Lexington Physician Plans for Future With Help from UC Oncofertility Team

For Micean Johnikin, MD, a 38-year-old pediatric cardiologist in Lexington, Kentucky, Christmas 2015 wasn't filled with tidings of comfort and joy.

The first week of December 2015, Johnikin found a lump in her right breast during her monthly self-examination. On Dec. 23, she found a lump in her right armpit. 

"My mother and my maternal grandmother were both diagnosed with breast cancer," Johnikin explains. "I always considered myself high-risk and did breast self-exams monthly. But I wasn't prepared to find a lump before I turned 40. As a physician, I knew this wasn't a good sign."

Knowing that early detection is the best offense, Johnikin searched for a mammography appointment. She was surprised to find difficulty in seeking care. "I was told it would take four to five weeks to get a mammogram, even with a known lump in my breast and armpit," she says. "Also insurance companies can be reluctant to cover mammograms in younger women."

Johnikin was grateful to find care at the Saint Joseph East Breast Center in Lexington where she received both a mammogram and ultrasound. Her radiologist, Kimberly Stigers, MD, opted to biopsy her breast and lymph nodes, which appeared abnormal on ultrasound. On New Year's Eve 2015, Johnikin was diagnosed with Stage 2 breast cancer.

"In pediatric cardiology, we diagnose children and infants with critical heart defects," she says. "For the first time, I was the patient facing a life-threatening diagnosis."

As cancer treatment can impair fertility, fertility preservation is one of many issues facing young women with cancer. 

"My world was turned upside down," Johnikin says, "but I had to transpose my fear to faith in God to fight." 

After consulting her oncologist, Jessica Moss, MD and surgeon, John Strifling, MD, both at Saint Joseph East, Johnikin visited Leslie Appiah, an oncogyncologist at the University of Kentucky. 

"The first question I asked when I knew I had to face chemotherapy was how to preserve my fertility," she says. "We only had a small window before I was to begin treatment, and still being young and single, I wanted to make sure I had the option to have a family one day. 

"Unfortunately, (oncofertility) services are not offered in Lexington, but Dr. Appiah had a great connection with UC; she put me in touch with the oncofertility program there. I had an appointment the first week of January—within four days of the initial call from Dr. Appiah."

After preliminary blood work and ultrasounds, Johnikin started medications for the egg harvesting within 24 hours of her appointment. Thanks to a partnership with LIVESTRONG, these medicines were shipped right to her home. Julie Sroga-Rios, MD, assistant professor in the Department of Obstetrics and Gynecology and an oncofertility specialist at the University of Cincinnati Cancer Institute, monitored Johnikin's egg production every few days via ultrasound. For each appointment, she drove back and forth until her eggs were ready to harvest—which happened to be on a Sunday.

"I didn't mind a bit because of the incredible service I received at UC," she says. "The UC team was so prompt and so caring, and they made everything extremely easy for me. Even the fact that they were available to do the procedure on a Sunday—a weekend—was such a great testament to how service-oriented they are."

Johnikin began pre–surgical chemotherapy at Saint Joseph East in Lexington one week after her harvesting procedure. "Chemotherapy was challenging," she says, "but through faith, family and friends, I persevered. 

"Exercising regularly, including aerobic boxing classes twice a week, also helped. Sometimes it seemed crazy to be boxing in the middle of chemotherapy treatment, but I figured if I could make it through a round of boxing I could take another round of chemo."

This aggressive chemotherapy regimen worked. No signs of cancer were seen at the time of Johnikin's lumpectomy in July. She went on to complete radiation therapy under the care of Jacqueline Matar, MD, radiation oncologist also at Saint Joseph East.

 "Cancer was terrifying," she recalls, "but having the faith to fight and a great medical team made all the difference." 

"I want others to know you can make it through," she adds. "Early detection is critical, even for women under 40. Breast self-exams are important as well as following up with your doctor.

"I am so grateful that I found the oncofertility program at the UC Cancer Institute. I may have had cancer but cancer didn't have me. Cancer did not and will not stop me from living life and fulfilling my purpose."