Female Voices of Cancer: Leukemia and Breast Cancer Patient Finds Her Voice

Lynn Leiro

"In the beginning I just tried to be a 'nice' patient," recalled Lynn Leiro, a 39-year-old legal assistant from Alhambra, California.

These days though, Leiro basks in the praise of her Instagram buddies who describe her much differently. "You are such a tough lady!" says one. "You are a force!" says another. "A rockstar!" chimes in a third.

Collectively they admire and envy Leiro's hard-learned ability to stand up, speak her mind, ask questions and demand the care she's entitled to receive. And they are amazed by her perseverance through two separate bouts of cancer which required major surgery, massive chemotherapy, radiation, CAR T cell therapy and a bone marrow transplant.

She is a double survivor; diagnosed with triple negative breast cancer in 2022 and acute lymphocytic leukemia in 2023. And she's doing just fine.

"From fighter to survivor to thriver!" she says.

Leiro is part of a growing number of women under 50 who are diagnosed with cancer each year. Cancer rates in women are now 82% higher than in men in the same age range. These women are increasingly having to advocate for their own health - and seeking to take their cancer journey into their own hands.

Leiro was always active and healthy. The daughter of Cuban emigrants who met and married in Los Angeles, Leiro played soccer and basketball in middle school. She became a young mom at 21 but ultimately found the love of her life a decade later, marrying in 2021. Life was good. An avid traveler, her social media feeds overflow with photos and videos from the many exotic spots she has visited.

At age 36 she thought she was "just getting older" when back pain and fatigue set in. Most of her friends were feeling the same things. But then, over the July 4 weekend in 2022, Leiro detected a lump in her armpit. She called her doctor, who had a nurse practitioner examine her. Immediately they sent her for a mammogram.

"By then they knew," she said, "that I had five breast tumors - some no larger than a grain of sand - plus a swollen lymph node. They were 95% sure it was cancer. But they didn't say so. They just handed me a piece of paper and said, 'go get an ultrasound.'

"I started Googling and by the time I got out of the elevator I knew I had cancer."

Leiro had Stage 3C triple-negative breast cancer, a rare and aggressive form of the disease that frequently strikes younger women.

City of Hope, where Leiro was ultimately treated, is joining with American Cancer Society, Together for Supportive Care, Tigerlily Foundation and others to raise awareness about this issue and call for change.

Dealing with Breast Cancer

Leiro during treatment

The news hit Leiro hard.

"I was definitely in shock for two weeks," she said. "It was the first thing I thought about when I got up and the last thing when I went to sleep. My blood pressure went through the roof. I was trembling constantly. My ears were ringing."

Her local hospital paired Leiro with an oncologist who had treated her grandmother. The hospital kept "dropping the ball" with multiple delays. When she finally underwent yet another scan, this time a computed tomography (CT) procedure, more cancerous lymph nodes were found in her neck, pushing the diagnosis to a possible Stage 4.

Leiro was eager to begin chemotherapy. In September she started a three-month course of taxol and carboplatin, supplemented by the immunotherapy drug Keytruda. That was followed by another three months of doxorubicin, the so-called "Red Devil" chemo. The "Red Devil" lived up to its name, making Leiro seriously ill and putting her back in the hospital.

But the chemo had worked. The tumors were now smaller, prompting Leiro to search for a surgeon.

Her social media profile looked quite different now. Glitzy vacation posts gave way to shots of Leiro in her hospital gown, sometimes with short hair, sometimes with no hair, always with determination to keep going. It was here that Leiro connected with The Breasties, described as "an all-inclusive community with members providing peer-to-peer support around the world." As Leiro began polling surgeons around the country, The Breasties weighed in.

When the first surgeon recommended a minimal lumpectomy one "Breastie" vehemently disagreed and pointed Leiro to City of Hope and surgeon Lorena Gonzalez, M.D., herself a breast cancer survivor. Gonzalez advocated a more extensive mastectomy, as did a third surgeon at another institution out of state.

By this time, Leiro had no problem seeking out second, third, even fourth opinions. "I do so much research on a restaurant before I go," she said. "Why shouldn't I do that when choosing my treatment?"

Ultimately, Leiro chose the out-of-state surgeon, spending three months away from home for the procedure and the radiation that followed. The news was good: a "complete response." Cancer gone. By October 2023 Leiro was ready for reconstructive surgery.

But she was getting headaches.

An Unexpected Leukemia Diagnosis

The pain kept getting worse, and her migraine medicine didn't help. Multiple scans detected nothing. Bloodwork told another story. A doctor walked into the room, matter-of-factly said, "the labs are back. You have leukemia," and walked out.

"I'm thinking, this has got to be a joke," recalled Leiro.

No joke. It doesn't happen often, maybe in 1% of cases. But treatment for one cancer can trigger another.

Vaibhav Agrawal, M.D.

"It's called Therapy Related Acute Leukemia," explained City of Hope oncologist Vaibhav Agrawal, M.D., assistant professor in the Division of Leukemia, Department of Hematology & Hematopoietic Cell Transplantation. "Chemo and radiation put you at increased risk, modifying your DNA."

With more encouragement from her Breasties buds, Leiro decided immediately on City of Hope for her leukemia treatment, calling at 3 a.m., and getting a quick response. She arrived full of questions.

"Because of her prior experience, we had a higher level of discussion," he said. "But she was drawing parallels to her breast cancer treatment. I had to adjust that. Leukemia is different."

Leiro appreciated a doctor and an institution that made her feel heard.

"Dr. Agrawal was very nice, very reassuring. And everyone at City of Hope is so kind and so caring, even in the way they treat each other."

It was not an easy road. ("By far, the hardest thing I have ever gone through - physically, mentally and emotionally," she said). Five different chemotherapies failed to completely eliminate the leukemia. So, doctors turned to CAR T cell therapy, re-engineering Leiro's immune cells. This achieved a remission, but at a cost: a case of cytokine release syndrome, a result more likely when the initial cancer burden is high.

Only a bone marrow transplant could turn that remission into a permanent cure. Once a donor was found, Leiro had the procedure in August 2024.

Recovery has been slow; she battled a brief case of graft versus host disease. But nearly a year since the transplant, Leiro is doing better and getting stronger.

Her experience has also strengthened her determination to always speak up.

"I feel more competent and confident now," she said. "It's frustrating when you're not heard. People in healthcare can forget how traumatic this is for someone going through it for the first time. They just want patients to trust them. Never feel like you're being a burden just because you're asking questions."

Dr. Agrawal, who had leukemia as a child and believes it helped him relate to Leiro, is impressed by his patient, and agrees with her completely. And he says City of Hope does it right.

"Our culture is contagious," he said. "We put the patient first."