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 unique challenges: I was diagnosed in a foreign country, I didn’t have any health insurance, I was early retired, I was technically homeless by choice to travel the world non-stop with my husband Tedly.
I needed answers to tough questions. Here are a few.
- 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? And how long would that take?
- 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. One thing at a time.
I researched for hours. I asked for guidance from friends who work in health care. 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 ductal carcinoma in situ (DCIS) had to be removed as soon as possible.
Pathologists upstaged me after my double mastectomy.
They found a tiny invasive tumor we did not know was there.
It is somewhat rare to catch an invasive tumor that early. It was 1.5 millimeters. About the size of the period at the end of this sentence.
It appears all the cancer was removed. My sentinel node was negative, with clear margins, so the cancer did not appear to have spread outside my breast.
My final diagnosis is for Stage IA, triple positive breast cancer.
For patients with invasive tumors as small as mine, and with some other specific biological features, there are no clear recommendations for treatment. I sought many opinions on what to do, from doctors in two countries – Croatia and America.
My treatment decision is detailed on another blog I run about tiny tumors in triple positive breast cancer cases.
Bottom line of this cancer journey: we kept traveling.
Some miles back, I met another world traveler who also was diagnosed with breast cancer while she was in a foreign country. She could uniquely relate to some of my angst. She was nothing short of amazing. She helped me before she died from breast cancer.
I feel a duty to pay her kindness forward. I’ll share my experience so that it might help another woman.
Life really is right now. It is not later.
Don’t wait to live how you want to live. There isn’t time.
- A digital mammogram and stereotactic biopsy while traveling
- How I found a surgeon in a foreign country
- What it was like, and what it cost, to have surgery overseas
- Why I decided “living flat” was right for me
- Post-breast cancer checkups with oncologists in:
- The website I created for other triple-positive women with tumors as tiny as mine (1.5 millimeters)
- Traveling as a Super Patient: a Q+A with Cancer Commons
- 3D mammogram message on World Cancer Day
- Mental Health update on a ‘cancerversary’
Ellen’s diagnosis was June 28, 2018; surgery was July 11, 2018. This post was updated on September 29, 2019.