Cheera Rinker, 39, of Morgantown, is a mammographer and breast sonographer at the WVU Cancer Institute Betty Puskar Breast Care Center. When she found a lump in her breast during a routine self-examination, she knew she needed to take action to have the best chance of survival if it was, in fact, cancer.
“It’s pretty crazy,” Cheera said. “I think everyone feels that way, but not everyone works at a cancer center.”
Cheera has worked for WVU Medicine for 10 years, seven of which were with breast imaging, including time spent working on the Bonnie’s Bus Mobile Mammography Unit. When she made the decision to stop traveling with Bonnie’s Bus to spend more time with her daughter, she accepted a position in the Breast Care Center with the condition that they teach her everything because she wanted to be able to advocate for her patients. She pursued board certifications and attended a conference to become certified as a cancer navigator.
When a cancer navigator position opened in Texas, she became consumed with renovating her house to put on the market and didn’t think much of changes to her weight.
“When you’re renovating, you’re not really paying attention to what you eat,” Cheera said. “I had lost a little bit of weight. I also have sensitive skin, and when I bought a new kind of soap, I broke out in hives. I was scratching one of the hives when I noticed the lump. I knew my breast tissue pretty well because I picked a day every month to do breast exams, so I knew it couldn’t have been there long. It was tiny, very hard, and it wasn’t movable. I was like, ‘Well, those aren’t good signs, but maybe it’s a fibroadenoma.’”
She scheduled an appointment for imaging, and when she saw her mammogram and ultrasound, she was pretty sure from her experience that it was invasive ductile carcinoma. Her doctors confirmed what she saw, and a biopsy revealed it was triple negative, making it more difficult to treat.
Triple negative breast cancers do not have estrogen or progesterone receptors and create very little or any of the epidermal growth factor HER2. This means that triple negative cancer does not respond to treatments that work on those receptors, narrowing treatment options. Triple negative breast cancer also has a higher recurrence rate over five years.
“I was supposed to start this new job Dec. 20, 2021, and I was diagnosed on Dec. 12,” Cheera said. “I didn’t see the point of leaving when I already knew the radiologists and doctors I work with, and they are amazing. Why would I leave at the most crucial time and start over? I’d have to vet new doctors and ask about references when I knew that it was important to treat this quickly. I withdrew from that job and got the treatment I needed.”
Cheera found her cancer at one centimeter, which is uncommon.
“If we’re being honest, it’s really a big deal,” Cheera said. “That doesn’t normally happen. It’s not normally that small when you find it yourself. We find smaller with imaging all the time, but when you’re feeling something yourself, it’s usually bigger than one centimeter.”
She had an idea of her treatment plan going into her first appointment at the Comprehensive Breast Clinic because she was a cancer navigator. However, her oncologist wanted to take a more aggressive approach because it was triple negative, treating it as though it was a two-centimeter tumor. This meant more chemotherapy.
“I almost threw an infantile fit,” Cheera said. “I didn’t recognize myself. I didn’t want to do it. I thought I would have been the best cancer patient ever because of what I do. They say healthcare workers make the worst patients, and they’re not wrong.”
Cancer diagnoses are difficult for patients, and Cheera said that even though she didn’t anticipate her reaction to her treatment plan, her reaction was normal.
“I’ve witnessed my doctors be incredible humans to everybody who walks through the door, and there is a wide range of patient personalities. Once you start talking about biopsies, even the most sane, normal human will have these over-the-top reactions, or they just shut down and not want to talk. Both reactions are never rude to me. All these things are coping mechanisms, and it’s just how your mind is safeguarding you at the time,” she said.
“I’ve watched all of our providers handle patient reactions, and there isn’t a day that they don’t show up for their patients and support them through their cancer journey.”
Cheera received her first chemotherapy infusion Dec. 27, 2021. She underwent four rounds of Adriamycin and 12 rounds of Taxol. She did not require radiation therapy.
“I know I’m quite privileged in a number of ways,” Cheera said. “I had the knowledge of my own breast tissue and my education, and I work with some of the best in their field. I caught it really early. I was lucky that it didn’t have any lymph node involvement.”
Cheera expressed her gratitude to her medical team, who held her hand through her treatment and any issues or concerns she had, but says she didn’t receive more attention than patients who aren’t also employees.
“When I was planning to leave before I was diagnosed, I said it would be ideal if I could take all the people here and just airlift them to where I was going because everyone here is exceptional at what they do. I can’t believe I’m privileged to work with such whip-smart people who are geniuses in their field. I’ve watched them hold the hands of people and be kind and gentle,” she said.
“If any of the nurses were having a bad day, I wouldn’t have known it. There were a couple of bad days when I was told my blood work wasn’t good enough to receive my treatments, and I was upset because it was another delay. I was upset, not belligerently, but I definitely wasn’t cuddly, and those nurses sat there and understood. We understand, and it’s OK to be mad.”
When she completed her chemotherapy treatments, Cheera chose to undergo a bilateral skin-sparing mastectomy, which is the removal of the tissue from both breasts. Depending on the type and stage of their breast cancer, patients have the option of a lumpectomy or uni- or bilateral mastectomy, if they require surgical intervention.
“I was given my options for surgery. Numbers wise, there wasn’t a huge difference between lumpectomy and mastectomy. My odds of recurrence were slightly lower with a bilateral mastectomy. I knew that if I went that route, I wouldn’t be as hypervigilant about recurrence, so I chose a bilateral mastectomy to be proactive,” Cheera said.
“I am a widowed parent, and my 13-year-old daughter played a big part in my decision. A lot of women say they couldn’t face losing their breasts, but I couldn’t live with the possibility of my cancer coming back hanging over my head. Breasts are a large part of the female identity, so I reserve no judgements for people who choose a lumpectomy.”
Cheera has completed the tissue expansion process for her reconstruction with breast implants and looks forward to having her final surgery soon. She said that the physical changes that she saw while undergoing chemotherapy and a mastectomy were emotionally challenging, but working with a psychologist who specializes in cancer care helped her cope.
“It really plays on your emotions and your mental health. For the longest time after my mastectomy, I refused to look at my chest without the bandages. I knew I needed to bite the bullet and look so I would know if something went wrong that my doctors needed to address,” Cheera said.
“I took the bandage off, and I was just like, ‘This is me now.’ I had no hair, eyebrows, or eyelashes because of chemo, and my torso looked like I had been hit by a truck. How do you reconcile that as a woman who wants to feel feminine? You can’t go through the absolute devastation of treatment without a mental coach behind you saying it’s OK to have a bad day and not want to make dinner or to go for a run once you’re cleared to get some steam out. There’s no wrong emotion here, and all mental reactions are appropriate.”
As she nears what she hopes is the end of her breast cancer journey and enters into survivorship, Cheera says she wants other women who are going through the same experience to know that no response to a breast cancer diagnosis is wrong.
“You’re allowed to feel every way you want to feel. Don’t let anybody diminish what you’re feeling because your cancer is treatable; it’s still cancer, and it’s still terrifying,” Cheera said.
“It affects 1 in 8 women, so chances are you know somebody who has gone through this and maybe their journey was worse or better. Cancer can make you feel isolated, but it’s more helpful to be around the people who love and support you and do the things you love and that bring you joy. Otherwise, it will eat you whole.”
Cheera discovered her cancer through regular self-examinations and early detection, allowing her to receive treatment before it had the opportunity to grow and spread. She encourages everyone to get a mammogram when they are eligible, whether they have insurance or not. Women and individuals assigned female at birth over the age of 40 should talk to their healthcare provider about when they should receive a mammogram.
The WVU Cancer Institute Mary Babb Randolph Cancer Center partners with the West Virginia Breast and Cervical Cancer Screening Program to provide low- or no-cost screening mammograms for those who qualify.
To learn more about breast cancer screening or schedule a mammogram, visit WVUMedicine.org/Cancer or call 1-855-WVUCARE.