For seven years, Melinda Aholt kept taking a daily reminder of the breast cancer that changed her life.

Last month, she took the final dose.

“I feel like I have more energy now than I have had in a long time,” said Aholt, who served as the Linn High School principal for two years before moving to Blair Oaks. “It’s nice to be done with it.”

The milestone closes one of the longest chapters in a journey that began unexpectedly in July 2019, when a routine mammogram detected something suspicious in her left breast.

Aholt, now an assistant superintendent with the Missouri Schools for the Severely Disabled, had been diligent about preventive care.

“I’m just somebody who goes to the eye doctor every year. I do everything like I’m supposed to,” she said. “You turn 40, you get a mammogram.”

That test led quickly to another examination and then a biopsy. “Every time they’re like, ‘Let’s do this, let’s do this,’ I was so stressed,” Aholt said.

The biopsy confirmed breast cancer, with a tumor that measured 2.4 centimeters.

Within weeks, Aholt went from preparing for another school year to preparing for an operation she had never imagined needing. She started the first day of school in August 2019 and then underwent a bilateral mastectomy.

It was her first surgery and hospitalization. “I was a little bit what we would call scared — frightened,” she said.

The cancer had been found only in her left breast, leaving Aholt with a choice between a lumpectomy and more extensive surgery.

Initially, she planned the lumpectomy. Then she began thinking about the mammograms that would follow and what another suspicious lump might mean — not only for her, but for her husband, Clay, and stepson, Andrew.

“What about if this happens again next year?” she remembered thinking. “I just didn’t see myself putting Clay and Andrew through this, and maybe myself through this, again.”

She chose the bilateral mastectomy. “I just needed to know that I did everything possible to not have breast cancer again,” Aholt said.

However, that decision did not eliminate every fear. “Do I still think about it? Yes,” she said. But the surgery gave her something she needed: “that peace of mind.”

Aholt received her care in Jefferson City. Dr. Diane Light performed her breast surgery, while Dr. Raonak Ekram guided much of her oncology treatment and Dr. James Allen oversaw her radiation treatment at Goldschmidt Cancer Center.

She remembers arriving at appointments armed with questions and paper for notes. “They knew that I was going to put them through the wringer every time I showed up,” she said.

She believes patients should be willing to do exactly that.

Aholt also remembers how Dr. Light included Clay rather than treating him merely as the person accompanying the patient.

“She didn’t just talk to me; she talked to Clay, and she made him a part of the process,” Aholt said. “She asked how he was.”

That mattered because, she came to realize, cancer rarely belongs only to the person whose name appears on the chart. “When someone’s going through cancer, there’s somebody else that’s going through cancer with that person,” she said, adding that circle of support extended to Clay’s parents, Jeff and Brenda Aholt. “My mother- and father-in-law were a huge support to me. They are seriously the best in-laws.”

One of the most difficult moments came outside an operating room or doctor’s office: telling Andrew.

He was about 11 when Aholt was diagnosed. She and Clay initially waited, wanting answers before asking a child to absorb one frightening word — cancer.

“It was absolutely the hardest thing I’ve ever done, telling Andrew that I had cancer,” Aholt said. “It wasn’t that I was worried about having cancer. It was that I didn’t want him to worry.”

Treatment brought its own decisions.

Testing of Aholt’s tumor indicated chemotherapy was unlikely to benefit her, so she did not receive traditional chemotherapy. But she underwent 25 radiation treatments.

The cancer was hormone-driven, Aholt said, meaning hormones in her body could help fuel the cancer’s growth. She ultimately had her ovaries removed and began long-term medication intended to reduce the chance of recurrence.

Hormone receptor-positive breast cancers contain receptors for estrogen, progesterone, or both. Those hormones can encourage the cancer cells to grow, and endocrine treatments work by reducing hormone levels or preventing hormones from acting on the cancer cells.

Aholt stayed on the medication for seven years.

Radiation brought another unexpected experience.

As happy as she was to finish the 25 treatments, Aholt discovered she missed the people who had administered them.

“I saw them every day for that radiation, and they are so encouraging,” she said. “They just become like that little family that takes care of you for that 15 minutes that you’re there.”

Reconstruction surgery carried another emotional weight.

Aholt said her husband never pressured her toward a particular choice.

“He was like, ‘I want you to do what you want. I’m going to support you with whatever you decide,’” she said. “He never missed an appointment.”

For Aholt, reconstruction was about recovering something cancer had abruptly taken from her. “It’s like you’re taking that feminine part of me,” she said. “I wanted it back.”

She rejects the sometimes-lighthearted description of reconstruction following breast cancer as a “free boob job.”

“Getting a boob job when you have cancer does not look like getting a boob job if you don’t have cancer,” Aholt said. “It’s a totally different look.”

Cancer also caused her to look harder at family history.

Her mother had previously been treated for breast cancer with a lumpectomy. On her father’s side, her father and uncle had prostate cancer, while her grandmother died of ovarian cancer.

That history qualified Aholt for genetic testing for BRCA1 and BRCA2 variants associated with increased cancer risk. She was told that if her situation did not qualify, she would be responsible for paying for the test. Regardless, Aholt was committed to knowing for sure whether she was genetically prone to cancer. Fortunately, her testing was negative.

Since completing surgery and radiation, Aholt has remained under close medical surveillance. For several years, appointments came every three months before eventually moving to six-month intervals.

Because of the bilateral mastectomy, she no longer undergoes routine mammograms. She expects an appointment in November may be her last regular visit with the cancer center.

The possibility of recurrence has never disappeared entirely from her thoughts. For years, she repeatedly asked whether doctors should perform scans to search for anything that might be developing elsewhere.

Eventually, she said, she accepted their advice and stopped asking. “I’ve kind of put it to bed,” Aholt said. “I’ve kind of just decided, like, I just need to trust these doctors, trust the Lord — not in that order — and just move on.”

Faith has been woven throughout her experience, along with connection. “As hard as cancer was, and as much as my body has changed because of cancer, and as much as I would do to not ever have cancer, I have seen so many blessings come out of having cancer that I’d almost do it all over again,” Aholt said.

One of those changes came within her family. She said the experience helped strengthen the relationship among herself, Clay, and Andrew’s mother, Deanne.

“Me having cancer just made Clay and Deanne and me realize that life is short, and we need to support our kid through this,” she said.

Seven years later, that relationship remains close.

Cancer also connected Aholt with other survivors.

She created a GroupMe group for cancer survivors, giving newly diagnosed people somewhere to ask questions and find people who understand what they are facing.

“I’ve been able to support a lot of friends, which is great because I had so many people support me,” she said.

She keeps another reminder at home.

Each year, Aholt puts up a pink tree decorated with ornaments bearing the names of people in her life who have faced breast cancer. “It’s just a good reminder to pray for them,” she said.

When someone she knows is undergoing treatment, Aholt also wears a pink bracelet. She keeps it on until that person finishes treatment.

Most people, she said, have no idea why it is there.

The woman who began this journey by faithfully going for a routine mammogram now urges others to pay attention to screening and to changes in their own bodies.

The American Cancer Society advises women to be familiar with how their breasts normally look and feel and to report changes promptly. Breast self-examination is not considered a substitute for recommended mammography.

Aholt believes women should not discount what they notice themselves. “Don’t be afraid to give yourself a self-exam because you will feel it,” she said. “I always thought, ‘Am I ever going to feel this? Will I ever catch it myself?’ And yes, people are catching it themselves a lot.”

Her own cancer was found through a mammogram before she discovered a lump herself.

Seven years later, Aholt has finished the medication, her follow-up appointments may soon end, and the cancer that once dictated surgeries, radiation treatments, and doctor visits occupies far less space in the family’s daily life.

She does not know whether Clay or Andrew still think about it. They rarely talk about it anymore.

But the pink tree comes back. The bracelet remains on her wrist when someone else needs it. New survivors still have someone they can call.

Cancer changed Aholt’s body and, for a time, rearranged nearly everything around her.

What remained afterward was something she chose for herself: the chance to make someone else’s journey a little less frightening.