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Dear Scientist, breast cancer has disrupted my plans for a family. What’s next for me?

Kaye McDonald, of Orange County, was preparing to take a big step before cancer rerouted her life. Scientist Jennifer LaFontaine is determined to help her remain hopeful.

On October 1, 2018, on the La Jolla campus of Pfizer’s research labs in San Diego, California, Kaye McDonald takes a deep breath before entering the main building.

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As someone living with metastatic breast cancer, McDonald is used to meeting with the doctors who prescribe oncology medications, but never before has she spoken to a scientist responsible for developing them. Her journey leading up to this day has been challenging, with cancer uprooting her plans for a life she didn’t know she wanted until shortly before her diagnosis. But today she’s arrived ready to share her story.

There to meet her—and to listen and enlighten—is Jennifer LaFontaine, a senior director of Oncology Medicinal Chemistry, who has been doing research at Pfizer for 20 years. Once seated, the two women establish an immediate connection, bonding over a disease that has affected each of their lives in its own way, as it has for so many others.

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The best laid plans

While growing up the daughter of a Chinese mother and a South Indian father in the suburbs of Los Angeles County, McDonald always felt different, inside and out, a high note in a chorus of baritones.

“I was always the kid that stuck out,” she says. “I looked different, at Chinese school or other places, but it was honestly okay. Being someone who’s never blended into the crowd has strengthened me over time.”

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Kaye and her husband, Chris

A self-described free spirit, McDonald was the young adult who took most things in stride, one day at a time, without any concrete plans for the future. “I mostly did what felt right in the moment,” she says. Looking back now, she points out, that attitude probably would not have resulted in “a life that progressed how I would have wanted it to.”

Then, at age 23, McDonald met the young man who would become her husband. Almost immediately, she felt something shift in herself.

“Chris was very clear about what he wanted in life,” she says. Not only was he truly chasing his goals, but “he helped me plan and work toward achieving mine. After being adrift for so long, I felt supported having someone there willing to help me achieve every dream I had for myself.”

It wasn’t long before the two were married, making the plans that would shape the next stage of their lives together. And five years later—after McDonald received her graduate degree in communications, the two moved to a new home in Trabuco County, and started new jobs—it was time, they thought, to start a family.

Then McDonald discovered the lump.

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A plan of action

“By the time I found it, it was really, really big,” she says. “And the ultrasound showed it had spread to the lymph nodes as well. I was told I had hormone receptor-positive, HER2-negative breast cancer.”

At McDonald’s young age, she knew no one else who had been diagnosed with breast cancer. She did her best to decipher pages of medical lingo. She clung to every recommendation her doctors gave her. She kept her husband close at all times. However, one question blared inside her head: Would she still be able to have children?

The doctors recommended the swift treatment plan of chemotherapy, surgery, and radiation. But after a PET scan revealed that the cancer had also spread to her spine, that plan was halted. With a refined diagnosis of metastatic breast cancer, McDonald now needed to start on hormone therapy.

“I had this thing in my body set to kill me, and my gut is telling me to hit it hard, kill it, smash it,” McDonald says. But her treatment from the beginning was “not at all what I was expecting.”

Hormone therapies lower the levels of estrogen and progesterone in the body in order to keep cancer cells from using these hormones to grow. For McDonald, that meant going through ovarian suppression, which is meant to stop the ovaries from producing any estrogen at all.

This treatment, while keeping things stable for about a year, came with a major side effect: At age 28, she started to go through menopause. Her chances of having her own children had plummeted.

Planning ahead

“That was the hardest part of your letter for me to read,” LaFontaine says to McDonald during their conversation at Pfizer’s La Jolla offices. “When I was your age, I didn’t necessarily think I wanted kids,” she notes, “but after you find love, things can change. To know that door might not be open, that’s got to be really hard.”

“It is,” McDonald says, shoulders square and eyes glossy. “But if it’s taught me anything, it’s that there’s never a ‘right’ time to do the things you want to do. I waited. If I could go back in time, knowing what I know now, I wouldn’t make that same decision.”

Pfizer researcher Jennifer LaFontaine

LaFontaine leans forward. “Don’t regret,” she says. “You make the best decisions in the moment.”

After a year of hormone therapy, McDonald underwent additional measures, including surgery to remove tissue from her left breast and radiation. Eventually, her cancer spread to more bones and her medication changed to a different therapy. Since then, though her treatment has changed, McDonald’s outlook has remained positive.

“Since my diagnosis, I’ve learned to appreciate the everyday things I’m still able to do,” says McDonald. “I go to work every day, do yoga, cook, and travel. There are bad minutes and good hours, but overall, there’s been little day-to-day change in my life.”

LaFontaine gives an encouraging smile. “Right now, we’re looking at ways to help your life stay this way as long as possible,” she says. “Cancer has a way of finding resistance to certain treatments, so we try to stay ahead of that.”

In terms of what’s next, McDonald is curious to know how the development and discovery of new drugs is aided by the existence of what’s currently out there. Do future treatments build on current ones, or are they focused on different aspects of the disease? And how soon can new treatments be expected?

After a brief pause, LaFontaine says, “Every time we discover something new or get a different medicine approved, it sets a higher bar. Our goal is always to beat the accepted standard of care. And we do everything we can to speed things along, like receiving breakthrough designations from the FDA or accelerating the approval processes, while also making sure we adhere to the rigorous processes needed to ensure the therapies we develop are safe and effective. We’re working with a lot of emotional urgency.”

“That means a lot to hear,” McDonald says. “I am so grateful for your work and all the developments you’ve helped advance. Without all that you’ve done, my life would be completely different.”

LaFontaine is confident that her team will find McDonald’s words incredibly motivating. Finally, she adds: “I know right now it might seem like you have a lot to worry about, but I hope you don’t worry often. You can only deal with what comes your way as it comes, and so far you’ve been dealing really well. Hopefully you can—and do—plan ahead. It’s like you said, don’t wait.”

With this, the two women part ways. McDonald heads back to her day job, an opportunity afforded to her thanks to the continuing strides in medical research made on the campus she’s currently standing on. And LaFontaine heads back to the lab, more ready than ever to follow through with the plans that McDonald, and thousands of other breast cancer patients, are looking forward to.

This content was produced by Boston Globe Media's BG BrandLab in collaboration with the advertiser. The news and editorial departments of The Boston Globe had no role in its production or display.