Clonked by an Empty Gun: Why "Low Risk" Is a Dangerous Medical Illusion

And why you cannot afford to skip your annual medical exams if your work life is stressful.

“Genetics loads the gun and the Environment pulls the trigger.”

Have you ever heard that phrase? Well, I’ve got news for you. Even without bullets in the proverbial Genetic gun, the Environment can still clonk you upside the head with that empty gun. I’m proof of that.

My ZERO Risk Factors

I am probably in the lowest of all genetic risk categories for breast cancer:

No family history

No BRCA genes (and in fact they checked 70 other genes for rare mutations - all clear).

So that’s the genetic piece.

Now for the other typical risk factors they always ask about:

Never been overweight,

Had my one baby when I was older than 20 but younger than 30,

Breast fed her for 2 years.

Never smoked and don’t drink much alcohol

And I have always eaten pretty healthy. My mom didn’t let us eat sugary cereals or drink sodas growing up. (I loved the rare occasion when I was at my cousin’s house for breakfast, because my Aunt bought Fruity Pebbles and Captain Crunch!).

I started eating more organic 15+ years ago, and switched to mostly gluten free and dairy free 10+ years ago to manage auto immune inflammation due to Hashimotos.

Regarding monthly self exams, well, I will admit that I always felt a bit weird about “feeling myself up” once a month, so I was not doing my monthly checks. Instead I relied on my yearly mammograms, especially since I had no risk factors. I just sailed along with a false sense of “not me!” when it came to cancer.

AND YET -- HERE WE ARE.

Check ‘Em! (And everything else. Really.)

Fortunately, I AM very good about keeping up with my yearly physicals and mammograms. Early in my career I had a peer (one of my favorite peer 2nd-line managers I mentioned in a prior post) who ignored some symptoms and issues because she was so focused on her job.

She ended up being diagnosed with colon cancer, which was (and still is) one of the most survivable when found early. But hers was too far advanced for them to save her. In one of my last conversations with her, she told me to always keep up with those yearly appointments. That nothing is more important and she so regrets that she didn’t. She was hoping to live long enough to at least see the birth of her first grand child, and that wish came true. But the passed away the following year.

Her words stuck with me, and so I always kept up with my annual appointments. Which meant we caught it early.

That didn’t make it any easier though. Especially in those first few days and weeks when I didn’t know what I was dealing with and what the treatments would entail.

When I first noticed the little lump, I didn’t think much of it. I thought it was a cyst we had checked out previously. But the more I thought about it, the more I decided not to wait. Just go ahead and make sure.

When I asked my doc to move up my mammogram, she sent me to a new imaging place, where they actually have a doctor look at your scans while you are still there, in case they need to do any more. And they did.

First they did the normal scans and sent me out to the waiting room to wait for the doctor’s review. Then they called me back into the mammogram room to repeat one of the scans. Back to the waiting room. Then they called me to the ultrasound room. Then the doctor sat down and explained what she saw, and said she wanted to do a biopsy.

She didn’t use the ‘c’ word, and the blessed interwebs informed me that 75-80% of breast biopsies are benign. So I managed to not be too nervous while waiting to get that scheduled and get the results.

But the day came when I got the call. I am so grateful that my husband happened to be home. We were having lunch and watching a show when I motioned for him to mute the TV so I could take the call. He couldn’t hear the other end when she said they found a malignancy, but he watched my face, and when I said “well, shit”, he was there. I didn’t have to call him at work or wait until he got home, and agonize over how to tell him. He was already there. Holding me. And ready to do whatever he could to help.

Looking Good

I’m now 18 months down the road. We started with a lumpectomy, 4 weeks of radiation, and then endocrine therapy (which basically keeps my estrogen down in case there are any stragglers, since my kind of cancer loves estrogen). I was able to get into a trial for the endocrine therapy which has much milder side effects than the standard care. I’ve been on it for over a year now and it hasn’t been too bad at all. Which is really great because I need to be on it for a total of 5-7 years to achieve the best long-term survival rates.

I also opt’ed to have a hysterectomy about six months ago. This wasn’t a requirement. I did have a problematic fibroid that needed to be removed, but I decided I didn’t want to be worrying about uterine, ovarian, or cervical cancer down the road.

Because even though I didn’t have any of the genetic risk factors.....yeah, well, we know how that played out with the breast cancer, don’t we. And those other cancers are quiet until they’re much farther along. So for peace of mind, I decided to yeet the ute, and all the rest of the baby factory.

Given everything I’ve done over the last 18 months, I have a very excellent chance of not having to deal with this ever again. Something will eventually kill me, but it probably won’t be this.

But I want all of you who think you are somehow immune, exempt, or bullet proof, to take a moment and rethink. At the very least, please prioritize your monthly self-exams. Get those mammograms on time. And Pap smears. And guys, start testing your PSA so you’ve got a baseline to track against, because the velocity of change is actually more important than the actual number. If your score jumps up, but is still “normal”, that’s a red flag you won’t see if you aren’t tracking. And everybody get your colonoscopies when it’s time!

The S-Factor

Let’s circle back to the risk factor discussion, and the one thing that I COULDN’T claim when I was making my low risk list above. It is the thing that most likely contributed to this. Because only 5-10% of cancers are caused by inherited mutated genes. The rest are related to all the other factors in the Environment, including this biggie: STRESS.

I already suspected that my work stress contributed to my autoimmune condition. Well - it likely contributed to the cancer as well. From some of what I have read, given the size and growth rate of my tumor, it probably got its start 10 years prior, which is right around the same time as my autoimmune diagnosis.

And the wild part is that 10 years ago I was in a job that I was loving! I was building a new team, putting in place new processes and metrics. And having a blast. But stress is stress, even if it’s stress that you’re enjoying.

I was loving the work so much that’s all I was doing. I wasn’t taking care of myself. And I think the piece that really hurt me was this cool new job had me away from home three nights a week, so I didn’t have my husband to gently remind me to get off the computer and eat some dinner or come to bed. Which meant that I regularly lost track of time in my hotel and kept working until well after midnight. I wasn’t making sure I was sleeping, I wasn’t getting any exercise, I wasn’t eating healthy.

When I got the autoimmune diagnosis, that was a huge wake-up call. I immediately started making changes to how I managed my calendar, making the time to exercise, making healthier food choices. Even changing the way I traveled. And I was able to reduce my inflammation and medication, while still continuing to contribute at a high level. In fact, a year later I got an executive promotion!

But I guess for me the damage was already done. The seed was planted. Literally. Some tiny little seed that slowly grew until I noticed a lump and moved up that mammogram.

Not a Fluffy Ad-on

Even though I was oblivious to that seed growing, I saw the benefit of managing my own work stress in the last 10 years of my career. Benefits to my productivity as well as my health. So when I stepped out of corporate to focus on coaching, I was already including stress management in my coaching and mentoring. I created my own assessment to determine satisfaction levels across four domains of our life, and get under burnout symptoms to figure out root causes. I created a program to use that assessment to build out recovery plans and go-forward plans to address those root causes. It was already clearly a need in my mind.

Since my cancer diagnosis, I’m even more convinced that stress management is the key. Managing your calendar, getting your sleep and exercise, choosing healthy foods. These are not just optional add-ons to my leadership and career coaching. I don’t only ask about someone’s physical and mental health if I think they might be open to discussing it. Those questions are built into my THRIVE Assessment. This is required as a fully integrated approach to helping people figure out how to not just survive but thrive across all dimensions of their life.

While I was still in the middle of my treatments, I had a client tell me that she hadn’t been taking her vacation days and had been delaying medical appointments because of her very busy, very stressful job. I immediately interrupted her. I hadn’t told anyone outside of family yet about my diagnosis and treatments. But I broke that silence to tell her what was going on, and strongly counseled her to schedule those exams and take some time off! (Which she did!)

According to one of the books I read on this topic (Breasts: The Owner’s Manual, by Dr. Kristi Funk), it is never too late to start addressing some of those environmental factors, including stress. If you start now, you can significantly reduce your risk of getting clonked like I did. And if it does happen, you will be much healthier heading into treatments, which I think made a huge difference in my recovery.

What about You?

If you made it this far into my story, I want to ask you to do something for me today. Actually NOT for me or for my coaching business, but for YOU, and for the people who sit on the couch next to you watching TV at night.Take a completely honest look at these three things:

• Are you taking time off so you can give your body and brain a break from your work stress? Or are you banking the days, waiting for that fictitious time window when things will “calm down” at work?

• Are you keeping up with your medical appointments, annual physicals, etc? Or are you putting them off “just until this project is over”?

• And what about that job stress? Are you eating right and putting yourself to bed on time? Or does your calendar hold you in an iron fist that you can’t escape?

I’ve lived both pieces: the work stress (even happy stress) and the health crisis. Because of that, I refuse to leave health out of career conversations anymore. It belongs at the center. I do this work because I want folks to thrive in their lives, not just white knuckle through each day.

If you are currently staring at a calendar that just won’t quit and feeling the exhaustion in your bones, and if you honestly have no idea how to change it, let’s chat. You don’t have to figure it out by yourself.

But more than anything else? Go schedule that vacation and those appointments!

And let me know in the comments one thing you’ll try to do in the next week to take better care of yourself.

Love and Light,

Pat ❤️ ✨

Crossroads Guide | Former Technology Executive

Human Design Coach | Compassion Key Facilitator