A ‘sandwich generation’ mom learned she had breast cancer, then lost her father. The hardest part was staying positive in front of her kids.

Katie Asturizaga was getting dressed before helping her son get ready for school when her thumb grazed a lump on her left breast. She quickly compared it to her right side, then asked her husband if he felt something. He didn’t.

“Thankfully, I was going to my yearly OB-GYN appointment the following day, and the doctor felt it as well,” Asturizaga, 45, told Business Insider. A mammogram confirmed the mass in her left breast and a smaller cyst on her right.

A few days before Memorial Day weekend 2024, Asturizaga learned she had breast cancer at 44. She cried when she learned she’d need chemotherapy and dreaded losing her hair in the process.

Then, less than a year later, her father died. Asturizaga had to balance grieving and planning his funeral with finishing her cancer treatment.

But with two kids, ages five and two-and-a-half, she felt there was a limit as to how much emotion she could show.

“I basically got up every morning and put a smile on my face,” Asturizaga said. “They need their mom, so I couldn’t just lie down in bed and be like, ‘poor me.'”

She’d missed a few annual screenings

In the US, 40 is the recommended age to start breast cancer screening. It’s also the age Asturizaga, who has some family history of breast cancer, became pregnant with her first child.

After giving birth, she was breastfeeding, which can make mammogram results harder to read if the breasts aren’t emptied of milk — it’s common for doctors to recommend waiting until after breastfeeding is over to get a breast cancer screening.

At 42, Asturizaga became pregnant with her daughter and was soon breastfeeding again. She never started screening for breast cancer until she was 44, when she discovered the lump.

Given her younger age (the average age of cancer diagnosis is around 65), Asturizaga received treatment through NYU Langone’s Early Onset Cancer Program, which aims to help patients who have additional concerns like fertility or childcare.

Dr. Mary Gemignani, a surgical oncologist at NYU Langone and Asturizaga’s doctor, told Business Insider that she’s seen an uptick in breast cancer cases among women in their 40s, and even in some patients as young as their 20s. She highlighted that patients like Asturizaga often deal with the “psychosocial aspects of juggling time-consuming treatments” with caring for their kids or aging parents.

Her first concern was her kids

When Asturizaga first learned she had cancer, she was about to go pick up her son from school.

“I was hysterically crying,” she said. “I needed to pull myself together because little kids — they pick up on everything.” She put her daughter in the car and watched her son run down the hallway to hug her. After she and her husband put him to bed that night, she cried.

She learned from a fine needle aspiration, a form of biopsy, that her cancer had spread to her lymph nodes, making it stage 2 and more advanced than she first thought.

While Gemignani helped her feel optimistic (“The first thing out of her mouth was ‘You’re going to be OK.'”), managing treatment and work-life schedules was a logistical challenge.

Treatment involved a mastectomy on her left side, six months of chemotherapy, and radiation for five weeks. Asturizaga, who is a stay-at-home mom, had her chemotherapy on Thursdays so her husband could take off work on Fridays and give her the weekend to rest.

By Monday, Asturizaga was back to getting them ready for school and picking them up. Once the chemotherapy drug was switched after the fourth appointment, she had more energy. It was the first few rounds that were the hardest. “That’s when I felt like I had been in a car accident,” she said.

A devastating loss during treatment

Throughout Asturizaga’s treatment, her dad was her rock, helping her to cope with the cognitive dissonance of being strong for her kids during the toughest moment of her adult life.

In February, a month before she became cancer-free, Asturizaga’s father died from a massive stroke.

“My dad was there during surgery. He came with me to chemo,” she said. “So losing him was very hard.” Asturizaga and her three brothers helped their mom plan the wake, funeral, and burial. They went back and forth from NYU Langone, for her ongoing cancer treatment, to their mother’s home.

The loss was especially devastating because he was the one who wanted to throw a party when her treatment was over. “On my last day, when I rang the bell, it was a little hard that he wasn’t there, but he was there in spirit,” she said.

Asturizaga said that physically, she feels fine. But being part of the sandwich generation, grieving her father while caring for her children, took an emotional toll.

“Everyone just keeps telling me, with everything I’ve been through this past year and losing my dad, ‘I don’t know how you’re just sitting here with a smile on your face — we would’ve been broken,'” Asturizaga said. “And I keep saying, ‘I have two little kids I need to be strong for.'”

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