CINCINNATI - “Life is Short; Climb Mountains!”
Cincinnati doctor Lisa Larkin carried that slogan on a banner as she and her children embarked on the trip of a lifetime — climbing to Africa’s highest peak, the snowy summit of Mount Kilimanjaro.
“Climbing the mountain was a nine-day, incredible experience,” Larkin said, “something my children and I always wanted to do.”
She had no idea back then, in January 2014, how much meaning her sign, and her trip to Africa, would have.
While Larkin was on that mountain in northern Tanzania, 8000 miles away from home, she discovered a lump in her breast that led to a yearlong battle with cancer and changed her life forever.
“It was probably about halfway into the climb. One night, when I was taking off my sports bra, I was kind of trying to get into my sleeping bag for bed, I felt a breast lump,” said Larkin.
She made a mental note, but kept it to herself.
“I remember very distinctly feeling it and saying, ‘hmm, well, okay,’ and then kind of putting it aside and just kept going.”…because I was really excited about the trip.”
Larkin focused on her African adventure. With specially-trained guides, Larkin and her 21-year-old daughter, Sydney, and 19-year-old son, John, conquered Mount Kilimanjaro. Next, they took a short safari, and then traveled to an extremely rural community in Kenya to volunteer in a clinic.
“We saw everything in the clinic, delivered babies, with no running water, saw lots of malaria, saw typhoid. [The clinic was] really operating with not even a physician there,” said Larkin.
Since Larkin specializes in women’s health at UC Health, learning about women’s healthcare in a third world country was important to her and her children.
“It was a life-altering experience,” said Larkin.
It wasn’t until she was back in the United States, on a business trip, that Larkin realized her own health was at issue and her breast lump needed urgent attention.
“After I finished giving a lecture at this course in San Diego, when I was taking a shower, I felt the lump again, in the shower,” said Larkin.
As a doctor, Larkin thinks she has a reasonable sense of what feels benign and what feels like cancer.
“Although I was not particularly worried about it on the mountain, I was as convinced as I can be that it was something significant when I felt it six weeks later,” said Larkin. “It was clearly larger, and it felt much more solid and not normal to me.”
CANCER: A NEW JOURNEY BEGINS
Larkin was right. Six weeks after she first noticed the breast lump while climbing Mount Kilimanjaro, a diagnostic mammogram, ultrasound, and biopsy conducted in Cincinnati confirmed she had breast cancer.
With that diagnosis, on Feb. 28, 2014, Dr. Larkin became a patient and another life-altering journey began.
Over the course of the next year, Larkin battled through biopsies, epidural steroids to manage excruciating back pain (another sudden, but separate medical issue), mastectomy, back surgery, four months of chemotherapy, hair loss, changes to her skin and nails, breast reconstruction surgery, and radiation.
“It’s overwhelming for the patient; it’s overwhelming for family members,” Larkin said.
Just as she encourages patients, she tried to “psyche herself up” for each treatment milestone and take one step at a time.
“You really put on your battle armor, and you really have to just kind of suck it up and say, 'I’m going to fight this' and 'I’m going to get through this,' and you keep going,” said Larkin. “It’s challenging, there’s no question.”
Now, more than nine months after her last radiation treatment, she’s finally starting to feel like her former self.
“It’s a gradual process,” said Larkin. “It’s only been in the last two or three months that I really had my physical energy all the way back and that I feel 100% normal again.”
The most disabling side effect for her now is chemotherapy-induced menopause.
“I’m having very severe and very frequent hot flashes now — probably 20 a day and several at night. I’ve gotten better about what I need to do to manage those with lifestyle, but they’re pretty severe.”
Mammograms clearly missed Larkin's cancer.
At the time of her diagnosis, she had five separate tumors in her right breast, and the primary tumor was “reasonably large,” sitting in a posterior (back) position on her chest wall. She was nearly 50 and had annual mammograms for 10 years, yet they revealed no trouble.
Why not? Like millions of women, Larkin had dense breasts, which sometimes make mammograms less accurate. Dense breasts contain lots of glandular and fibrous tissue, which looks “white” on mammogram pictures, often hiding the tumor.
“It’s like a polar bear in a snowstorm,” said Larkin. “You can’t see a white tumor very well in a white background when the breast tissue is so dense.”
What’s more, dense breasts increase your risk for breast cancer. According to the American Cancer Society, women with dense breasts have a “moderate” risk of breast cancer that is 1.2 to 2 times greater than women with average breast density.
Larkin says her experience highlights the need for women to know their body, through breast self-exams and regular checks with their physician.
“I encourage women to examine their breasts and be aware of their breasts, to know what their breast tissue feels like at baseline,” said Larkin. “I don’t necessarily mandate … that they have to do it every month, but again, it’s part of total body awareness.”
If annual mammograms reveal dense breasts, Larkin urges women to talk with their doctors about what this means and about which screening tests may be right for them.
Larkin calls her battle with breast cancer an “amazing journey” and says that while it may be hard to imagine, there have been positives.
“The outpouring of support that I had from friends, family, patients and the medical community was honestly overwhelming,” she said. “I think I felt more supported and more loved and more appreciated than at any other point in my entire life, and that was an amazing gift actually.”
Surviving breast cancer also highlighted how important being a physician is to her.
“I missed what it feels like to really try to help others. So I was really anxious during treatment to get better and get back to being a doctor. And having my life.”
This January will mark the two-year anniversary of her trip to Africa. Her slogan that she carried up Kilimanjaro, “Life is Short: Climb Mountains,” means more to her now than ever.
“I was really happy that I had had that trip with my children prior to my diagnosis,” said Larkin. “And for both the climb and for working in the clinic with my children, it was a profoundly important experience.”
AMERICAN CANCER SOCIETY RECOMMENDATIONS
- Women, age 40 and older, should have an annual mammogram and continue to do so as long as they are in good health.
- Know how your breasts normally look and feel, and report changes right away to your doctor.
- If your mammogram says that you have dense breasts, talk with your provider about what this means for you.
- For women with dense breasts who also have other risk factors, such as a strong family history of cancer, or certain gene mutations, doctors may recommend newer imaging tests, such as 3-D mammography, MRIs, and ultrasound.
BREAST HEALTH RESOURCES