Written by MSD in the Philippines
Triple-Negative Breast Cancer, otherwise known as TNBC, makes up only 15% of all known breast cancer cases. Compared to other types of breast cancer it lacks certain receptors involved in tumor growth, survival, and spread. Specifically, TNBC does not have receptors for estrogen and progesterone, and HER2.
Despite these differences, the symptoms of TNBC are the same as that of most breast cancers. Having a lump or mass in the breast is still common, as is swelling, pain, discharge, or other unusual appearances on the breast.
Sometimes, having a family history or certain risk factors can prepare someone for a potential diagnosis, unwanted as it may be. In other cases, they may come seemingly out of nowhere. Either way, it is a reality that millions of women must face.
Joy Formantes is one of these many women. An IT professional and new mother who lived an active lifestyle, getting her breast cancer diagnosis was a surprise.
She first noticed a breast lump in 2022, while taking a bath. No concern sprang to her mind just yet because, at the time, she was a few months off of breastfeeding her nearly one-year-old son. Formantes breastfed for about three to six months and thought that her lump was most likely just milk that had solidified.
Her gut told her something else, however. She eventually saw a doctor a year after first spotting the lump, expecting to be told that it was nothing alarming. But the revelations came one after another. The lump was detected to be around 6 centimeters in size, while a mammogram and ultrasound indicated a 95% chance of cancer. After a biopsy and consultations with multiple oncologists, the final diagnosis came in October of 2023 – Formantes had Stage 3A Triple-Negative Breast Cancer.
A wave of thoughts and emotions came crashing down when she heard this news. Questions surrounding her chances for recovery and survival, how her family would deal with the diagnosis, what her treatment options looked like, how she would fare while getting treated, and how the cancer would affect her son – all came up at once. These were overwhelming feelings but Formantes knew she now had to do two things: stay positive, and face her new situation head-on.
Her family was scared but supportive. Her partner was also by her side. And as for her team of medical professionals, they made sure that Formantes would get the best and most effective form of care.
Formantes’ treatment plan included surgery, as well as systemic therapy, incorporating chemotherapy, pre- and post-surgery. Despite popular belief, movies, and television shows portraying chemotherapy as having severe side effects, her doctors assured her that medicines are now available to address these side effects.
Additional to chemotherapy, Formantes also had to do immunotherapy, a treatment that helps the body’s immune system detect and eliminate cancer cells. Compared to other breast cancer types, TNBC does not respond as well to current standard therapies. However, with immunotherapy, some treatment gaps have been filled and higher recovery rates have been observed among TNBC cases.
Combining both treatments before surgery was difficult, even with ways to make them more manageable. By her second cycle of chemotherapy, Formantes became increasingly sensitive to the scent of garlic, onion, and ginger, which caused nausea and dizziness. Even eating was a challenge because she frequently felt like throwing up right after. Around her fifth or sixth cycle, Formantes had to be taken to the ER and confined due to severe vomiting. The immunotherapy added to her side effects, causing even more fatigue than usual.
It was this that made having a strong support system incredibly important. Formantes’ family and friends were supportive, but the cancer survivor also found comfort in fellow TNBC patients. Groups composed of women with either breast cancer or specifically TNBC were present across social media. Members would talk about what they were going through, reaffirming Formantes about what she was feeling and experiencing herself. For her, the ability to talk to those who know the TNBC journey first-hand was a very helpful supplement to her own support system.
The help and moral support provided by those close to her could not be discounted, of course. Formantes recalled her loved ones being by her side, even willingly providing financial assistance without being prompted to do so. Adding to it was an incredibly understanding employer, who contributed to her treatment expenses and decided not to deduct any additional absences from Formantes’ salary if they were due to her treatment sessions.
Realistically speaking, funds are one of the biggest concerns whenever anyone receives a cancer diagnosis. Getting high-quality care does not come cheap, and Formantes was thankful to have a world of support around her, as well as a company HMO that she could rely on.
Gaining and focusing on her personal strength throughout all of these was another source of resilience for Formantes. She focused on the present and on her priority of recovering. A million concerns were always on her mind, but she had to stay strong.
Even today, questions remain as Formantes hits the home stretch of her treatment. Pre-surgery combination chemotherapy and immunotherapy began in October 2023 and ended in March 2024, while her post-surgery immunotherapy is nearly done as well. She has also had her double mastectomy in between cycles. All her treatments have been done under the care of a multi-disciplinary team led by Dr. Frances Que [MSD/PATIENT TO CONFIRM], an oncologist from St. Luke’s Medical Center BGC.
The Future for TNBC Survivors
Recurrence rate goes up to 40% for cases of TNBC. Formantes’ main concern: what if the cancer recurs after she finishes her treatment? She and her doctors have agreed to do scans every six months, but there is still some fear of complacency. To combat this, the cancer survivor does what she can. She watches what she eats, and makes sure to get enough sleep, and has become generally more conscious of her new lifestyle. It’s her way of making sure that in case it recurs she has done her part.
Spending time where it really matters has also become a larger focal point. Formantes balances between getting personal time to work out or relax, while also allotting hours for her loved ones. Important family gatherings are no longer missed, while quality time with her son and partner is given more priority over other responsibilities.
Beyond her own story and journey, however, Formantes hopes to provide hope, knowledge, and support for her fellow TNBC patients. In the same way that so many people were able to lend a hand to her, she encourages others to get checked for the disease especially if they spot symptoms, and face it with strength and resilience if the diagnosis comes.
Formantes also wants to shine a brighter light on TNBC, and cancer in general. Not everyone will have the proper resources and support systems in place to deal with cancer and get the most appropriate treatment. She hopes that larger institutions like the government continue providing what they can, while at the same time improving on the help that they can offer to cancer patients.
A 2021 study notes that TNBC has a prevalence rate of 8% in the Philippines. Like Joy Formantes, the stories and journeys of these women remain as powerful testimonials that hope, resilience, and support from those around them light the path forward, reminding them that no one needs to face the battle with TNBC alone.
PH-NON-01083
