Our Story
Two Cancer Journeys
We experienced cancer twice as a family. In 2017, Dad—Joel—was diagnosed with colon cancer. Two years later, Mom—me—was diagnosed with breast cancer.
I walked alongside Joel through his cancer journey as his caregiver. Then I became the patient—navigating surgeries, treatment decisions, second opinions, and all the uncertainty that comes with cancer, while Joel cared for me.
Our journeys were very different, and so were many of the decisions we made along the way. I'm sharing both stories—not because our choices will be right for everyone, but because our experiences taught me so much about navigating cancer, asking questions, caring for the body, and ultimately learning to trust God with what I could not control.
Here is our story.
Joel’s Diagnosis
Colon Cancer, 2017
In August 2017, Joel began experiencing bouts of intense stomach pain. He went to the doctor and was sent for a CT scan. The diagnosis was diverticulitis. Two months later, the excruciating pain returned, and Joel was rushed to the hospital. After another CT scan, a doctor told us they were preparing him for emergency colon surgery. Then, just a few minutes later, the doctor returned. “We're going to slow down and reevaluate Joel's situation before jumping into surgery,” he said. Once again, Joel was diagnosed with diverticulitis—this time with a possible perforation of the colon and an abscess. He spent a week in the hospital before being sent home with a PICC line to receive six weeks of strong intravenous antibiotics. A laparoscopic colon surgery was scheduled to treat what we still believed was diverticulitis.
When the day of surgery finally arrived, the procedure began taking much longer than expected. I will never forget the look on the surgeon's face as he walked down the hallway toward me that November day. “I'm sorry, but Joel doesn't have diverticulitis. He has cancer.”
With those few words, our family's world was turned upside down.
Joel had an adenocarcinoma on the left side of his colon that had grown through the intestinal wall and into the abdominal wall. It was advanced, perforated colon cancer. Before beginning treatment, we sought multiple medical opinions from cancer centers around the country. The doctors we consulted strongly recommended chemotherapy and radiation because of the severity of his cancer. Read “Second Opinions” to learn more about our experiences.
As Joel began conventional cancer treatment, we continued researching complementary approaches that might support him along the way. His treatment included chemotherapy and radiation, and the year that followed was long and grueling, with treatments, setbacks, and several hospital visits.
By the end of that year, Joel's body was weary and worn—but his scans were looking good.
We were catching our breath and beginning to enjoy life returning to normal.
Then, suddenly, I was diagnosed with breast cancer.
We were blessed to be able to bring the whole family with us when we visited New York City for a second opinion from Memorial Sloan Kettering.
Breast Cancer, 2019
In 2019, I felt a lump in my left breast. A mammogram and ultrasound were highly suspicious for cancer, even though my annual mammogram had been clear just ten months earlier.
The initial biopsy showed no cancer, but my surgeon wasn't convinced and recommended a lumpectomy. I honestly didn't believe I could have cancer.
But he was right.
The lumpectomy revealed invasive ductal carcinoma (IDC). One month later, I underwent a double mastectomy and sentinel lymph node biopsy. Initially, we were told the two lymph nodes removed were cancer-free, but final pathology revealed cancer in one of them.
Because I chose not to undergo another surgery to remove additional lymph nodes, I had to live with some uncertainty about whether the cancer had spread farther.
I remember my radiation oncologist asking if I could live with that uncertainty.
“YES!”
I was determined to do everything I could to move toward optimal health.
But more uncertainty followed. A PET scan showed an area of concern in my pelvis. As I sought second opinions, I heard frightening descriptions of my cancer. Then genetic testing brought another shock: I carried an inherited cancer-predisposition gene. I was the first person in our family to discover that we carried it.
Because my cancer was hormone-sensitive, my doctors strongly recommended removing my ovaries to reduce estrogen production and address my inherited risk of ovarian cancer. After consulting with my medical team, I ultimately underwent a total hysterectomy with removal of my ovaries in January 2020—just months after my lumpectomy and double mastectomy.
Looking back, I wish I had slowed down.
I went through three major surgeries within a very short period of time.
Julie’s Diagnosis
I sent this photo to my sister, who was praying for me. After my exam, I was taken to a dark room where the radiologist told me the findings were “Category 5”—meaning cancer was highly suspected. (See the report below.)
At first, I hadn't believed I could possibly have cancer. I had spent much of my life focused on health and nutrition. When the diagnosis became real, I wasn't thinking clearly. I was overwhelmed by the reality that cancer had now affected both of us.
As I considered what to do next, I was drawn toward complementary and alternative medicine (CAM). After consulting with my doctors and seeking multiple opinions, I decided against chemotherapy and radiation. The decision about whether to take the recommended endocrine therapy (hormone-blocking drugs) was one of the most difficult decisions of my cancer journey.
I committed to a wide range of holistic therapies — everything from mistletoe therapy to high-dose IV vitamin C. I wanted to get to the root of why cancer was able to grow inside my body.
My diagnosis shook me to my core because I have dedicated my life to teaching health and nutrition. Healthy living was a huge part of my identity, and to receive a cancer diagnosis when I have worked to be so healthy shattered me. As a self-proclaimed, recovering perfectionist, I combed through my life, searching for the source of my cancer. I felt that if I could weed it out, then I could protect my family from anything like this ever happening again.
Along the way, I discovered many areas where I could live more naturally and holistically. I made changes, learned to care for my body differently, and became healthier in many ways.
But in the years that followed, God would show me that the most significant change I needed to make wasn't physical at all.
It was spiritual.
TIME TO CELEBRATE
In 2018, after Joel finished treatments, we celebrated as a family at Disney. It was time to have fun and praise God for his healing.
We never expected cancer to be the story of our family. I don't imagine that anyone ever does. But it is our hope and prayer that our journeys will bring glory to God and give hope to others walking the same path.
Celebrating the end of Joel's cancer treatments and reinacting a photo from 15 years earlier.
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Joel and me in Austin, TX, after my biopsy showed no cancer. My surgeon wasn't convinced and scheduled a lumpectomy for the following week.
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After my double mastectomy, Joel emptied my drains and tracked the fluid for my surgeon. I appreciated him caring for me!
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I still can't believe I check the cancer box on medical forms. Now, each time I do, I pray for others facing cancer.
JULIE’S Treatment Decisions
MY DECISION NOT TO DO CHEMOTHERAPY
My oncologist recommended a 12-week chemotherapy regimen. The thought of chemotherapy was difficult enough, but after everything our family had already experienced during Joel's treatment, it felt overwhelming. Still, I wanted to make an informed decision, so I researched my specific type of breast cancer, carefully studied my pathology report, underwent genomic testing, and sought multiple medical opinions.
WHAT I LEARNED THROUGH MY RESEARCH
As I researched chemotherapy, I learned about the TAILORx trial, a large study of more than 10,000 women with hormone receptor-positive, HER2-negative, node-negative breast cancer. The study found that chemotherapy could be avoided in about 70% of the women studied, based in part on their Oncotype DX Recurrence Score.
This research helped me better understand how genomic testing could be used in weighing the potential benefits of chemotherapy. My Oncotype DX score was 18, and my oncologist ordered an additional genomic test called MammaPrint, which returned a favorable result. I considered these results along with my pathology, age, lymph node involvement, medical recommendations, and other risk factors as I made my decision.
My decision was not simple. Some characteristics of my cancer were favorable, while others were concerning.
my surgical pathology report
I studied my surgical pathology report carefully because I wanted to understand exactly what we knew about my cancer before making treatment decisions.
Invasive ductal carcinoma (IDC): The tumor began in a milk duct and had invaded the surrounding breast tissue. IDC is the most common type of invasive breast cancer.
Tumor size: The tumor was just under 2 centimeters.
Nottingham Grade 3: The tumor was poorly differentiated, meaning the cancer cells looked very different from normal cells and had more aggressive characteristics.
Lymphovascular invasion (LVI) positive: Cancer cells were identified within lymphatic and/or blood vessels.
Perineural invasion (PNI) positive: Cancer cells were identified around or involving nerves.
Ki-67 approximately 20%: Ki-67 is a marker that helps indicate how actively tumor cells are proliferating.
ER: 90% positive / PR: 90% positive: The tumor was strongly hormone receptor-positive.
HER2 negative: The tumor did not have an overexpression of the HER2 protein.
BIOMARKER TESTING
Oncotype DX Recurrence Score: 18
MammaPrint: Favorable result
Visit the Investigate page to learn more about biomarker testing.
Sentinel lymph nodes: One of the two lymph nodes removed tested positive for a micrometastasis, meaning only a very small amount of cancer was found in the lymph node.
One oncologist described my tumor in a way I will never forget: “Sometimes cancer is like a baseball in a bush; but, Julie, your cancer is like a bush in a bush.”
Genetic testing brought another shock. I learned that I carried an inherited gene variant associated with an increased risk of breast and ovarian cancer. I was the first person in our family to discover that we carried it.
Taken together, my results presented a complicated picture. I had some characteristics associated with a more favorable prognosis and others associated with increased risk. I knew I couldn't make such an important decision based on any one number or test.
SEEKING SECOND OPINIONS
Before making my final decision, I sought additional opinions from Miami Cancer Institute, Memorial Sloan Kettering, and another local oncologist.
The Miami Cancer Institute oncologist strongly recommended radiation and agreed with my oncologist's recommendation that I take endocrine therapy for ten years, particularly since I had decided against chemotherapy.
My Memorial Sloan Kettering consultation took place virtually during COVID. By the time of the appointment, I was already leaning strongly against chemotherapy. The oncologist recommended chemotherapy, radiation, and ten years of endocrine therapy. Although I had largely made my chemotherapy decision, the strength of that recommendation caused me to think very carefully about my radiation and endocrine therapy decisions.
Another local oncologist also expressed concern about my decision not to pursue chemotherapy, radiation, and endocrine therapy, particularly because I had been premenopausal before cancer and had several higher-risk features.
listened carefully to all of these recommendations. Ultimately, I decided not to undergo chemotherapy.
It was a deeply personal decision that I made after extensive research, genomic testing, multiple medical opinions, and consideration of the potential risks and benefits as I understood them at the time.
LOOKING BACK
I don't want anyone reading my story to assume that the research I considered means chemotherapy would—or would not—be appropriate for them. Cancer research is continually evolving, and new information can change how treatment decisions are made. I highly encourage you to research your specific diagnosis, ask questions, discuss what you learn with your medical team, and seek second opinions when needed.
My decision not to undergo chemotherapy or radiation strengthened my commitment to caring for my health.
MY DECISION NOT TO DO RADIATION
Radiation was recommended for me, even though I had undergone a double mastectomy. I ultimately chose not to have it, but this was another decision I took very seriously. I researched radiation, reviewed my surgical pathology again, sought additional opinions, and met with my radiation oncologist three times to ask questions and better understand the potential benefits and risks.
My RADIATION ONCOLOGIST CONSULTATIONS
I met with my radiation oncologist three times in order to ask more and more questions before making the decision about whether or not to do radiation.
He explained that radiation was a good option for me, even though I had a double mastectomy. This was true in my case because there might still be cancer in my remaining lymph nodes. I didn't have a full axillary lymph node dissection, so I was faced with not really knowing if or how far the cancer had spread. I decided against doing a second surgery to remove more lymph nodes.
The radiation oncologist actually thought another surgery to remove more of my lymph nodes was possibly a good idea, and he strongly encouraged us to get a second opinion on this. Every appointment was like that for us. We took the information doctors provided us, researched it thoroughly, and always sought another opinion. It was tiring, but worth it.
He confirmed my long list of concerns about possible side effects: secondary skin cancer, blistering and peeling, increased inflammation, damage to the mitochondria, lung and heart disease (short and long-term), pneumonia or a cough that would require steroids for many months, and even death.
The tumor was on my left side, and studies show that the radiation risks could be even greater in cases with left breast cancer. The effects were often long-lasting, even up to ten years after diagnosis. https://pubmed.ncbi.nlm.nih.gov/23484825/ https://ascopubs.org/doi/10.1200/JCO.2005.05.1037 https://ascopubs.org/doi/pdf/10.1200/JCO.2006.09.6420 https://erj.ersjournals.com/content/23/1/9
What is even more concerning is the small risk of developing a second malignancy, called angiosarcoma, in the breast following radiation. https://pubmed.ncbi.nlm.nih.gov/14528072/
None of that sounded worth it to me, especially because my focus was to get my body in the best possible health so cancer could never grow again.
On my final visit, my radiation oncologist reviewed the side effects once more with me, and we filled out scenarios specific to my case on a tool that both MD Anderson and Sloan Kettering have online, called the Breast Cancer Nomogram. The software calculates the probability of finding additional positive lymph nodes in breast cancer patients like me.
MD ANDERSON CANCER CENTER PREDICTOR
http://www3.mdanderson.org/app/medcalc/bc_nomogram2/index.cfm?pagename=nsln
MEMORIAL SLOAN KETTERING CANCER CENTER PREDICTOR
http://nomograms.mskcc.org/breast/BreastAdditionalNonSLNMetastasesPage.aspx
The scenarios helped us get an idea of my chances of recurrence, which totaled about 20%. If I did radiation, it would reduce my chance of recurrence to 5%. The two reasons this radiation decision was so difficult were because of my unknown lymph node situation and because I knew I wasn’t willing to take the hormone blocker drug long term. I ended up taking only one drug, called Letrozole, every other day for nine months, and then I stopped. Mentally, it wasn’t the right thing for me.
One thing that continued to bother me, besides all of the scary side effects, was that although radiation can kill some cancer cells, it does not kill all. I sat quietly thinking through everything.
Then the doctor looked at me and said, “It’s up to you. Can you live with a 20% chance of recurrence?”
Without hesitation, my response was, “Yes. Especially because I am fully committed to taking great care of myself with diet, hydration, exercise, de-stressing and sleep.”
He accepted my answer without any argument.
It was definitely a risk for me not to do radiation, but I felt in my heart the risks of doing it would be greater. I often think about my decision and what the lasting side effects would have been had I chosen to do radiation. Because I don’t have to deal with the aftermath on a day to day basis, it makes me extremely thankful that I chose to heal the terrain of my body.
MY HORMONE THERAPY “INDECISION”
Many forms of cancer, particularly breast cancer, are hormone driven. When breast cancer is discovered, the breast tumor is tested for two proteins, called hormone receptors. These receptors are: estrogen (ER) and progesterone (PR). The cancer will be identified as either estrogen receptor (ER) and/or progesterone receptor (PR) positive or negative. A cancer that is found to be positive for these proteins is called hormone-receptor-positive breast cancer. This means that the cancer can be fueled by estrogen and/or progesterone hormones.
Because my tumor was ER+ and PR+, a long-term hormone therapy (5-10 years) was recommended as treatment with a drug that blocks hormone production like tamoxifen, letrozole, or another aromatase inhibitor. These drugs work by stopping a key enzyme (called aromatase) from changing other hormones into estrogen. The idea is that if your body is no longer making estrogen then it “starves” the cancer, stopping or slowing the growth. Women with metastatic breast cancer are encouraged to take different hormone therapy drugs.
Whether or not to take a hormone blocker (endocrine therapy) was definitely the hardest decision on my cancer journey.
All of the oncologists were strongly recommending at least an oophorectomy (removal of ovaries), which would force me into menopause and stop the estrogen flow, as well as remove the risk of an ovarian cancer diagnosis down the road due to the gene. In addition to the oophorectomy they were emphatic that I needed to take the hormone blocking drug. The following information corroborated what the doctors said. A 2011 study found a 50% increase in overall survival for ER+ breast cancer patients who had an oopherectomy and took the hormone drug. https://pubmed.ncbi.nlm.nih.gov/18086800/
I underwent a total hysterectomy in January of 2020, just two months after my lumpectomy and double mastectomy.
My oncologist said that if I was not going to do chemotherapy or radiation, I had to take the hormone drug (letrozole) probably for ten years. She said, "Julie, you had an aggressive tumor. If you don't take the hormone drug and the cancer returns, I cannot save you. Especially since you are not doing chemotherapy or radiation." I got opinions from other doctors and oncologists, and they were all the same — take the hormone blocker, or you greatly increase your risk of recurrence, metastasis, or death.
This made the decision very difficult. The other factor complicating the decision was that Joel also had cancer. Otherwise, I think it would have been easier to say no. I just knew I didn't want to make a foolish decision. I picked up the recommended hormone drug at the pharmacy and carried it around in my purse. I just couldn't imagine taking it. I had read the pharmacy pamphlet describing the side effects: bone and joint pain, faster aging, carpel tunnel, trigger finger, hair thinning, osteoporosis, hot flashes, fatigue, depression, vaginal dryness, difficulty sleeping, and the list goes on. It sat in my purse for three months as I continued to agonize over the decision.
I wanted to regulate my hormones naturally, and I felt like this drug would prevent me from getting my body into optimal health. I am the kind of person who will make the changes necessary to get to the root problem. In this case, it was reducing excess estrogen in my body. For some reason, I had a high level of hormones circulating in my body. I don't know if this high level was due to the fact that I hadn't reached menopause yet, or if my body wasn't getting rid of excess estrogen effectively, so it was recirculating in my body. I started researching and learning how to rid my body of excess hormones and how to achieve hormonal balance.
I made an appointment to see a holistic MD who was very well known in the cancer community. I just wanted him to tell me it was okay for me not to take the drug. After reviewing my records, he told me to get the hormone drug out of my purse and take it immediately. So I did. I reluctantly took the drug every other day for nine months, and then I discontinued. I stopped, but not because I was having terrible side effects (which is often the reason people stop). Instead, I hated the idea that this hormone blocker kept my body from getting the proper amount of estrogen every day. I knew it wasn’t natural. I was doing everything I could to work toward optimal health, and I was already well on my way on the hormonal-balance journey. It was a hard decision to stop, but mentally it was the right one for me.
At every follow-up appointment for the first five years, my oncologist reminded me that I was foolishly risking my life with the decision not to take the drug. I’m thankful she still monitored me, even though I went against her recommendations. I was fine with her scolding me, and she was fine with me sharing all of the holistic things I was doing. She seemed intrigued, but not overly excited.
I know I took a risk, but I was more determined than ever to teach my body to maintain proper hormone balance and get rid of the excess estrogens.
Visit the Investigate page to learn more about hormones and maintaining a healthy hormone balance.
chuck the beagle
In 2020, during COVID, Joel and I were pursuing several CAM (complementary and alternative medicine) treatments, and our family needed a break from the heaviness of cancer. The kids had been asking for a dog since they were little, so one morning we woke them up and said, “Let’s go buy some happiness!”
That was the day Chuck the beagle joined our family. He brought so much joy during a difficult season and quickly became the missing piece of our family.
What we Learned As Parents
We never imagined our children having to walk through one cancer diagnosis, let alone two. Looking back on those years, here are some things I would encourage other parents facing cancer in their family to consider:
Lean on the Lord — Pray with your children and encourage them with God's Word.
Listen and love — Give them space to share their feelings. Listen, reassure them, and hug them often.
Provide healthy outlets — Encourage activities that help them process their emotions. Hannah began painting, and Max joined her at times. (See gallery below.)
Consider counseling — Professional or family counseling can provide valuable support, even if you're unsure whether it's needed.
Surround them with support — Lean on trusted friends, family, church, and youth leaders who can encourage them.
Prioritize quality time — Spend time together and laugh as much as possible. We played games and watched funny movies often.
It always does.
Hannah's gift to Joel after his surgery.
One of my favorite reminders from Hannah.
Hannah gave this to both of us.
Hannah's gift to Joel during chemo.
Hannah's Christmas gift to me in 2019.
So true!
One of our favorite verses!
Hannah's pin board in her room is always a treasure box of encouragement.
Yes! Let's go!
Hannah gave this to Joel in the hospital.
Encouragement in the valley.
This is such an important reminder for any difficult journey!
Hannah knew this verse was special to me.
I pictured the Lord as a lion by my side.
Max painted this for me and said, "Mom, do you see the sad face?"