On Aug. 9, 2017, the Ream family’s entire world was altered.
Already stricken with an extensive history of cancer within the family, Becky Ream was diagnosed with breast cancer shortly after a family vacation. The Record-Herald reached out to the Ream family as part of its Breast Cancer Awareness Month coverage.
“I had my annual exam with my gynecologist at the end of July,” said Becky Ream, a Washington C.H. resident. “He actually found a lump when he was doing a breast exam. They sent me immediately over to Bethesda North Hospital in Cincinnati for a mammogram. I had been doing mammograms annually since I was 40. They did the mammogram and then told me we needed to do a biopsy. I was by myself at the time, so it was kind of frightening. I went in there not thinking anything was going to be wrong.”
What followed was one of the most difficult and challenging periods in the lives of Becky and her husband, Brian Ream.
“So we had the test done, they said it would be two to three days before we find out any results,” Becky said. “Waiting for the call was nerve-wracking, but the call came sooner than expected. It was the next day, about 3:30 in the afternoon, the phone rings and they told me I had triple negative breast cancer, which is the worst type of breast cancer to have.”
Triple negative results mean that the growth of the cancer is not supported by the hormones estrogen and progesterone, nor by the presence of human epidermal growth factor receptors (HER2). Triple negative breast cancer does not respond to hormonal therapy or therapies that target HER2 receptors.
About 10 to 20 percent of breast cancers — more than one out of every 10 — are found to be triple negative, according to breastcancer.org.
“It’s not hormone-related and it’s not as receptive to chemo treatments,” Becky said. “Bethesda deemed it to be fairly aggressive. You get this whirlwind of emotions and feelings….it’s like what do we do now?”
The natural tumultuous emotions that come with such a diagnosis had to be set aside by the Reams in order for them to formulate an effective plan of action.
“When Becky was diagnosed, we just said, ‘This is the new reality,’” said Brian Ream, whose little sister, Kari, died of cancer at the age of 27. Brian himself has also battled prostate cancer. “There’s no point in bemoaning the fact, it’s just this is the case and what do we need to do to get through each step. It’s figuring out what you can control…what’s in your control and what’s not in your control.”
One thing the Reams could control is looking into the type of care Becky might receive and which treatment center they would entrust with her care. The Stefanie Spielman Comprehensive Breast Center quickly emerged as the best option.
“I asked a good friend of mine who has breast cancer that metastasized, she was going to The James,” Becky said. “She highly recommended Spielman. There was nothing wrong with my doctors in Cincinnati, but I just had this feeling. So we call my health insurance to see if they would accept Spielman. They said, ‘Yes, we deal with them and all their doctors.’ I searched on the Spielman website and I came across one of their very accomplished doctors, Dr. William Farrar. I told Brian that I would love to have him as my surgeon. The next day I called the 800 number that was on their website and the lady on the other end was wonderful. I told her all of the facts of my diagnosis, and she said she would see who she could get me in with right away. She put me on hold for a second, came back and said, ‘OK, I have an opening with Dr. Farrar.’ She told me that he would be my surgeon and that Dr. Nicole Williams, who I also wanted, would be my oncologist. I was blown away.”
Shortly thereafter, Becky had another set of biopsies, and treatment began at the end of August.
“With triple negative, they do it a little differently,” said Brian. “They started with chemo right off. They did chemo, then surgery, then radiation. A lot of people have surgery first, followed by chemo and radiation. But because of the aggressiveness, they wanted to do chemo right away.”
Becky had to undergo two types of chemo — the first course was every other week for eight weeks and the second course was once a week for 12 weeks.
“The side effects were bone and muscle pain,” she said. “I was also on a clinical trial where I took a high dose of effectively Prilosec twice a day. The theory was that the Prilosec would make the tumor more receptive to chemo. I took that the entire five months I had chemo. The last dose of chemo I had could cause neuropathy in your hands and feet. I was doing great until about week eight, and then I started having neuropathy really bad. So they stopped it, that was around Christmas.”
Shortly before Christmas, Becky also developed two blood clots. A prescription of shots was provided to the Reams, and Brian had to give her two shots daily in the stomach for 30 straight days. She finished with chemo in January of this year, and in February had a bilateral mastectomy.
The pathology report came back within two or three days and there was no evidence of disease. All the tissue and all 14 lymph nodes they took out were clean.
“It was a little scary because they had done mammograms throughout, and they kept saying that the tumor wasn’t really shrinking, but that that doesn’t mean anything,” Becky said. “But then we found out that it was just scar tissue left there from the tumor. The scar tissue also had no cancer in it at all. So that was great. However with triple negative, you have a great risk of it coming back and metastasizing to your lungs or your brain. That’s usually where it goes if it comes back. The first three years is critical, and then the next five years. But right now, I’m OK.”
In the meantime, the Reams try to live and appreciate life one day at a time.
“We had been through this with my little sister,” said Brian. “Care has changed so much over time. Back then, she had a mastectomy, but they didn’t do chemo, they didn’t do radiation. That was just the standard of care. So she did that and they thought they got everything, but it came back. I remember Becky and I went in to see the doctor with her. She was in the other room and the doctor came in and told us that she had six months to live. And she died almost six months to the day.”
Brian’s older sister also experienced triple negative breast cancer about two years ago, and her oldest daughter had breast cancer as well.
“And it’s not just our family, we would see it every week going up to the hospital,” Brian said. “Some of these women didn’t have anyone to help them. There were times when we were up there and you see a woman being dropped off by a cab, doing this by themselves. It was just never ending. So we had a great community of support with our church (Grace United Methodist in Washington C.H.), our family and friends, but not everyone has that. We just kind of felt like don’t pray for us, pray for these women.”
The Reams decided to move up a European vacation that had been scheduled for next year. They just returned last week from what they described as a wonderful trip.
Also this year, the couple is planning to once again participate in the Making Strides Against Breast Cancer Walk in Dayton. Last year, the Reams’ youngest daughter, Elyse, organized a team to walk in the event.
“Our oldest daughter, Nicole, and her husband and two kids from Illinois surprised me and made it to the walk,” Becky said. “My mom and dad came in from Nashville, my three sisters and their spouses, one of my sister’s two children, my cousins. We had over 20 people on our team. I didn’t have enough energy to walk, so I sat with my mom and dad while the others walked. Last year we raised almost $6,000 toward breast cancer research.”
When asked what advice she could give to others following her experience, Becky said: “Make sure you have your regular mammograms and your follow-ups with your gynecologist because that’s who found mine. If not, I don’t know how far along the cancer would’ve been. And if you find out you have it, use your support groups as much as possible. Fayette County Memorial Hospital has a great support group that I attend.”
Although Becky’s condition has improved, there are still challenges that the Reams confront on a daily basis, but they have chosen to focus their energy on helping others.
“The neuropathy is still there,” Becky said. “They said it’s something that could stay forever or it could start to go away. I’ve just learned to deal with it. I try not to think about it. I have friends whose breast cancer has metastasized so I try to focus more on helping them and being a positive influence for them. So just trying to support other people kind of keeps my mind off of my own troubles. I don’t feel sorry for myself, I think about other people.”
Her husband echoes that sentiment.
“I know it sounds trite, but every day really is a gift,” Brian said. “And that’s how we should be living it even if we were completely healthy. This is a gift, so what are we going to do with it?”
Reach Ryan Carter at 740-313-0352 or on Twitter @rywica