Erin Maher waited 496 days to hear the news her oncologist delivered on Dec. 11.
Since that summer day in 2016 when Maher — 32 years old and 14 weeks pregnant — was diagnosed with breast cancer, she’s wanted to hear that her aggressive cancer had been beaten back, forced to retreat from her body.
And after chemotherapy, a lumpectomy, induced labor, more chemotherapy, radiation and one more round of chemotherapy, Maher learned that it had worked.
No evidence of disease.
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(Alisha Jucevic/The Columbian)
“This is the end,” Maher said. “I need to be confident that it’s not coming back. I need to move forward.”
But, in the back of her mind, Maher knows she’s not in the clear. Not yet.
Not for a few more years, at least.
“I think about it every single day,” she said.
Aggressive treatment
Maher was diagnosed with Stage 3C triple-negative invasive ductal carcinoma in August 2016. Her first round of chemotherapy was cut short because her cancer wasn’t responding well to the drug. Maher underwent surgery and then, after her daughter, Illianna, was born Dec. 30, 2016, the full-court press on her cancer began.
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(Alisha Jucevic/The Columbian)
Six days after her daughter was born, Maher began six rounds of chemotherapy with a stronger drug, CarboTaxol. That regimen was followed by 33 daily doses of radiation. Then, in June, Maher began her “last line of defense” — an oral chemotherapy drug, Xeloda.
She took the final dose of Xeloda on Dec. 31 — the last day of 2017 and one day after her daughter turned 1 year old.
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(Alisha Jucevic/The Columbian)
Her body showed no signs of cancer. Her chemotherapy was done. Her regular doctor visits were over.
“It’s crazy,” Maher said. “It just seemed like at the end of 2017, it just stopped.”
So Maher has spent the first several weeks of 2018 being just, normal.
She takes her son, Liam, to preschool. She chases after her now-walking daughter. She makes dinner when her husband, Brandon, gets home from work. She started a new job. She’s exercising.
“I’m finally able to live my life again,” Maher said.
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(Alisha Jucevic/The Columbian)
But while cancer treatment has ended, the possibility of recurrence hasn’t.
Doctors told Maher she has about a 40 percent chance of her cancer returning and taking her life. For the next 15 months or so, Maher remains in the “danger zone” — the time during which the odds of her cancer metastasizing, or spreading to other parts of her body, is highest.
Mother’s Day 2019 will mark the end of that period.
“My goal is to live without mets (metastasized cancer) until next Mother’s Day,” Maher said. “That’s when chances drop dramatically.”
“That’ll be the big relief,” she added.
That uncertainty may explain why Maher didn’t react with the same overwhelming excitement that her husband did when they learned in December that she showed no evidence of disease. After more than a year of fighting for her life, Maher barely reacted when she heard the good news, Brandon Maher said.
Tough therapy
Erin Maher’s type of cancer is difficult to treat and carries a high likelihood of not responding to traditional therapies. In triple-negative cancer, the three most common types of receptors known to fuel most breast cancer growth — estrogen, progesterone and HER-2 (human epidermal growth factor 2) — are not present in the tumor. The receptors are typically targeted in cancer therapies. Without those receptors, the therapies are not as effective.
“The battle’s not over,” Brandon Maher said. “It’s never over in her mind.”
So until Maher reaches the end of the danger zone, every ache and pain inflects fear. Symptoms of metastasis vary, depending on the location. If it spreads to bones, bone pain is likely. If it reaches the liver, shooting abdomen pain is possible. Headaches could mean cancer in the brain. “It could be anything,” Maher said. “Literally, every ache and pain you’re like, ‘Oh, my God.’ ”
While she tries to not let the possibility of recurrence hinder her ability to move forward, uncertainty still creeps in.
“Liam’s been talking about death lately, and I can’t say, ‘Mommy will be here,’ because I don’t know if I will,” Maher said.
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(Alisha Jucevic/The Columbian)
Sometimes, she wonders how many more times she’ll be able to kiss her children good night or whether she’ll live to see them become teenagers.
But Maher fights those thoughts away. She refuses to worry about something she can’t control.
“If I’m only here for a finite amount of time, I want to enjoy it with them,” Maher said.
Savoring life
And Maher has plenty to look forward to in her future.
Liam will turn 4 years old later this month. Maher enjoys seeing Liam thrive in preschool and gymnastics classes after a tough year and a half in which the toddler had to grow up too fast.
She’s also savoring her one-on-one time with Illianna. For the first year of Illianna’s life, Maher was undergoing treatment and battling the symptoms that accompanied it, particularly fatigue and agonizing bone pain. Now, Maher has a chance to get to know her daughter.
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(Alisha Jucevic/The Columbian)
“I didn’t really enjoy her the first year, because I couldn’t,” Maher said.
This summer, Maher and her husband will celebrate 10 years of marriage. Earlier in their marriage, they talked about renewing their vows after 10 years. Given the last year and a half, it seems like the perfect way to celebrate their anniversary, Maher said.
She’s also looking forward to the more mundane things in life: buying a house, moving, working more hours at her job. Because after waiting nearly 500 days to hear “no evidence of disease,” Maher is finally starting to feel it.
“I don’t feel like the mom with cancer anymore,” Maher said. “I feel like myself again.”
Marissa Harshman: 360-735-4546; marissa.harshman@columbian.com; twitter.com/MarissaHarshman