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‘Little time bombs were in my body’

ONE BRCA2 gene mutation is most commonly associated with breast cancer, but it can also increase the risk of other cancers. Two years after Michele Miller, 53, was diagnosed with breast cancer, she had to confront more frightening news: a tumor in her pancreas. Miller, who lives in Windham, Maine, shared his story with TODAY.

I started getting mammograms at the age of 30. I did not know much about my family history because I was adopted at birth, but I had a little nugget of information - I knew my birth mother had breast cancer at a young age. Based on that, my doctor started me early with mammography.

When I was diagnosed with breast cancer in 2019, the radiologist was able to detect it early. It was stage 1A.

I had genetic testing at the time and found out I had the BRCA2 mutation. The treatment for breast cancer could have been a lumpectomy with radiation, but because the BRCA2 mutation would give me a high risk of relapse, I chose a bilateral mastectomy.

I also had my tubes and ovaries removed. My doctor talked about the increased risk of breast and ovarian cancer and melanoma, but the one that haunted me in the conversation was this increased risk of pancreatic cancer. The genetic counselor said there really is not a good way to screen for pancreatic cancer and it stuck with me because I just did not like that answer. That worried me. I did not feel it was over. I felt like there were probably small time bombs in my body somewhere.

In April 2021, I started getting stomach symptoms. I wanted to eat a meal and feel so full - like Thanksgiving Day - full after eating half of what I would normally eat. It developed into this constant constant pain in my upper abdomen, right next to my stomach.

Because I was already undergoing treatment with an oncologist for my breast cancer, I called them first and they rushed in pretty quickly to get me in for a CT scan. The diagnosis: Stage 1B pancreatic cancer, which basically means that the tumor was contained in my pancreas and had not spread to other organs.

Pancreatic cancer has symptoms that can be easily dismissed as other things. People think it's stress or indigestion. You really have to listen to your body. I did not let these stomach symptoms continue for too long. I knew something was wrong. I think many primary care physicians might not have gone that fast for that CT scan. You can lose time if you try to treat it as a dietary problem or something along those lines.

Still, it was devastating. When you hear you have it, you automatically think of the survival rate - 11% of people diagnosed with pancreatic cancer will do so in five years.

It was very hard to think: What is going to happen to me? How much time do I have? I would wake up every morning and my nightmare would begin, instead of you going to bed and having a nightmare. That's how it felt.

However, I always had this underlying feeling of "I just want to fight this." Early in the diagnostic phase, my surgeon said I was a candidate for the Whipple procedure, which was wonderful. If pancreatic cancer can be cured, the only way is really to be able to have that surgery.

Miller had to undergo chemotherapy before and after the complicated surgery to remove the tumor in her pancreas.  (Courtesy Michele Miller)

Miller had to undergo chemotherapy before and after the complicated surgery to remove the tumor in her pancreas. (Courtesy Michele Miller)

I first took eight rounds of chemo, which started in May and ended in August. The operation was on October 4th. Many people think that when you have surgery to remove a tumor, you just go in and pick it out. But the pancreas is so intertwined with your stomach and parts of your gut and your gallbladder and all the ducts that are in there that a lot needs to be taken out to remove the tumor that is in the pancreas.

Then everything has to be stirred and the digestive system re-wired - that's why the operation is so complicated.

I had a really good result. I was only in the hospital for four days afterwards. I healed well. I would say that my surgery was easier than going through chemo.

Part of my stomach and part of my upper intestine were removed, so I had to start with very boring food, but I have been able to add different foods as time has passed. I need to eat small amounts a little bit more often and avoid foods high in fat and high in sugar.

I completed four more rounds of chemo after surgery, and finished in December. A CT scan shortly after showed no signs of illness, so it was really a good way to start Christmas and the new year. I plan to return to my job at an insurance company in February.

Miller and her husband shared a happy moment as she marked the final round of chemo in December.  (Courtesy Michele Miller)

Miller and her husband shared a happy moment as she marked the final round of chemo in December. (Courtesy Michele Miller)

I'll probably get scans the rest of my life somehow, shape or form. My focus right now is to rebuild my endurance. I have lost about 35 pounds from the chemotherapy and surgery. My favorite way to take care of my body is barre class because it focuses on strength and agility and balance, and I return to that pretty quickly.

I have three daughters. One of them has undergone genetic testing and she is also positive for the BRCA2 mutation. Another daughter is undergoing the process right now. Knowledge is power, and for anyone who has a family history of the cancers adapted to the BRCAs, it's smart to think about genetic testing.

It is very scary and intimidating to find out that you have a mutation, but getting that information as soon as you can helps make the right plan with your healthcare providers.

You can start taking a little control back instead of feeling like "I'm a victim of this BRCA2." I do not live in fear of it, but I try to be vigilant.

This interview was compressed and edited for clarity.

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