The Year We Got Cancer

"Hi Sarah, this is Patricia from Lenox Hill radiology. We found a little bit of cancer in your left breast." I fell to the floor of my Brooklyn apartment. What’s a little bit of cancer?

I immediately called Sophie. I often called my big sister in the “between moments.” I called her on walks between my apartment and the bodega, on subway platforms between stops, on breaks between jogs.

I was hyperventilating when she picked up. “I’m overwhelmed, I’m overwhelmed,” I repeated like a vocal tic was caught in my throat. I was 35 years old, had just lost my job, and now, had entered some surreal reality where I—me! the person who never got sick—had cancer?

Sophie, two years older at 37, always knew what to say as she’d done everything first. She’d kissed a boy first, had a Bat Mitzvah first. I trusted her implicitly because she was my big sister—but also because she seemed to be a version of me existing two years into my future. I liked to imagine she basically was me.

But Sophie had never done this before. She couldn’t relate, and she didn’t know what to say. Nonetheless, she and my mom flew to NYC to be by my side. At the hospital, a breast surgeon examined my chest. All eyes were on me until the surgeon glanced at my mom and Sophie. “Now that you have a first-degree relative with breast cancer, you both need mammograms and genetic testing. Right away.”

The breast surgeon brought her attention back to me, stating that I needed to freeze my eggs and that given my tumor size and genetic mutation, any surgery option—double mastectomy, unilateral mastectomy, lumpectomy—would be perfectly reasonable. “The choice is yours,” she said.

Chemo? Infertility? Mastectomy? These would be the biggest medical decisions of my life. I can’t even choose what to order off a menu! Indecision is core to my identity, not cancer. On the subway back to my apartment, I turned to my sister: “What would you do?” She said she would do the lumpectomy. Would she so easily make that choice if she were in my shoes? I wondered.

On one of my daily calls with Sophie after she’d returned to LA, she shared that they had found something in her mammogram. She was getting it biopsied.

“I mean, it’s probably going to be something,” she said, as if she were talking about the inevitable rise of the sun. She had also tested positive for the same breast cancer gene I carried.

“Are you okay?” I asked. Sophie assured me she was. Her head was not spinning, she was not getting tunnel vision, she was not on the floor. Odd, very odd, I thought.

My tunnel vision, head-spinning, and decision paralysis were becoming “tiresome” for doctors who refused to double as therapists. When no decision was a good decision, and every route was valid, it had to come down to my psychology. Who was I, really?

I have anxiety and panic attacks; and I would rather offload my decisions to professionals. I wanted to hand over my breasts to a surgeon to, literally, take my medical problems off my chest.

I decided with a massive exhale to have a double mastectomy. I scheduled the surgery; years of therapy tackling indecision and passivity condensed into one moment of clarity.

Days later, I was in my aunt’s Manhattan apartment when I got the call about Sophie. “She has it, too.” Mom was referring to the results of Sophie’s biopsy. Malignant.

I called her right away. “Isn’t this crazy!” Sophie giggled. The absurdity was laughable, so I giggled too. “You know, I saved your life,” I joked. “If it wasn’t for me, you never would have gotten a mammogram.”

“And also because of you, I’m basically a cancer expert now,” she said proudly, noting that the learning curve didn’t feel quite so insurmountable given what she’d already gleaned from my experience. We yelled a big “Love you!” before hanging up.

In my temporary stint as “big sister” to Sophie, I had charted a path she could follow if she wanted. I had sifted through the chaos of appointments, synthesized difficult medical information, and landed on a team and hospital system. I had spent weeks deliberating on a surgery decision, and had gone through egg freezing. I was proud of the hard work I had done—for us.

But Sophie was used to making her own way, and she wasn’t desperate to follow me the way I had been to follow her. She gave me the rundown after her appointment: “I found this team in Santa Monica that provides a ‘holistic approach.’ I’m going to meet with the surgeon. She specializes in a procedure called oncoplasty, a kind of lumpectomy with reconstruction.” Aesthetics aside, I pressed Sophie on why she would choose to keep her breasts when we had a genetic mutation and a strong family history of breast cancer.

“Sarah, the research isn’t really there on the gene,” she said. Sophie’s analytical mind served her professionally as a researcher at Google, and now I could see she’d take an analytical approach to cancer, too—treating it like an interesting problem to solve instead of one to resist, as I had. But her wait-and-see attitude was coming from privileged circumstances too; she had stability with a house, a fiancé, and a job with great insurance. Her tumor was also smaller than mine.

I had thought my sister and I to be just the same, but the more I observed her process information and make medical choices, the more I noticed the ways we operated differently. She wanted to proactively handle it all herself. She wanted to keep her breasts and continually monitor them. I did not. Our different decisions complicated my case and challenged my resolve. It seemed that having a diagnosis alongside my best friend would not make for the beautiful story of sisterly bonding that I thought it might.

It all came to a head two nights before my surgery, when my mom called. “You’re not getting the mastectomy! We met with Sophie’s surgeon, and she said she can save your breasts! You’d be crazy to get the double mastectomy.”

My heart raced with panic and I could not stop tears from welling up in my eyes. I fell to the floor of my apartment once again. “My surgery is this week!”

“You need to fly down to LA this week. You’re doing the surgery here with Sophie’s surgeon,” she said.

I yelled that she was lumping me and my sister together, but we were not the same. Our shared experience stopped at the diagnosis. I cried that I wanted my breasts gone, that I didn’t want the anxiety of having endless scans for the rest of my life.

“I am not Sophie. I am me!”

My plan derailed in a matter of minutes. I could not go through with major surgery when the people I trusted most would not rally behind my already shaky logic. But if I were to follow in my big sister’s path, I wanted agency and for the decision to be mine—not hers. I canceled my double mastectomy the night before it was scheduled and flew to Los Angeles to meet with my sister’s surgeon and ask my own questions. What followed was a string of short appointments and a quick decision to go through with surgery that would preserve my breasts. I scheduled my oncoplasty.

When the surgery was over, I groggily woke up and looked down at my breasts, unsure of how I felt about the fact that they were still there. For better or worse, keeping our breasts would add another dimension to our bond as we’d now need to similarly be vigilant about monitoring our bodies for the rest of our lives.

The rest of my treatment plan would play out differently from my sister’s given our different pathologies. My sister and I were not the same person.

I would do chemo, and I would stay in Los Angeles for the year we got breast cancer.

Sophie would not need chemo, and she would not lose her hair. But she would provide endless support and love through my experience, as I would for her. Our experiences were completely different from the start, so in that sense, I did not go through cancer with my sister. I went through cancer—and my sister also went through cancer. It happened to be at the same time.

Sophie came with me for my first chemo infusion, holding my hand as I cried with an IV in my arm. She smiled at me and told me I could do it and that it would be okay. She promised to hang out with me every day for the next several months in Los Angeles. We would have plenty of time to be together, strengthen our bond, and navigate treatment.

But at that moment, she could only stay for a little bit. She had to go upstairs in that same hospital, that same day, to get her oncoplastic surgery.

Sarah Barness is a writer, editor, content marketer, and SEO strategist.