Couple endures simultaneous breast cancer diagnoses
When Mark and Joanna Clausen moved to Dennis from Norton, MA, four years ago, they had visions of gardening, golfing and the quiet life of Cape Cod. Unpacking and settling into their new home and way of life was their focus.
That all changed when Joanna was diagnosed with breast cancer, followed by Mark’s diagnosis of the same disease a few months later. Their focus then turned to biopsies, surgery, treatment, managing side effects of treatment, Joanna’s heart attack, and COVID-19.
I met Mark, who is president and chairman of the board of the Cape Wellness Collaborative, and Joanna for the first time at the 10th annual Cape Cod Healthcare Cancer Survivors’ Day in September 2024. Mark gave a very moving and inspirational speech about the challenges of their cancer journeys.
The second time I met with them was at their home, where I was greeted by a bounding yellow Labrador retriever named Chester, who did not show any signs of the emergency surgery he had during Mark and Joanna’s cancer treatments.
Joanna’s Diagnosis and Treatment
“I was diagnosed with breast cancer on November 11, 2022,” said Joanna. “I had a lump for a while that I discovered during a breast self-exam. I was able to see Naomi Kalliath, DO, at the Cape Cod Healthcare Breast Surgery - Hyannis, who recommended a biopsy. Once we knew the biopsy was positive for cancer, Dr. Kalliath recommended surgery to remove it.
“I don’t think I was psychologically prepared to do that at the time and so I decided to wait. Mark and I planned to tell our children about my breast cancer during their holiday visit and once we did, I decided to schedule my surgery in February 2023. Dr. Kalliath only had to remove one positive lymph node in addition to the tumor during the surgery.”
Joanna was diagnosed with stage I, HER2 positive breast cancer. She met with Edward Wyluda, DO, a medical oncologist at the Davenport-Mugar Cancer Center, to discuss treatment options, which were radiation and chemotherapy. She chose chemotherapy once a week for 12 weeks.
Mark’s Diagnosis and Treatment
While Mark and Joanna were dealing with her diagnosis, surgery, and beginning chemotherapy, they were hit with Mark’s breast cancer diagnosis.
“I had an appointment with my primary care physician in Norwood on February 23, 2023,” said Mark. “I didn’t have a PCP down here yet and had some issues with my shoulder that I wanted to address. It was a beautiful day, 58 degrees, and I had my golf clubs in the back of my car to play a round of golf following my appointment. During my exam, my doctor noticed that my right chest wall looked inflamed and a little swollen which, he said, it shouldn’t. He asked if I had been hit by someone or something and, when I replied no, he told me he wanted to order a mammogram and ultrasound while I was there.
“I remember thinking as the technician was squeezing my chest with the mammogram machine, that I had a newfound respect for women who have to go through this,” Mark said. “After my mammogram and ultrasound, the radiologist came into the room and told me I had breast cancer and I would need to schedule a biopsy. I asked three times if she was sure and she said ‘yes.’”
Mark decided he would take his records with him to be treated by Dr. Kalliath and Dr. Wyluda.
“I drove home wondering how I was going to tell Joanna I had breast cancer, too,” said Mark. “I waited about 20 minutes after I got home to talk with her. It was very hard telling her and then sharing it with my kids.”
A Heart Attack Changed Schedules
As Mark was preparing for his upcoming surgery with Dr. Kalliath, Joanna suffered a heart attack in her second week of chemotherapy treatment.
“I was outside doing my gardening, which I love because it gives me a very peaceful feeling,” said Joanna. “When I came inside, I began not to feel well, I was having difficulty breathing and pain in my arm.”
Mark called 911 and she was taken to Cape Cod Hospital.
“The ambulance was here in five minutes and at the hospital within 25 minutes,” said Mark. “She had a cardiac procedure to place a stent in an artery and spent three days in the hospital.”
Three weeks later, Joanna resumed the chemotherapy treatment.
“My goal became getting through treatment,” she said. “I didn’t think about it; I just went along with what my healthcare providers told me to do. I felt so reassured by all of them, they were so very kind, empathetic, and they listened.”
Joanna suffered a second cardiac setback, which stopped her chemotherapy treatment until she recovered, and it pushed Mark’s surgery back about six weeks to the first week in May.
Mark’s Treatment
“My surgery was scheduled for May 6, and I was very nervous,” said Mark. “The staff held my hand trying to keep me calm. The surgery ended up having a couple of surprises because in addition to removing the left chest mass, Dr. Kalliath found abnormal nodes and so she had to make an additional incision into my armpit and remove 21 lymph nodes. Seventeen of the 21 nodes were cancerous. I was diagnosed with stage III breast cancer because the cancer had spread.”
Mark’s type of cancer, HER2 negative, estrogen and progesterone positive required an intensive chemotherapy treatment plan of AC-T (Adriamycin, Cytoxan, and Taxol). He received chemotherapy every two weeks for a total of eight treatments.
“I would get the treatment, Joanna would drive me home and then I would be in bed for one week,” said Mark. “I would be sick for 8 days with side effects and then slowly feel better in time to have my next treatment on the 14th day. Joanna received her chemotherapy on the 9th day after my treatment when I was starting to feel better. It was the same cadence over and over.”
After completing eight weeks of the first chemotherapy regimen, Mark began a second regimen of weekly chemotherapy treatments for 18 weeks, followed by radiation.
He met with Jeffrey Martin, MD, a radiation oncologist at the Davenport-Mugar Cancer Center, to discuss radiation treatment options. Given Mark’s cancer type and his preceding 26 weeks of chemotherapy, Dr. Martin recommended a 25-day cycle of radiation. Mark completed his daily radiation treatments at the end of January 2024.
In addition to their diagnoses, surgery and treatment, their dog, Chester, injured one of his knees and tore his ACL, which required surgery. Mark and Joanna were both too sick and weak to care for him, so their veterinarian took over Chester’s care and kept him at his clinic for four weeks until he recovered.
The couple both caught COVID-19 just before Christmas 2023, which added to their ordeal.
“We were too weak to stand and could barely get out of bed. We couldn’t do much of anything,” said Joanna.
Then and Now
Mark, Joanna and Chester have recovered from the journeys. Joanna is in remission and Mark takes Tamoxifen and Verzenio daily to ward off the cancer, and has follow-up oncology visits every two to three months. Chester now bounds around the house with no signs of his injury.
The couple is grateful for all the care and support they received from the staff and physicians at the Cuda Breast Care Center, Cape Cod Hospital and the Davenport-Mugar Cancer Center, which is relocating next month to its new home within the Edwin Barbey Patient Care Pavilion on the Cape Cod Hospital campus.
“Joanna and I never considered going to Boston for treatment. Our doctors consulted with oncologists at Dana Farber Cancer Institute and it was a team effort. We just felt we could trust them. For the level of technology, tools and knowledge that Cape Cod Healthcare offers, we felt the only difference between staying here and going to Boston would have been the commute each way.”
“Vitamin F”
“Whenever we were feeling sorry for ourselves and feeling at our lowest, I would be reminded what my mom called “Vitamin F,” said Mark. “Vitamin F got us through our roughest patches in our 18-month journey. Vitamin F is faith, family and friends. We had deep faith that we would push through and be well. We had a village of family and friends helping us and we put our trust in Cape Cod Healthcare.”
Mark and Joanna look at life differently now.
“We have a really good outlook on life,” said Mark. “We have a great family, we love being on Cape Cod and we have a great support system at Cape Cod Hospital. We have some really good people in our lives and we are very fortunate.”
