Photo Credit: Courtesy of Rana Kahl
Rana Kahl, now 43, will never forget the phone call that changed everything. She and her husband Kevin were on a trip to Cabo San Lucas where they decided that when they returned home they were going to slow down and start a family. Kahl had been working around the clock as one of 20 employees in a start-up internet company, and although she loved her job and the people who worked there, it was time to focus on family. Back home, relaxed and tan, Kahl was in the shower when she felt a small lump under her right arm. Her OB/GYN assured her it was probably nothing, but referred her to a breast surgeon, who recommended a biopsy “just to be on the safe side.”
The day after the biopsy was Kahl’s 33rd birthday and she was working from home. While on the phone with a coworker, her breast surgeon called on the other line. “When I remember the call, I am right back in that moment,” Kahl says. “He said, ‘We just got your lab results back and I’m sorry to tell you but we found a malignancy.’ In the six seconds it took me to process what he said, my whole life changed in front of me. I told him I couldn’t talk to him right then, and I hung up on him and on my coworker. I collapsed in tears at the top of my stairs, and that’s where I was ten minutes later when my husband got home. It was the one time I really broke down.”
The diagnosis was stage I breast cancer. Although her cancer was in an early, treatable stage, the fact that Kahl wanted to have children complicated her treatment options -- certain kinds of chemotherapy can cause women to go into early menopause. “I went to three oncologists, because I needed to hear the same thing twice. I needed to know that at least two oncologists agreed about the best treatment for me,” she says. “I remember telling my husband, ‘I can’t make a decision that will cost us having children, because it’s not just my dream anymore, it’s yours, too. I can’t make that decision for you.’ He looked at me and said, ‘I married you. I didn’t marry the kids we’re going to have. I can’t be married to you if you’re not here. We need to figure out that part first. One way or another we will have children. Let’s focus on this part first.” His words gave me the freedom to do what I needed to do.”
After weighing her options and hearing the same recommendation from two specialists, Kahl had a lumpectomy and then went through four intense chemotherapy treatments, each three weeks apart, chosen because it was more likely than other chemo regimens to spare her fertility. She shaved her head before the rest of her hair could fall out and she donned a reddish wig named “Sherry” that she says complemented her skin, yellowed slightly by the chemo.
“I got sick on the chemo only once,” Kahl recalls. “Most of the time after a chemo treatment I would just feel like I had a bad hangover.” Her chemotherapy was followed by a course of radiation and therapy with tamoxifen, anti-estrogen pills that block the hormone needed for the kind of cancer cells that Kahl had fought off. Usually doctors recommend that women with Kahl’s type of breast cancer take tamoxifen for five years, but by that time she would have been 38 years old and she didn’t want to wait that long to begin trying to conceive a child. So, she struck a deal with her doctor -- she would take tamoxifen until exactly two years after her diagnosis, then go off of it and try to get pregnant. She agreed to go back on the drug post-pregnancy. Once Kahl stopped taking tamoxifen, she waited three months for the drug to clear her system, and fingers crossed, start trying to get pregnant.
A dream come true
Not long after, Kahl was in her first week of working for a new company, feeling unusually tired and a little queasy, symptoms she chalked up to the stress of starting a new job, until she realized that her period was late. A pregnancy test confirmed her suspicions. On May 31, 2003 she gave birth to a son, Aidan Marc Charles Kahl, whose two middle names were those of the OB/GYN who was by her side throughout her medical journey. Kahl breastfed Aidan for three months with her left breast, which was unaffected by the cancer that had occurred in her right. She supplemented her natural milk supply with formula bottles as well. A few months later, Kahl kept her promise and went back on tamoxifen for another year-and-a-half, after which she went of the drug again and conceived her second son Ethan, who was born December 7, 2006.
Although Kahl considered trying for a third child, her doctors advised her against another pregnancy. “They said that every time I get pregnant as a post-breast-cancer patient I am running the risk of a recurrence because the type of cancer I had is fed by hormones. During pregnancy, your hormones are surging,” she says. “I’ve rolled the dice twice and been incredibly lucky, but I’d be pushing my luck to roll them a third time.”
The gifts of cancer
Today Kahl is a happy working mom of two whose “hobby” is cancer advocacy. Here’s her advice to other women who are diagnosed with breast cancer: “Realize that you have choices, and make sure you understand those choices. Be informed. Don’t be afraid to ask questions. Do your research. Get the consults, and don’t work with anybody who doesn’t want to partner with you.”
Her own prognosis is excellent. She now gets yearly mammograms on the same schedule that a woman who never had cancer would, a fact that brings her some relief, but also makes her uneasy. “Every cancer patient will tell you that one of the toughest parts is when you come out of treatment and you’re not getting checked every couple of weeks,” says Kahl. “Nobody is looking as frequently to make sure nothing has come back to surprise you. You’re on your own and you can’t see what’s underneath, so it’s very common to be a little fearful.”
Kahl does not let that fear slow her down. Instead, she juggles a full-time job, motherhood and marriage. She continues to enjoy what she calls “the gifts of cancer,” which include a sense of clarity about what’s important in her life, the power of faith and the love and support of people around her. “I’ve seen the depths of people’s souls and the size of their hearts,” she says. “We live in a world where the other shoe is going to drop at any minute, but that means you better live the day and live it well. Don’t look at the world through a lens of fear; try to view the world through a lens of abundance and optimism. I can attest to what a difference that meant for me. There was a time when I was sure I wouldn’t make it to 40. And look at me now. I’m a mom.”
Do you have breast cancer or know someone who does? Visit our breast cancer support community board.
Did you or someone you know have a baby after beating breast cancer? Chime in below!