Jackie McKuin never thought her name would be linked to a cancer diagnosis. There is no history of breast cancer in her family. She lives an exceptionally healthy lifestyle that includes daily exercise and regular screenings, and she has regularly performed self breast exams to help assure her good health.
McKuin is a CPA with the local firm of Riley, Stubbs & Cato, where she has worked for the past 16 years. Her profession calls for control and accuracy, precise data and organization. In her daily life, she seems to exude those same qualities. Acquaintances know her to be a bright, caring, soft-spoken friend, a loving wife and mother, and always with a clear direction and a winning smile.
On March 8, 2012, all of Jackie McKuin's patience, control, and grace under pressure, was put to the test.
During a self exam in February, Jackie noticed an unusual lump in the right breast. Having been diagnosed with fibrocystic disease years ago, which is simply a thickening of breast tissue that is often misinterpreted by women as a breast mass, Jackie was familiar with its characteristics.
"This was different," she recalls. "This was hard and unlike anything I'd felt before, and I was immediately suspicious."
She immediately called Kneibert Clinic in Poplar Bluff, where she annually reports for mammograms. McKuin was an employee at the clinic several years ago, and was well acquainted with some of the staff still on hand there.
A mammogram was administered, and shortly thereafter, and so was an ultrasound of the right breast.
"Although the staff administering the tests are not supposed to say anything, I could read their emotions and I knew something was wrong."
One technician gave Jackie an uncharacteristic hug and another had tears in her eyes. It was clear there would not be good news delivered.
An appointment was made for Jackie to see a surgeon, and two days later a needle biopsy was performed in the offices of Dr. John Moll, a general surgeon practicing in Cape Girardeau.
Much to her surprise, the biopsy came back "clean."
"But I'm cautious by nature," she explains, "and he was, too. He told me he didn't want to trust that alone and told me, 'Miss Jackie, I've done this too long. We're not going to take this.'"
An ultrasound needle biopsy followed five days later a metallic marker was put into place at the location of the mass. That marker would come into play in the months ahead.
The results of the second biopsy came back on Thursday, March 8. On that day, Jackie McKuin became a statistic -- a nearly golf ball-sized cancerous tumor existed in the right breast.
Plans were quickly put into motion. By her choice, Jackie's records were forwarded to the renowned Siteman Cancer Center in St. Louis.
"It was the most fearful thing I've ever gone through in my entire life," Jackie remembers.
Jackie's cancer was referred to as a "Triple Negative" type of breast cancer. Triple Negative refers to any breast cancer that does not express the genes for estrogen receptor (ER), progesterone receptor (PR) or Her2/neu. Triple negative breast cancers have a relapse pattern that is very different from hormone-positive breast cancers: the risk of relapse is much higher for the first 3-5 years but drops sharply and substantially below that of hormone-positive breast cancers after that. It is less common than most.
A meeting with an oncologist at the Siteman Center resulted in a prescription of chemotherapy. Jackie would travel to St. Louis for the treatments -- one treatment every three weeks for 18 weeks. From mid-March through July 10, Wayne McKuin took his wife of 39 years for her treatments.
"I had several others offer to take me, but Wayne wanted to be there with me. He laughed and said anyone who wanted to come with us was welcome, but he said I was not going without him."
McKuin tolerated the treatment better than most. She opted for treatments on Thursdays in case nausea would set in the following day and cause her to miss work.
"I really did not have significant discomfort," she says. "On about the fifth day following one cocktail treatment, I would feel cramping and it was uncomfortable, but I didn't have to miss much work during the treatment schedule."
It wasn't long into the chemo process before Jackie was finding more and more of her hair on the shower floor and in her hairbrush. While she initially found those episodes to be somewhat disconcerting, she dealt with the loss with the same grace as she did the cancer itself.
"I decided I was going to take some control over the situation from the start -- so when I knew I was going to lose my hair anyway, I went to my hairdresser and told her to cut it off short."
Later she would opt for a wig, which she still dons occasionally, but three months after concluding chemotherapy, she has produced a new crop of silver hair with a style that seems to suit her well.
Once Jackie's chemo was completed, another ultrasound was administered. The marker that had been placed at the site of the tumor was clearly evident, but there was no sign of cancer. For the moment, Jackie was considered to be cancer-free.
Erring on the side of caution, however, and with her doctor's concurrence, Jackie opted to undergo a mastectomy. On Aug. 10, 2012, she underwent surgery at the Siteman Center.
"While the surgery was not as bad as I had anticipated," she explains, "the expander that was inserted during surgery as part of the reconstructive process that was to come later was very uncomfortable."
The expander is inserted in a patient who is opting for reconstructive breast surgery to expand the skin so that an implant may be placed into position at a later date after healing takes place.
"It's uncomfortable to the point that it's painful," McKuin says.
She is still in that process of stretching out the chest wall and the skin, with the final stage of the reconstructive process to be completed in November.
"This has been a learning experience," she smiles.
In the meantime, McKuin has resumed her walking routine, and says she feels better with each passing day, especially after having returned to her exercise program.
If there is a lesson that has been learned through her journey with cancer, Jackie says, it's been the realization that sometimes it's best to allow oneself the benefit of helping hands.
"I have always considered myself a strong person, and I've always felt that I needed to take care of everything myself. But through this experience, I've learned that to accept help from someone in no way means that you're weak."
McKuin resisted that help early in her treatment stage, but came to realize that those who were offering assistance in a number of ways were being helped themselves in the process.
"I found that it's comforting to allow friends and family to participate in this journey, and come to find out, it's good for them, too!"
"I've truly gained appreciation for what a small act of kindness means for someone who needs it. Those acts make a huge impact on the recovery process."
There were times, the survivor says, when a pity party was in progress but there would come a message from a caring friend.
"I'd get a text or a call from a friend asking me how I was doing. How can I not be good when people are kind enough to remember you in those small but special ways? I am so grateful to all of the cancer survivors who supported me and shared their experience and their knowledge.
Jackie McKuin says she couldn't help but think that something positive would come from her cancer experience. And it has, she says, in the form of accepting the kindness of others as the gift that it is.