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.
Nicole screamed. Tyler caught her as she collapsed. All he could say was, “Please, no.” Nicole walked past Abbey, who was watching a video in the living room, and into the bathroom. She sat on the edge of the tub, gripped the porcelain, and tried to breathe. She called her aunt, her father, and a friend, who was a breast-cancer survivor, and that afternoon they all arrived at the Kaiser Franklin Medical Center. Just like that first day of chemo two years earlier, it was bright and sunny, with a cool breeze. A somber Dr. Azar explained that the cancer had taken over more than half of her liver. Liver failure would eventually kill her; it might be in several months, or it might be a couple of years. A series of oral chemo drugs—some 13 pills daily—could prolong Nicole’s life, but it was impossible to know for how long. Without the drugs, she would likely die within months.
Azar told Nicole and her family she wasn’t sure why earlier blood tests that can indicate whether cancer has spread to distant sites had shown no signs of metastasis, though Borges, of the CU School of Medicine, and several other oncologists say such tests sometimes don’t. The guidelines for follow-up care after breast cancer include physical exams, review of any new symptoms, and standard blood work twice a year, all protocols that were followed in Nicole’s case. Scans are the best way to discover metastases, but the tests are only given after something raises the doctor’s concern. “It is uncommon for a triple-positive breast cancer to recur as soon as hers did, but we do see it happen,” Borges says of Nicole. “It gets very complicated when you overlap her young age and that she was pregnant.”
Aunt Marilyn wept and stared out the window. Tyler and Nicole’s father sobbed openly. Nicole, numb, watched Azar’s mouth form words—asking if she would take the oral chemo drugs. Tyler touched her shoulder. “What do you want to do?” he said. In that split second Nicole felt a deep rage overtake her. “Yes!” she yelled. “I’ll take them!”
The next afternoon, on February 16, Nicole sat in her living room drinking coffee and resurrected her CaringBridge.org website from the year before (the organization provides free websites for people enduring major illnesses). “The final outcome will ultimately be liver failure,” she wrote. “It will be fast. I don’t know how much time I have. Abigail keeps me holding on to everyday that I am granted here on this earth. ... My husband is going to raise my baby girl and love her always. He has promised me he will never ever let her forget who her mommy was. ... My baby girl will need lots of women in her life to help her shop for dresses, and bras, and talk to when she needs a mother.”
In the following days, while she was feeding Abbey her Cheerios or coloring with her, Nicole would watch her daughter and wonder about all the things she would miss. Would she be here to take Abbey to preschool in two years? Kindergarten? First grade? A parade of milestones flickered in her mind, taunting her: Abbey learning how to write, going on a first date, graduating from high school. Sometimes when the two-year-old wandered up and snuggled her on the couch, Nicole would find a reason to get up and walk away. People said it was a normal reaction, but she felt like a bad parent.
Nights, she would close herself in her closet, sucked into a spiral of unanswerable questions, not about the future, but about the past. Could she have done something at some point that would have landed her on a different square on the board of Life? Maybe if she’d insisted on getting a mastectomy right away, instead of waiting, the cancer wouldn’t have come back, she thought. Azar had stressed repeatedly that this was a terribly aggressive cancer and that she did nothing wrong, but Nicole couldn’t keep the questions at bay. She wondered about her diet, if eating healthier could have helped, and about stress. Did her childhood play a role? Did Columbine?