As they wheeled her down for breast cancer surgery at University Hospital last month, Barbara Lasky envisioned girding herself for battle like Xena from the Xena: Warrior Princess television show.
"Xena always wins," Ms. Lasky said.
Gail Wilkinson, 58, is looking at the silver lining.
When she is finally done with her breast cancer treatment, she will be "60, thinner and with perky tatas" after breast reconstruction, she said jokingly.
Attitude is important for women newly diagnosed with breast cancer, as Ms. Wilkinson was in July and Ms. Lasky was in August. Ms. Lasky said she has kept a bright outlook and tries to avoid those who would pity her or look at her as someone with "one foot in the grave," she said.
"I think a positive attitude is crucial to your healing and onward," Ms. Lasky said.
Always an optimist, Ms. Wilkinson decided not to abandon her glass-half-full approach, and she keeps in mind something the woman who did her biopsy told her: "Be informed but not obsessed."
"Otherwise," Ms. Wilkinson said, "it is self-defeating."
Ms. Wilkinson, of Aiken, and Ms. Lasky, of Augusta, are two of the 192,370 women who will be diagnosed with invasive breast cancer in 2009, according to the estimate from the American Cancer Society. Ms. Wilkinson is one of 2,820 women who will be diagnosed in South Carolina, and Ms. Lasky joins 5,370 women who will be diagnosed in Georgia.
The rate of new breast cancer diagnoses actually declined 2.2 percent a year from 1999-2005, the cancer society reported, perhaps in part because mammography rates also had declined, from 70.6 percent in 2001 to 66.4 percent in 2005, meaning fewer opportunities to catch it.
Like many women, both Ms. Wilkinson and Ms. Lasky found the tumors themselves. Ms. Lasky found a dimple that had not been there before and brought it to the attention of her family practitioner.
"I could tell by the look on his face that he knew this was something serious," she said.
Ms. Wilkinson said she always did breast self-exams but "obviously I wasn't doing it right," she said. She was in the shower and felt not one lump but two. She had not had a mammogram for about four years, but a physical more than a year before found no major problems. That physical came with a request to go get a mammogram, but because Ms. Wilkinson was a busy fourth-grade teacher, the test kept getting pushed further and further down the list.
"I just got busy and blew it off," said Ms. Wilkinson, who had put herself "last on the list."
The mammogram showed three tumors in her left breast and two in the lymph nodes. Ms. Wilkinson doesn't dwell on how things might have been different if she had gone for the mammogram. "You already feel guilty," she said. "You already feel like you did something wrong."
Guilt is something women frequently struggle with after a breast cancer diagnosis, said Pam Anderson, a cancer services program coordinator at University Hospital and a 12-year survivor.
"I think everybody feels guilty when they get breast cancer because everybody thinks they did or did not do something that caused it," she said. "And if you didn't have your mammogram, that even compounds it. But I think everybody comes around to the realization that it is not going to change anything to feel guilty about it."
The multidisciplinary team that sees newly diagnosed breast cancer patients at Medical College of Georgia Hospital now includes a psychologist, said D. Scott Lind, the chief of surgical oncology.
Even before a definitive diagnosis, all of the questions that arise can be overwhelming, said Carolyn Cook, a breast health nurse navigator at Aiken Regional Medical Centers.
"It is a fear of the unknown," she said. "You don't know what is happening next. You don't know at that point, is this going to take my life? Is this going to be something that I'll have to lose my breast?"
Mrs. Cook's job is a new position at Aiken Regional's Cancer Care Institute of Carolina. Radiologists call her in as soon as they see something on the mammogram so she can help guide patients through the next steps, often a biopsy.
Women diagnosed at University are frequently sent straight to Mrs. Anderson at the Breast Health Center.
"They come in here, they're pale, they have that look of 'oh my God,' " she said. "And when they leave they are hugging me, saying, 'Thank you. I can do this.' "
The next decisions and the next steps can happen fast.
For Ms. Lasky, the decision for a lumpectomy and radiation therapy seemed to fly at her.
"Things moved really quickly," she said.
Instead of going into surgery right away, as most breast cancer patients do, Ms. Wilkinson opted for an aggressive three-drug chemotherapy regimen every three weeks.
"I opted for the more aggressive treatment because I believe if you're going to do it you might as well get the biggest bang for your buck," she said.
Recently, she and her daughter, Jacqueline, went to pick out a wig at the American Cancer Society that she can wear once her hair starts to fall out. She picked out a long black number that provoked a laugh from her daughter.
"You look like Ozzy Osbourne's daughter," she said.
Her mother laughed, too.
"I guess I'm being silly," she said. "I'm trying to be silly rather than be in tears."
Ms. Wilkinson knows what the numbers say about her cancer returning within five years -- she said she was told it was about a 15 percent chance -- but she considers the odds in her favor.
"It's all in how you look at it," her daughter said.
Reach Tom Corwin at (706) 823-3213 or email@example.com.
Reach Tom Corwin at (706) 823-3213 or firstname.lastname@example.org.
SOME SUPPORT GROUPS FOR BREAST CANCER PATIENTS IN THE AUGUSTA AREA
The Pink Magnolias Breast Cancer Support Group , University Hospital Breast Health Center, next meeting Oct. 12, 6:30 p.m. Call (706) 774-4141 for more information
Medical College of Georgia Hospital and Clinics Breast Cancer Support Group , every second Thursday, 5:30 p.m. to 7 p.m. Call (706) 721-4109
Journey of Hope cancer support group , Barney's Pharmacy, 2604 Peach Orchard Road, every third Monday at 7 p.m. Call (706) 798-5645.
Cancer Survivors Support Group , 6 p.m. every second Thursday, Augusta Oncology Associates, 3696 Wheeler Road. Call Lance at (706) 651-2283
Pink Ribbonettes , Oct. 6 at Millbrook Baptist Church, 176 East Pine Log Road, Aiken. Call Peggy at (803) 648-1911 or Zelda at (803) 649-9412. This meeting will be to sew pillows, so bring a needle.
RESOURCES FOR EDUCATION AND SUPPORT
- Breast cancer clinical treatment trials at Medical College of Georgia: www.mcg.edu/cancer/clinical/trials/breastcancer.html
- American Cancer Society: www.cancer.org
- National Cancer Institute: www.cancer.gov/cancertopics/types/breast
- Susan G. Komen for the Cure : ww5.komen.org
- Breast Cancer Network of Strength: networkofstrength.org
- Centers for Disease Control and Prevention: www.cdc.gov/cancer/breast
- Breastcancer.org: www.breastcancer.org
- Your Breast Cancer Treatment Handbook: Your Guide to Understanding the Disease, Treatments, Emotions and Recovery from Breast Cancer by Judy C. Neece
- Helping Your Mate Face Breast Cancer by Judy C. Neese
- A Breast Cancer Journey from the American Cancer Society
Source: Pamela Anderson, program coordinator for cancer services at University Hospital