Thirteen years after Vici Robinson was treated for estrogen receptor-positive breast cancer, she began experiencing shortness of breath. Her local physicians in New Hampshire determined her symptoms came from liquid that was filling her lung.
Then came the shocking news that this was caused by a breast cancer recurrence which had metastasized.
At 81, Robinson thought cancer was behind her, but now she was facing the prospect of more treatment. She was adamant that she wanted to “be with the best physicians,” so she decided to come to Dana-Farber Brigham Cancer Center all the way from her home an hour south of the Canadian border. Now 84, is currently being cared for by Rachel Freedman, MD, and Jennifer McKenna, NP.
McKenna, a nurse practitioner who has been practicing for 23 years, says that these kinds of delayed recurrences are common for Robinson’s type of cancer, but respond well to treatment. For the last four years, Robinson’s cancer has been stable with the help of an estrogen-reducing drug, letrozole, and a CDK 4/6 inhibitor, which stops cancer cells from growing. Still, given her age, Robinson worried about her mental and physical well-being.
Robinson is used to being on the move. More than 40 years ago, she and her husband moved to a town in Franklin County, Maine without a single stoplight. They had lived their whole lives in places like New York City, Philadelphia, and Boston, but Robinson’s husband got a job in the logging industry, and they found themselves in a tight-knit rural community.
“They were taking bets on how long we’d last before going back to the city,” Robinson remembers, chuckling.
Robinson and her husband rolled up their sleeves and set out to prove themselves as valuable members of the community. First, Robinson organized a volunteer teaching group to help in the schools around Franklin County. Then, she and her husband helped start a ski academy at Sugarloaf Mountain where Robinson worked everything from public relations to admissions and financial aid. When she retired, Robinson and a group of community members founded a music festival, the Kingfield POPS, with the Bangor Symphony. It’s now in its 20th year.
At home, the couple — who have been married since 1966 — raised three children alongside pigs and cattle. Today, they’re both in retirement and their kids have kids of their own, but Robinson continues to volunteer, does yoga, and walks regularly.
Creating a team
Dana-Farber’s Program for Older Adults with Breast Cancer was created for patients like Robinson to ensure that they can live fulfilling lives. Most patients with breast cancer are older than 70, and the program offers them resources tailored for people with age-related concerns.
“For patients with metastatic cancer, the goal is to improve how long somebody lives while optimizing quality of life,” McKenna explains. This work is personal: Her own mother is 82, and McKenna understands the challenges faced by this age group.
During Robinson’s four years of treatment, she and McKenna have become friends.
“She’s approachable and knowledgeable. I can tell her almost anything,” Robinson says of her nurse practitioner. “Of course, I don’t do that.”
The two bonded over their love of skiing and hiking, and McKenna has a deep admiration for Robinson’s attitude.
“She has a joy for life,” McKenna observes.
McKenna and Freedman set Robinson up with a host of experts through the Program for Older Adults with Breast Cancer. They included geriatrician Tammy Hshieh, MD, a dietitian, and a specialized pharmacist.
Together, the team helped answer Robinson’s questions about memory, medication, nutrition, and exercise. They now have a plan for monitoring her diet and energy levels, improving her memory, and furthering her education.
“I want to know everything I can,” Robinson explains. She attends monthly online forums hosted by the Program for Older Adults with Breast Cancer where experts, including McKenna, present on topics of interest, including nutrition, exercise, ongoing research, and integrative therapies during and after cancer treatment, and then give patients an opportunity to ask questions in an intimate setting.
“I was so impressed,” Robinson says of the program. “I tell my friends about it, and they can’t believe it. Rachel and Jen and the team there are at the top of what’s going on in oncology.”
Jen McKenna is one of the very best, and made my visits from Vermont with her seem like a trip to see an old friend!
Jen is a great listener and is very knowledgeable in her field. She and Dr. Freedman are truly a dynamic duo!
Lynne
Gosh, what a lovely story! An approach like this simply must resonate with so many older people whose situation and desires may be different than a younger person’s. It sounds like the listening, the understanding, the efforts of the clinicians to help each individual live the best life they can on their terms are perfect. More, please!
I’m going to mark down this day as “I read a story about metastatic breast cancer and was uplifted and inspired!”