Teri Pollastro slams the medicine ball, hard, onto the gym floor. “I pretend it’s my cancer,” she says.

Pollastro received her first cancer diagnosis just six weeks after giving birth to her second daughter. Her doctors told her she had a noninvasive form of breast cancer called ductal carcinoma in situ. After a mastectomy and immediate reconstruction, they thought she was cured. It was 1999.

After four years of being cancer-free, Pollastro received another cancer diagnosis: stage IV metastatic breast cancer — it had spread to her liver. In these cases, a patient’s average life expectancy is just three to four years.

At the time, Pollastro was 43 years old. Her two girls were 3 and 7. “I was devastated and in shock,” says Pollastro. “I never thought it would come back.”

I feel like I have this great team. They understand that I don’t have time for cancer.

After her first diagnosis, Pollastro sought a second opinion from UW Medicine oncologist Julie Gralow, M.D., director of breast medical oncology at Seattle Cancer Care Alliance (SCCA) and the Jill Bennett Endowed Professor in Breast Cancer. Impressed by Gralow’s approach, Pollastro transferred her care to UW Medicine.

“Right from the get-go, Dr. Gralow was extremely positive,” says Pollastro. “But she didn’t tell me I was going to be cancer-free. Instead, she was just very forthcoming with things I could do. I’ll never forget, one time she told me, ‘The statistics are not good, but you are not a statistic.’ When things got bad, I would play that tape in my head.”

Gralow says her approach is to plan for the worst, but hope for the best.

“Metastatic disease is treatable, but it’s not curable,” she says. “Any time a metastatic diagnosis of breast cancer is made, our primary goal shifts from a cure to maintaining a good quality of life for as long as possible.”

For Teri Pollastro, “as long as possible” has lasted more than a decade. And counting.

Gralow started Pollastro on a milder form of chemotherapy known to work well with Herceptin, a drug for women with HER2-positive breast cancer.

After just two weeks of treatment, Pollastro felt much better. After eight weeks, her liver was so improved that doctors were calling her recovery “almost miraculous.” And after six months, Pollastro had only a little residual disease and was able to discontinue chemotherapy.

Pollastro knows she is an anomaly. It is far more common for metastatic cancer patients to continue chemotherapy for the rest of their lives, changing their treatment plans repeatedly as their cancers develop resistance.

With only a few spots of cancer left in her breast, Pollastro began searching for other treatments, including clinical trials. That’s when Gralow told her about an early-stage trial to test a vaccine for women with metastatic HER2-positive breast cancer. The trial was being led by Nora Disis, M.D., director of the UW Medicine Cancer Vaccine Institute and the Athena Distinguished Professor of Breast Cancer Research. Her immunotherapy research focuses on vaccines to prevent breast cancer and its recurrence.

To enroll, patients had to be in complete remission, with no evidence of disease. One year after her diagnosis, Pollastro qualified — and she signed up.

No Time for Cancer

“Wouldn’t it be nice if, after you’re done having kids, you could get a vaccine that would reduce your risk of developing breast cancer?” asks Disis.

The trial that Pollastro enrolled in was the first Disis-led trial to test the HER2-positive vaccine with Herceptin. But like all early-stage trials, there were many uncertainties — including whether there would be any benefit to the people enrolled in it.

However, nine years after the trial, when Disis and her team followed up with trial participants, they found that over 50 percent of the patients, including Pollastro, were still alive and doing well. Patients receiving the standard course of treatment, by comparison, had an average survival of a little more than three years.

“Our ability to figure out how to use cancer vaccines and design them better has skyrocketed,” says Disis — a fact she attributes to breakthroughs happening across scientific disciplines.

“I do believe there will be a vaccine for breast cancer in the next five years,” she says.

Pollastro has been on Herceptin, an immunotherapeutic drug, for many years now. She gets an infusion every three weeks, her blood tested every six weeks, and an annual scan to make sure Herceptin hasn’t weakened her heart. If this happened, she would have to discontinue therapy.

But Pollastro tries to leave most of the worrying to her doctors at UW Medicine.

“Between Dr. Gralow, Dr. Disis and Dr. Yeung, my surgeon, I feel like I have this great team,” says Pollastro. “They understand that I don’t have time for cancer. Cancer is a little piece of my life, but it doesn’t run my life.”

Pollastro keeps busy. She serves as an advocate in the national Translational Breast Cancer Research Consortium. And she meets with newly diagnosed breast cancer patients, many of whom have young families. But she doesn’t always share her own story. Instead, she listens to what the women need.

“When a woman is diagnosed with breast cancer, she needs a good support team, both from her family and friends and from her physicians. She needs to educate herself about her journey and how she’ll make choices about her treatments,” says Pollastro. “But most of all, she needs a cure. For patients with metastatic cancer, there is no cure, and people don’t understand that.”

Pollastro’s husband, Gary, is usually the first in the Pollastro family to get up in the morning. Breakfast is important to the household. “We have the best conversations in the morning,” says Pollastro. The Pollastros chat with their youngest daughter, Joelle, about the colleges she might attend. The family dog, Pearl, lies patiently under the table and is eventually rewarded with a piece of ham.

Having stage IV cancer has crystallized what’s most important to Pollastro: her family. She’s grateful to her UW Medicine care team for the gift of time — for being able to raise her girls and watch them turn into resilient, accomplished adults.

“I feel so lucky we have UW Medicine here, and that I was able to take advantage of a lot of the things they offered. I feel like everything they did helped. Every little thing,” says Pollastro. “And I feel hopeful,” she adds. “I want to keep moving forward.”

By Eleanor Licata
Photos: Doug Plummer

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