By Leigh Farmer

Spider webs are deceptively tough. While it looks like one gust of wind could tear the netting to shreds, each piece of silk is more stable than steel. On top of that, when a web is damaged, it can repair itself quickly. Together, the small network of strings represents strength and resilience – supporting the spider high above the ground.

Those webs often pop up on Samantha “Sam” Edall’s farm. It’s just part of country living. So is the predictability of the sun rising.

“Every sunset, every sunrise, everything is like the best that it's ever been in my mind,” Sam said. “I’m excited to live the rest of my life with that.” 

Spider webs are a common occurrence on Sam Edall's family farm. (Jonathan Mehring, Enterprise Marketing and Communications)

Some may find Sam’s optimism overwhelming. But those people just don’t know how many hits Sam’s own complex life has taken – how many times she has had to repair her own web. 

And when her web wasn’t strong enough, she turned to VCU Health’s multidisciplinary health care team to help rebuild it. 

Multidisciplinary collaboration is the cornerstone of care at VCU Health, placing the well-being of each patient at the forefront. And in this case, for Sam, they were determined to get her back to her farm and family as soon as possible.

How Samantha faced postpartum heart failure and breast cancer together

Sam’s story begins long before her encounter with VCU Health. It starts with her quest to have a baby. After years of trying, she and her husband were finally able to conceive through in vitro fertilization (IVF). Her pregnancy was everything she dreamed of. 

The birth of her daughter, however, was a nightmare.  

Sam Edall learned she had breast cancer and heart failure several months after the birth of her daughter, Lucy. (Contributed photo)An emergency c-section at a hospital outside of the VCU Health network led to rehospitalization for a bowel perforation. She ended up in the hospital with sepsis and heart complications. After five weeks, she was discharged and, presumably, the nightmare was over. She was told to follow up with a cardiologist to rule out any serious heart conditions.  

Sam was excited to enjoy life with her now five-week-old baby, Lucy. For several months, she did just that. “It had taken so many years to even get her into this world. I finally had the thing I wanted my whole life,” Sam said.  

She lived life to the fullest. She and her husband bought a farm – a lifelong dream that, after a brush with death, Sam was no longer willing to put off. 

One day, while Sam was in the shower, her web took another hit. She felt a lump in her breast. Soon after, a mammogram revealed she had cancer in both of her breasts.  

The day after that devastating diagnosis, her cardiologist called with the results of her echocardiogram – she was in heart failure. The team believes she developed postpartum heart failure, also known as cardiomyopathy, due to the complications from the birth of her daughter.  

“It felt unreal,” Sam recalled. “How much stuff could my body handle. How much could my mind handle?” 

Her dual diagnoses meant she needed a new level of care, one that could balance breast cancer treatment and heart failure safely. That’s where the VCU Health cardio-oncology program became her lifeline.

Inside Samantha’s coordinated care journey with VCU Health’s cardio-oncology program

Once Sam’s health complexities became clear, she was referred to the cardio-oncology team at VCU Health Pauley Heart Center. There, Sam met David Chuquin, M.D., a cardio-oncologist who also turned out to be a determined and compassionate advocate for her health and her life. The cardio-oncology program is part of VCU Health’s broader commitment to integrated, multidisciplinary care, bringing together cardiologists, oncologists, nurses, and researchers to create personalized treatment plans that protect the heart while fighting cancer. 

“My goal was to allow this young new mom to get the best cancer therapies,” Chuquin said. “If someone has preexisting heart problems [when they are diagnosed with cancer], sometimes doors to certain types of cancer therapy begin to close.” 

The anticipated chemotherapy that Sam would have to endure is known to cause complications in a healthy heart. Had her cardiology and cancer teams not worked together closely, she may have gotten less aggressive treatment. VCU Health’s model ensures that treatment of breast cancer and heart failure can be managed at the same time, without sacrificing effectiveness. 

“If we had not had [cardiology] input, we probably would have pulled our punches and used less chemo, which could have affected her cancer outcome,” said Kandace McGuire, M.D., chief of breast surgery and the interim chief of the Cancer Service Line (CSL) at VCU Massey Comprehensive Cancer Center.

Sam’s heart was already weak, so Chuquin put her on a series of medications that not only resolved her heart failure, but also strengthened her heart for the next battle ahead – fighting cancer.

"In the realm of cardio-oncology, I’m constantly having to think outside of the heart. I’m thinking about different cancer treatments and how they might affect the heart and other organs,” Chuquin said.

My goal was to allow this young new mom to get the best cancer therapies. If someone has preexisting heart problems, sometimes doors to certain types of cancer therapy begin to close.

David Chuquin, M.D., cardio-oncologist at VCU Health Pauley Heart Center

The web of safety is strengthened through the multidisciplinary involvement of other teams within VCU Health. Primarily, and in Sam’s case, Chuquin and the rest of the cardio-oncology team work very closely with the Massey team. Throughout treatment, proactive heart monitoring helped her doctors detect issues early and keep her cancer plan on track. 

“If she were in a place where she was just dealing with a cancer team or just dealing with a cardiac team, they may have had their own personal biases as to what was more important and ignored one problem to treat the other,” McGuire said. Together, the teams at Massey Comprehensive Cancer Center and Pauley Heart Center put a plan in place to beat breast cancer, while protecting Sam’s heart.  

“I felt that the doctors at VCU, and the way they did it at VCU, was so comprehensive,” Sam recalled. “To have my cardiologist in communication with my oncologist in communication with my surgeon in communication with my plastic surgeon in communication with my radiology oncologist. It was just so nice to have just one system.” 

Sam’s heart, body, and mind endured 20 treatments of chemotherapy, a double mastectomy with reconstruction, and 33 treatments of radiation. She put her health and her life in the hands of the VCU Health team. Her journey is a testament to the power of a multidisciplinary health care team, where specialists from cardiology, oncology, and surgery unite with precision and compassion to take on even the most complex cases. At VCU Health, that collaboration isn’t just treatment; it’s life-saving innovation in action. 

“I had no control over any of it,” Sam said. 

In the end, Sam’s web kept her safe. Treatment worked and today she is in remission and has a heart that is stronger than ever.  

Life after breast cancer and postpartum heart failure

“Over this past year, as I finished treatment, I feel more confident that the future does exist for me,” Sam said. “So, it’s one of those things where I look forward to everything.” 

Sam’s once frayed web is now stronger than ever. And she will always look at the sun with the kind of optimism that will sicken a skeptic. But she doesn’t care.  

“After getting out of the hospital (the first time) I had a whole new lens on life. And then I was diagnosed with breast cancer and heart failure, went through all that treatment and then it’s like that lens just expanded,” she said.

Sam Edall went to VCU Health because of its highly regarded cardio-oncology program at the Pauley Heart Center. Her dedicated team of heart failure and breast cancer specialists included Kandace McGuire, M.D. (left); David Chuquin, M.D. (middle); and Hetal Vachhani, M.D. (right). (Jonathan Mehring, Enterprise Marketing and Communications)Sam’s victory is one shared by the whole VCU Health team. With regular follow-up, Sam’s life after breast cancer includes wellness, heart monitoring, and ongoing support that meets patients where they are. 

“To be able to be part of the team that took her from a point of turbulence to a point of stability has been really, really satisfying,” Chuquin said. 

It’s that spirit of collaboration and teamwork, the cornerstone of the work done at VCU Health, that ensures Sam will always have a safety net of doctors to count on. 

“It’s been really great to get Samantha through this period,” Chuquin said. “But now my goal is to make sure her heart remains strong. She is able to take care of her kid, she is able to do all the things she wants to do for the rest of her life.” 

Sam will always have to see her cardio-oncologist. But that’s ok. He’s become a part of her new and improved web. And she would have it no other way.  

Watch Samantha Edall's story of Unbelievable Joy. (Taylor MacKillop and Robin McLeod, Enterprise Marketing and Communications)

FAQs About breast cancer and heart failure 

Can heart problems develop after chemotherapy or radiation?

Yes. Some chemotherapy medications and breast cancer radiation therapy can place extra stress on the heart, especially in patients with existing cardiac conditions. At VCU Health, heart monitoring during cancer treatment helps detect any early signs of heart strain, so doctors can adjust therapies safely. 

What are the warning signs of heart failure after pregnancy?

Postpartum heart failure, also known as peripartum cardiomyopathy, can cause symptoms like shortness of breath, fatigue, swelling in the legs, and rapid weight gain. If these occur after childbirth, patients should seek immediate medical care. VCU Health Pauley Heart Center specialists in cardio-obstetrics can provide early diagnosis and treatment to prevent long-term complications. 

Can patients with heart conditions still receive complete cancer treatment?

Yes. Through VCU Health’s cardio-oncology program, patients with existing heart conditions can safely undergo cancer therapies like chemotherapy and radiation. The care team uses advanced heart monitoring and customized medication plans to minimize risks while ensuring that treatment remains effective against cancer. 

Explore VCU’s cardio-oncology program and patient resources to take the next step toward lifesaving, integrated care.

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