Heather James

One last health update for 2025. Coming out of these few days of family, friends, and opportunities for thankfulness, I continued to celebrate the care and support of this amazing community.

Thank you for walking with Hana and I during my initial diagnosis and treatment.

Thank you for holding onto hope for full healing, and for the many ways you showed up with tangible help along the way.

Thank you for coming alongside us with love.

I am grateful to have passed the one year mark of surgery and radiation with no returning cancer. I’m especially grateful to be finished with the active and ongoing treatment that comes with diagnosis.

I continue to work with my medical team to manage the ever changing effects of lymphedema. We were able to secure a FlexiTouch machine that I use twice a day for 50-minute treatments. It helps move the gathering fluid away from my left arm and chest, and encourage healthy lymphatic drainage. We still haven’t found the perfect way to manage these new symptoms, but every step helps us refine the treatment and get closer to the goal of manageable pain, stronger muscles, and freedom of movement.

Thank you for staying with us on this wild ride. For Advent this year, I am going to do a series of *regular* blog posts (non health related) on the themes of this season: hope, peace, joy, and love. The first post is here. If you’d like to receive notifications for when those post, you can subscribe to the mailing list.

I will keep this page open for occasional updates as things change, or to celebrate new milestones. However, I’m grateful to have the energy and returning creativity that will allow me to work on new projects and communicate in other ways.

Once again, thank you. This community has served as a lifeline for us, and I’m ever so grateful.

Hope With Me:

• Continued freedom from cancer and for the interventions (walking, meds, physical therapy, and monitoring) to continue to nurture my health and wellbeing.
• Relief from the effects of lymphedema, and wisdom for my medical team as we manage the symptoms.
• For Hana’s new year as a high school freshman. Join me in cheering her on academically, athletically, and in gathering a community of friends who will build her up and make her laugh when she most needs it.

I started this new year with a post thanking you all for your incredible support during my cancer treatment and recovery. There have been many moments in the last ten months when things haven’t gone according to plan. With the help of friends and family, we navigated through those challenges. The experience has deepened my sense of the way we are connected to one another, and has been a crash course in learning to accept help.

Navigating this time of treatment has also invited me to cultivate gratitude in the face of less-than-favorable circumstances. Gratitude that doesn’t depend on being optimistic or seeing a positive outcome, but instead looks for what is true, lovely, and honest growing underneath the chaos.

February kicked off a round of three month check-ins with my cancer team. My oncologist recently moved to another practice which also meant needing to identify a new doctor to lead the team. About ten days before this flurry of appointments, I started to notice pain and swelling in the radiated tissue. Concerned that the seroma was expanding again, I started the check-ins with my surgeon who was able to image the seroma and see that it was stable. However she quickly identified the growing problem—lymphedema.

In response, my new oncologist ordered a variety of support treatments involving physical therapy and cancer rehab (who knew there was such a thing?). The primary task is to try and move fluid through the tissue and out through the lymphatic system. Without improved movement, the fluid will continue to pool and eventually become permanent. Obviously, we are trying to avoid that outcome but this is proving to be a complex problem without an easy fix.

I’m also continuing to receive support for some of the health concerns that were either discovered during or caused by the cancer treatment. In May, I will have a follow up ultrasound to make sure the thyroid nodules are stable.

There is much that is out of my control in this process. However, I can continue to walk regularly. I can work to regain motion with targeted stretching, and regain strength with some modified weight training. I can do the exercises and lymphatic drainage work that my PT prescribes. I can practice gratitude for the team that is guiding this effort, and for the community (you!) that surrounds us.

All this is happening in a time when our world also feels (or is) out of control. We do have voice and we do have agency, but the current administration is making decisions on our behalf that are designed to reduce our interconnectedness and increase chaos. For example, I have spent much of my professional life partnering with organizations that rely on USAID, and the loss of that work in the world is devastating. To real people (my friends) in real places. In real ways.

In the face of the swirling news, I have been trying to apply the learning of the last ten months to this new situation. How can I cultivate gratitude by looking below the swirl for what is true, lovely, and honest? How can I nurture our connections, and prioritize the interconnectedness of the human family? What can I control and how can I use my voice for good?

So today, I want to use my voice to share a part of my story that I hope you will remember as you consider your own agency and voice in this time. You rejoiced with me when I found out I would not need chemo as a part of my cancer treatment. Using technology that was developed through funded research, my tumor was analyzed for specific markers. It was then compared to the research data and reoccurrence outcomes, and my doctor was able to confidently determine that my risk of reoccurrence was low and the risk would not be decreased by the use of chemo.

The policies and budget implications now being debated and initiated by our government have real world consequences for real people like me. You already know this. I hope you will join me in using your voice and actions to do what we can, however we can, whenever we can. We can choose to stay connected. We can choose to care for our neighbors. We can keep walking—together.

Hope With Me:

• For the lymphedema treatment to be successful, reducing the swelling and healing the lymphatic system
• For patience with this new round of hospital visits, PT appointments, and treatment protocols
• For wisdom in holding both personal and global concerns, and discernment in choosing actions that will make the world a better place
• For laughter, love, healing, and meaningful time spent with those I love

As always, I am grateful for you.

As I reflect on the power of gratitude this morning, I was reminded once again of the gift of this support community in our lives. Thank you for walking with us over the past several months. For your well wishes and prayers for my recovery, your tangible support in so many ways, and your willingness to carry hope for us in it all.

It has been a few weeks since my last post. Radiation was a difficult experience and I am so very grateful to have finished the treatment and be in a healing phase from its effects.

It was a gift to have a great team of technicians who cared for me in the process. My side effects have been minimal and radiation was the final step of invasive treatments. While I will continue with regular monitoring and medications, I am celebrating the opportunity to move on into a new season of life.

This week, I have been reflecting on the words “tune my heart” from the hymn Come, Thou Fount of Every Blessing. The work of tuning a voice, an instrument, and a heart takes time. We grow in skill and the ability to bring forth grace-filled tones as we faithfully practice and learn.

These several months of treatment have been a part of my tuning. The words of Psalm 137:4 come to mind: How can we sing the songs of the Lord while in a foreign land? Singing songs of grace and hope in the midst of grief and disruption is a calling worth the work of tuning.

Thank you for the ways you have held and supported us as I was learning new ways to tune my heart in a difficult season. And thank you for continuing to walk with us in hope for healing and new life.

Hope With Me:

• For continued healing from the effects of treatment. Particularly for the return of my energy and focus.
• For continuing to learn to tune my heart and life to rest and restoration. It is my hope to re-enter my life with better balance and a commitment to the healthy practices I have learned in this process.
• For wisdom to prioritize work that brings healing and hope in our world.

I’m deeply grateful for the many encouraging words you shared with us after my last post. Thank you for cheering us on, praying for us, and offering support in tangible ways.

It has been a long haul since the discovery of the abscess on August 12. Wound care and aspirating the seroma (emptying the fluid build up in the tumor cavity) has taken me to the hospital 3-5 days a week, and there were times where I thought this was my new permanent reality. The original treatment plan has changed week by week and the process has felt a bit rudderless.

Finally, in early October we started seeing significant improvement in both the wound and the seroma. This progress lifted my spirits. Then about a week ago, my medical team gave me the green light to begin radiation treatment. I have met with all three doctors to talk over the pros and cons of radiation, given the significant delay to starting treatment. After much discussion and deliberation, I am confident that moving forward with radiation is wise and will bring healing.

Today was the first treatment. The radiation treatment team did a great job preparing me with a dress rehearsal yesterday and plenty of time to talk through the steps and expectations. I will be going daily, Monday through Friday, through mid November.

I will also be returning to work next week. I’m grateful to be able to return to a job I love with people we have missed. While the next several weeks will be a bit of a balancing act, and I will need to work and play at a slower pace as the cumulative effects of the radiation treatment mount, I am looking forward to the change of focus.

In other news, we just celebrated Hana’s 14th birthday with great fanfare and joy. She continues to be a thoughtful and kind companion both in life and in this cancer navigation. I’m grateful for her presence in the world.

Hope With Me:

• For the side effects of radiation therapy to be minimal and manageable.
• For the radiation therapy to be effective in eradicating any rogue cancer cells.
• For wisdom as I prioritize rest and healing during treatment and also joyfully return to the work I love.
• Giving thanks for the many ways our community of friends and family have sustained us through the past 3 months.

For those wanting other ideas about how to walk with us in this process, you can scroll down past the other updates and find a “Ways You Can Help” list below.

It’s been a long couple weeks with all the expected highs and lows. With significant uncertainty about the best next step, it’s been hard to know what to communicate with others. Thank you for your continued prayers, words of encouragement, and support. It means so much in the ups and downs of this time.

Wanting to share some sort of update with you, I’ve been reflecting on what has happened over the past two weeks and what we do know about what is next. No trigger warning needed as I will spare you the details, but everything seems to revolve around needles.

💉 The thyroid molecular test returned with a low cancer threat, so I am grateful to be able to lay that concern aside. The molecular test was done about six weeks ago with several large biopsy needles. The material removed was sent to a lab and the report came back a few days ago. My ENT surgeon will continue to monitor my thyroid health yearly with ultrasounds, and no further intervention will be necessary as long as everything stays the same.

💉 I went through my radiation simulation a few days ago, and was given tattooed marks that will help the radiation doctor and technicians line me up in the machine for treatment. Right now, I’m scheduled to begin radiation treatment at the end of September, and will go five days a week for four weeks.

💉 The start date for treatment is unknown as I am still being treated for a seroma—fluid that is collecting in the space left when the tumor was removed. Usually, seromas are emptied and addressed in reconstruction surgery. Because my reconstruction turned into an abscess management surgery, the seroma went untouched. The surgical team began to address the issue a few weeks later as it became clear I was no longer a candidate for reconstruction.

Initially, aspirating 💉 the seroma yielded about 160ml of fluid (almost two specimen vials full). We are down to about 70ml per time, and are stepping up the aspiration schedule to every other day. In a perfect world, the seroma would be healed (no longer filling with fluid) before radiation begins. As radiation progresses, the tissue is no longer able to absorb fluid and the seroma would be come a chronic condition where the discomfort it causes would be permanent. However, we are nearing the end of the time frame when starting radiation would still be considered an effective treatment option. The ongoing management of the tumor site and abscess has really upset the normal sequence of events.

It’s been difficult to navigate the different care teams and seeking answers to my question about the effectiveness, safety, and timing of radiation treatment. My frustration level has been high as the different teams seem to have different opinions. Yesterday I was able to talk with my cancer surgeon about my concerns and was grateful for her assurance that she would make the connections needed to get the answers I am seeking.

I’m tired. But trusting that what is murky will come clear. What is sharp will soften over time. And that at some point, there will be an end to this part of my life. I’m ready to shift my energy to something more life-giving (I recognize the irony in that statement) but for now I will continue to put my energy into healing and holding on to hope.

On another note, Hana is glad to be an eight grader and back in school with her friends! It’s volleyball season and our next several weeks are filled with games and tournaments. Unfortunately, she’s caught the obligatory beginning-of-school illness and recovery has been slow. She is looking forward to being back to full strength and her full schedule soon.

Hope With Me:

• For the seroma to be resolved and healed.
• For that healing and resolution to happen before radiation begins, AND in time for radiation to still be an effective treatment option.
• For my own energy and outlook as I navigate between doctors, opinions, personal conviction, and treatments.
• For Hana’s return to health, and that I would stay healthy during this back-to-school season.
• Giving thanks for the good thyroid report and taking that treatment plan off my plate.

It’s been an intense week of ups and downs. Grateful for the care of this community and your willingness to cheer me on through these challenging days.

I’m grateful to report a couple things today.

First, the wound is showing signs of healthy closure, and the nurse verified that the antibiotics are working. She anticipates that we will wrap up this management phase next week and then just need to monitor for healthy signs of healing.

In addition, the surgeon’s office has arranged for me to see another plastic surgeon and get a second opinion regarding the reconstruction. This seems complicated as there are technical moving parts trying to get the wound healed, and move into the next cancer treatment phase. It may be that the window is truly closed, but it seems wise to gather more information and find out all my options.

Last but not least, my tumor’s Oncotype DX score was low (20 out of 100) which means no chemo. I’m moving straight to radiation and medication to help reduce the risk of recurrence.

At the end of a hard week, this morning was refreshing to body, mind, and spirit. It still feels like a technical climb, but without quite so much scree.

Hope With Me:

• Gratitude for today’s good news all the way around.
• For good rest in the midst of wound care, medical decisions, and anticipation of what is to come.
• For our family as school starts up. For new good habits, healthy choices, and the joy of renewed friendship.For our family as school starts up. For new good habits, healthy choices, and the joy of renewed friendship.
• For healing for this wound and patience with the process.

Back when I was posting on the previous platform, I said that I would prefer not to call this experience a season, a journey, or an adventure. Instead, I used the word navigate. Somehow I need to navigate this experience. Some days it feels like an obstacle. Other days it’s more of a stalled engine. Today, it feels like mountain climbing. On scree. With no ropes.

The infection continues to need attention – I was given ten additional days of the stronger antibiotic with hope that the greater dose would do the trick. I continue to have the wound management protocols, although yesterday the nurse came up with an alternative method that is far less invasive and requires less intervention. Let’s call that a win.

The second surgery, reconstruction, has been cancelled. Given the infection, and another ongoing issue with the lumpectomy site, the surgeon does not feel it is wise to do anything further. If everything went according to plan, we might be able to manage the timing of surgery and upcoming cancer treatments, but he is not willing to risk a complication that would delay the cancer care.

On Friday, I will meet with the oncologist for a review of the tumor’s oncotype score and find out his recommendation for necessary treatment. Having the second surgery cancelled will make this process a bit more straight forward, but for today it still feels like sliding back on scree.

Friday will bring its own challenges, but we will navigate them when they come. We brought our dog back home from the kennel today which brings joy and lots of furry snuggles. Hana has started volleyball practices for her school’s MS team and is delighted to be back on the court with her friends. This weekend will hold some fun time with both family and friends—an opportunity to rest and play a bit before dropping Hana off at school for the first day of 8th grade this week. All in all, we are doing well. And there are brighter days ahead.

Hope With Me:

• For good rest in the midst of wound care, medical decisions, and anticipation of what is to come.
• For our family as school starts up. For new good habits, healthy choices, and the joy of renewed friendship.
• For healing for this wound and patience with the process.

On Monday morning bright and early, I checked in for surgery #2. We thought we were on track, and the nurses and doctor working with me were optimistic about a successful procedure.

Once I was asleep and on the table, the doctor discovered an abscess deep in the lymph node incision from surgery #1. It was extensive, and problematic. While I was still under anesthesia, the doctor was able to clean out the infection and start a protocol for healing. I woke up to find out that things hadn’t gone according to plan.

While the set back is a small disappointment, my greater emotion was relief. I had been in great pain for about a week—I had been in three times to have it looked at, but the problem went undiagnosed. Wound management has proven to be painful and exhausting, but is considerably more tolerable that last week’s unexplained and debilitating pain.

We have a plan for treatment for the next couple weeks, and then I will go back to meet with the second surgeon and hopefully receive a go ahead for the surgery to be rescheduled.

I’m deeply grateful for family and friends who have stayed with me, provided much needed nursing care (wound care I am unable to do for myself), and cared for Hana’s needs while I’m unable to drive and manage basic household tasks. We feel incredibly loved and supported.

Hope With Me:

• For total healing of this infection
• For a rescheduled surgery #2 that won’t be in conflict with other ongoing oncology treatment plans
• For pain to continue to subside
• For laughter with friends and family as I seek to heal in body, mind, and spirit

Thank you for the many ways you have come around us with provisions, encouragement, help with heavy lifting, and other tangible assists. This morning I am particularly grateful to so many people who have engaged Hana in some new adventures as well as time with old friends. Thank you for helping us both navigate this summer with laughter and love.

Healing from surgery 1 has been a slow road. I am doing well, and still needing to manage pain and swelling as the tissue recovers.

The pathology report came back with good news. The tumor was a 6cm mass of ductal carcinoma (non-invasive form of breast cancer) with areas of invasive cancer within it. There was no cancer found in the margins of the tumor or within the lymph nodes biopsied. I will be meeting with my oncologist this coming week to discuss the treatment path from here.

My oncologist also sent me to an ENT specialist for further study of the masses in my thyroid. He was very helpful, and also slowed the process down a bit assuring me that we can take steps to understand what is happening in my thyroid without needing to do immediate surgery. I will be going in on Monday for a second thyroid biopsy that will be more extensive and also include molecular testing of the masses so that we know whether surgery will be needed.

My dance card is full this week as I move through these appointments along with beginning physical therapy and doing surgery pre-op appointments for the next surgery happening the week of August 12.

Hope With Me:

• For the biopsy of the thyroid to be effective in helping us understand next steps needed and for those masses to be benign.
• For continued rest and restoration of my energy.
• For continued healing of the swelling and management of pain from the first surgery.
• For laughter and joyful time with friends and family as we continue to make the most of the summer we’ve been given.

For those wanting other ideas about how to walk with us in this process, you can scroll down past the other updates and find a “Ways You Can Help” list below.

I woke up yesterday morning with the thought ‘Today’s going to be a good day.’

It was. The care team at the Regional Cancer Center was amazing. My surgeon was the right expert in the right place at the right time. The tumor has been removed, and I’m resting comfortably at my parents’ home, sleeping in a cozy arm chair that is full of fond memories.

The sleepiness and brain fog of the anesthesia are still with me. The surgical site is sore, but we’ve found a rhythm of meds that seem to be keeping the worst of it at bay. Going slow will be the theme for a while.

There were some lovely moments of robust laughter with surgeon and staff, the thoughtful care of the pre- and post- op teams, deep gratitude for my family’s support, and the way I could feel you all holding me up. Thank you for holding us in light, love, and hope.

Hope With Me:

• For an effective pathology report that will give us a clear path for treatment.
• As always, holding on to hope that the lymph nodes will be cancer free.
• For good rest and pain management.

It’s been a great two weeks of time with friends, mountains, water, and rest. I’m on my fourth Inspector Gamache novel and well into Accessing the Healing Power of the Vagus Nerve by Stanley Rosenberg. I’ve hiked, napped, and enjoyed long conversations with dear friends in beautiful settings.

During my time at Holden Village, a friend asked what goals or hopes we had for our time there. It was a great question and helped me focus my time on the things that really mattered – deep connection with others, laughter, and being grounded in creation (or earthing). I spent time everyday barefoot in the grass, looking up at the mountains, and cold dipping in the river. I sat on the porch with friends, enjoying good coffee and conversation or playing improv games and celebrating space monkeys.

The week at Holden followed a few nights of camping with a dear friend out at the coast. It gave us a chance to escape the heat, play Triominos, and enjoy the sound of the ocean in the dark of night.

My heart is full. I’m rested. I’m ready.

The first cancer surgery happens this week. Step one is a lumpectomy where they will remove the tumor and surrounding tissue, as well as 6-8 lymph nodes on my left side. There’s a wildly amazing process by which they inject an agent that will travel from the tumor site up through the lymph system. The surgeon will remove the first (sentinel) node and several of the next tier nodes. The pathology of the tumor and the lymph nodes will be what determines the treatment moving forward: chemo, radiation, and/or medication.

I will have about 2 weeks to recover from the lumpectomy and then if all goes as planned, I will have the second surgery (reconstruction) the week of August 12.

In addition, I have an appointment this Friday with the ENT surgeon who will be helping me understand my options for addressing the suspicious masses they discovered in my thyroid.

Thank you to so many who have offered us help, sent words of encouragement, provided gift cards for food delivery, donated to help cover medical costs, showed up to mow my lawn and weed the flower beds… the list goes on. Hana and I are so very grateful for your care and support in both words and deeds. Thank you for being the community that is holding us in this different sort of time.

Hope With Me:

• For an effective and successful surgery this week to remove the cancer and figure out the best next steps for treatment.
• Peace for myself and my family as we walk through the days ahead.
• For the willingness to learn how to “do very little slowly” as I give my body time to heal and recover. (Credit to Lionel Hardcastle in As Time Goes By for that helpful description.)

I loved being in worship with my congregation at Japanese Presbyterian this morning. The songs and spoken word resonated with themes of being loved and held in the midst of difficult things. It was an encouraging way to transition from work to medical leave and a time of healing.

The next few weeks are full, but also intentionally planned to be restful and peaceful. Ocean and mountains. People and solitude. Movement and stillness. With a few pre-op appointments thrown in for good measure.

Thank you for wanting to follow along and stand with me in hope as we navigate this next step of surgeries, treatment, and intervention. I’m grateful to have you by my side.

Hope With Me:

• For deep rest, lots of laughter, and thoughtful conversations over the next few weeks.

• For the first surgery (lumpectomy and lymph node biopsy) to be successful in removing all the breast cancer with clear margins. (I am hoping for cancer-free lymph nodes as well!)

• For peace during the waiting times—waiting for surgery, waiting for pathology reports, waiting for follow up appointments.

Welcome to the new place to find updates about Heather’s cancer treatment and recovery. 

First, a couple notes: The previous platform (posthope.org) was permanently shut down. Those updates are lost to cyberspace, but I believe all the donations made through the site were deposited into my account prior to the closure. If you have questions about this, please email me for clarification. 

Many of you have asked how to support Hana and I during this time. I’ve created a short list of links under the heading “Ways You Can Help” and hope that gives you some tangible ideas. 

If you want to subscribe and receive an email when I post an update, sign up for the personal update mailing list. 

I will also end each post with a “Hope with Me” list. I am so grateful to be surrounded by a diverse and thoughtful community. Some of us pray, some send good mojo, some hold others in light, others know just the right words, or can offer a good laugh. One of the best ways to support us right now is to hold onto hope with us – in whatever way is authentic for you. I’m deeply grateful you are here, and walking with us. 

Finally, a quick re-cap and health update: 

On May 10th, I was diagnosed with ER/PR+, HER2- breast cancer. There’s a longer story to the cancer’s discovery that I will save for another post. In the days following the diagnosis, I received a myriad of scans and tests to figure out the nature of the tumor and the effect on my body’s wellbeing. In that process, they discovered three unfriendly masses in my thyroid. Two of them were biopsied, and one was determined to be highly suspicious. 

The current treatment plan is for a lumpectomy with lymph node removal in July, reconstructive surgery in August, to be followed by thyroid surgery in late August or early September. The pathology of the tumor and lymph nodes will determine whether the next steps will involve both chemo and radiation. The oncologist will be designing treatment based on both the breast cancer and the final thyroid pathology.

Hope with Me: 

• This health challenge is renovating my life in some significant ways, starting with the need to slow down, rest, and learn to heal. Hope with me for an open heart to receive these lessons and let slower days be enough. 

• That Hana and I would find ways to connect and play.

• For this final week of work at my church before I begin medical leave – for good connections, and the wisdom to finish what needs to be done and let the rest go.