‘We Have To Stop Everything.’ Breast Cancer Patient Faces 2nd Cancer Diagnosis

Yocinthia Mitchell loved Thursdays the best.

On those days, she headed from Orlando to Daytona Beach for a morning of solitude and reflection. Equipped with her blanket, snacks, crossword puzzles and favorite jazz playlist, she would take in the peaceful tranquility of the ocean, meditating and praying.

“I’d just sit and listen to the waves,” she says. “My questions have always been answered at the ocean.”

For Mitchell, a 55 year-old former makeup artist, beach day was part of an active, yet calm lifestyle. In between solo outings, she spent much of her spare time with her family, including her sister, her son and three granddaughters.

In August 2022, Mitchell’s weekly getaways to her favorite beach were put on hold. That’s when a routine mammogram led to a discovery of triple negative, Stage 3 breast cancer.

The diagnosis came as a shock. Mitchell had lost her mother, father and brother to cancer, so she was cautious about her health. She cooked at home, exercised and kept a strict schedule for routine screenings.

“It was a fear always in the back of my mind,” Mitchell says. “I ran to the doctor every chance I got to get everything checked.”

Triple negative breast cancer occurs in about 10 percent to 20 percent of diagnosed breast cancer cases. The aggressive form of cancer occurs when the three receptors responsible for cancer growth are not present in the tumor. Without these receptors, treatments like hormone therapy and drugs are ineffective, leaving chemotherapy as Mitchell’s best option.

Under the care of Dr. Ana Cuesta Fernandez and the breast cancer team at the Orlando Health Cancer Institute, Mitchell immediately began treatment.  Dr. Cuesta recommended Mitchell first undergo genetic testing, which confirmed she carried the BRCA1 gene mutation often connected to a higher risk for triple negative breast cancer. For Mitchell, the test result was “like a light bulb that just kept going off.” Suddenly, her medical history made more sense.

“I really didn’t know about genetic testing, even with my family history being a red flag,” Mitchell says.

Not deterred by the results of Mitchell’s test, Dr. Cuesta moved forward with chemotherapy as the first line of treatment.

“If we identify triple negative breast cancer early, it's actually something that we can cure, especially with the most up-to-date therapies, including immunotherapy, which Yocinthia started,” Dr. Cuesta says.

The plan was to get through an initial round of chemotherapy to shrink the cancer, and then have surgery to remove the remaining tumor, Mitchell recalls.

‘We Have To Stop Everything’

The first few chemo sessions went smoothly, with Mitchell eyeing the finish line to surgery. During those early days, her best friend Meredith served as the level-headed medical translator for Mitchell, who was still coping with her diagnosis – even keeping it a secret from some family members.

“At every chemo treatment, every doctor's appointment, she was the one taking the notes,” Mitchell says.

But shortly after her third chemotherapy session, Mitchell noticed swollen lymph nodes on each side of her neck, and a large lump forming under her arm. She immediately notified Dr. Cuesta, who began working with Dr. Michael Kahky, Orlando Health Cancer Institute’s team leader for surgical oncology.

The news was another blow for Mitchell: A biopsy revealed that her swollen lymph nodes were positive for diffuse B cell lymphoma, a type of blood cancer that affects the immune system. With a second cancer now in Mitchell’s body, Dr. Cuesta put the breast cancer treatment on hold.

“She said, ‘Yocinthia, we have to stop everything and come up with a new chemo regimen,’” Mitchell recalls.

Lymphoma combined with breast cancer makes treatment challenging, because doctors must monitor responses to treatments for two cancers simultaneously.

“That's something that normally we don't see together, especially during treatment at the point where Yocinthia was,” says Dr. Cuesta. “Fortunately, we have chemotherapies that are active for both cancers, so we use that combination of medications that would take care of both.”

Back To the Beach

We went to Ormond Beach to say goodbye to my tatas. Tears were flowing down my cheek; I just sat out there and listened to the ocean. – Yocinthia Mitchell

After officially wrapping up her initial round of chemotherapy for both cancers, Mitchell was finally cleared for a comprehensive procedure to surgically remove the remaining cancer and undergo a bilateral mastectomy to reduce any risks of the breast cancer returning. With a BRCA1 mutation that put her at risk for other cancers appearing, her team also performed an oophorectomy to remove her ovaries and fallopian tubes. Total surgery time: nine hours.

That milestone moment in her life and her cancer journey led Mitchell down a renewed path of reflection and hope. There was only one place that seemed fitting for a pre-surgery reunion with her closest friends and family: the beach.

And just like those Thursdays before her diagnosis, she was up early to catch the sunrise, pray and meditate.

“We went to Ormond Beach to say goodbye to my tatas,” Mitchell says. “Tears were flowing down my cheek; I just sat out there and listened to the ocean.”

The surgeries were successful and today, Mitchell has achieved NED status, the term doctors use when no evidence of disease remains in the body after treatment and surgery. Her lymphoma is also in remission.

Sticking To the Plan

After Mitchell’s major surgery, a new round of care began to ensure her breast cancer wouldn’t return, this time via immunotherapy administered every three weeks. Although Mitchell is now cancer-free, those Keytruda IV infusions help stop cancer cells from emerging in her immune system. In conjunction with a physical therapist, a counselor and a nutritionist, they represent a new era in Mitchell’s recovery journey.

It’s all part of what Dr. Cuesta calls “The Plan.”

“She really did everything she had to do to get better, to get through the process and keep her life together, trying to see the positive side all the time while going through this,” Dr. Cuesta says.

Breast cancer support groups have also provided Mitchell with a sense of community and sisterhood. She’s a part of Orlando Health’s breast cancer support group and a handful of other networks made up of patients, caregivers and survivors. More recently, she joined a group of women fighting breast cancer on a fly-fishing retreat in North Florida. It was an opportunity to meet women walking a similar path, and Mitchell returned with a few new lifelong friendship — and fishing skills.

“If I'm going to share something with someone, I want to share the love that I have inside of me, and I don’t want them to look at me as if they see cancer first.” Mitchell says. “Nobody, except somebody that's going through it with you, really, truly understands that.”

Up next for Mitchell is her final milestone as a breast cancer survivor: Reconstructive surgery. To qualify, she must complete her 12 immunotherapy treatments.

“I don't feel like I'm on the other side; I feel like I'm on my way there,” Mitchell says. “If I follow through the plan and stay on the plan, I’ll make it to the other side.”