Laughing Without Fear of the Future: Laura Faw's Breast Cancer Story

"She is clothed with strength and dignity, and she laughs without fear of the future." (Proverbs 31:25)

 Laura Faw's friends made "team Laura" bracelets inscribed with this quote, honoring her positive and lighthearted outlook as she's battled breast cancer. 

Considering her story, Laura acknowledges, "It's been dark, at times, but most people who love me laugh along with me because they understand that's how I've always been."

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The year 2022 was a doozy for Laura. She lost her dad to a sudden cardiac event in February. Her mother joined him in June, also passing from heart conditions. 

While grappling with these unexpected losses, she began experiencing a chaffing on her left breast, beginning in April. It would appear after workouts. 

"I'd put a band aid over my left nipple because it was scaly — to help relieve some of the discomfort. I particularly remember in April that I was at a wedding and forgot band aids. I was concerned since one of our activities required me to wear a bathing suit," shares Laura.

In mid-May, she had an obstetrics and gynecology appointment that included a mammogram. Days before Memorial Day, she received a call to return for a left breast ultrasound. 

Laura went in for the appointment and while there, the radiologist informed her that she would need a biopsy. 

"The crazy part," says Laura, "is the reason I got my insurance plan was to get my mammograms without waiting 365 days. I was 42 and had a couple by then, so I went to this one a month early. Since my parents had both died unexpectantly, I was very busy managing their affairs and decided it would be best to go early rather than wait until June as I might put it off."

A Breast Cancer Diagnosis

In June, the biopsy revealed that Laura had stage zero high grade ductal carcinoma in situ (DCIS) breast cancer. She had three inches of cancer cells in her ductal walls that had not spread. She was simultaneously diagnosed with Paget's disease of her breast, a rare skin change at the nipple associated with underlying breast cancer. This explained the chaffing. 

On July 16, the day before Laura's parents' would-be 50th wedding anniversary, she underwent a left mastectomy as well as a contralateral prophylactic right mastectomy with breast reconstruction.

"The entire experience was surreal," explains Laura. "I had put my bingo card on dying of cardiac issues, and here I was, instead, battling cancer. My dad died on the operating table from an aortic aneurysm that ruptured. My mom passed from congestive heart failure and broken heart syndrome. I would joke with friends, 'When I go, it's definitely going to be my heart.'"

At the three-week mark, the care team removed the last drain of four total in Laura's breasts.

"At the end of that week, I woke up one morning to find there was something coming out, and I was like 'That doesn't look right,' and it wasn't right."

A Persistent Infection Sets In

Laura had an infection. She was immediately put on an antibiotic over that weekend, and her doctor informed her to give it until Monday to clear up. The condition did not resolve, and in August, she had to have the implant removed.

"I wanted a new implant put in because I was 42 and still wanted breasts. Maybe I'd feel differently if I'd been 62 or even 52, but I wasn't. The doctor explained it was not safe to undergo the surgery immediately and instead sewed me up. My left breast looked like a sock mouth!"

The care team waited for the return of her pathology labs to determine the safest course of action. After proper diagnosis and three necessary rounds of antibiotics, Laura was able to receive another implant.

"He put in an implant, and the same infection returned."

The team repeated the treatment cycle to remove the infection and scheduled her for another implant in October.

"At that point, I was debating whether to keep doing this, but I was only 42, so I told my doctor I wanted to try the implant again."

The physician informed Laura that they needed to allow her body to recover and extend the antibiotic treatment before trying again. In February 2023, the doctor removed scar tissue and installed an expander. Her body did not succumb to infection.

All was well, and Laura enjoyed a very adventurous 2023 with lots of trips around the country for her 13-year-old daughter's travel ice hockey team.

A Nagging Cough Turns Out to Be More

In January 2024, Laura's primary care provider treated her for a cough assumed to be bronchitis. After four separate courses of antibiotics with no improvement in symptoms, in February, her provider referred her to a pulmonologist, where she underwent pulmonary function testing and computed tomography (CT) imaging. She also had a bronchoscopy and tissue samples taken to assess her cancer nodules. This showed cancer cells in her lungs compatible with metastasis from breast primary.

On March 7, Laura's provider called to see how she was feeling. 

Laura remembers, "I told them I was in horrible pain, so they urged me to go to my nearest emergency department. That's how we found out about WakeMed, and I'm so glad we did."

An Introduction to WakeMed's Exceptional Care 

With no sign of relief, on March 7, Laura went to WakeMed Garner Healthplex Emergency Department. 

"Around that time," laughs Laura, "I was supposed to get the expander out, so I could get my implant, but then I developed the cough and found out it was cancer. That sixth surgery was going to give me back boobs." 

The WakeMed team at Garner Healthplex transferred Laura to WakeMed Raleigh Campus Emergency Department on March 9. In addition to her cancer diagnosis, her oxygen levels were dangerously low, so they immediately put her on oxygen, discharging her from the hospital on March 11.

"I was glad for the oxygen because it was really a struggle to breathe. They told me that my lungs were pretty cloudy, so they were impressed I was breathing as well as I was prior to them providing me an oxygen tank. I did pass out three times prior to their treatment."

WakeMed Shines: A Swift and Empathetic Approach to Cancer Care

On March 12, Julia, a nurse navigator, called to introduce herself to Laura. She informed her that she would receive a positron emission tomography (PET) scan the following week on March 19. The scan revealed that Laura had stage IV, HER2 positive, metastatic breast cancer that had traveled to her bones, liver, lungs and lymph nodes. On March 20, WakeMed Cancer Care – Hematology & Medical Oncology provider Pallavi Kopparthy, MD, met with Laura to review her treatment options for cancer.

Laura began treatment the following day on March 21. Her treatment involved 1000 milligrams of calcium to address the bone cancer, a bone marrow stimulant, a monoclonal antibody for the treatment of metastatic HER2-positive breast cancer, a monoclonal antibody drug used to treat HER2 positive receptor breast cancer, an additional antibody as well as a chemotherapy drug for advanced-stage breast cancer. Laura received this treatment cocktail at WakeMed Cancer Care – Hematology & Medical Oncology – Raleigh Medical Park for one day every three weeks from March through June.

"The second, third and fourth treatments were pretty tolerable. Overall, I had fatigue for a couple days following each treatment that would hit me like the sudden onset of the flu, and, of course, I lost my hair."

Overall, Laura was grateful to continue working as an auditor, even in the hospital during treatments. As the lung nodules subsided, by June 12, she was able to walk around the clinic independently without oxygen, and her cough was mostly gone.

An Uphill Climb to Good News

Yet, Laura's treatment was not without challenges. Chemotherapy does not cross the blood-brain barrier (tightly locked layer of cells that defend the brain from harmful substances). As such, she developed brain metastasis that was found on a surveillance magnetic resonance imaging (MRI) scan completed on June 29. She also could not receive radiation because of the number of lesions found on her brain. 

"Dr. Kopparthy called me that night around 10 pm to say, 'I'm sure you've seen your MyChart. I'll be in the office in the morning, and we can talk. We can treat this.' She was so reassuring. They already had a plan to treat me. I was shocked by how quickly WakeMed managed my care and reached out to me before I would reach out to them."

On July 8, Laura was taken off her treatment regimen and started on a new therapy that would cross the blood-brain barrier. On September 3, she received amazing news that her brain was tumor-free.

"This was the first good news I'd received in a long time. I currently have no lesions on my brain, and the other ones throughout my body are no longer growing."

Laura will remain on this treatment indefinitely. 

Dr. Kopparthy confirms, "Laura Faw presented to us with stage 4 metastatic HER2 positive breast cancer. She was very symptomatic, with low oxygen and a chronic cough. While we cannot cure this disease, we have numerous treatment options. We readily started her on the first line of treatments, and within just a few weeks, we saw a huge difference clinically. That was gratifying. She was herself again: laughing, cracking jokes and feeling energetic. Then, in her three-month scan, several spots were evidenced in her brain. HER2 positive cancers like to go to the brain, so this was not surprising though it was sad to see. Gratefully, she was not symptomatic. Typically, we do whole brain radiation, but because she is a young patient with a young family with whom she is very involved, we had to take note of the emotional, social and sexual side effects of this treatment. Quality of life is of utmost importance, and whole brain radiation can impact cognition and memory. The treatment we chose crosses the blood brain barrier, and our scans show no evidence of disease in the brain. I will keep her on this regimen as long as she responds. She has many more options should the need arise to switch her to a new treatment."

And, while the side effects are very tolerable, she has hot flashes.

Laura jokes, "It's good for me that my now 14-year-old daughter and nine-year-old son do competitive ice hockey. While everyone else is bundled up, I sit there with no jacket thinking, 'This is my kind of temperature. Perfect.'" 

She is grateful, too, for her husband who has stuck by her side throughout her entire cancer journey. 

"For those three weeks I was on oxygen, I had a ball and chain, so he had to do all the things. He drove everywhere, including taking the kids to all their sports, while also taking me to my chemotherapy. He doesn't complain about having to sit there. We both sit and work. He's been a rock. He's also very encouraging. Whenever we get good news, he gets really happy. I can't ride the waves of high or low emotions because I don't know what will come next, but it is nice to have him so upbeat."

Laura's Life Today

"Life revolves around when the treatment date is and how I feel after treatment. I also monitor more carefully if I can be around a bunch of people since I don't want COVID cough. Yet, I still participate in my children's travel sports. I attend church with my family. I'm also working, and I'm grateful for my job being so flexible about my work locations."

Laura is especially happy to have wound up at WakeMed. 

"I couldn't be more pleased. Immediately once I entered their care, my experience was all-hands-on-deck. My other medical group would have me waiting days after bad news to reach out to me or return my calls. Not so with WakeMed. They quickly got me in. And, during my appointments, I have never felt rushed. They take their time, are thorough and are very responsive. I am especially amazed that when I send MyChart messages, Dr. Kopparthy responds herself, as opposed to a nurse navigator or someone else. And, when I'm there, simply everybody is wonderful. They laugh and joke along with me as I cope."

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About WakeMed Cancer Care – Hematology & Medical Oncology

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