Patient reveals how she adds joy to life despite metastatic breast cancer

Jennifer Hill Attisano felt as healthy as a horse. Life couldn’t have been better.

Her career was going well, and she had lost close to 50 pounds because her sugar level had gotten a bit too high. “I was feeling great. I let my hair grow long because I thought this will be one last time before I get too old to have long hair. I was feeling really good.”

Then she went in for a routine exam with her gynecologist in October 2017, and her doctor paused while doing her breast exam. “I had this one pea-sized tumor in the breast that was way up under the tissue. I would have never found it on a self-exam, but she was able to because of the way my arm was pulled back. All of a sudden, she said ‘Wait a minute,’ and she rolled it around like a little ball.”

Attisano tried not to worry. She had big plans to go to Las Vegas with her husband, Mike. Having been married for just a few years, they still were like newlyweds, their love story reading like something out of a Hallmark movie. She had a biopsy, and they decided to keep their travel plans, so they boarded a plane for Las Vegas. Shopping in a Louis Vuitton store, she was eyeing an expensive purse that her husband was insisting he would buy.

 

“I told him if he was going to buy me a Louis Vuitton, he must think I was going to die. This was before I even knew that I had cancer.” 

Shortly after she said that, her phone rang. It was her doctor’s office. Attisano, a manager of a historic hotel in downtown Charleston with more than 170 employees in her care, didn’t want to wait. “I said, go ahead and give it to me straight. And they said, ‘It’s cancer.’”

The couple considered canceling their dinner plans at the Eiffel Tower restaurant on the top of the Paris Las Vegas hotel that evening, but true to how they’ve handled the rest of this journey, they opted instead to keep their plans. He donned black tie, she a gown.

“We had a fabulous time. It was one of the best meals I’ve ever had.”

Life with cancer

Since that day, Attisano, 55, has learned a lot. She found out she has dense breasts, which means she has a type of breast tissue that makes scans hard to read and can put women who have this type of tissue at a higher risk — not only of breast cancer but of cancers being missed on mammograms. She thinks her cancer was growing several years before it was discovered.

She wanted to go to MUSC Hollings Cancer Center, since she knew that it was the state’s only National Cancer Institute-designated cancer center. She began working with Hollings oncologist Antonio Giordano, M.D., Ph.D., and found that her cancer was more extensive than she thought. Instead of it being just the tumor in her breast and the involvement of one lymph node, doctors found she had about 20 tumors in her liver.

That radically changed her treatment plans. Giordano was frank with her, telling her it was one of the most advanced cases he had seen. They tried a round of chemotherapy that didn’t work for her, and Attisano mourned the loss of her hair and eyebrows. When Giordano saw the treatment wasn’t working, he consulted a colleague at Dana-Farber Cancer Institute to explore what clinical trials might be best for her. Hollings is one of 71 NCI-designated centers in the nation and part of a network of institutions at the forefront of developing clinical trials to advance cancer care.

While she didn’t find a new trial, she did have an FSH, or follicle stimulating hormone, test that found her cancer was 100% hormone driven. Doctors found that she had an HER2-negative, ER-positive type of breast cancer and put her on Kisqali, which had just been approved.

 

There was a special moment when she got some scans back in late May after being put on the new therapy. Giordano, who praises Attisano's  lively and optimistic spirit, said she was one of the first patients at MUSC Health to receive this type of treatment. He came into her room and was trying to be serious and somber, Attisano recalled. “I'm like, 'How are the scans?' And all of a sudden, he couldn't help himself. He's beaming. He said, ‘You are not going to believe the scans. They are awesome. I have never seen such constant tumor reduction in my entire breast oncology career.’”

Attisano learned she had no metastatic disease in the upper torso, and her tumors had dropped down to just two. It was a day of celebration. Although she knows she’ll always be battling this disease, she said she’s surprised herself by how she’s handled her diagnosis.

She used to think that if she ever got cancer, she would wither away, get into bed and just be depressed. “I thought I would just get in my hole and say, 'I can't believe this,' but it was the opposite. Let me tell you what — I came out fighting, and I have fought every step of the way. And I think the number one thing that affects your recovery is your attitude.”

Hallmark dream

Though Attisano knows her cancer isn’t curable, she plans to do everything she can to hang on to the best quality of life that she can. She has good reason, she said, as she shows off amazing photos of her wedding in Las Vegas.

Having been single since her divorce about 20 years ago, Attisano was focused on her career. Then she attended an art walk in Charleston and went to a restaurant, where she spotted Mike. Mike remembers he had just ordered an appetizer. “She popped her little blonde head over and said, ‘That looks good. What's that?’ So I said, ‘Well, this is my favorite appetizer here. Would you like to try some?’ I'm no dummy, right?” he said, adding that he ended up joining her group of friends.

“And that was pretty much it. I was very smitten with her right away, and we struck up a conversation, and before I knew it — that was it. I was hooked.”

 

They dated a couple of years, and then Mike invited her out to an art gallery to show her a special painting. There was champagne, and their special song “Feels Like Home” by Bonnie Raitt was playing. He unveiled a painting that read “Will you marry me?” Flying to Las Vegas to get married in September 2015, they decided on a vintage ‘50s theme, finding special clothing and renting a red convertible for their drive-through ceremony.

They grin like two teenagers describing the moments.

Attisano said she felt like her diagnosis, that came shortly after their two-year anniversary, was unfair to Mike. She lost her mother to lung cancer and remembered how hard it was traveling back and forth to Selma, North Carolina, to visit her mom. “I was like, 'I have looked for this wonderful man my whole life who loves me more than anything, and oh my gosh, I'm not going to be here to love him and for him to love me,'” she said.

“I thought, 'I'm like my mom, and now you're stuck. You’re stuck with this broken person, you know?' And he's like, ‘You're not broken. You're wonderful.’”

The couple decided to focus on what they had together instead of the diagnosis. Attisano, who went on a hormone blocker and Kisqali in February of 2018, said the toughest new challenge has been COVID-19, as the treatment she’s on makes her more susceptible to the virus. Her oncologist recommended that she stay home, which was a hard change for her. Her husband also works remotely to be able to protect her.

“I'm very much a people person, and this has been the hardest thing I've ever done in my life,” she said of the impact of COVID-19. Except for walks, she hasn’t been out of the house. They have their food delivered. “It's been tough, but I think you dig down and decide that you can't let it win.”

Attisano researches new treatments in case her current therapy stops working or makes her immune system too weak. Her oncologists Giordano and Frank Brescia, M.D., have been critical in her care, and she wants to educate other women about the importance of screening and how important it is to know about dense breasts as that can affect how screenings are done.

“I'm surviving cancer because of my unwavering attitude, my family, friends and prayer and the amazing research that’s been done in oncology and modern medicine. There's going to be something else with the great research that's going on. I think most oncologists would tell you your attitude is a lot of the battle. If you give up, it wins in the end,” she said.

“And, I'm not going to give up because there's so much I want to live for. I think it's just an inner strength of wanting to live and wanting to have those experiences in the future.”

Surviving cancer and a COVID-19 lockdown

Attisano shares some of her tips to help fellow cancer patients cope with being stuck at home during the pandemic.

1. Have a routine, even if you’re at home, preferably something that has a purpose and where you can see you’re accomplishing something — a project or activity.
2. Allow yourself down days when you’re not feeling well.
3. Have dress-up days, even if you’re not going out, where you put on some make-up and a favorite outfit that you feel beautiful in.
4. Spend quality time doing fun things — playing games, watching comedies — with people (and pets) you love.
5. Make time for the things that bring you joy and passion. For her, it’s art and time with her husband. They watch comedies together.
6. Communicate about real issues. She and her husband played a 100-question game that was fun and helped them grow closer together.
7. They’ve been together 24/7 for more than six months. If you’re sheltering in place with someone, give each other space.

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