I was diagnosed with breast cancer while traveling in Eastern Europe. Doctors in Split, Croatia, gave me the initial news.
One in eight women will be diagnosed with breast cancer in her lifetime. I had some extra, unique challenges: I was diagnosed in a foreign country, had no health insurance, was early retired, and homeless by choice to travel the world non-stop with my husband Tedly.
I needed answers to tough questions.
- Unilateral or bilateral mastectomy?
- What node(s) should be removed?
- What’s my recurrence risk?
- Immediate, delayed, or no reconstruction?
- Would implants impede future detection?
- What about flap procedures?
- Risks to each option?
- Complications for each option?
- How long was recovery for each option?
- Where would I recover?
- Surgical treatment abroad, or the U.S.?
- If abroad, where?
- How would I find English-speaking doctors abroad, and not hacks or quacks?
- If in the U.S., where?
- How would I find a great medical team back home?
- Would a U.S. medical team accept biopsy results from another country, or would I have to start over?
- What would each option in each country cost?
- What if I’m ‘upstaged’ after another biopsy — what if more cancer is found that was not initially detected?
It wasn’t easy, yet I discovered I have a supreme ability for crisis management.
I researched for hours. I asked for guidance from friends who work in health care in other countries. I got recommendations on different doctors, and checked them out. I talked with people at specialized breast health clinics in countries that cater to international clients. I visited clinics in Croatia and a hospital in Sarajevo. I was ready to fly to London or India.
And then, exhausted in every way, I would cry in bed with the covers over my head before I could again emerge as a productive crisis manager.
I had to figure out what doctors were going to help me, and where in the world it was going to happen, as soon as possible.
All options were on the table.
Eventually, the best options for me emerged:
- a bilateral mastectomy
- a breast surgeon I trusted with a private clinic in Zagreb, Croatia
- no reconstruction
I was initially diagnosed with Stage 0 breast cancer, which is non-invasive. However, my type was fast-growing and high-risk for turning into invasive cancer at any time. Several doctors agreed my high-grade DCIS had to be removed as soon as possible.
Pathologists upstaged me when they found something else in the post-mastectomy biopsy: a tiny invasive tumor we did not know was there. It appears it was all removed, and my sentinel node was negative, with clear margins, so the cancer does not appear to have spread outside my breast.
My final diagnosis is for Stage IA, triple positive breast cancer. The invasive tumor was tiny – 1.5 mm.
Targeted therapy with Herceptin for one year and hormonal therapy with Tamoxifen for several years with no chemotherapy is the recommendation — so far. I will seek out more opinions. As of this writing, I’m still working on adjuvant therapy options.
Bottom line of this cancer journey: we will keep traveling.
Some miles back, I met another world traveler who also was diagnosed with breast cancer while in a foreign country. She could uniquely relate to some of my angst. She is nothing short of amazing.
I feel a duty to pay her kindness forward. I’ll share my experience so that it might help another woman.
In the coming weeks, I will share things like:
- how I found foreign health clinics for a mammogram, a biopsy, and a double mastectomy
- how much my medical care abroad has cost without health insurance
- my clear understanding of high-grade DCIS, in the face of media confusion
- why I decided to “go flat” and skip the fake ta-tas
- why Pink Ribbons bother me, and why you don’t see many outside the U.S.
- how mastectomies are different in a foreign country
- my ongoing recovery and treatment decisions abroad
This won’t become a breast cancer blog. But this is a blog about our lives as early retired budget travelers, and my diagnosis and treatment abroad is part of our life story now.
When I’ve said all I have to say about this life-changing development, I’ll refocus on the fortunate, fun, fabulous lifestyle I share with the most amazing, supportive, loving and caring man on Earth.
Life really is right now. It is not later. Don’t wait to live how you want to live. There isn’t time.
I am acutely aware of how finite my time is.