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Living with Stage 4 Cancer: Nalie Agustin’s Journey to Inspiring the World

Best-selling author, public speaker, and social media influencer has made it her mission to spread light and hope on her path to raising breast cancer awareness

“You have cancer.”

These are the words that changed Nalie Agustin’s life when she heard them for the first time in 2013. Eight years later, Agustin is thriving despite living with stage 4 metastatic breast cancer – and she’s doing it in the most inspiring way.

At 24 years old, Agustin found a lump in her left breast. Initially, she didn’t think much of it, given that breast cancer is known to be most common in older women. It wasn’t until the lump continued to grow larger that she decided to take action and seek medical assistance. After several tests, the results came back: On July 17, 2013, Agustin was diagnosed with stage 2 breast cancer.

Driving home from the hospital on that very day, after receiving life-altering news, Agustin recorded a raw, unfiltered and incredibly emotional vlog in her car for her YouTube channel. “The reason why I’m recording this is [be]cause I know I have a crazy journey ahead of me, and this is day one,” she says to the camera.

Eight years later, Agustin has a growing community of over 29,000 YouTube subscribers and 110,000 Instagram followers who are inspired by her ability to shift perspective, find inspiration in the everyday and remain resilient, brave and courageous despite her cancer diagnosis.

These unique abilities have been instilled in Agustin since childhood.

Growing up, Agustin was raised to be thankful for the little things. With family in the Philippines who didn’t have much, her parents always ensured that she and her two brothers understood the importance of gratitude. In the Agustin household, even a simple dinner began with a prayer. “We had to be grateful for everything on the table, no matter if it was big or small, or fancy or not,” she said.

The resilience, courage and bravery that she emanates today also stems from her childhood. As the only girl in her tight-knit family, Agustin was always ready to prove that she could successfully take on any new challenge that stood in front of her with determination and drive. Naturally, from a young age, her ability to face any obstacle head-on was clear.

After completing CEGEP in 2008, Agustin enrolled in communication studies at Concordia University, a program she felt would allow for the exploration of her creativity in several facets of media, including writing and video. As a self-proclaimed “multi-passionate” individual, this program was perfect for her. However, post-graduation in 2012, Agustin landed a job working in eCommerce where she felt incredibly lost and unfulfilled. She knew it wasn’t the right fit for her.

Photograph by Karolina Victoria Jez

“I always knew I was meant to do something special,” recalled Agustin as she reflected back on this time in her life.

While a cancer diagnosis may not have been her idea of “special,” raising awareness about breast cancer in young women and inspiring both the cancer and non-cancer community may have been the “special” she was searching for.

It wasn’t long after Agustin graduated from Concordia University that she received her diagnosis: stage 2 breast cancer.

She spent the following year in and out of the hospital receiving the standard treatment, while simultaneously sharing blog posts to “nalie.ca” and vlogs to her YouTube channel. “As a creative, and being a communications graduate, it just felt therapeutic and right to express myself and write,” she said.

Her blog posts were written in the form of personal diary entries. At the time, Agustin’s goal was to keep her large Filipino family updated with the treatments she was receiving, as well as how she was coping with the challenges she was facing.

What started out as a way to communicate with her close relatives and express herself eventually grew into a large and supportive online community.

“I dedicated my entire journey at that point to advocating and spreading awareness because I didn’t know any other 24-year-old who had breast cancer,” said Agustin.

As Agustin sees it, going through breast cancer at a young age raises unique concerns that may not impact older women in the same way, such as the potential of infertility.

In 2014, after chemotherapy, a mastectomy, and 23 rounds of radiation, Agustin was considered to be in remission. For three years, she was travelling, speaking and sharing her story with many individuals around the world. “I was really living that dream list of things I’ve always wanted to do,” she said.

The sense of freedom that Agustin felt was cut short in 2017, when she had a recurrence. She was diagnosed with stage 4 metastatic breast cancer — which spread to her lungs. “That was really traumatic because I really thought it was over,” Agustin recalled. “I really thought I was in the clear.”

A stage 4 diagnosis is considered incurable and terminal. Evidently, this reality was a scary prognosis that weighed heavily on Agustin and her loved ones.

Although difficult, she continued to share her journey with a growing social media following who were “beyond just followers on Instagram.” Based on the overwhelming support she receives, it’s evident to Agustin that her “followers” genuinely care about her health, happiness, and progress. This is evident in the hundreds of kind, supportive and empowering comments left on every post, and in the meaningful interactions Agustin has with individuals in her direct messages.

For a while, the cancer was quite stable and everything seemed to be going well — until May 2020, when Agustin’s cancer journey took an unexpected and unfortunate turn.

Agustin began experiencing neck pain, headaches, muscle spasms and sudden numbness in her legs. An immediate visit to the hospital and an emergency CT scan confirmed that Agustin’s cancer had spread from her lungs to her brain.

“All I remember hearing in my head was ‘no.’ No, this can’t be true […] No, this can’t be the end,” shared Agustin in an Instagram caption.

What followed were five rounds of whole brain radiation, Taxol (a chemotherapy medication) and stereotactic radiosurgery. “That was probably the toughest time of my entire eight-year journey,” she said.

“My brain is like my artifact, it’s where I get all my ideas, it’s what controls my whole body […] it’s my mind which is key to everything,” she explained.

With such a traumatic diagnosis, Agustin disconnected from social media. She knew that focusing on healing herself had to be the biggest priority. “I had really dedicated my last seven years to helping others, and now I realized I really need to help myself,” she explained.

However, although she temporarily ceased writing for her active online community, she never stopped writing for herself.

Writing by hand in her diary, Agustin wrote out her life lessons learned amidst the trauma.

When Agustin returned to social media four months later, she decided to make separate dated Instagram posts to update her followers. Each post represented an event or an experience that she had undergone during those intense months of treatment. But most importantly, each post had an incredibly powerful caption with an inspiring takeaway. Organizing all these posts within Instagram’s “Guides” feature, she titled them “The Diary of Nalie.”

These posts are the inspiration behind Agustin’s new book, The Diary of Nalie: A collection of life lessons and reflections shared while thriving through stage IV cancer.

“I always wanted to write a book and have something tangible and physical that my community can hold,” expressed Agustin.

Overnight, her book found its place as a #1 Amazon Best Seller in Canada, as well as in two specific categories: #1 Best Seller in Cancer, and #1 Best Seller in Practical and Motivational Self-Help.

“There’s such a big analogy between a stage 4 cancer diagnosis and not knowing what’s to come, and I feel like that’s what people are facing right now – complete unknown and uncertainty,” said Agustin, referencing how the ongoing pandemic has changed life for everyone.

In an Amazon review, one reader shares, “I do not have cancer and I felt like this book spoke to me […] This journal is raw and authentic with so many incredible life lessons that would definitely make you do a double take on how to perceive things in life and how to handle it with grace.”

Another reader wrote that “Nalie will walk you through her journey and inspire you to keep moving forward in the midst of your battles.”

Evidently, The Diary of Nalie is offering a glimmer of hope and inspiration that many are so desperately seeking in such an unpredictable time. That’s why Agustin believes her book has seen so much quick success.

During some of the lowest lows of her cancer journey, her book and its success has ignited a sense of purpose and joy in Agustin and her family’s life. Launching the book was a beautiful way to “flip the script and really celebrate the wins rather than focus on the trauma,” she said.

In true Agustin spirit, she has found a way to give back. On Oct. 20, she will be hosting a book signing at Maison Principal. All ticket sale proceeds will be donated to the Program for Women’s Cancer Research at the McGill University Health Centre Division of Radiation Oncology.

It’s been eight years since the words Agustin never thought she would hear changed her life.

But she will continue to live every day with gratitude and faith.

She will thrive.

She will grow.

She will evolve.

She is determined to do so.

“To me all that matters is focusing not on eradicating the illness, but making sure [I] feel as strong and good as possible, because when you feel strong and good, then that’s living,” she said.

While Agustin is eternally grateful for the medicine she has received and her team of oncologists at the hospital, she believes that’s only half the battle. “Healing happens at home,” she explained.

She believes that effective cancer care is the perfect combination between standard treatments in hospitals and integrative out-of-hospital holistic therapies.

Agustin’s years of undoubtable challenges have also been marked by unforgettable life lessons: taking care of your mind and body is key to truly living. Mindfulness, meditation, healthy eating and light exercise is “the reason I believe I am still here today,” she said.

Agustin is the epitome of what it means to face adversity and uncertainty with resilience and bravery. Throughout it all, she has continued to use her platform as a way of giving back in incredible ways. She remains driven to inspire thousands online, advocate for young women diagnosed with breast cancer, and be a voice of hope within the cancer community.

Agustin calls herself a “Thriver,” and by continuously sharing her genuine and authentic self, she inspires the rest of the world to thrive alongside her.

 

Feature photograph provided by Nalie Agustin

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News

McGill University Health Centre implements deficit plan

The McGill University Health Centre’s implementation of cost-cutting measures in order to reign in a growing budget deficit has led to the layoffs of nine trauma and orthopedic nurses working at the Montreal General Hospital.

After government auditors came to the conclusion last December that the MUHC network was looking at a projected deficit of $115 million, the network came up with a series of cost effective strategies.

The cuts planned by MUHC Chief Executive Officer Normand Rinfret for the 2013-2014 year include: 65 per cent reduction of manpower hours, 16.4 per cent related to contracts and other non-salary expense reductions, seven per cent from standardization of practices, 5.6 per cent related to team consolidation/work redesign, 3.5 per cent from capping clinical volumes based on budget and 2.5 per cent from unspecified application of the Quebec Health Department policies.

As reported by The Gazette last week, it appears as though employees are now part of the cuts the MUHC will be establishing as part of the budget deficit plan. About one quarter of the Montreal General’s 12th floor trauma recovery nurses have been notified that their positions in the hospital have been cut and closed.

Montreal Children’s Hospital nurse, Nathan Friedland, worries that the cuts will affect aspiring nursing students as well.

“When new nurses join the profession they’re already somewhat discouraged because they know they’ll get burned out because of the long hours and so on, so when they read about cutbacks and layoffs, they realize it’ll likely be them, the young new ones being laid off,” Friedland said. “Two new nurses, who were grads, had 90 per cent of their hours cut, because they don’t have a specialized position. They’re mostly filling in for someone on a leave of absence.”

Not only will these cuts be affecting MUHC employees but with fewer nurses in each ward of the hospital, nurse-to-patient ratios will be significantly altered.

Where originally there was one nurse with four or five patients, each nurse will now have up to eight patients, essentially doubling the workload. This will add more responsibility and more pressure to nurses to make sure that they perform up to par.

The MUHC network controls six of Montreal’s major hospitals including the Montreal Children’s Hospital, the Montreal General Hospital, the Royal Victoria Hospital, the Montreal Neurological Hospital, the Montreal Chest Institute and the Lachine Hospital.

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