The Drummer Who Changed the Beat of TNBC
How April Samuels set her own rhythm in the fight against triple-negative breast cancer.
The thing that saved April Samuels’ life was her rhythm.
For seven years before her diagnosis, her doctor had her come in every six months for screening. She had fibrocystic breasts, the lumpy, cyst-prone kind, and she knew the drill cold: ultrasound, aspirate, biopsy, all clear, come back in six months. She got so used to the screen beside the exam table that she could read her own cysts. Black, oblong, a thin blue line around them. So in July 2010, when a new spot showed up round with speckles inside it, she saw it before anyone said a word. That looks different.
It was ten millimeters. Small. Caught early, because somebody kept time.
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April tells anyone who will listen - If you have fibrocystic or dense breasts, you are playing a harder game than you know. That tissue shows up white on a mammogram, and so does a tumor, so a cancer can sit there hiding in plain sight (American Cancer Society). Dense tissue also carries a higher risk to begin with (see episode 3 with Sheila Mikhail for more on how to screen if you have dense breast tissue).
April’s cancer was found at ten millimeters, not because she got lucky, but because her doctor refused to stretch the six-month interval. The tempo caught it.
The Beat Goes On
Triple negative breast cancer is only 10 to 15 percent of all breast cancers, but it is the aggressive one, more common in younger and premenopausal women, quicker to grow and to spread (American Cancer Society). Buried under that scary headline is that it tends to respond well to chemotherapy. April’s tumor was stage one. She went from diagnosis to double mastectomy in two weeks, a decision she had privately made years earlier, and she has not doubted it for a single second since. She was always “flat”, got teased for it as a kid, and chose flat again on her own terms. When she got fitted for prosthetics that matched her old weight and size, she cried in the dressing room. Happy tears. She calls them her foobies now. Her friends call them chicken cutlets. Humor was another way of refusing to sit still and be pitied.
And that allergy to pity drove her to create community and boldly physical experiences that bring survivors together and raise money for research. Survivors, she says, tell each other things they will never tell their own families, because they don’t want to console the people who love them while they’re the ones bleeding. Going through cancer, she said, was almost like attending your own funeral, everyone finally telling you how they feel about you, people coming out of the woodwork you didn’t know cared.
“Breast Cancer Can Stick It”
Within weeks of her diagnosis, she was selling shirts out of her car that said Breast Cancer Can Stick It, the logo a woman behind a drum kit. By 2013, it was a 501 (c) (3) funding treatment assistance, mammograms, and research. Today it has raised close to $700,000.
The engine is Drumathon, and the idea is pure April: instead of a few drummers playing a lot, a lot of drummers playing a little.
Regular people fundraise, and the top fundraisers get a minute on stage. Celebrity drummers fly in, more than forty of them over the years, from Pink’s band, the Go-Go’s, Prince’s world. A stranger can walk past, drop some money, and end up drumming next to their hero. She got the idea after chemo, at a rock-and-roll fantasy camp where she jammed with Sammy Hagar. She took the thing that gave her joy and turned it into the thing that funds other people’s survival.
A Smarter Tempo for Medicine
What gives me hope is that medicine is finally learning to keep time the way April’s doctor did. The WISDOM study, led by Dr. Laura Esserman (catch Epidose 32) at UCSF, has enrolled more than 50,000 women to test whether screening built around your actual risk, your breast density, your genetics, and your family history protects you better than the same annual mammogram for everyone. It is expanding to women as young as 30. Esserman’s line for it is test smarter, not test more. That is April’s doctor’s instinct, scaled to a nation.
And further upstream, researchers like Dr. Sacha Howell (episode 43) are asking whether triple negative can be headed off before it ever forms. His early work on antiprogestin drugs, some of them already used in emergency contraception, shows they can lower breast density and reduce the very cells that go on to become aggressive, triple negative tumors. It is early. It was a small study, and it needs larger and longer trials before anyone changes what they do. But the direction is everything: get ahead of the beat, not just react to it.
April told me her cancer was an odd blessing. My cancer year became one of the happiest of my life. Neither of us is romanticizing it. What we are describing is what happens when you stop waiting to find out what cancer will do to you and start setting the tempo yourself. April spotted a speckled dot on a screen and never missed a beat. She is still playing. So are the rest of us.
