hen April Knowles graced the cover of Bella in October of 2016, there was no evidence of cancer in her body. Diagnosed with stage IV metastatic breast cancer in 2015, which had already spread to her spine and hip, she had undergone seven months of chemotherapy as well as numerous surgeries. But, she knew it could turn on a dime.
Don’t let guilt make you feel like you have to stay positive all the time. We are complicated emotional beings; we need to feel all the feelings life gives us.”
“It’s just difficult, you pretty much live from scan to scan, wondering if it spread,” Knowles said in 2016.
For the past six years, she has been living a full life while riding the rollercoaster of scan, treat and repeat. She considers herself fortunate – her hormone receptor-positive disease responds to the treatments available on the market. Not all HR+ cancer responds to treatment, for cancer is a mutation in the DNA of someone’s cells, so no two cases are exactly alike.
She has friends who have not been so lucky.
Fulvestrant and Ibrance are the medications she takes to manage her metastatic disease. Although she feels fortunate to be living in the era when these drugs were developed and became available, the side effects can be brutal – joint pain, weakness and fatigue to name a few.
As if managing metastatic cancer wasn’t enough, last year Knowles was diagnosed with a new, pathologically different stage I triple negative breast cancer. She underwent a bilateral mastectomy with DIEP flap reconstruction. The DIEP flap reconstruction is today’s most advanced form of breast reconstruction. The procedure uses the patient’s lower abdominal skin and fat to reconstruct a breast after mastectomy. She had no idea how difficult the recovery from the two surgeries would be, but she works hard in physical therapy to improve her recovery and regain her strength.
Knowles is going to need that strength. She is scheduled for open heart surgery in January at Vanderbilt Hospital. Due to a congenital heart defect as well as the likely weakening effects of chemotherapy and cancer treatment, she suffered a heart attack in 2021. A defibrillator and pacemaker were implanted, but now she needs a valve replacement.
How does one stay strong in the face of such adversity?
“Being pissed off about it keeps me going. It’s OK to be sad and angry, you may not feel grateful and think every day is a gift sometimes,” Knowles laughed.
According to Knowles, so many people say, “Just stay positive, that’s the answer!”
She disagrees. Toxic positivity is a dysfunctional approach to emotional management that happens when people don’t fully acknowledge negative emotions. As women, we are expected to make other people comfy with our cancer – wear pink ribbons, join the sisterhood, etc.
“Don’t let guilt make you feel like you have to stay positive all the time. We are complicated emotional beings; we need to feel all the feelings life gives us,” she said.
Knowles also struggles with the phrase “fighting cancer.”
“It’s not a fight. Cancer is in your DNA, part of you. When you die, the cancer dies,” she said. “Nobody fights harder than anybody else. Your body responds to treatment based on your diagnosis.”
She tries to take one day at a time. She wants to do things now, like travel, instead of waiting for retirement. She’s learned to appreciate certain things more – her son will be sixteen soon and she is happy he will be able to drive himself to and from school when she is recuperating from her heart surgery.
April Knowles is never happy “just to be alive,” she wants to live life to the fullest. She is a thriver, not a survivor.
