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Expand Your Life



A lot of people already know about Vicky Westra. They’ve seen the pictures she’s taken of her sons and their hockey teams and of her Fargo Moorhead front lawn and the snow that often occupies it. They’ve read her daily happenings of driving her kids to school when they miss the bus and spending the weekend at a cabin by the lake. But they also know about her doctor appointments, the side effects of her treatment and the cancer she was diagnosed with in 2011. Vicky has stage 4 metastatic breast cancer and has been sharing her story on her blog, The Westra World, with friends, family and complete strangers.

“I actually started the blog before I was diagnosed, in 2008.” says Vicky. “The tone and the topic has changed, but the point is still the same. I want to document my life and capture the stories of it for my kids.

Vicky’s blog began transforming after she noticed a lump on her breast in 2011. She quickly made an appointment and received an ultrasound.

“The tech went to talk to the doctor,” Vicky remembers. “She came back in and said that she usually doesn’t do this, that they usually wait for more tests, but she told me that there was no doubt that it was cancer.”

The best laid plans
She met with Amit Panwalkar, MD, a medical oncologist from Sanford Roger Maris Cancer Center in Fargo, N.D., and a plan began to take shape to treat her stage 4 breast cancer. Dr. Panwalkar recommended Vicky enroll in a research study that was studying a new drug. The trial was so new that very few hospitals had access it to it. Even the Mayo Clinic in Rochester, M.N., wasn’t offering the trial that was available at RMCC. Vicky enrolled and started a round of medication for the next ten months. A year later her tumors were noticeably reduced in size, however another test also showed that her cancer had spread further, this time to her brain and lungs.

A specific target
This time around, Vicky started a chemotherapy agent, and also was treated with stereotactic radiosurgery. This type of radiation can be directed at the precise area of the tumor.

“We can treat the specific spot,” says Ethan Foster, MD, and radiation oncologist at RMCC. “We are accurate within one millimeter of our target.”

In order to be so precise, patients need to lie in exactly the same spot throughout the length of treatment, which is usually between 30 and 40 minutes. To make sure no movement is made, patients are held still by a body cast, or like in Vicky’s case, a mesh head mask that is secured to the table. This type of radiation is extremely powerful and usually only needs to be done only a handful of times. Having fewer treatments can be a big benefit to the patient.

“This type of treatment can really improve the quality of life for a patient,” explains Dr. Foster. “Through this type of treatment, the entire brain isn’t affected. We can spare brain tissue. Patients are able to experience fewer of those side effects that often come with radiation treatment.”

A year later, Vicky would have two more spots in her brain treated with stereotactic radiosurgery.

It’s your decision to make
Along with the brain metastases, progression was also found in her lungs. Vicky started two different oral targeted therapy drugs which kept her cancer stable for a length of time.

After progression was found in her lungs again, the team decided to try hormone therapy. At only 46, Vicky’s body was too young for many of the hormone treatments, which are geared to menopausal women. She had her ovaries removed and began treatments. Vicky has received six weeks of hormone treatments so far, and is feeling pretty good. She says she has more energy than before and is so grateful to her care team at RMCC.

“They know what you are going through,” says Vicky. “They know exactly what to say and when to say it to give you that support and encouragement you need. I have so much gratitude for them guiding me through with their expertise, knowledge, and compassion.”

But Vicky is as much a part of the team as her doctors.

“Vicky is definitely her own advocate,” explains Dr. Panwalkar. “She asks the questions and asks why. She is actively involved in every decision that we make when it comes to her care.”

And as Vicky continues her treatments, she says that she is focusing on something more than just surviving.

“I’m not just focused on extending my life. I really want to expand it,” says Vicky. “At the end of the day I want to be able to go to bed and know that I was fully present, that I saw and heard and felt everything that happened, that I explored the richness and beauty that the world had to offer me that day. And that is something where you don’t have to have cancer in order to appreciate.”

Posted Date: May 2014

Expand Your Life

How battling stage 4 breast cancer inspired a new outlook on life.