Crystal Alhilali, left, talks to a nurse administering her chemotherapy drug. Alhilali has chemotherapy once a week for three weeks and then has a week off.
CONFRONTING BREAST CANCER
TODAY’S SPECIAL SECTION: Each year, more than 200,000 U.S. women are diagnosed with breast cancer. In honor of their fight — and as part of National Breast Cancer Awareness Month — our special section tells stories about the women who have received breast cancer diagnoses, the science and technological advances for treating them, and the community that supports them.
Find information on the history of cancer and treatment and more stories about people in Clark County and the Northwest battling cancer and contributing to the community at www.columbian.com/news/health/breast-cancer.
From the moment Linda Stief and Crystal Alhilali met five years ago, they believed there was a bigger reason for their meeting.
Stief and her husband, John, moved into their home in the Sifton neighborhood in 2007. The next year, Alhilali, her husband, Ahmed, and their six daughters moved in next door.
The two women clicked immediately.
"It was like we had known each other forever," Stief said. "We're like kindred spirits."
In August 2009, Alhilali, who was 35 years old at the time, was diagnosed with breast cancer. Stief stood by Alhilali's side throughout the treatment, surgery and recovery.
That diagnosis, they thought, was why the women were destined to be friends. But that was just the beginning.
In April of this year, Stief was diagnosed with breast cancer. A month later, Alhilali received her second breast cancer diagnosis.
Together, their perilous journey toward recovery had begun.
The first diagnosis
Sometimes the relationship between Linda Stief and Crystal Alhilali is like that of sisters. Alhilali calls Stief her partner in crime. Stief jokingly calls Alhilali the pain in her butt.
Sometimes, their relationship better resembles that of a mother and daughter. Alhilali, 39, asks Stief, 55, for advice about raising her six daughters, ages 5 to 18. The younger girls don't know Stief technically isn't their grandmother.
Never, though, has their relationship resembled that of ordinary neighbors. They were best friends from the beginning. And, together, they endured their first hardship in 2009.
Alhilali discovered the cancer by chance. She was wearing a new bra and as she slipped her hand beneath the bra to scratch an itch, she felt a lump.
Alhilali scheduled a mammogram. At the appointment, her doctors told her it was likely just a clogged milk duct and to come back in six months.
But Alhilali didn't feel right. She had a gut feeling the lump was more than a clogged duct. She pushed for a biopsy. After about 20 minutes, her doctor relented.
Alhilali was right. It was cancer.
"The oncologist said I saved my own life," Alhilali said. "If I had waited six months, there wouldn't have been anything they could do."
Alhilali underwent surgery to remove the cancerous lump and endured 11/2 years of chemotherapy and radiation treatment. Throughout the treatment, Stief kept a calendar of Alhilali's appointments. She sat by her friend's side for hours as drugs were pumped into Alhilali's veins.
Some days, Alhilali couldn't bring herself to crawl out of bed.
Those days, Stief threw back the blankets, pulled Alhilali to her feet and dragged her to chemotherapy.
'I just knew'
In March of this year, Stief went in for her annual mammogram. She pointed to a spot on the three-dimensional image of her breast and asked the doctor what it was. The doctor wasn't sure.
"Well, I knew," Stief said. "I just knew."
A few weeks later, Stief returned for another mammogram and an ultrasound. Based on what they saw, the doctors decided to do a biopsy.
"I cried," Stief said. "I knew."
A few days later, Stief returned to the doctor's office for her results. They confirmed what Stief knew all along. On May 8, Stief had a lumpectomy to remove the cancer.
"In the meantime, I thought I'd be the one to take care of her this time," Alhilali said.
After Stief's surgery, Alhilali stayed the night at Stief's house and watched over her friend. The next day, Alhilali went in for her own routine mammogram.
During the exam, doctors spotted something unusual and performed an ultrasound and biopsy before Alhilali left the office.
Then Alhilali got her own bad news. She too had breast cancer. This time, it was a different but equally aggressive form of cancer — one that required a double mastectomy. She underwent surgery on May 30.
After the surgery, Alhilali was afraid to look in the mirror and see what remained of her breasts. Stief looked for her.
"Sometimes I look at her, and I feel bad that she doesn't have breasts," Stief said. "Then I remember she's going to get new ones, and they're going to be perky."
On June 24, Stief began chemotherapy treatment. Her body revolted.
Stief was vomiting. She was feverish. She couldn't even drink water.
"To me, it looked like she was dying on the spot," Alhilali said.
Alhilali called an ambulance and Stief was rushed to a local hospital. She was having a rare reaction to the chemotherapy drug. Stief was hospitalized for five days.
Not long after, Alhilali started chemotherapy with the same drug. She experienced stomach pain, followed by the same symptoms her friend had endured.
Alhilali was suffering from the same rare reaction. She was hospitalized for 14 days.
After the reactions, the women continued to have stomach pains. They each received CT scans, which revealed both women had inflamed colons. They were both diagnosed with colitis.
Both women have since resumed chemotherapy treatment. This time doctors are using a different drug, one that hasn't caused any problems. They undergo treatment one day per week for three weeks and then have a week off. Since they're on the same schedule, the pair decided to schedule their appointments together.
"We made a pact that we're doing this from the beginning to the end together," Stief said, clutching Alhilali's hand as tears rolled down her cheeks. "Because without her, I don't think I could do this. I need her."
Stief will finish her current course of chemotherapy this month. She'll then begin her radiation treatment — 33 doses stretched over about six weeks — and get started on another round of chemo that will last about a year.
For Alhilali, the road to recovery will be even more grueling.
While the new chemo drug hasn't caused any problems, the lingering effects of the first drug reaction has.
For most of the summer, Alhilali was in and out of the hospital and unable to receive treatment. Her stomach was still healing from the drug reaction and, in the meantime, Alhilali battled constant nausea and vomiting. The resulting dehydration landed Alhilali in the hospital three times, each stay for nine to 15 days.
Then, Alhilali got an infection in her bloodstream. Once again, she was sidelined from chemo treatment while antibiotics attacked the infection. She has since resumed chemotherapy.
Alhilali won't need radiation, but she does have a round of high-dose chemotherapy in her future. Once she's done with treatment, Alhilali will resume the breast reconstruction process surgeons halted earlier this year. It too will be difficult.
The radiation Alhilali endured during her first round of cancer damaged the tissue in her breast. As a result, the expander in Alhilali's right breast didn't stretch the skin as much as the surgeons had hoped. They had tried using cadaver skin, but too much of the tissue died. She'll likely need a skin graft from her back in order to have enough room for implants.
So Alhilali's plastic surgeon wants to wait until she finishes chemotherapy to continue with the reconstruction. And that means it'll be another year or so before Alhilali has breasts again.
Out of concern for her daughters, Alhilali was tested for BRCA gene mutations, an inherited mutation that greatly increases a woman's odds of getting breast and ovarian cancers. The tests came back negative.
Since her diagnosis, followed by Alhilali's diagnosis, Stief has experienced a range of emotions.
Anger because she's a good person and wonders why God would allow her to get cancer.
Sadness because Alhilali is young and diagnosed with such an aggressive form of cancer.
And guilt because, since the first drug reaction, she's felt good. So good, sometimes she doesn't even feel like she has cancer.
Alhilali regrets not having a double mastectomy after her first cancer diagnosis in 2009. Maybe then, she thinks, the second diagnosis never would've come. But she tries to stay lighthearted to keep the situation from weighing her down.
"I'm going to get 20-year-old boobs again," she said, a smile spread wide across her face.
And even though it'll take a while before Alhilali gets those breasts, she knows Stief — her neighbor, her best friend — will be by her side through it all.
"It's different this time because she knows what it's like," Alhilali said. "There's nothing better than going through something this awful with someone you love, your best friend."
"I think back to when we first met and she said there's a reason we're supposed to be together," she said.