When Ryen Esquivel was diagnosed with metastatic breast cancer near her home in Mansfield, Texas, she felt hope – and her future – evaporating faster with each passing day.

A doctor estimated she had less than five years to live. It was a prognosis Mrs. Esquivel just wasn’t prepared to accept. What about the graduations, the anniversaries, and all the adventures she had planned?

“I admit I was pretty down at that point,” said Mrs. Esquivel, age 44. “It seemed like everyone was saying I should go to UT Southwestern, that they’re the best for cancer patients. But I really didn’t think it would make a difference where I went, that it was just too late for me.”

With the previous grim diagnosis still echoing in her ears, she couldn’t bear the thought of being told one last option wasn’t going to work out.

“But deep inside I knew I had to try to do something,” she added. “I have a 15-year-old son and a whole lot of things to live for. I couldn’t just sit there and wait to die.”

‘Things were going to be different’

Once she summoned the courage to make the call to UTSW, everything changed.

“I could tell things were going to be different from the moment I pulled up to the UT Southwestern Cancer Care Outpatient Building – just by the way the valet greeted me,” Mrs. Esquivel recalled. “Everyone – and I mean everyone – was so nice and so focused on making sure that patients feel they’re truly cared about.

Mrs. Esquivel, right, and wife Chelsea are overjoyed following good news at the checkup.

“They were all rooting for me, in sync, and committed to what they do. I knew they were going to do everything they could to save my life.”

Her wife, Chelsea Esquivel, who has been documenting every part of Ryen’s cancer journey, said she was disarmed by the warmth and compassion at UT Southwestern, and the way doctors and nurses take time to listen to every single patient concern.

Getting a second opinion isn’t just a wish or a prayer, said Dawn Klemow, M.D., the medical oncologist who became Mrs. Esquivel’s primary doctor at UT Southwestern’s Harold C. Simmons Comprehensive Cancer Center. Sometimes people assume all physicians have the same training and information, so the answer will be identical everywhere, she added. But as the only National Cancer Institute-designated Comprehensive Cancer Center in North Texas, UT Southwestern offers advanced technology, techniques, and expertise.

“This case is an excellent example of the reasons patients should get a second opinion,” said Dr. Klemow, Clinical Associate Professor of Internal Medicine and a member of the Simmons Cancer Center and Department of Internal Medicine’s Division of Hematology and Oncology. “It’s always a good idea to know all your options, and I’m confident there are many things we can do to help patients that they might not find somewhere else.”

And that made all the difference for Mrs. Esquivel.

Reversing a ‘death sentence’

A positron emission topography (PET) scan taken by her previous doctor had revealed a spot on her liver. It was most likely cancer, she was told. And if her breast cancer – which led to a double mastectomy two years ago – had spread, it would now be considered stage 4 metastatic disease.

“I was told to get my affairs in order because there wasn’t much that could be done,” Mrs. Esquivel remembered. “I thought I was getting better … but then to hear that I was dying. There are so many things I wanted to do with my life and people who depended on me. I was crushed.”

Dr. Klemow wasn’t convinced by that diagnosis, however.

“It was a difficult situation,” Dr. Klemow said. “She had a regular PET scan that showed something very suspicious in a location that made it very hard to biopsy. They concluded it was stage 4. But, as I often tell patients, you can’t make a stage 4 diagnosis with just a PET scan.”

UTSW medical oncologist Dawn Klemow, M.D., left, examines Mrs. Esquivel at a checkup following her recent regimen of chemotherapy. Tests in August found no remaining evidence of cancer.

Dr. Klemow recommended a FES PET-CT scan, which differs from a regular PET by searching for estrogen receptors in places where they shouldn’t be. The FES stands for fluoroestradiol F18, the radiotracer that homes in on estrogen receptors that would signal breast cancer.

“We have the ability to do a different kind of scan that is very specific to finding breast cancer and cancer in other parts of the body,” Dr. Klemow said. “We did that scan, and it was negative. So I told her we don’t have any proof of stage 4 disease, and therefore I was going to treat her with the potential for a cure.”

After Mrs. Esquivel completed her last round of chemotherapy Aug. 5, she had a new scan. It came back with the four words any cancer patient wants to hear most: No evidence of disease. The tiny spot on Mrs. Esquivel’s liver was gone. Testing was unable to conclusively determine whether the spot had been cancer. Going forward, Dr. Klemow said she would monitor for signs of cancer recurrence – and help her patient fight again if needed.

“I see no reason to believe Ryen won’t have as much of a chance at a normal life span as any of us,” Dr. Klemow said. “She went from basically being given a death sentence without any definitive data to getting her life back.”

For Mrs. Esquivel’s son, Easton, seeing his mom with her hope restored means everything. A second opinion, he said, became a second chance for them both.

“I knew this was going to be a journey, and I always believed she was going to be able to do it,” Easton said. “But it seemed like it was so much harder before she went to UT Southwestern. They treat her like family, and that makes everything so much more positive and hopeful.”