiet stares at my chest. And while that kind of anonymity might bring comfort, it also brings a quiet kind of grief. For the past three and a half years, this outward identity has exposed me and at times, made me feel deeply alone. But I’m not sure what feels heavier: being visibly marked by cancer, or blending in so completely that no one sees what I’ve been through?
Emotionally al dente. That’s how I’m feeling these days. Just tender enough to know I’ve been through it, but still holding my shape well enough to pass as a functioning human again. This spring wrecked me. I went to the ER more times this year than I ever did during active treatment, took my fragile little body to Japan, and somehow, in the middle of all that chaos, planned and pulled off the third annual Madison & Friends fundraiser, raising over $9,000 for the Tri-Cities Cancer Center.
I also managed to sneak in a second opinion at Fred Hutchinson Cancer Center in Seattle (one of the top cancer treatment centers in the country) and got a pretty unexpected hot take on my current treatment plan.
The provider I saw mostly agreed with the approach my oncologist has me on, except for one critical difference. Back in April, my oncologist took me off Verzenio, aka the drug that gave me unpredictable diarrhea and absolutely tanked my immune system. That drug was supposed to be a two-year stint, but she decided to stop it early, saying it had “failed” because of my .06 Signatera test in November. (In cancer-speak, “failure” usually means recurrence, which I thankfully haven’t had, but still, she pulled the plug.) And if you remember that conversation, she was wishy washy as fuck about that at the time. One month she said it didn’t matter, and then the next she said it did…
So, she put me back on Lynparza, the oral chemo I was on from 2023 to early 2024. It’s gentler, and honestly, I feel like a functional human being on it. No public restroom roulette, no hiding from germs like I’m in a post-apocalyptic bunker. Just…life. And as of my most recent labs, I am tolerating it super well and I don’t mind it at all.
But the Fred Hutch provider had a very different opinion. She recommended stopping Lynparza, not because it isn’t working now, but because if I ever do have a recurrence, I won’t be able to use it again. It’s more effective as a treatment after recurrence, and if I “burn it” now, I lose that option. Instead, she suggested going back on Verzenio for another year or switching to Kisquali—a related drug that has similar outcomes in long-term survival when taken for three years. Oh and she said she thinks Signatera is not a great way to monitor for recurrence. She doesn’t even use it. I was like girl, WHAT.
That was not the conversation I expected to have.
And honestly? It’s a hard sell. Choosing to go back on Verzenio or try Kisquali means willingly wrecking my quality of life, for the sake of long-term odds that may or may not even apply to me. Lynparza is treating me kindly. I can go out, be around people, and feel like myself. But knowing it’s not the preferred drug for someone being treated as stage III (which they are still treating me as such because of how few of mets I had in my spine) makes this whole decision feel…impossible. Do I choose the drug that lets me live my life now, or the one that might help me live longer?
We also talked about family planning. The second opinion provider was incredibly supportive of me keeping my ovaries and, if I choose to, having children someday—after at least five years on hormone blockers and completing a stint with Verzenio or Kisquali.
That conversation cracked something open in me. It felt human. Hopeful. Like someone finally acknowledged that I’m still a whole person with ambitions and dreams and a desire to live this second life, not just a body to be treated. But now, two months later, I still don’t know where to place that hope. I carry it around like a fragile secret: beautiful and terrifying. Because how do you plan for a future you weren’t even sure you’d get to imagine?
And truthfully, I haven’t brought any of it up with my current oncologist. Our communication has not felt very open lately, and at this point, I’ve developed some real trauma responses when it comes to interacting with her. I’ve been cornered in appointments, pressured to remove my ovaries, dismissed when I brought up concerns like my DVT and long-term management of cancer side effects. And each time that happens, something in me retreats a little further. It’s not just frustration. It’s grief. It’s the emotional fallout of being dismissed by someone who holds your life in their hands. When your doctor treats your body like a battleground but ignores the person inside it, it chips away at your ability to feel safe in your own care.
Once again, I’m left with more questions than answers and at this point, I’m living life strictly one day (and one belly button photo) at a time. I’m soaking up every CrossFit class I can, savoring my independence while I’ve got it, and paying tribute to my soon-to-be-retired navel like it’s a hometown hero.
If you’d like to support me through this next wild chapter, a very kind friend has set up a Meal Train to help me out while I recover. I won’t be able to do much for myself the first few weeks (think T-Rex arms and naps galore) and I’ll be out of work for about eight weeks total.
To the friends, family, internet strangers, and relentless little weirdos who keep showing up for me: thank you. I’m only still here because you refuse to let me peace out.
Here’s to healing, hot girl summer (from the couch), and finally becoming the boobalicious girl of my dreamz.
Today’s song lyrics of the day are brought to you by Incubus.
“Sometimes, I feel the fear of
Uncertainty stinging clear
And I, I can’t help but ask myself
How much I’ll let the fear take the wheel and steer
It’s driven me before, and it seems to have a vague
Haunting mass appeal
But lately, I’m beginning to find that I
Should be the one behind the wheel”
madisonhatescancer 