Living a Full Life with Stage 4 Cancer

Brain and spine illustration
Katie Mackin
Katie Mackin

In November 2017, Katie Mackin was a 34-year-old mother of a six-month-old baby when she felt something in her back pop. Mackin is a physician assistant in an orthopedic practice, and her first thought was that she had a slipped disc. The pain kept getting worse, even after two months of physical therapy and anti-inflammatories. In January 2018, an MRI revealed tumors on her spine, which turned out to be metastases of breast cancer that Mackin didn’t know she had. By February, she was having spine surgery at the Duke's Center for Brain and Spine Metastasis.

Fast forward to March 2020. Mackin missed only about five months of work, and is able to keep up with her two-and-a-half year old son. “I’m able to do most of the things I want to do,” she says. And she attributes that to the care she’s gotten from providers at the Duke Cancer Center, including spine surgeon Rory Goodwin, MD, PhD.

“He has been fantastic,” she says. “I can’t say enough good about him. He makes you feel like you’re a person, not just another patient-number.” 

Rory Goodwin and Catherine Praxede Lavau, PhD, in the lab
Spine surgeon Rory Goodwin also investigates new treatments for spinal metastasis. Here, in the lab with Assistant Professor in Neurosurgery Catherine Praxede Lavau, PhD.

When Mackin first met with Goodwin, he explained that surgery to remove cancer and stabilize her spine carried a risk of paralysis, but doing nothing carried a higher risk of paralysis. “It was a no-brainer,” she says. “I felt super confident with him. He had every scenario covered.” The surgery went well, and Mackin started back at work, part-time at first, just five months later. 

Mackin had radiation before surgery for pain relief in her hip and lower back, with the goal of making post-surgical rehab easier. She also started on Trastuzumab (Herceptin) and Pertuzumab (Perjeta), which she continues to this day, at three-week intervals. After the surgery, and more radiation to kill any remaining cancer cells, she also underwent several rounds of chemotherapy. 

Since then, she’s done well. “When you’re stage 4, you never get told you’re in remission,” she says. “But I’ve been stable since August 2018, and I hope to be stable for a lot longer.”