Cory Pacheco, RN, on Breast cancer survivor recommends seeking a second opinion

It’s been 12 years since Registered Nurse Cory Pacheco heard the one word every single person fears … cancer. 

“When I got that phone call, it sucked the life right out of me,” she recalls vividly. "I eat right, I exercise regularly, I don't smoke, I drink socially … I do everything I can to stay healthy and there is no family history of cancer, but I still got it. My life took an about face in just seconds,” she shares during The Breast of Everything podcast, hosted by Comprehensive Breast Care Surgeon Linsey Gold, DO, FACOS, FACS.

“I have a younger relative who smokes, has high blood pressure, is overweight, eats fast food, and isn’t compliant with her medications. Her mammogram was clean. I felt like my body had betrayed me,” Cory announces.

“We are not as in charge as we think we are,” she reflects.

Her next step was to find the right medical team to take care of her. Cory lined up three surgeons and set up visits with each. 

The first surgeon directed her on what she had to do, giving her no options. After her second appointment – with Linsey Gold, DO, FACOS, FACS – Cory decided she did not need a third opinion. Dr. Gold was her choice. She spent three hours with Cory answering every one of Cory’s questions. 

“I needed everything answered and Dr. Gold did just that. She laid it all on the table and gave me my options. She didn’t rush my decision; she gave me plenty of time to think it through. I had the freedom to make my choice. It is my body; it should be my decision,” Cory says with conviction.

Together, Cory and Dr. Gold came up with a treatment plan that Cory was comfortable with. 

"I felt like I was talking with a friend," Cory notes. "Dr. Gold wanted to know my fears, she suggested I see two or three other doctors for a second opinion, and she even encouraged it. I don't see that very often with physicians." 

After Cory’s surgery, Dr. Gold recommended radiation therapy, but, after extensive research and long discussions with Dr. Gold, Cory declined that treatment as well as chemotherapy. Dr. Gold respected and honored Cory’s decision. 

Today, 12 years later, Cory is cancer-free and looking forward to retirement in a couple of years. “This experience changed my life,” she reflects. “I got rid of the toxic relationships in my life, I’m going to church again, my faith is stronger than ever before, and I don’t focus on the negative. It’s changed me as a nurse, too. I listen more intently when patients talk with me, and I’ve learned I can learn a lot from my patients just by listening more.”

Transcript

Unknown Speaker  0:01  
Welcome to the breast of everything podcast your trusted resource for breast health information support and encouragement. Your host today is Dr. Lindsay gold of comprehensive breast care. Welcome.

Unknown Speaker  0:16  
Hello, listeners. Welcome to the breast of everything podcast. I'm your host today, Dr. Lindsay gold of comprehensive breast care. I am so happy to have my friend Corey Pacheco as my guest today. Corey, how are you? And thank you so much for joining us. I am doing great. Well, I'll introduce you and then you can introduce yourself. Cory is a 13 year breast cancer survivor and a critical care registered nurse at Hurley Medical Center in Flint, Michigan. She's looking forward to retirement in two years and starting the next chapter in her life. She is here today to tell the story of her breast cancer journey and how it changed her life. And she's a really awesome cook. Just saying. Okay, Cory. So where do you want to start? For our listeners? You have lots and lots of awesome advice. But tell us a little bit about what happened to you. When you get I don't know the phone call? Well, you know, your mammograms abnormal.

Unknown Speaker  1:27  
Yeah, it all started with, I forgot to get my mammogram. And then I felt kind of like, well, that's not gonna look good. A nurse for getting the mammogram. So I went and got it. And you know, usually they get back with you right away say, hey, great, no problem. See you next year. Well, I didn't get that call. And so a friend and I at work, were discussing it. And she was like, uh, no news is good news, right? And I said, Yeah, maybe. But I just had a funny feeling. And they called me and wanted to repeat it. And they said, don't worry about it. You know, this happens a lot of times. And so get it done. I didn't I didn't worry. My neighbor, which was kind of funny. My neighbor worked on the X ray machines. And he asked me, Do you what, who was a nurse that did it? And he said, Oh, she's phenomenal. He goes said she catches everything. So if she, if she's worried about it, she's just double checking. So you know, it's okay. Well, when I got the phone call, yes. And needless to say, suck the life right out of me.

Unknown Speaker  2:46  
Yeah, yeah, your life changes doesn't about face and, you know, in a matter of seconds.

Unknown Speaker  2:52  
And I know who called me first, the pathologist who had known my whole life because my mother worked at Hurley in pathology. So I grew up knowing all the pathologist. So then my ob gyn called, and I had known him since he was a resident, and he said, Hey, kid, and I knew and I just, I just couldn't believe it. couldn't believe it. no family history. You know, I don't smoke, don't drink. Why did drink, but not. not crazy. I mean, what do you know, our friends? I exercise my whole life.

Unknown Speaker  3:39  
And so I think it's really hard for it's hard for every woman, but it's really hard for ladies who basically take good care of themselves. To feel like well, wait a minute. How, how could this happen to me, you know, you feel like your body betrayed you. I've done everything I've supposed to. I did everything right. How could this happen? Exactly. Mm hmm. And I don't have an easy answer for that. I don't have any answer for that. That we don't know yet. But

Unknown Speaker  4:14  
yeah, and what was really crazy was I have a cousin who is a year younger than me. total opposite lifestyle. She smokes, drinks, eats all the, you know, fast food stuff, overweight, not compliant with meds. And she went in for a suspicious spot also and biopsied it totally clean. And she even admitted to me, she said, I thought I was going to be the one. Yeah. And I was so baffled. And I think at that moment there, it made me realize that we're not as in charge as we think we are. Yes, that's an excellent point. And probably quite true. So what was it like? For you to tell? Family, friends, co workers? My co workers is actually it was it was easier than I thought it was gonna be. I mean, we see it every day we work with it. You know, everybody's got an opinion. You know, it's, you know, the hardest thing was telling my parents and then my dad saw my godson, Zachary was, it was so hard to tell him. And my mother just about collapsed. And so hard. Oh, it was, I had never seen her like that. And to be honest, once you get past that, I, I truthfully felt like it was harder on my family than it was on me. Hmm, I, I don't know, I kind of, you know, I have you to thank for that. Because I want to just to get this taken care of and go right back to work. Yeah, you're the one that said no. And then it happened. And, and, and that was good, because it forced me to look into myself and kind of analyze what's going on. And I did a lot of soul searching. I think overall, it it was easier on me than it was on my family.

Unknown Speaker  6:46  
Yeah, you know, as the clinician or a friend or whatever. I mean, we we, we can't force soul searching, but I think in you know, an experience positive or negative. If you can find the greater meaning of it. Right. Then, you know, sometimes you can take a negative, right and turn it into a positive. And I think a lot of successful, you know, hard working women like you want to do exactly what you just said, because it's a lot easier to just sort of compartmentalize, absolutely this diagnosis and be like, Okay, well, this is what we're gonna do. Here's my plan. Here's my plan. I'm just gonna do this and move on. And then that's your way of saying, Okay, well, I'm not really gonna deal with this emotionally. I'm just gonna put it aside. But you know, you can't run from your own brain. It catches up with you. It's not possible.

Unknown Speaker  7:43  
I had I had the biopsy. Once the doctor told me it was positive. I could not say the word. I could not get it out. I would say, what were the results or they were positive. Okay. I could not say the word cancer. And I remember I was driving down the road. I remember the intersection. It was a cold, rainy day in February. And I just said out loud. I have cancer. And broke down. Yeah. And yeah, I it was it. Yeah, you know.

Unknown Speaker  8:25  
Yep. It has. I mean, it has to happen. it'll catch up with you one way or the other. But, I mean, I feel like is it most emotional things? Sometimes if you can address it, look at it head on, get it out in the open, then it's actually even though it's painful. Yeah. A little bit easier to deal with it. It frees you up for other things. Yes. So you and I both know, but now we'll tell the listeners that I was not the first surgeon that you saw. No. So tell us about that.

Unknown Speaker  9:00  
Well, as you mentioned, I work at a medical center. And I grew up knowing all the doctors because my mother worked there. And I got to hang out there when she worked in an office. So I got to hang out there and meet all the doctors. I went to nursing school at Hurley. So I grew up knowing pretty much all the intensivist and specialist and so I went to see our doctor, our surgeon and he immediately told me what I was going to do. Hmm. And I remember I was just taken aback by that. And he unbeknownst to him, I had already had you lined up and somebody at U of M lined up. And I hadn't I had never heard of you because I lived in a Hurley world. And my mother knew my mother phoned you for me she when she retired. She worked at other hospitals and hey, there's this new girl. It surgeon that everybody's taught out, and because she's crazy just ever seeing you and thinking, How old is she? And the difference was, you didn't tell me what was going to happen. You gave me options. Yeah, you flat out, laid it on the table. And you said, Here it is. Do you have any questions, and I didn't feel rushed. My questions were answered. After I walked out of your office, I had the next appointment, two days later, and I told my mom, I'm done. I'm, this is where I'm choosing. And she said, You're sure I said, I am sure. And I said, I don't want to be slotted in between a gallbladder and small bowel obstruction. This is all she got. Huh? Yeah. And I said, and she didn't tell me what my deal might what my plan was, she offered it to me. I really had to do even more soul searching. And that was it. It I had the freedom to make up my own choice. Yeah.

Unknown Speaker  11:24  
Yeah. So and that's how I see my role as the clinician, the surgeon, right? My job is to give you the information that I've learned that I've trained to know, and to present what I think are, you know, your best options. And my job is also to listen to you and to hear what you're saying what what things are most important to you, and then come up with a solution together that you are comfortable with. Right? I mean, I don't know that I could ever tell anybody what to do. Even if I had to, I would really struggle.

Unknown Speaker  12:06  
Yeah, you know, and I don't know if that's just, you know, because I had known him all my life. I don't know if that's the case, or if that's the old stereotypical mentality. Oh, yeah. paternalistic? Yeah. What you know, and I did, I felt a sense of betrayal. But, I mean, I, I really prayed quite a bit on it. And I thought, No, this is my body. It's my decision. I it was hard. It was very hard. Yes.

Unknown Speaker  12:41  
Yeah. And it's also hard to let me say, so to decline, your treatment that people say, Well, this is what we generally recommend, you know, for XYZ reason, and you say, you know, I hear what you're saying, but I don't I don't know that. That's

Unknown Speaker  13:02  
right for me. Exactly. And I appreciate it. Right. There was because you did you spent Oh, my God, the time you spent answering my questions it made me think of when my mother said, Yeah, you when you went through that y stage, she said it was an unbearable. That's how I felt with you. Because I, I needed everything answered.

Unknown Speaker  13:27  
Yeah. Yeah, I think keep women's especially but people can tolerate a lot of what we what we do to them, right as physicians, and if they understand why, right, I feel like you can't treat people like, you know, you treat a child where the answer is because I said, so. You know, because I'm the doctor that doesn't that doesn't fly, particularly not in an information age, right? Where people do a lot of their own research, they come in with a lot of knowledge. And so yeah, it just, it just doesn't, it just doesn't work that way. So, yeah, and especially if you have a healthcare background, right, like, my assumption is that you've already talked to 100 people done a lot of work and, you know, you're just gonna come in and tell me, because then it makes my job easy. This is what I want. But it is, yeah, it's, it's, um, it's very difficult. So, as probably a lot of the listeners know, when we do breast conserving surgery, we usually recommend postoperative radiation therapy. Right. Yeah. And, you know, we talked about it, and you made the decision not to do it for if you know why you can share with the listeners. If not, that's okay, too.

Unknown Speaker  14:53  
I was. Well, as you said, with a medical background, I did my own research and I, I questioned a lot I question I, you know, with my mother working in pathology, she used to come home talking about different cases. And why doctors thought this or that. And I thought, okay, in my situation, it was DCIS. So I thought, why, if it's encapsulated? Are we doing all this for a what if, and I, you know, I picked a lot of brains, you know, when I was at the hospital asking different doctors, and I thought, Okay, so now I know, my body has the ability to have this cancer it, you know, it can go haywire. So why can't I? What can I do to stop I was deathly afraid of developing a secondary cancer. And just thought, you know, I'm one of those people, I don't take a lot of meds. I don't know, I just had this gut feeling. And I just, I, I, it was such an intense feeling that I just could not go against it. I can't even answer that, really.

Unknown Speaker  16:22  
But that is the answer. Because so as as a female, a lot of times, I'm asked, you know, patients will ask me, Well, what would you do? Right? I mean, I get it, I boobs too. And I always tell them, I mean, my answer is always the same. Not because I'm trying to get out of answering it, but because you really can't answer it. Right? So number one, it's easy to tell somebody else what to do. And number two, everybody thinks they know what they would do until they're the ones that have to do it. Right. And it's just not the same when it's you. Right? So I tell ladies, I just had this conversation last night. I said, Well, I'm gonna, you know, struggling with a decision, I was talking with a woman, also a nurse, as it were. And I just said, what I'm gonna tell you is totally not scientific. But you have to the answer for you is whatever your gut tells you, whatever answer you keep coming back to whatever answer you keep defending to somebody else, or to yourself or to whomever that's the answer, because that's what's right for you. I do believe that women have an incredible sense of themselves. Oh, and they know what's right.

Unknown Speaker  17:41  
Absolutely. And I yeah, it was the strangest thing, because being a nurse and knowing the treatment for not just cancer, but various other illnesses. I've struggled with my patients also, when they move, what would you do? And I mean, my gosh, there's so much to take into account, you know, your lifestyle, your children, you know, your area, you know, I mean, everything, everything plays a part in it. And I don't know I that it was a resounding no. With me, in it. My family was not happy.

Unknown Speaker  18:24  
Right. I'm sure. They're not not uncommon to hear.

Unknown Speaker  18:28  
Yeah. And I said, I have to, I have to trust this. And knock on wood. 13 years. And thank you and good Lord above.

Unknown Speaker  18:39  
Yeah. Probably the good Lord first, but yeah. Thanks. You and I'm forever grateful. Yeah. So it is, it is a difficult position for people to be in to choose their own treatment, right. As much as you often want choices, it's also as difficult to be the one to have to choose that. Correct. It's like a double edged sword. Yes, right.

Unknown Speaker  19:07  
Yes, yes. Because here's many nights I laid there and thought, what if, what if it comes back? What do I do? And right?

Unknown Speaker  19:15  
And people, people ask me all the time, and I want to be able to answer and help you, but how can I write and all of the advice or, you know, information that we give people? The This is based on large, you know, population based data, right? So that means that, you know, when you when you're when you get granular on it when you're talking individually one on one, it's very difficult to translate that data to an individual level. You can't I don't, I don't know what, well, I know which group you're going to fall into or

Unknown Speaker  19:51  
exactly because I remember talking to you saying, you know, the more I thought about it, no family history. You know, I didn't have you know, I, I did all the right things. So what were the chances? And I just thought you can't put everybody in a box. Everybody's not a protocol, you know. I mean, that's that was my thinking when I chose not to take the treatment and I thought to myself, okay, if I'm not going to do the treatment, then I have to fix whatever was broken. And I it's, it took me back to that soul searching, and it took me back to what is toxic in your life? Or what are you doing that could possibly. You know, as in Madison, you you do you compartmentalized a lot of emotion? Mm hmm. And so I had to think of, what am I doing that I'm not paying attention to? And a lot of it was me. I was constantly doing things for other people. Yes. And not really taking time out for me, because I didn't want to disappoint. Right.

Unknown Speaker  21:04  
So what did you change? Do you think in your life, what was one of the biggest things you changed as a result of this experience?

Unknown Speaker  21:12  
A lot of it was toxic relationships. Good as part of the not wanting to disappoint? Hmm, that was the main thing. And I never felt freer. And I looked back to the time that I was diagnosed, and I was in a toxic relationship. And it just, it cleared up so much. I changed Of course, I tweaked my diet a little bit more. I I started to end my day with something light or inspirational. Yeah, because I was a big fan of true crime. Before I went into nursing. I had wanted to be a forensic psychologist. Yeah, so I had, you know, that was my fascination. And I decided, Okay, it's too dark to end the day with. So I got even closer to God, I went back to church and really did some deep, deep soul searching and change my habits there. And it just made a huge difference. Yeah, huge.

Unknown Speaker  22:31  
Yes. And my observation is that just people in general, who do have a strong faith basis, regardless of what it is, tend to do better emotionally. You know, they, they come out on the, on the other end of this with a stronger faith, or just sort of mentally tolerating it. Well, again, it's, you know, that's going to be a hard thing to ever study can't randomize people to pay, they're no faith, but

Unknown Speaker  23:02  
no, I remember that old saying, you know, make plans and God laughs Hmm. I thought that's exactly what I did. And I remember saying, Okay, I get it now.

Unknown Speaker  23:18  
Yeah. So probably your experience, in turn, helped to save other people's lives. Right? Because you're pretty open. I talk about and you educate?

Unknown Speaker  23:30  
I hope so you know, and I tried not to ever with my patients, divulge my problems. But I remember this lady in particular, who was in her mid 60s, and she came in, and I don't remember how we found it, but she had stomach cancer. And this poor woman was so distraught and very withdrawn. And just, I remember one night going in to check on her. And I just sat down, I didn't say anything. And she started crying. And she said, What do I do now? And then I told her about my experience. And I said, You've got so much to live for. Yeah. And we pointed out the good things. I said, don't focus on the negative. It's okay to be scared. It's okay to feel vulnerable. And, you know, she was a mother, a wife, a grandmother, so I'm sure she was used to taking care of everybody. Oh, sure. And I said, this is your time. Let them help you. Mm hmm. super hard concept for lots of ladies. Yes. And I still wonder what happened to her. And I just, you know, I just pray that it's changed me as a nurse that every night that I go in Try to just remember that they're at their worst. Yeah, just give them the eight hours that I'm there. I just want them to feel safe and comfortable. They don't have to say anything to me if they don't want to, I just want them to be okay for that eight hours. If they want to vent if they just, you know, whatever, I just,

Unknown Speaker  25:27  
I don't know.

Unknown Speaker  25:29  
It's made me listen to them more. It's made me really, you know, and as you know, there's so many times we have a patient that we can't find what's wrong with them. And sometimes they're so frustrated. And I really try to be that one that's in their corner, you know, because they think that nobody believes them. Are they right? You know how many women say, Oh, they think I'm crazy, huh? And before I get diagnosed, I remember feeling not so great. And I remember saying I shouldn't be feeling this way in my 30s. Yeah. And I hear that a lot with these patients. And I, I get it.

Unknown Speaker  26:12  
Yeah. Yeah. We should all be so lucky to have a nurse like you if we end up in the hospital. I mean, I hope we don't. But if we did, right, well, we would all be fortunate.

Unknown Speaker  26:24  
My patients teach me a lot. I've learned so much from my patients.

Unknown Speaker  26:29  
Yeah, it is a privilege to care for people. There's no doubt about that. Well, I could talk to you for hours and hours on end, shame on our listeners, if they were if they were here, but I will end by thanking you for allowing me to care for you because it is definitely an honor and a privilege. And I like you say I've learned a lot from you.

Unknown Speaker  26:58  
Well, I think the Lord, people like you and you're in my prayers. Daily, that you keep doing your good work.

Unknown Speaker  27:08  
I try. Yeah, I try. Thank you so much. Well, thank you for for joining me today and sharing your very personal story. I'm certain it will help so many other breast cancer patients who definitely could use some support and words of encouragement. listeners. Thank you so much for joining us at the breast of everything podcast. I'm Dr. Lindsay gold of comprehensive breast care. We want to hear from you. If you have a topic you'd like us to talk about. We welcome your suggestions. You can send them to comp breast care that com that's COMPBREASTC ar e.com Till next time,

Unknown Speaker  27:55  
you've been listening to the breast of everything podcast with your host and board certified breast surgeon, Dr. Lindsay gold of comprehensive breast care. If you have a subject you would like the surgeons to discuss, please email your suggestions online at comp breast care. com. That's compbeastcare.com the doctors want to hear from you. The views thoughts and opinions shared in this podcast are intended for general education and informational purposes only and should not be substituted for medical advice, treatment or care from your physician or healthcare provider. Always consult your healthcare provider first.

Transcribed by https://otter.ai