Through grace, within 2 weeks she was able to have a few critical surgeries to remove 2 liters of liquid from her lungs and have a port installed, start chemo, and then move to Houston to continue at MD Anderson Cancer Center, under the care of one of the world’s experts in IBC.  She got genetic testing and saw a multidisciplinary team covering breast oncology, surgery, and radiation.  Janice spent 9.5 years at MDACC and a year at UCSF, culminating in 11 treatments, radiation, 6 surgeries, and 3 clinical trials.  She had responded well to anastrozole (AI) and palbociclib (CDK 4/6), for 7 years combined.  Other notable treatments were Capecitabine (anti metabolic) and Enhertu (HER2) + Keytruda (immunotherapy).

Despite the mack-truck hitting news, a lot had actually gone right. Janice considered herself a lucky one, having been diagnosed accurately at the start because her first physician in New Jersey recognized it was aggressive and immediately did an in-house biopsy. She was then referred to an oncologist who was able to quickly diagnose the cancer as IBC, having learned about it at a recent oncology conference. Many are misdiagnosed, often due to lack of awareness rather than empathy. (This must change.)

But this was not a passive game, and Janice was intensively active as a partner in her treatment and an advocate for herself -  researching how each drug works and the impact on quality of life, listening to her body, evaluating alternative complementary treatments for side effects, and researching clinical trials.  When the treatment was more stable, she took a risk with her husband Wang and moved to California to be closer to things that sparked joy - in this case, epic hiking trails and outdoor experiences; they hiked Yosemite 4 times.  Later, Janice researched options and opted to enroll in a clinical trial at UCSF, which was local, to avoid extensive travel (Houston option).

Early on, Janice realized she needed to transform her mindset and whole self to co-exist with the incurable cancer, on-going treatments/medications, and side effects.  She pivoted from being a survivor and warrior to the more profound "thriver".  To her, a thriver is able to channel love, optimism, joy, and sparkle from within to enable a life of possibilities and fulfillment, rather than imagery of battles and limitations.

As part of the transformation, she found and embraced yoga to strengthen her breath, body, mind, and spirit.  She lived with monks in the mountains of Korea, learning mindfulness, simplicity, and ritual.  She learned to be kind to herself and to embrace imperfection.  Not stopping there, Janice explored many alternative treatments, most of which had positive effects.  The thriver mindset enabled her to take ownership and it was paying off.