When a routine mammogram changes everything

Kelly Titus, 45, lives in Weatherly. In late 2024, she’d just spent the weekend celebrating her son’s 12th birthday. An Eagles game, family time — the kind of moments she lives for.

On Monday, she opened MyChart to check her biopsy results from a test done the week before. Because she works in healthcare, she recognized it right away. It was cancer.

“I didn’t feel the lump. The doctors didn’t feel the lump. It was triple negative,” Ms. Titus says.

She felt fine. No symptoms. No warning. Just a routine screening mammogram that flagged something irregular.

Within days, life split into before and after.

A life in motion

Before the diagnosis, Ms. Titus’ days were loud and full.

She is surrounded by farms and family. She and her husband are raising 2 boys — Owen, 13, and Finn, 7 — who spend most of their time on baseball fields. Ms. Titus coached and served on the Little League board. She rarely ever missed a game.

The Titus family also mountain bikes, boats, water-skis and snowmobiles. They hunt, travel to national parks and try to visit a different baseball stadium each year. 

Ms. Titus also takes care of people at Geisinger. Over nearly 20 years, she’s helped start pediatric urgent care, served as an operations manager and now works as a pediatric triage nurse and team lead.

But in December 2024, she had to step back. Even from helping her father, who was being treated for bone cancer. “I had to stop being the nurse and be the patient,” she says.

No time to waste

After more biopsies and scans, Ms. Titus met with Jose Castillo, MD, a medical oncologist at Geisinger Hazleton.

“I’ll never forget when I walked into Dr. Castillo’s office and he said, ‘You’re too young to have this. We’re going to be very aggressive. We’re going to fight this together,’” she recalls.

Triple-negative breast cancer is an aggressive form of the disease that tends to grow and spread faster than other types. Ms. Titus didn’t want to waste any time.

She had a mediport placed in December and started chemotherapy in January. She had 20 rounds of chemotherapy and weekly infusions for 12 weeks. That was followed by doxorubicin and cyclophosphamide — the regimen many patients call the “Red Devil.”

Chemo was rough. After Dr. Castillo told her she’d lose her hair, she shaved her head. Her uncle shaved his head, too. At her next infusion, she wore a shirt that read “My oncologist does my hair.”

But she made a promise to herself: Cancer wouldn’t run the household. She missed only one baseball game for each of her sons during chemo. If she felt sick, she put on her “game face.” 

The hardest part

In August, Ms. Titus had a double mastectomy with lymph node surgery in Danville with plastic surgeon Sean Devitt, MD, and her breast surgeon, Rosemary Leeming, MD. She went home the next day.

“Surgery was the hardest,” she says. “With chemo, you’re sick. But after surgery, I couldn’t hug my kids.”

There were drains. She had pain and limited arm movement. She had to sleep upright and be away from her boys. “That was the worst part,” she says quietly. “Not being able to hold them.”

A week later, she was readmitted for high-dose IV antibiotics after an allergic reaction to Bactrim. The drains stayed in until Labor Day.

Then came another blow: Pathology showed cancer in a lymph node. 

Holding her breath and moving forward

Once she’d healed from surgery, Ms. Titus began radiation therapy in Pottsville with Geisinger radiation oncologist Gregory Treharne, MD. She went every weekday for 5 weeks while continuing to work. 

Because her cancer was on the left side, Ms. Titus’ treatment included the deep inspiration breath hold (DIBH) technique.

DIBH times radiation with a patient’s breaths. When Ms. Titus took and held a deep breath, her lungs expanded and her heart moved slightly away from her chest wall. “The DIBH separates the heart from the targeted structures receiving radiation, which means the heart receives less incidental radiation exposure,” says Dr. Treharne.

Now, more than a year into treatment, she continues immunotherapy and is starting to take an oral chemotherapy drug. A recent circulating tumor DNA blood test came back negative. 

“She tolerated all treatment really well — chemo, surgery and radiation,” says Dr. Treharne, adding that Ms. Titus’ “great mindset and attitude toward treatment” have been beneficial.

But Dr. Treharne and Ms. Titus both know there’s a need for guarded optimism. She has at least another year of treatment ahead. 

Throughout it all, though, her perspective has shifted. “You’re replaceable at work,” she says. “You’re not replaceable with family.”

She’s leaned hard on her support system: her family, her friends, her coworkers who donated time-off days. Not to mention the teachers who helped her sons through hard days.

She counts her care team in that circle, too. The infusion nurses who knew when she needed quiet. The radiation therapists who coached her through each breath hold. Her doctors answering patient portal messages at night. “They’ve been with me every step,” she says.

Ms. Titus still pushes herself to be present. She still shows up. She still plans trips. And though last year looked different, with fewer mountain bike rides and fewer vacations, her goals haven’t changed.

“You can’t let cancer run your life,” she emphasizes. “You just fight.”

Next steps: 

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