When Samantha Ciaccia, now 38, was traveling around the world in May 2022, she noticed bloody discharge from her nipples. The fitness entrepreneur and former emergency medicine physician assistant knew this was a serious symptom not to be ignored. But the doctors she saw in Croatia initially dismissed her concerns. As things got worse she sought a second opinion in Croatia and got a breast cancer diagnosis—via an email subject line—in October 2022. Her experience led her to start a business focused on helping others get back into fitness after breast cancer treatment. Here’s her story, as told to health journalist Caitlin Carlson.
About 10 years into practicing medicine in New York City, I started getting burnt out. I had been training clients on the side as a certified strength and conditioning specialist (CSCS), and I decided to take the risk and go all in. I also established a course for consumers as well as other movement professionals focused on preventing injuries I would see in the ER. I flew to Europe in 2022, intending to travel the world while working on my business remotely.
Things were going really well, but a few months later, in May 2022, I noticed my left nipple was bleeding. Based on my medical experience, I was worried about cancer, and it was nerve-racking, so I decided to go to the doctor in Croatia and get it checked out. They did a cytology smear, which screens for cancer by looking at bodily tissue, cells, or fluid—in my case, the nipple discharge—under a microscope. They weren’t concerned, though. I was 34 at the time and didn’t have a worrisome medical history, so they thought the likelihood of it being cancer was very, very low.
So I continued on with my travels. But the discharge never stopped. A client suggested I see her doctor, also located in Croatia, for a second opinion. This time, they did an ultrasound followed by a galactogram (a special type of X-ray), and what they saw looked very concerning. I had my first biopsy, but it took a month for my results to come back. At this point I was vacationing on a Nile River cruise in Egypt when I got an email with the subject line “DCIS,” which stands for ductal carcinoma in situ. I didn’t even have to open the email—as soon as I saw the subject line, I was like, Oh my gosh. But I was literally in the middle of the river. There was nothing I could do at that moment, so I just went about my vacation. I had some work to do in Jordan for my business, so I was like, Let me just get this work done. I was supposed to go to Dubai for another business trip, but instead I rerouted and returned to New York because at this point the Croatian doctors wanted to do a double mastectomy without any further testing.
Back in New York the doctors confirmed the cancer had spread through all the milk ducts in my left breast and a double mastectomy was my only option. My first thought was, This is interrupting my life, and it’s an inconvenience. I was traveling. I was starting a new business and making these great connections and traveling the world, and I had to uproot my trip to come back for treatment. But as my breast cancer journey continued, my diagnosis transitioned from feeling like an inconvenience to something that changed my life for the better.
I’ve always been a go-getter, type A person who just doesn’t stop. My cancer experience forced me to slow down. When I really evaluated where I was, I realized I wasn’t healthy in a lot of ways, not only physically because of the cancer but also mentally and emotionally. Going through this disease was healing in the sense that it helped me figure out what I wanted to prioritize and what I needed to do to feel more purposeful in life and more intentional with my time and energy.
Before cancer I gave so much time and energy to everyone else, but now I know I don’t have the headspace to do that. I have to protect that for myself so I can be present for the people in my life who truly matter and for my business.
My treatment journey
When I had my double mastectomy in February 2023, they gave me a stage 1A diagnosis. I then had breast reconstructive surgery in June 2023. Coming from a world of movement, I realized the instructions for getting back to exercise after breast surgery and reconstruction were pretty much nonexistent. Essentially the advice was: “Don’t lift more than five to 10 pounds for the first four to six weeks, and then go back to what you were doing.” The reality is you can’t immediately pick your routine back up, no matter what your level of fitness was before. But it’s important to reintroduce movement into your life because it is essential for your health. That’s what inspired my second business, H.E.R. which I created during my rehab and healing journey and launched in October 2023. It provides programs to help breast cancer survivors return to movement after going through surgery, chemo, and/or radiation. I worked with a handful of training clients and built my two businesses full time until I got pregnant last year. I had my baby boy in February and started getting back into work in the spring. Now I’m nurturing, cultivating, and growing my businesses again from my home in East Rockaway, Long Island.
My second business. H.E.R. (which stands for heal. empower. rebuild.) was designed to help women regain strength, confidence, and mobility after breast surgery.
My breast cancer checkups are now every six months, and they incorporate breast exams. I will also start taking tamoxifen again in a few months, which can help prevent recurrence. (I had to take a break because of my pregnancy.)
Since having my son I was back at square one with my fitness routine. It’s a very parallel experience to when I was getting back to working out after surgery. In the spring I went for my first run in a year and couldn’t jog for more than two minutes, but it was a start. I really believe something is better than nothing—the most important thing is building that consistency again by working in a little bit of movement here and there when I can.
There are studies suggesting that being on a regular training regimen reduces your risk of cancer recurrence. So just like I know I need to drink water every day, I know I need to train—it’s part of being and staying healthy. I’ve realized how much I took movement for granted before. Now I have a much greater appreciation for simply being able to move my body and no longer experiencing the overwhelming fatigue that once made it impossible to get out of bed.
I’m also more intentional with movement. When I’m programming my warm-ups for strength training, I prioritize chest openers, listening to my body, and choosing nurturing movements and exercises rather than crushing it all the time.
For others navigating a similar experience
The first piece of advice I would give anyone who’s going through a cancer diagnosis or any big, life-changing event is to ask, Why is this happening for me? I know the initial thought is: Why is this happening to me? But I really encourage you to shift that perspective and look for the positive. Trust me, I’ve been there. Though it’s really hard when you’re in the trenches, I promise there will be something great for you on the other side because life is happening for you.
The biggest message I want to continue to get out is that no matter where you are in life, movement is for everyone. It’s just about finding your entry point into movement, whether you’re totally new to exercise or coming back to it after a major life change like breast cancer or pregnancy. Learning to listen to your body and knowing your progress won’t be linear is key. One day you’ll do five push-ups and feel great, and then the next day you’ll do one and feel terrible. That’s okay—your progress will wax and wane. If you feel like you’re on a nice, smooth trajectory with your movement and then, all of a sudden, you’re going two steps back, just know everyone goes through it. The most important thing is to keep moving forward no matter what. You’ve got this!