Last Updated on June 3, 2023 by Ellen
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.
Afraid of health care overseas? Don’t be!
Our special guide on global health care shows you:
- 7 easy steps to find the right doctors and hospitals
- Specific price examples for various medical services
- What to know about medical visas
- And more!
We go without travel health insurance, but many of the principles apply to those with coverage.
- 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:
- Kuala Lumpur, Malaysia
- Chiang Mai, Thailand
- Penang, Malaysia (needed a CT scan, which turned out to be a broken rib, not bone metastasis)
- 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.
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Dear Ellie,
We were brought to tears reading about your ordeal with breast cancer and also about your beloved friend Jodi. You are in our hearts.
thank you xo
What an incredible story you have dear sister! Your story is truly unique! Traveling abroad without health insurance sounds like a tremendous challenge! Good for you for doing your research and learning what your options are! I too dislike pink ribbons and made the decision NOT to have reconstructive surgery! I created a youtube video about the topic that helped me win a local Toastmasters Humorous speech contest. I am also a huge believer in adjuvant therapies and lifestyle changes. I have learned that when we give our bodies what they need, they can heal themselves or at the very least improve our quality of life.
I love your last line: 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.
I don’t believe most of us ever truly start living until we are faced with a diagnosis that could easily end our lives.
Thank you for sharing this real world information on your blog. After reading your follow up posts, I now I understand why you are willing to travel without medical insurance (self-insure). The cost of quality medical care abroad is so much more affordable than the U.S.
I hope you recover well and enjoy your travels!
Wow, I cannot even imagine what you have been going though but you sound like you are doing an amazing job handling it and kudos to you for continuing to travel. Thank you for sharing and know that my thoughts are with you.
Thank you!
Very sorry to hear of this diagnosis. My thoughts and prayers are with you both. I know you can kick its butt!!
Thank you!
As you say, cancer is part of your “life story,” and life has not ended. Thanks for continuing to share your life with us, who will be cheering you on!
Thank you!
Thank you for sharing, and positive thoughts for a speedy recovery! You will help so many others by telling your story. Very brave of you. All of us nomads need and appreciate the info you will be sharing. Thank you!
Thank you!
Ellie I am so humbled by your strength. Such a hard thing to go threw, and yet YOU DID IT!
I know that your Mom was totaled, but somehow you do remind me of her. I pray that God gives your family the wisdom and strength it needs.
God bless you in your travels, we do love your stories!!!
Thank you!