Triple-Negative Breast Cancer Diagnosis Inspires Memoir

Couple Pens Book About Life, Love, Marriage, and Cancer

When Liza Marshall was diagnosed with stage III triple-negative breast cancer (TNBC) in November 2006, the then 43-year-old wife, mother, attorney, and volunteer didn’t hear the news from her doctor. She heard it from her husband.

“He had accidentally been copied on a pathology report,” Liza told Patient Power co-founders Andrew and Esther Schorr when the couples met via Zoom to discuss the Marshalls’ new memoir. “He happened to see it while we were on the phone together. Even though I had had a biopsy, neither one of us was expecting that to be the result.”

Liza’s husband, John Marshall, MD, is an oncologist but not a breast cancer specialist. John specializes in gastrointestinal cancer and is the chief of the Division of Hematology/Oncology at Medstar Georgetown University Hospital. He is also the director of the Ruesch Center for the Cure of Gastrointestinal Cancer at Georgetown Lombardi Comprehensive Cancer Center.

Although John deals with cancer every day, being on the other side of a diagnosis was a new experience. He says being a care partner has made him a different doctor.

“You don’t know where you are, you don’t know what’s next, you don’t know what to plan for,” John said about the moments immediately following a cancer diagnosis. “I now know what that feels like…that disorder, that feeling of loss. I feel for [my patients] and know that I’m the gatekeeper to restore order.”

A Breast Cancer Memoir

In their book, “Off Our Chests: A Candid Tour Through the World of Cancer,” the Marshalls tell the story of Liza’s diagnosis and treatment. They discuss deeply personal topics that arise when two people who have built a life together suddenly face the possibility that one of them may die at a young age and with children at home.

The book also covers issues like healthcare disparities and the rising costs of medical care in the United States. And John very candidly explains his past and present views on inequalities in cancer research funding — namely that breast cancer receives too much funding compared to other types of cancer.

“The truth is, and was then, that there is ten times more funding for breast cancer than all the other cancers combined,” John told the Schorrs. “The feeling in the medical community was that the lessons we would learn from breast cancer would trickle down…would apply to the other cancers, so it was money well spent. But when I saw the success that that funding generated — the new studies, the new medicines, the better outcomes — and then went back to my clinic where we were slogging along just trying to make it another few months, I got mad.”

Although John recognizes the extent to which he and Liza have benefitted from the money invested in breast cancer research, he says her diagnosis and their experience only confirm his belief that all cancers need more funding.

“She had a very bad cancer… years before she would be dead now,” John said. “We benefitted from the progress that was being made, there is no question. But it only shone more light on just how important that funding line and that focus is for us to help all the other people that are out there. When you have funding for particular kinds of cancers, it draws good smart people to do the research.”

Advice from a Cancer Survivor

Liza is grateful for the research that kept her alive, and she helped further advancements for future patients by participating in a breast cancer clinical trial. She remains cancer-free 14 years after her diagnosis and feels “very lucky to still be here.” She now mentors other patients and shares this advice for anyone who is newly diagnosed:

1. Avoid the rabbit hole of internet searches. “‘Don’t Google’ is my lesson number one. Once you start, it’s hard to stop.”

2. Access appropriate healthcare. “Make decisions about where you want to be treated. It doesn’t have to be the best health care; it has to be the right healthcare for you.”

3. Be compassionate. “You don’t know what somebody else is going through or has been through. Try to give them some forgiveness for perhaps being grouchy with you or not approaching an interaction in the way you expect them to approach it.”

4. Say yes when people offer to help. “Any support anybody offers you, always say yes. You don’t know what you’re going to need or what it might bring even though you think you don’t need it.”

5. Don’t forget to live. “I think it’s really important for all of us, no matter what the circumstances, to recognize how quickly life can change in any regard, even just our abilities to do things.”

It was important for Liza to continue living her life during treatment, and she shared that message with those around her, including her husband. John credits his wife with teaching him to remember to live life throughout their cancer journey, and he now shares that same message with his patients and their loved ones.

“Go out of your house. Go do something. Put something on the calendar. Let’s live again,” John said, recalling a recent conversation he had with a patient and her husband. “All they were doing was one scan to the next, one treatment to the next, and then hunkering down in between waiting on the anvil to fall. And that’s not what it’s about. It’s about keeping your head up. Keep looking forward. You’re doing the treatment so you can have another day.”

To learn more about the Marshalls and their story, visit offourchestsbook.com.