The night of her October 2019 wedding, Erica Nix danced the traditional father-daughter dance at the reception. Her husband followed by dancing the traditional mother-son dance with his mother.
But Erica, who had survived a breast cancer diagnosis the year before, had a surprise in store. She called to the dance floor her mother, Cindi Stephenson, who had survived her own pancreatic cancer diagnosis the same year.
Together, the two cancer survivors danced a mother-daughter dance to “Fight Song” by Rachel Platten.
“I danced with my mom just because we had both been through such a terrible year the year before,” Erica says. “Everybody was up and standing and clapping. I didn’t expect that. I just wanted to dance with her because we both just fought for our lives and made it out.”
Cindi hadn’t expected the gesture and was moved by it.
“It was a tear-jerker for everybody,” Cindi says.
Both Erica and Cindi fought cancer in 2018 and survived, leaning on each other and their other loved ones the entire time. And the shared experience made an already close mother and daughter even closer.
“I feel like it was almost a blessing that we had it around the same time,” Erica says. “It’s almost like I got diagnosed first and went through what I did so I could help her through what she was about to go through.”
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‘I Was Just in Shock’
Cindi and her husband Mark have been married for 45 years and raised four children in western Pennsylvania.
Erica, the youngest of the four children, was in her late 20s when she first discovered a lump in her breast in 2017. Her doctor believed it was an infection and prescribed antibiotics. The condition didn’t resolve and multiple ultrasounds didn’t show exactly what Erica’s problem was.
In April 2018, Erica saw another nurse practitioner, who recommended another ultrasound. But, believing something else was wrong, she wanted to see a specialist.
“At that point, I knew that (the treatment) wasn’t working,” Erica says. “And either way, I would have to have this lump removed because it was noticeable and it was bothering me.”
Erica asked Cindi, who had worked in health care for 40 years before retiring in December 2017, for a referral to a breast surgeon. She had a breast scan taken on a Friday, and on the following Monday, her surgeon called with her diagnosis.
It was breast cancer.
Erica says she “blacked out” when she heard those words.
“She talked probably for five minutes after that, and I didn’t hear a single word she said,” Erica says.
Erica’s first call was to Cindi.
“It was breaking my heart,” Cindi says. “And I felt like, ‘I should be doing this. You shouldn’t have to go through chemo or anything like that in your life. You’re too young. This should have happened to me.'”
The next few days, Erica kept the news of her diagnosis a secret from many of her family members and her friends. She tried to keep a calm demeanor but felt herself struggling inside.
“I was just in shock of ‘I can’t believe this is happening,'” she says. “It’s scary because you don’t know. I didn’t know if I had stage 4. Did I let it go so long that I was going to not make it? You have no idea. And so many things are going through your head at the time.”
A few days later, Erica had a follow-up appointment. She learned she had stage 2 Paget’s disease, a rare form of breast cancer. Her case was unusual not only because of the rare cancer, but also because of her age.
Despite that, she had a good prognosis. She would need a right breast mastectomy, but her cancer’s indicators showed she was eligible for hormonal therapy. She wouldn’t have to go through chemotherapy or radiation.
“When they told me what I had to do and that I was going to beat it , then I was like, ‘OK, I’ve got this,'” Erica says. “‘This will be fine.'”
In late May 2018, about a month after her diagnosis, Erica had a mastectomy.
“Having a surgery that changes your body when you’re young like that, not married or anything, I was just a little paranoid about my appearance,” Erica says. “But then, after the surgery, I was like, ‘What is that? I beat cancer. Who cares?'”
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‘I Don’t Have Time to Be Sick’
A week after her surgery in early June, Erica was recovering at home. She had recently gotten a puppy, and Cindi was helping her take care of the puppy as Erica recuperated.
While she was helping out, Cindi began to feel tired herself.
“I kept feeling exhausted, sitting down on a swing out in their backyard with the dog,” she says. “I’m thinking, ‘What is wrong with me that I’m this tired? I’m not doing anything.'”
As a diabetic, Cindi was checking her blood sugar and noticed it was higher than usual. But she still didn’t think much of it. With an endocrinology appointment coming up, she had some blood work done.
The next day, Cindi was attending one of her grandsons’ baseball game. Her other daughter, Erica’s older sister, noticed that Cindi’s eyes looked yellow. Cindi brushed it off but, when she returned home, she noticed it herself. She also checked her blood sugar and saw that it was extremely high.
Cindi called her doctor the next morning and was prescribed insulin. But the next morning, her doctor called her again and told her to go to the hospital immediately because her blood work looked abnormal.
A magnetic resonance angiogram (MRA) didn’t reveal anything unusual, but Cindi’s gastrointestinal doctor ordered more tests — an internal ultrasound and endoscopic retrograde cholangiopancreatography (ERCP) — to study her further.
“He said, ‘I think you have cancer,'” Cindi says.
Sure enough, Cindi’s scans revealed she had pancreatic cancer — a very difficult diagnosis. Although the survival rates for pancreatic cancer have increased in recent years, it is still very deadly.
“That was devastating,” Cindi says. “Being in health care for 40 years, you know how bad this is.”
Despite the diagnosis, Cindi’s focus remained on Erica.
“I thought, ‘I don’t have time for this,'” Cindi says. “‘I have a child that has cancer. I don’t have time to be sick.'”
Erica learned of her mother’s diagnosis from her father.
“My first thought was she wished this on herself because she kept saying, ‘I wish it was me instead of you,'” Erica says. “In our family, we like to crack jokes. And I was like, ‘She even had to get a better cancer than me. She couldn’t let me just have my cancer.’
“But I was really scared for her. It was as absolutely devastating. When you hear pancreatic cancer, you think it’s a death sentence. I was shocked. I just knew that she was going to have a long battle ahead of her.”
‘They Were There for Each Other’
Pancreatic cancer is a very aggressive disease. But at the time of her diagnosis, Cindi’s cancer had not spread.
Because of the location of her tumor, Cindi was a candidate for a pancreatoduodenectomy, better known as the Whipple procedure. The procedure removes the head of the pancreas, gallbladder, bile duct, part of the intestines, and sometimes part of the stomach.
Before undergoing the Whipple, Cindi would need to receive chemotherapy. And coincidentally enough, she began her treatments at the same time as Erica was beginning her hormone treatments.
“It was an anxious time for both of them because being diagnosed with two family members with cancer at the same time was overwhelming,” says Gaurav Goel, MD, hematologist-oncologist, St. Clair Hospital Cancer Center, in affiliation with UPMC Hillman Cancer Center.
Dr. Goel was the treating medical oncologist for both Erica and Cindi. Erica received anti-estrogen therapy along with a novel oral CDK 4/6 inhibitor on a promising clinical trial. Cindi received intravenous chemotherapy.
Often, Erica’s and Cindi’s appointments were back to back. Even when they weren’t, they often would accompany one another.
“I got to see them a lot of times together, and they were there for each other and a huge support,” Dr. Goel says. “They were constantly encouraging each other throughout the journey, and they always had a great attitude.”
In October 2018, Cindi underwent the Whipple at UPMC Hillman — which pioneered the robotic form of the procedure.
The Whipple removed the tumor successfully. Cindi needed several more months of follow-up chemotherapy, and her treatment finished in February 2019. She also received radiation to a tiny lung nodule in December 2020.
Although she says the chemotherapy and Whipple surgery were difficult, Cindi stayed positive through it all. Her focus remained on Erica and the rest of her family.
“I’m glad (Erica) didn’t have to go through any chemo, and if that’s what I had to do, that’s what I had to do,” Cindi says. “I was fortunate I was able to have the Whipple surgery and have a good doctor.
“I was just thinking of my family and kids and grandkids. I just wanted to be there for them.”
‘Everything Happens for a Reason’
Erica got engaged to her longtime boyfriend in August 2018 on a family beach vacation. The wedding was more than a year later, in October 2019 — coincidentally, during Breast Cancer Awareness Month.
Before the wedding, one of Erica’s friends collected pink Terrible Towels that were distributed at a Pittsburgh Steelers game. The wedding party posed for photos with the towels, and many people at the wedding wore pink in support of Erica.
“It was so cool,” says Erica, who calls the photo with the Terrible Towels her favorite wedding picture.
And, of course, there was the mother-daughter dance.
The wedding was a reminder of the love and support Erica and Cindi had received from their family and friends when they had cancer.
“I had such a great support system. I think she did as well,” Erica says. “Just surround yourself with loved ones and stay positive would be the best advice to give to somebody.”
One of the most important support people for Cindi was Erica herself. Erica having overcome cancer provided Cindi with strength during her own cancer journey.
“I’m the type of person who believes everything happens for a reason,” Erica says. “I think that was why mine was so minor — because hers was going to be worse than mine and we could be there for each other.”
‘The Joy of Hanging in There’
Since their treatments, Erica and Cindi have been in remission. Cindi continues to have follow-up appointments and gets periodic scans for monitoring. A couple of years ago, she had a stent procedure to help with a heart condition.
But both women are healthy today.
“It’s one of the most precious moments in oncology, which is so gratifying, when you see such positive outcomes,” Dr. Goel says. “Despite having an aggressive tumor such as pancreatic cancer, Cindi has done amazingly well. As a medical oncologist, it is really encouraging and boosts the morale for what we do every day.
“And as for Erica, the fact that she was so young when she was diagnosed with breast cancer makes you worry about the potential psychological impact of treatment, which involved mastectomy and anti-estrogen therapy. But she went through the cancer treatment journey very gracefully and came out of it with flying colors.”
Erica paused her hormonal treatments to try to become pregnant. She gave birth to her first child, a baby girl, just over a year ago. Cindi often babysits her and her other grandchildren.
“I’m lucky to be healthy enough to take care of my grandkids now,” she says. “That’s the joy of hanging in there.”
Erica and Cindi both believed the positive attitude they held throughout their cancer treatments helped them. They advise other people to keep positive — and to find a strong support system.
Almost five years after their cancer journey began, Erica, Cindi, and their family are closer than ever. They continue to support each other, as they did throughout the entire experience.
“We both leaned on each other during everything, and I think that helped us,” Erica says. “We still do that. We definitely have a better relationship now.”
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About UPMC Hillman Cancer Center
When you are facing cancer, you need the best care possible. UPMC Hillman Cancer Center provides world-class cancer care, from diagnosis to treatment, to help you in your cancer battle. We are the only comprehensive cancer center in our region, as designated by the National Cancer Institute. We have more than 70 locations throughout Pennsylvania, Ohio, and New York, with more than 200 oncologists – making it easier for you to find world-class care close to home. Our internationally renowned research team is striving to find new advances in prevention, detection, and treatment. Most of all, we are here for you. Our patient-first approach aims to provide you and your loved ones the care and support you need. To find a provider near you, visit our website.