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Toni, Kassie’s mom, has dedicated the past 10 years to Oncology, serving in various roles as a Nurse Practitioner. With 25 years of nursing experience, Toni has supported hundreds of patients and their families. Through her work she has witnessed the valuable role of CaringBridge in helping to facilitate communication and updates for families navigating complex medical journeys. Yet, she never anticipated that her family would need to set up a CaringBridge site for their own 28-year-old daughter…not her family, not their daughter!
On a seemingly ordinary morning in February 2024, Kassie started her day as usual with a shower. However, during that shower she noticed a lump in her right breast. Very small, but still detectable. Was she imagining it, or was it truly a lump? With Trey’s urging and support, Kassie did the adult, responsible thing and scheduled an appointment with her doctor.
Fast forward after several weeks of appointments, ultrasounds, scans and a biopsy and the news was not what anyone wanted to hear. Kassie was diagnosed with breast cancer. Invasive Ductal Carcinoma: Estrogen/ Progesterone receptor positive, and Her2 negative. Imaging revealed the tumor was just over 2 centimeters, and it did not appear the lymph nodes were involved. The diagnosis had favorable features, but due to Kassie’s young age was very rare and would indicate that she needed to be treated quickly and aggressively to avoid spread of the disease and to decrease risk of recurrence.
Faced with the daunting array of treatment options, the recommended course of action included a couple of options: 1. A lumpectomy and sentinel node biopsy followed by radiation. 2. A bilateral mastectomy with immediate reconstruction followed by a second stage reconstruction, and likely chemotherapy. Plan 2 was contingent upon whether there was lymph node involvement and tumor markers and included eventual removal of her ovaries to reduce the production of estrogen. This type of cancer is estrogen-fueled. Kassie would also need antiestrogen therapy after all chemotherapy and surgery is complete; a minimum of 5-10 years, leaning towards 10 years with her age.
As a young married couple, Kassie and Trey planned on having a child, so this news was devastating not only because Kassie had Cancer, but their plans for the future were now out of their control. When you have envisioned your future a certain way, and that is taken away from you, you grieve for the loss. Although Kassie’s health has always been the most important thing, it was difficult to understand why two amazing people who decided to dedicate their lives to nurturing young minds and shaping futures, were at risk for their dreams of having their own child.
Throughout these past weeks, Kassie has exemplified the true spirit of resilience and strength. While the term "warrior" may sometimes feel cliché in the context of cancer, it's the most fitting description for Kassie's unwavering courage and determination. Trey is Kassie’s rock, helping her to understand and accept, and always being positive. Everything else would be dealt with when the time was right. Kassie, Trey and both families focused on the battle ahead. Kassie decided she will win this fight and do whatever it takes, and the double-mastectomy was scheduled for Thursday, March 28. This decision, as long as there was no node involvement, allowed her to avoid radiation and decreased years of breast imaging that often causes great anxiety to patients.
During this difficult time the Scherling family was blessed to be able to celebrate Kassie’s younger sister Samantha and her now husband Ben’s wedding in Costa Rica. It was an amazing trip that allowed them to have precious family time together. Kassie’s surgery was scheduled for the week after the wedding.
Having just returned from Costa Rica for Sami’s wedding celebration, Kassie didn’t have time for her pre-surgery physical until the day of surgery. The physical seemed to take an eternity while Trey and the family waited! Finally, the nurse called Trey and Toni back to the exam room to find Kassie sitting and waiting quietly in her bed, both asking if she was alright or if something had happened? Kass assured them she was fine. Dr. Ritter then came into the room and sat next to Kass, she asked, “So I assume you have been updated?” Trey and Toni looked at each other and at Kassie, and said, “No, what?” Dr. Ritter then stated that Kassie was pregnant! A wave of disbelief washed over all of them, tinged with a glimmer of hope and wonder, mixed with fear and a bit of nausea. Now what?
Faced with this unexpected news, an immediate decision was made to change the plan from the double-mastectomy and proceed with a lumpectomy and the removal of several lymph nodes. Fortunately, the lymph nodes did not show involvement since with the pregnancy, radiation was off the table as a treatment option. Friday, the day following surgery, Kassie had an ultrasound which to everyone’s surprise confirmed the pregnancy but also confirmed she was over 9 weeks pregnant, and showed a baby perfectly formed with an amazing strong heart beat!
They learned that Kassie and Trey could proceed with the pregnancy and Kassie could be treated in a fashion that kept her and the baby safe through her cancer treatment. Kass has been blessed with a wonderful medical team. Her Surgical Oncologist, Dr. Ritter, was amazing the day of surgery and helped set up the work up and follow up for Kassie. Her Oncologist, Dr. Atkins, has been sensitive and supportive of Kassie and Trey and has let them know she will work with Kassie to fight and eradicate this cancer, as well as support the baby and pregnancy. Due to the high risk of the cancer recurring, and because they cannot block the hormones that drive her cancer during pregnancy (estrogen and progesterone) the oncologist recommended starting chemotherapy during the second trimester (May) while delaying the double-mastectomy, ovarian suppression, and hormone blocking therapy until after the baby is born. Some chemotherapies can be given safely without significant risk to the baby. The babies do tend to be somewhat smaller at time of delivery but no meaningful risk of developmental or growth problems. Kassie and Trey had a new plan…and a baby!
Next stop…meeting with the OB specialist and an appointment with the maternal fetal medicine doctor. On April 8th Kassie and Trey met with their OB who has a focus in high risk pregnancies, specifically patients with cancer and needing chemotherapy. An ultrasound showed a 10-week-old baby with a strong heartbeat, who was very active. “A very determined baby,“ was how the OB described this child. Again a blessing that provided Trey and Kassie hope and the confidence that they could now share the wonder of this baby with others in the face of a very scary and at times daunting diagnosis.
As a family, our heartfelt intention is to use this CaringBridge site to keep all those who cherish Kassie and Trey informed throughout this journey. We will strive to post updates for both Kassie and the baby weekly. This is not just about rallying together to support Kassie as she courageously fights and triumphs over cancer, but to share the joyous and exciting moments of welcoming baby Nehowig!
Kassie update: We feel blessed to share some good news we got from the Oncologist (Dr. Atkins) last Friday. We’ve been patiently waiting for the results of some final testing on the tumor itself, called Oncotype. Kassie’s Oncotype score was 18, falling in the intermediate range. This indicates she will need the initial treatment with chemotherapy which we have been preparing for. Fortunately because the score was below 26, she will not require a second round of chemotherapy after the baby is born. We also learned Kass can wait until she is between 16-18 weeks pregnant to start the chemotherapy. The final decision to start chemotherapy from the baby's perspective will be made by the Maternal Fetal Medicine Doctor (Dr. Parker) who will monitor Baby Nehowig during the pregnancy and chemotherapy.
Baby update: Kassie met with the Nurse Practitioner/Midwife who will be taking care of her during the pregnancy, Jennifer Hanson. Jennifer will alternate with Dr. Lanasa (Kassie’s OB) for visits. Kass and Trey got to view another ultrasound of Baby Nehowig who entertained them with lots of movement and a strong heartbeat in the 150’s. Kass also got lots of blood drawn which will be used to help the Maternal Fetal Medicine Doctor as she cares for Baby Nehowig - this blood work will also identify the gender of the baby!!!!! So lots of fun news ahead!!!
Doctor appointments coming up include EchoCardiogram this Thursday April 25, then Dr. Parker (Maternal Fetal Medicine) Friday April 26, and Monday April 29 Kass will get her PORT in; PORT is a device inserted in her upper chest wall and her Superior Vena Cava which will allow for safe delivery of chemotherapy and can be used for lab work and delivery of IV fluids.
Thank you again for all the support and prayers as Kassie and Trey navigate these tough days. We will do our best to keep you updated each week.
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