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photographs by Nicole Moulton, Sara Magaletta and Anna Sullivan

Thirty Something

We thought we were too young to get cancer. We were wrong

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Creating Community

The disheartening truth is people much younger than both of us are getting cancer now, despite their healthy lifestyle choices, and a lot of the support that exists is for older generations. We strongly about creating a space to support others going through challenging times, without a built-in bestie by their side.

Healing and Dealing is a way for us to connect with people, our greatest joy. The other day someone sent us a message saying that she stumbled upon our Substack, and was about to begin chemo. She told us that our writing made her feel so much better about starting treatment. Sara cried and called Anna immediately.

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Reality Bites

I am not the only ‘80s baby dealing with cancer

By Sara Magaletta

I was 38 when my symptoms intensified to the degree that I thought I should engage a medical professional.

The now weekly bright red blood in the toilet paired with the constant stomach discomfort and debilitating exhaustion had finally reached an unsettling frequency. I had been experiencing this myriad of symptoms for at least five months. As a woman, I am accustomed to a certain level of discomfort, so when the blood arrived, I did what I’d always done: observed, acknowledged and endured.

A few months later, on my 39th birthday, I met via Zoom with my gastroenterologist. I felt so proud and grown up, following up with specialists regarding my health. This was peak adulting, as I took a selfie to commemorate the moment and jumped into the virtual waiting room. She listened to my concerns, expressed her feelings about my age—surely too young for anything to be too dire—but given my family history of colorectal cancer, she decided it best to schedule a colonoscopy as soon as possible.

I had been warned countless times about the agony of colonoscopy prep, but I lucked out given that due to COVID-19 and the lack of plastics available, I got to use Miralax, instead of GoLYTELY, which I have since faced and understand more why it’s so daunting. Now that colonoscopies are more routine for me, I’ve incorporated prep strategies like using heaps of ice cubes, lime slices to combat nausea (also useful during chemo), eating mango gummy bears and mindlessly binging Bravo throughout the process.

It was an unseasonably rainy morning when we drove down I-25 to my colonoscopy. The April storm clouds and slow traffic presented a harbinger of what was to come. It was the first time I had ever been put under, and I awoke at ease, in awe of Western medicine and eager to thank Brad, the anesthesiologist. My gastroenterologist was deliberate and somber, unwilling to speak until my partner arrived. Once he did, she told us that she found three polyps and she thought that one was cancer. I said, “OK.” My gastroenterologist is a reserved woman, but you could see the shock and sadness in her eyes, the unjustness. I was too young.

There are infinite horror stories of colorectal cancer patients being ignored and misdiagnosed, especially younger ones. So many people have been dismissed or told it was something else. To have a doctor who listened and was proactive saved my life. The day my biopsy results confirmed her suspicion, she picked up the phone and made sure I was cared for by a team of brilliant surgeons and oncologists at the University of New Mexico.

Although my story should be unique, I couldn’t help but think of Halloween three years prior, when my best friend Anna had told me about her lump and our world exploded. It was unfathomable that she was sick. She was also too young. She had two small children. Her mother had just died of the same disease and I remember being astounded at how unbelievably unfair life could be. I found comfort in the fact that she had survived; though we would have never wished her diagnosis in a million years, her resilience thereafter would inspire me to make it through. Younger people are getting cancer more often but, on a hopeful note, this is also due to improved screening protocols. Unlike in the decades of our childhoods, treatments have advanced and, with early diagnosis, cancer does not have to mean death.

I felt genuine peace with this new information, putting a name to my phantom symptoms. There would be immeasurable hours of waiting in the coming year, but those initial few weeks were the worst. Waiting to learn if the cancer had spread and what the prognosis was, was like watching a broken clock and willing the hands to move.

There is no correct way to tell people you have cancer. Cancer is complicated, confusing and ongoing. Most people have cared for or lost a loved one to the disease. Perhaps that’s why I felt like a burden whenever I tried to share my diagnosis. I didn’t want anyone to worry about me. It was April 2021; who needed more bad news after a year of horror that was the pandemic?

The morning after my colonoscopy, I gathered the courage to email Anna. I was so nervous to tell friends who had lost their parents to cancer, and her mother’s death felt so recent, not to mention Anna’s own experience. I wanted her to be able to process on her own time, without the urgency of an unsolicited call.

My phone rang seconds after I hit send. Hearing Anna’s steady voice brought an instant lump to my throat. I missed my friend. She was making pancakes, and I could hear the clamoring of pots, chairs, her two sons—Max and Freddie—while she somehow calmly told me that it would suck, but it was going to be OK. Anna also immediately connected me with a woman who had a similar diagnosis, which anchored me during the chaos. She knew what I needed before I did: community. It was also during that conversation that she shared the tip I would not understand until years later—that survivorship is the hardest part. I had no idea what she meant, but I never forgot it. It turns out that she was right.

Don’t get me wrong: The treatment was lonely and brutal, a seemingly never-ending series of outlandish and unpredictably painful events. Chemo’s side effects were varying and bizarre. I felt like a human science experiment as I sat there in my sleeveless summer dress while the nurse put on a full hazmat suit to administer the drug that would go directly into my bloodstream. Similarly, during radiation, everyone would flee behind the massive lead doors, while beams of invisible poison burned my insides. Surgery and my ileostomy brought a whole new set of wonders. My partner and I spent hours and hours trying to perfect the angle at which my ostomy bag was connected, and on days when it proved particularly difficult, I sobbed in the shower, refusing to emerge and try again. It was endlessly fascinating. It had to be. The alternative was too grim.

A bright spot of getting cancer as a woman approaching 40 is that just when society was about to deem me old and useless, I was constantly reminded of how “young” I was. In the year leading up to my 40th birthday, people remarked on my youth more times than ever before.

A few months after diagnosis, radiation ushered me into medically induced menopause. Luckily, Anna was waiting with open arms. While I was fortunate to have decided that I did not want kids before the choice was made for me, it still felt like an extra layer of cruelty. While bombarded with what felt like a million decisions regarding treatment, timing and procedures, one more remained. Upon facing my own mortality, I had to choose whether I would freeze my eggs and eventually bring another life into this world. It was unexpected and rough, especially since I made the unpopular choice. Not only was I losing my chance of ever bearing my own children, I couldn’t even pretend to be sad about it.

Following rounds of chemo, radiation, an ileostomy and reversal, which lasted 11 months, I was crushed to learn that I have Lynch syndrome—a genetic condition that places me at a greater risk of getting certain cancers. I burst into tears when my genetic counselor told me of the new findings, and I was shocked by my reaction. I was devastated to be presented with another procedure, but even more surprised when I realized how much I wanted it. I never thought I would undergo elective surgery, I had secretly judged someone else for doing so weeks earlier. “Yes” was the immediate answer. I even jokingly asked the surgeon to please remove any other unnecessary organs while they were in there. Any way to avoid more cancer, anything.

Last summer’s full hysterectomy pushed me squarely into early menopause and aligned me even more with Anna. In what felt like an instant, our conversations abruptly shifted from lighthearted gossip of late nights at Santa Fe’s former Corazón bar to how to cope with constant low-grade depression, fear of recurrence, vaginal dryness and painful sex. Not in my most outlandish thought spirals did I imagine my best friend and I surviving cancer and entering menopause before we both turned 40. Menopause had always felt so far away, and cancer seems impossible until you’re told you have it. As Anna said, survivorship is the hardest part, and there is not a day that goes by when I don’t feel grateful to be navigating it with her.

Sara Magaletta is a writer and co-host of Healing + Dealing. She is getting her MA in Counseling at NMHU and works at Kindle Project.

37 Going On 57

Cancer treatment pushed me into premature menopause. Then, the same thing happened to my best friend

By Anna Sullivan

In October 2017, I found a small hard lump sitting just above my right breast. At first, I assumed it was something leftover from breastfeeding my 18-month-old son, Freddie. However, two years earlier, I’d lost my mother to fast-moving bone cancer. I decided to follow up with my primary care doctor just in case.

Following a biopsy, I learned my breast cancer diagnosis was early-onset and estrogen receptor-positive (ER+), meaning it was receptive to medication that lowered the estrogen levels in my body and, in turn, lowered my risk for recurrence. It also meant that I didn’t need chemotherapy. As I sat half naked on an examination table, my doctor explained that given my age and staging, it would be most effective for me to undergo a unilateral mastectomy and hormone therapy. “If we kill the estrogen in your body, and shut down your ovaries, then the malignancy most likely can’t grow back,” he said, as if he were explaining a math equation. “But these medications will induce premature menopause.”

“OK?” I said, not understanding what that meant. I was relieved—ecstatic even—to learn I wouldn’t need chemotherapy, so everything else was gravy. I wasn’t going to be sick for months or lose my hair, which had been another big fear. I was 37 years old, rounding out my years of fertility. The idea of “going into menopause” was abstract, like trying to understand childbirth before experiencing labor pain.

When I left the appointment, I called my best friend Sara. As soon as I heard her voice, I burst into tears. She immediately offered to drive to my house and watch my two children so that I could schedule follow-up appointments and consultations with surgeons. “Don’t worry. I’ll be right over,” she said.

We had met in the fall of 2010. Back then Sara drove a silver ‘86 Volkswagen Cabriolet. She’d pick me up at my small adobe rental on Agua Fria, and we’d cruise around town with the top down, singing along to Bruce Springsteen. The highway days for the Cabriolet were long gone, but it didn’t matter. Back then, everything we wanted—and needed—was in Santa Fe.

Over the years, Sara has seen me through all my big life events: my marriage, the births of my children and my mother’s death. Our friendship was proof that you can still make best friends in your late 20s, and they will stick around through the hard stuff.

Following my mastectomy, my oncologist prescribed a 10-year treatment plan of quarterly Lupron injections and a daily medication, Letrozole. Within a matter of weeks, an onslaught of symptoms hit me with brute force. I suffered insomnia and night sweats, muscle and body aches, brain fog, mood swings, fatigue, and hot flashes. I also had symptoms of Genitourinary Syndrome of Menopause (GSM), which caused frequent urinary tract infections and vaginal dryness that disrupted my sex life. It felt as though the medications had hijacked my body and left me marooned in an unknown land—menopause.

“This totally sucks,” Sara said over dinner at TerraCotta. “But on the bright side, you’ll never have to experience PMS rage again.” We both laughed. It was a joke that only your best friend could make.

In April 2021, in the midst of COVID-19, Sara called me with alarming news: she had stage 3 colorectal cancer. I failed to hold back tears as Sara told me about her prognosis and complex treatment plan. She was trying to be her usual positive self, but her voice sounded frail and distant. How did this happen? Upon diagnosis, we were both healthy young women without any preexisting health conditions. We looked healthy, and we felt healthy. We exercised regularly and consumed organic vegetables (and wine). And yet, we both got cancer before the age of 40. I wish that our story was somehow unique, but lately it seems like more and more young people are facing a similar prognosis.

A 2024 study published by the American Cancer Society showed a dismal prediction: 2024 will be the first year the United States can expect more than two million cases of cancer. That’s nearly 5,500 new diagnoses a day. Another study showed that more young people are getting diagnosed with cancer at an earlier age, particularly women and adults in their 30s. While the risk of dying from cancer has steadily declined, early-onset cancer diagnoses are on the rise due in part to better screening recommendations and increased awareness of risk factors.

In the days following my cancer diagnosis, while I waited to learn how far the disease had spread, it felt like time came to a sudden halt and all my priorities lined up like the leaning Tower of Pisa. At the foundation of the tower was my family. At the time, my son, Max, was 3 years old, and Freddie was a baby. I was grounded by my overwhelming love for them. I’d lie on the floor of their shared bedroom, long after they fell asleep, and listen to the sound of their breathing. In those dark moments, when I allowed myself to think about what it would be like to leave this world, to leave the two of them, it felt like my tower might topple over.

Early in my treatment, my husband Alex and I made a decision not to tell our children that I had cancer. We agreed that they were too young to understand what it meant. While I recovered from my surgeries, we explained that Mommy needed to stay in bed because she was “hurt.” They sort of got it. “Don’t jump on Mommy! Be careful with mommy!” Alex yelled repeatedly, terrified they might open a stitch. Back then, my scars were visible and raw— I knew what needed tending to.

Eventually, my mastectomy scars healed and life moved on all around me. During my treatment, I’d been so focused on getting my life “back to normal.” I just wanted to feel like a regular healthy person who wasn’t a cancer patient. A person who could feel present, for a moment, without worry that some errant cell was multiplying and forming a new malignancy while I rang up chicken nuggets at the grocery store or drove my kids to school. I’d taken to following other cancer survivors on Instagram who all seemed so happy and together, even the ones who went through chemo and radiation. They’d pop up on my feed, as they touted their green smoothies and organic supplements. Even though I was also drinking green juice and taking vitamins, I wasn’t smiling. I was feeling lost and alone, on autopilot, as if an alien force was operating my body from another galaxy.

I tried to recall the days post-diagnosis when my priorities had lined up so perfectly, but I no longer felt that sense of groundedness. Not in my career as a counselor, not in my marriage, and not even in my role as a mother. Survivorship had knocked me down and left me standing in the pieces of my old life.

Sara and I often discuss our pre-cancer vs post-cancer selves. Pre-cancer, I rarely went to the doctor. But in the years following my diagnosis, I assumed every physical ailment was dire and that a recurrence was imminent. I walked through the world anxious and afraid. I constantly scanned my body, waiting to discover the next abnormality. Over time, I’ve learned to accept that these feelings might always be with me. As much as we try to control the unknown—we can’t. Cancer taught me that life is unpredictable, but infinitely better with your best friend by your side. Sara and I have always said: The silver lining of getting cancer was getting it together.

Over the years, I’ve surrendered to the idea that healing doesn’t happen on a timeline. I guess that’s the thing about survivorship no one tells you. You don’t just process one life experience and feel better. You have to get rid of the stuff you’ve been holding onto forever. It’s radical. It’s total. It’s how we move forward.

Anna Sullivan is a mental health therapist, writer, and co-host of Healing + Dealing. She is currently writing a book, Private Parts, about going through early induced menopause due to cancer treatment.