“Precision medicine provides clarity, and clarity leads to better, more confident care decisions”

My name is Lindsay Gustafson, and I am a 41-year-old Northwestern Ontario girl that has called Winnipeg, Manitoba “home” for the past 15 years. I am a Fur Mama to two loving dogs, and am a Grade 1-2 teacher, a reading intervention teacher, a virtual reading tutor, a children’s yoga teacher, and a volunteer in my community. I love the outdoors, new adventures, being crafty, and learning new skills. I am a daughter, a sister, and as of October 11, 2025, I am now a wife! And one more very important aspect of who I am: I am a THRIVER. 

 I was originally diagnosed with Stage 2 Triple Negative Breast Cancer (with no lymph node involvement) on October 26, 2022, at the new age of 38. Being young and heading into a Walk-In Doctor appointment with a lump on my right breast, I very easily may have been dismissed. I am very grateful to the doctor that I met that day. He did not dismiss me due to my age. Instead, he recognized the seriousness and immediately referred me for a mammogram, looking me in the eyes with compassion and empathy as he ignited the process to my diagnosis. 

Two-and-a-half months later, I received a phone call from my family doctor. It was 6:00pm and I had just finished shopping at Home Dept for long-awaited new kitchen appliances. I took the phone call in my bedroom and will never forget being told the words, “I am sorry, but it is breast cancer”. The sounds that exited my body were guttural and animalistic as the pain, fear, and ultimate sense of doom came closing in. My boyfriend held me as I walked out of the room, barely able to walk. I collapsed into his arms, crying “I don’t want to die”. Despite the deepest sense of pain we felt, this moment changed the trajectory of my relationship with my now-husband. We were now forever united in our moment of fear and grief. He promised to be with me through it all and has not left my side since. I am forever grateful. 

I completed 14 months of aggressive medical treatments in January 2024 (16 rounds of IV chemotherapy, lumpectomy and sentinel lymph node removal surgery, 20 rounds of radiation, five months of oral chemotherapy pills alongside one year of immunotherapy). Three weeks after completing my treatments, I headed into my oncology appointment wearing pink pants and a “Survivor” t-shirt…ready to get a celebratory picture with my oncologist and anticipating the good news of clear scans. Unfortunately, this was not the case. We learned of a new lung nodule that had appeared on my most recent CT scan—the same scan that was supposed to give my clear bill of health. At this time, the nodule was too small to biopsy, so all that we could do was hope, pray, and wait for three months to see if this new nodule would continue to grow. On April 23, 2024, the most feared outcome had come true, and we learned that at the age of 39, I had metastatic breast cancer (Stage 4) with lung metastasis. As one could imagine, my world (and that of my family and friends) had been permanently shaken. Dreams of returning to work as a Grade 1-2 teacher, starting a family, building a cabin, returning to a “normal” life as a healthy soon-to-be 40-year-old, all came crashing down around me. Over the next two months, I attended appointments, tests, scans and consults to make the best treatment plan possible. We were ecstatic at the end of June to learn that I was officially “oligometastatic”. There was no evidence of other malignant tumours anywhere in my body (I had been scanned from head-to-toe) and this made me eligible (according to a consensus with the Tumour Board) for a hopeful surgery…a lower right lobectomy. This was the best news that we could receive at the time, and my outlook had changed. Two months prior, one cancerous lung nodule was the worst news that I could receive… now, hearing that I ONLY had one lung nodule was the best news that I could receive! Amazing how our brains can adapt and perspective can change; how a glimmer of hope can make all the difference.  

 Waiting for a surgery date was difficult. Almost three months had passed before I finally received an official surgery date. Unfortunately, the date was bumped twice due to more urgent cases needing to be treated before me. I fully understand that reasoning and thought it must be good news, that I was not considered “urgent”. Surgery plans had been made, frozen meals prepared and bought, and family arrangements organized to help us out at home as I recovered from surgery. As I had not had a CT scan for four months, it was necessary for me to have an updated scan in preparation for surgery. This is when we encountered a new twist in our rollercoaster journey. Two days before my 40th birthday, we learned that my primary lung tumour had doubled in size over the summer. However, most concerning was the presence of 25 (yes, 25!) new micro metastases in my lower right lung. This made me ineligible for the eagerly anticipated surgery as well as any course of radiation. Plans needed to be pivoted quickly and one week later I returned to chemotherapy…something that I had never pictured reliving, especially, so soon after completing 14 months of treatment. From October 2024 to March 2025, I returned to chemotherapy treatments every three weeks, which was quite devastating. However, on a positive note, two weeks before my 40th birthday (and before discovering the micro-metastases that had spread like wildfire), my boyfriend proposed to me! Together for 12 years, it was time to officially tie the knot! We were over the moon after getting engaged! Our plans had been rocked with the cancellation of my surgery and return to chemotherapy, however, having a wedding to plan was the best distraction a girl could have while enduring chemo. We were determined that I would walk down the aisle to my soon-to-be husband, healthy and happy. 

The return to chemo has been the ultimate test of my body, mind, and soul. It appears that two years of living a life of cancer had finally broken me. I used to proudly tell people that I had rarely cried since being diagnosed with cancer…now, I was breaking into tears at the grocery store! As I embarked on this new leg of the metastatic cancer journey, I continued to do all that I could do to support my body holistically: mind, body and soul. This included a variety of treatments, appointments, and activities: naturopathic treatments, prescribed vitamins and supplements, transitioning my personal care products, cleaning and homeware to “safer” and less toxic choices; transitioning my diet to whole, nutritional foods and removing alcohol and sugar; physiotherapy, counselling, support groups, acupuncture, bio resonance, lymphatic massage…any information that I could find in books, videos, articles, podcasts, websites, from healthcare providers or fellow patients…I tried it all! 

After eight more months of chemotherapy, we received amazing news! The 25 micro-metastases had disappeared early on in my treatment, and the primary lung metastasis had remained stable at one cm for a period of three months. Due to my positive progress, my medical oncologist and surgeon both agreed that removing my lower right lobe was, again, a possibility! We could not believe it: the surgery we had hoped and longed for was once again on our horizon! My surgeon consulted every thoracic surgeon in the region as well as presented my case for a second time to the Tumour Board. It was unanimous! Everyone agreed that we could stop chemotherapy immediately and move forward with the plan to have a lobectomy surgery. On June 30th, 2025, I had the lower right lobe of my lung removed. One month later, we met with my surgeon to receive the pathology results. He was in disbelief that there was zero cancer left in the tumour bed…it was only dead tissue. He even remarked that perhaps, in the future, doctors need to reconsider how women with metastatic cancer are treated (it is unusual to be eligible for surgery once malignant spread has occurred). I have never felt such a rush of bliss overcome me before – it felt truly miraculous. After two and a half years, I was officially declared No Evidence of Disease. I had been given a second chance at life. Our hopes and dreams for a future were bright and once again, attainable.  

From the very beginning, my care was shaped around me; not just my diagnosis. At my first appointment with my healthcare team, the social worker spoke to me about fertility preservation. Due to my age and our desire to have a family, I was immediately referred to a fertility clinic to begin the process of egg preservation. Before starting my first treatment of chemotherapy, I was able to preserve my eggs as my healthcare team recognized that my future mattered alongside my treatment. Also, before beginning my treatment, I was given access to genetic testing in Ontario to test for inherited mutations and immune markers that could guide potential treatment decisions. While I did not have any noted genetic mutations, this information was still critical as it helped my doctor choose the most appropriate treatments for my specific cancer and to avoid therapies that were unlikely to benefit me. As well, when I was diagnosed with a lung metastasis, the tumour was biopsied for any changes in its profile. This guided future treatment as we discovered that I was HER2 Low (instead of purely HER2 negative) and I was also PDL1 negative, meaning that further immunotherapy would have little benefit to my situation. Lastly, twice one year, my surgeon presented my case to the Tumour Board to gain consensus regarding performing a lobectomy. It is known that metastatic patients are not often offered surgery with curative intent. He, as well as my medical oncologist advocated for me. They both stated that I was “young and healthy” (minus the cancerous tumours!) and they recognized my will to fight and live. In fact, when sharing the news of my lung metastasis with me, my oncologist told me to not look online or at statistics. He told me that “every patient is unique and different”, that I am “in charge”, and that I “get to write the rest of my story”. Those words have stuck with me since that day, and I use those words to fuel my fight: I get to write the rest of my story. From Day 1 to Day 1046, my care portrayed what precision medicine really means: using data, biology, and personal context to make thoughtful, individualized decisions. 

Precision medicine improves care by helping patients receive the right treatment at the right time and just as importantly, avoid treatments that will not work for them. In my case, testing prevented unnecessary treatments that would have added toxicity without benefit. This matters greatly when you are facing the emotional and physical toll of cancer. I was also given a surgery that has greatly improved the quality of my life and the opportunity to be officially NED…hopefully, for a very long-time. Precision medicine provides clarity, and clarity leads to better, more confident care decisions. 

 It is becoming increasingly evident that cancer is not one uniform illness and that each patient is unique and individual. Yet, many people still receive treatments based on broad categories rather than the unique biology of their cancer or their individual characteristics. Bringing precision medicine to more cancer patients means more personalized and equitable care; fewer patients enduring ineffective or overly toxic treatments, quicker progress in research by learning from real patient data and improved long-term outcomes and survivorship experiences. 

Terry Fox believed in bold, collective action to change the future of cancer. Expanding precision medicine honours that legacy by ensuring that every patient – regardless of age, cancer type, or location – has access to care that sees them as an individual, not just a diagnosis. My hope is that “my story” can contribute to the larger story of Terry Fox and his vision.