CHANGED BY CANCER

There is a version of this podcast that Dr. Randi Paynter imagined making before she started. She would sit across from strangers, ask them to trust her with the hardest thing that ever happened to them, and there would be a clean line between host and guest.This is not that episode.Brenda is Randi's sister. She is 52 years old. She works in human services — a career built on trying to do right by people the system overlooks. She has a dog named Lucy. She has metastatic breast cancer. And she asked Randi to tell her story — because she believes that if it helps even one person feel less alone, something good will have come from all of this.In March of 2024, Brenda found a change in her breast. She had just started a new job in Albuquerque, New Mexico — a city where she had lived for just over a year, with no local family. She tried to get a diagnostic mammogram. She was told to wait two months. She went to urgent care. She called every imaging center in the city. Every nurse practitioner that examined her told her the lump didn't feel like cancer.What finally got Brenda an appointment wasn't the system. It was a coincidence — a connection between her mother in Montana and a nurse practitioner whose husband worked in radiology. A phone call. A favor.By the time she got in, her cancer was already Stage III. An invasive ductal carcinoma, Grade 3, with an Oncotype score of 52. The most aggressive category. Chemotherapy was never a question — only how fast they could start. She started on May 2nd, 2024. She was 50 years old, the only income in her household, and her job was the insurance that was paying for her treatment. Stopping work was never an option.In this first part of Brenda's story, she and Dr. Paynter discuss:-- The two-month wait for a diagnostic mammogram on a Stage III tumor — and what it means for the women who don't have systemic connections-- Switching oncologists when the first one wasn't moving fast enough, and why that decision mattered-- What 16 rounds of chemotherapy actually feels like, week after week, while working full-time-- Hair loss, fatigue, and the moment cancer stops being abstract and becomes real-- Compartmentalizing: being a worker, a patient, and a wife in separate rooms of the same life-- The brutal financial reality of being the sole earner while undergoing cancer treatment-- Surgery, lymph node removal, and 30 rounds of radiation before work every morning-- What "No Evidence of Disease" feels like after a year of fighting — and why Brenda thought she was finally doneThis episode is produced with voice, archival photos, and host narration. There is no standard interview video. Some stories are better told this way.-- Go to ChangedByCancer.com for show notes and episode linksResources mentioned in this episode:-- Oncotype DX genomic testing: genomichealth.com-- NCI-designated cancer centers by state: cancer.gov/research/infrastructure/cancer-centers/find-- Indian Health Service cancer resources: ihs.gov-- CancerCare (free counseling and financial assistance): cancercare.orgChanged By Cancer is hosted by Dr. Randi Paynter, a cancer epidemiologist. This podcast shares personal experiences and systemic issues in healthcare. It is not medical advice. Please consult your own medical team for health-related decisions.

Rachel is a two-time ovarian cancer survivor, an 18-year veteran of the cancer journey, and the author of The No-Bull**** Guide to Dealing with Cancer (written with co-author Dr. Mercedes Castiel). She was 32 years old when persistent, progressing symptoms led her to an OB-GYN, an ultrasound, a CAT scan, and — three days after her first appointment at Memorial Sloan Kettering — surgery for a rare form of ovarian cancer. She went into remission, had a recurrence in 2017, and is back in remission today.She wrote The No-Bull**** Guide because she couldn't find the book she needed when she was first diagnosed. Not a memoir. Not a cure book. A practical, honest guide to navigating every stage of the cancer journey — from the first moment something feels wrong, through diagnosis, treatment, survivorship, and remission.In this episode, Dr. Randi Paynter and Rachel discuss:-- Ovarian cancer symptoms — what Rachel experienced, why she delayed, and why she calls ovarian cancer "a sneak, not a killer"-- Ring theory — the comfort in, dump out framework for the constellation of people around a patient in crisis-- Cancer ghosting and blame — why people disappear, why patients blame themselves, and what's actually happening psychologically-- Self-advocacy — why women in particular are conditioned to underadvocate, what the stakes are, and the story of a friend who pushed for a third biopsy and saved her own life-- The Friday CT scan — a story about vulnerability, fear, and what happened when Rachel simply told a hospital desk clerk how terrified she was-- Fertility — why it must be asked about immediately after diagnosis, and before treatment begins-- Recurrence and survivorship — what 18 years of navigating cancer looks like, including a 2024 scare with co-author Dr. Castiel in the room-- The CEO of your own care — how to build a crew, delegate effectively, and understand that the choices are always yoursMore info about Rachel:-- Book: https://www.nobullguidetodealingwithcancer.com/Resources mentioned:-- NCI-designated cancer centers: cancer.gov/research/infrastructure/cancer-centers/find-- Memorial Sloan Kettering Cancer Center: mskcc.org-- Ring theory: https://en.wikipedia.org/wiki/Ring_theory_(psychology)-- Dr. Mercedes Castiel: https://thecancercareconcierge.com/-- Fertility preservation: fertilehope.org-- CancerCare (free counseling): cancercare.org-- Go to ChangedByCancer.com for show notes and episode linksChanged By Cancer is hosted by Dr. Randi Paynter, a cancer epidemiologist. This podcast shares personal experiences and systemic issues in healthcare. It is not medical advice. Please consult your own medical team for health-related decisions.

Sasha's cancer was never supposed to be found when it was.Invasive lobular carcinoma — the second most common form of breast cancer — grows not in a lump, but in sheets and lines of cells. It only shows up on mammograms about thirty percent of the time. Sasha's first mammogram had come back clear. It was a chance ultrasound, performed alongside an unrelated finding, that caught a shadow no one was looking for. A needle core biopsy confirmed it: invasive lobular carcinoma, grade one.Then came the MRI. What had initially looked like 1.5 cm turned out to be 6.5 cm. And the pathology revealed something rarer still — Sasha was HER2-positive, making their cancer triple-positive ILC. That combination represents just 0.4% of all breast cancers. There is only one specialist in the country who studies it.What followed was six rounds of chemotherapy, a planned bilateral mastectomy, and a year of treatment that Sasha has approached with a scientist's precision, a community organizer's sense of equity, and a parent's fierce honesty.In this conversation, Sasha and Dr. Randi Paynter discuss:-- Why invasive lobular carcinoma is so frequently missed — and what that means for outcomes-- What it's like to be a 0.4% patient navigating a treatment protocol designed for a different cancer-- The real cost of chemo — $55,000 per session, $2,000 per shot — and what happens to people without good insurance-- How Kaiser Permanente's integrated care model changed Sasha's experience of diagnosis and treatment-- The social model of disability — and why cancer is one of its most clarifying examples-- What actually helps when someone you love is going through treatment (and what doesn't)-- Giving a 13-year-old clippers, green hair dye, and a moment of control in a scary year-- How Sasha has used public storytelling — through CaringBridge and beyond — to process, inform, and connectSasha is a non-binary business owner and parent living in San Francisco, California. Their episode is one of the most clear-eyed and generous conversations you will hear about what cancer asks of us — and what we deserve to ask of the systems meant to care for us.-- Go to ChangedByCancer.com for show notes and episode linksResources mentioned:-- Lobular Breast Cancer Alliance — lobularbreastcancer.org-- CaringBridge — caringbridge.org-- The Emperor of All Maladies by Siddhartha Mukherjee-- The Cancer-Fighting Kitchen by Rebecca KatzChanged By Cancer is hosted by Dr. Randi Paynter, a cancer epidemiologist. This podcast shares personal experiences and systemic issues in healthcare. It is not medical advice. Please consult your own medical team for health-related decisions.

Renee was 50 when her first mammogram came back with a diagnosis: ductal carcinoma in situ (DCIS). She had a lumpectomy, radiation, and got on with her life. Two years later, the DCIS was back — same breast, more aggressive, with a feature called comedonecrosis that changed the calculus entirely.This time, Renee came to her surgeon armed. Two years of research, Facebook groups, Reddit threads, and hard questions had prepared her to advocate for exactly what she wanted: a double mastectomy with flat closure, performed by both a cancer surgeon and a plastic surgeon, in a single surgery.But the medical story is only half of what makes Renee's experience remarkable. A biomechanical engineer who has been doing aerial circus since her early 40s, Renee has turned cancer fear into something else entirely — performance art. Her "Maria Variations" series uses aerial acrobatics to move through the emotional stages of diagnosis and treatment, from purgatory to recovery.In this episode, Renee talks about the decisions behind flat closure, navigating the Canadian healthcare system, the group therapy that changed how she approached her second diagnosis, and why she refused to cancel a single thing until she absolutely had to.This is what cancer actually looks like — not the warrior, not the miracle. Just a person, figuring it out.-- Go to ChangedByCancer.com for show notes and episode linksMore info about Renee:-- YouTube: @reneef1608-- Vlog: https://youtube.com/playlistlist=PLObEuAagsg7_a2loLvCPBY6zHKXdw923t&si=HsMjsvrdslHq9h6A-- Instagram: @cirqueduoldlady-- Website: www.lucidengineering.caResources mentioned:-- Wellspring Cancer Support: wellspring.ca-- Goldilocks mastectomy technique — ask your breast surgeonResearch articles referenced:-- Hosaka N, et al., J Clin Pathol, 2006. https://pmc.ncbi.nlm.nih.gov/articles/PMC1860433/-- Sobti N, et al., Sci Rep, 2020. https://pmc.ncbi.nlm.nih.gov/articles/PMC6981172/-- Cevallos P, et al., Ann Transl Med, 2023. https://pmc.ncbi.nlm.nih.gov/articles/PMC10777214/Changed By Cancer is hosted by Dr. Randi Paynter, a cancer epidemiologist. This podcast shares personal experiences and systemic issues in healthcare. It is not medical advice. Please consult your own medical team for health-related decisions.

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