She was 25 years old and pregnant with her first child—the picture of health, happiness, and the potential of life. But Nicole Davis had no idea that she’d developed a relentless form of cancer that was, in a cruel twist, aggravated by her pregnancy.
Days later, Nicole arrived at the Kaiser Franklin Medical Center to meet with Dr. Azar. Like so many times before, the room was packed with family. Azar told them she didn’t know why the cancer had spread, but it was likely resistant to Tamoxifen. She ordered Nicole to stop taking the drug immediately. Azar said cancer had likely grown since Nicole had had MRI scans and an ultrasound in October, both of which were clear. It was HER2 and estrogen and progesterone positive.
Though the surgeon had removed the tumor, as with most cancers, it was impossible to tell if any rogue cells had spread, so Nicole would need another year of treatment (this time with a different type of chemo, since repeating the AC regimen can increase the risk of congestive heart failure). According to experts, some HER2-positive cancers just don’t respond to treatment, even Herceptin. Various types of cancer—not just HER2-positive ones—can be similarly stubborn, undeterred by chemotherapy. Scientists are developing new drugs to target them, usually by blocking the activity of specific proteins. As Nicole sat in Azar’s office, she thought about how she’d just grown her hair to a length she liked, and now she would lose it again. Her entire body tightened taught as a bow, and she wanted to scream. She wanted to unleash a fiery trail of angry destruction through the hospital and the parking lot and the entire city.
She wanted to know the worst that could happen. And no matter how disconcerting, she wanted the straight facts. “What if the cancer has spread?” she demanded to know. There was so far no indication it had, Azar told her, but if it did spread to distant organs, there would be no cure. Azar asked if she’d noticed any new symptoms. Actually, Nicole said, she did have pain on her right side, under her ribs. Azar ordered a PET scan for February 11, 2011. The call came a few days later, while Nicole was making Abbey breakfast. It was a nurse from Azar’s office whom Nicole now knew well. She told Nicole to come in to see the doctor that day at 3 p.m.
“Why?” Nicole asked. “What did my PET scan show?”
“What did it show?”
After another pause, the nurse spoke, and she was weeping. “It’s in your liver.”