Meet Courtney Cates: Courtney is a triple-negative breast cancer survivor

How did your cancer journey begin?

My cancer journey began almost by accident. In July 2021, after COVID, I developed headaches that lasted about a week. I assumed they were caused by working in front of a computer, but I went to my doctor anyway. They ordered a CT scan of my head. When the NP handed me the slip of paper with the location, it was pink.  She said it was that color because that is also where they do mammograms.  I let her know I was in need of one - I was 45 and hadn’t had one yet, so she scheduled it.. Ironically, the CT scanner was broken, so I never had the head scan, but I did have the mammogram. A few days later, while traveling to my nephew’s rehearsal dinner, I got a call that they had found an area of concern. After an ultrasound and biopsy, I was diagnosed with Stage 1B triple-negative breast cancer.

What happened after your diagnosis?

I started chemotherapy about two weeks after being diagnosed. Everything happened very quickly. I also chose to cold cap during treatment to help preserve my hair, so I was preparing for both chemotherapy and the cold-capping process at the same time.

What has your journey looked like since then?

I began chemotherapy in August 2021 and finished in December. I had a double mastectomy in January and was declared NED (No Evidence of Disease). In January 2024, I noticed a small spot under my arm. Although previous scans hadn't shown anything concerning, my plastic surgeon ordered another ultrasound. A lymph node appeared abnormal, and a biopsy confirmed the cancer had returned in my lymph nodes. I underwent a full axillary lymph node dissection and lymphovenous bypass. Cancer was found in 15 of 20 lymph nodes, so I completed another six months of chemotherapy followed by radiation and immunotherapy. I finished active treatment in December 2024 and now receive CT and bone scans every four months. Thankfully, my scans have remained clear.

 How has cancer affected your mental health?

Nothing prepares you for the mental side of cancer. Living in my mind has often been harder than living in my body. Even after treatment, there's constant uncertainty and fear of recurrence. I think about death far more than I ever did before cancer. I work with a psychiatrist who is also a cancer survivor, and that shared experience has made a tremendous difference. I wish oncology-specific mental health specialists were more widely available because survivorship comes with emotional challenges that many people don't fully understand.

What advice would you give someone newly diagnosed or facing a recurrence?

Find your community. Whether it's an online group, a support group through your oncology center, or just a few people who truly understand, you shouldn't go through cancer alone. Other survivors understand what you're experiencing in a way that even loving family members often cannot. Remember that everyone attending those support groups was once nervous too.

How did cancer change your relationships?

 It made me much more intentional. I reach out to people more often, send birthday cards, text friends just to let them know I'm thinking about them, and make an effort to show kindness every day. Cancer also taught me that everyone is carrying something you can't see, so I try to be more patient and compassionate.

What do you wish people without cancer understood?

 You don't have to know the perfect thing to say. Sometimes a simple heart emoji or a short message letting someone know you're thinking of them means more than asking lots of questions. Don't feel pressured to compare someone else's cancer story, especially stories that end badly. Small gestures of support matter.

What kinds of gifts or support were most helpful?

 Meals were incredibly helpful, but I appreciated it most when people simply dropped food off instead of asking me what I wanted to order. Decision fatigue is real during treatment. Fresh fruit, vegetable trays, and healthy snacks were wonderful. Flowers also brightened my day. I received plenty of cookies, but healthier options would have been even more appreciated.

Were there unexpected side effects people should know about?

One side effect many people don't realize is how much chemotherapy changes your sense of taste. Water tasted metallic to me, almost like sucking on a nickel. Everyone experiences different food aversions, so it's important to understand that each patient's needs are different.

What final message would you like to leave readers?

Advocate for your health. If something feels different, speak up. Know your body and don't ignore new symptoms, lumps, or changes. If you're uncomfortable advocating for yourself, bring someone who can advocate for you. Early detection truly matters. Most importantly, remember that you're never alone.