Originally created 10/03/04

Breast cancer triumphs and tribulations



STATISTIC: About one in 8 American women (13.3 percent) will develop breast cancer.

Source: National Cancer Institute

Breast cancer doesn't affect just the patient.

For every person diagnosed with the disease, there are sometimes dozens of people affected by the outcome: doctors who pour their talents into treatments; friends who helplessly have to watch others suffer. Most of all, it is the family that has to deal with the glorious highs and devastating lows of a disease that doesn't differentiate between old or young, black or white, rich or poor.

Cheryl Howard and Robert Rose know those highs and lows all too well.

Cheryl and Robert wanted to share both of their stories: Cheryl's frightening journey through a disease she initially knew nothing about and Robert's devastating loss of his beloved wife, Dawn.

Cheryl

Cheryl Howard married her high school sweetheart and left home to live the life of a military wife.

The New Hampshire native traveled the world until she and her husband, Michael, landed at Fort Gordon, where she got to earn the physical therapy degree she'd always wanted as he prepared to retire from the service.

She was living a charmed life: a dream job at Walton Rehabilitation Center working with stroke patients, a husband who loved her like mad and a young son, Matthew, who was the light of her life.

She could have lost it all had it not been for an off-the-cuff decision by her new gynecologist.

It was a routine checkup, but Dr. Carla Morgan-Gibbs decided to have Cheryl get a mammogram, saying that many women get screened between the ages of 35 and 40.

Cheryl was 38, physically fit with no previous medical problems and no family history of cancer.

When the mammogram came back, though, the doctor made a startling discovery. There, smaller than 1 centimeter, was an abnormality.

Cheryl was sent to surgeon Randy Cooper for a biopsy. It was the Friday before the Fourth of July weekend, and Dr. Cooper urged Cheryl to enjoy her time off and not be too concerned. He said not to worry. Have a great weekend. It was a fibroadenoma. Don't even worry about it.

Cheryl put the biopsy and its potential consequences out of mind, determined to enjoy the holiday.

On Monday morning the phone rang; it was Dr. Cooper. The tests had come back.

It was malignant.

Dawn

Dawn Balderson bowled Robert Rose over the first time he saw her. Robert had just gotten a new job and bought a house. He was getting his life in order; he had goals, and romance wasn't in the plans.

But there was Dawn. Beautiful and intelligent, she was a sea of serenity in Robert's life. She was a "genuinely nice person," and Robert began a romantic campaign that hinged on Shoney's strawberry pies. The couple would go to the restaurant to talk for hours before Robert would return Dawn home ... with extra slices of pie for her parents.

After six months of dating, Robert knew Dawn was the woman he was going to spend the rest of his life with. They married in 1986.

Dawn had graduated magna cum laude with a degree in accounting from Augusta State University and placed first in the Georgia accounting exam. She was a financial analyst, but gave up her career without a second thought when she became pregnant with the first of their three children: Eric, now 14; Ryan, 12; and Alex, 8.

In 2002, Robert had just received a promotion at Vogtle Nuclear Power Plant, where he is an assistant team leader, and Dawn was busy with the children, numerous charities and church organizations. They'd just put a pool in the back yard.

Then Dawn found a lump in a breast self-exam.

She'd had a baseline mammogram just six months before, but she would take no chances. Robert was in Birmingham, Ala., for a three-week supervisory training course, so she went by herself to the doctor. At first, the doctor prescribed antibiotics, thinking the fast-growing mass was an infection because "it couldn't be cancer." In the next seven days, the mass continued to grow, and Dawn was getting worried. Before going back to the doctor, she called Robert in Birmingham: "Pray for me."

The doctor brought Dawn back for a CT scan that revealed the devastating news: Stage 4 breast cancer.

There is no Stage 5 breast cancer.

She was only 38.

STATISTIC: More than 2 million women in the United States have been diagnosed and treated for breast cancer.

Source: Susan G. Komen Breast Cancer Foundation

Cheryl

Dr. Cooper was still talking on the phone, but Cheryl couldn't hear him.

She was in shock.

"When he said it was malignant, I was like thinking, 'OK, which one was malignant, which one was cancer. Malignant, benign ... he said malignant!'" Cheryl says. "The whole time he's talking to me, I'm still thinking, seeing that word - 'malignant' - that's the bad one."

Dr. Cooper ended the conversation with a suggestion that Cheryl and her husband come to his office later that day to discuss options.

Cheryl finally got hold of Michael at Fort Gordon, where he is a civilian satellite systems instructor. She told him the news: "You have to come home."

The doctor's appointment wasn't until 4:30, so they sat for hours on their living room couch. They watched the clock, cried and hugged each other as the minutes counted down.

At Dr. Cooper's office, they got the details. Cheryl's tumor, deep in the breast, was Stage 1 cancer. Highly treatable, the cancer hadn't spread outside the breast, and Dr. Cooper advised the couple on their options: lumpectomy or mastectomy.

With a lumpectomy, just the tumor and a portion of the healthy surrounding tissue would be excised. The surgery would be followed by a mandatory six-week regimen of daily radiation treatments.

A mastectomy entailed removal of the breast.

Doctors wouldn't know whether the cancer had spread to Cheryl's lymph nodes until they went in and checked, so a mastectomy would be the catch-all procedure to make sure all the cancer was taken care of at once.

Cheryl and Michael were sent directly upstairs to decide on a course of action and book the surgery for the next day.

As Cheryl sat in the waiting room, thoughts flew through her head: "I'm a physical therapist, I'm very physical. I can't have this thing. I don't want to be uneven. I can't do this tomorrow ... I can't do this tomorrow."

With a deep breath, Cheryl went back to Dr. Cooper's office. There she stated her case: They'd caught it early. She didn't have to make a decision right that second. She needed time to get all the facts.

Dr. Cooper took the news in stride and didn't try to sway Cheryl in any particular direction, but did stress the importance of making a decision rather soon.

Back home, Cheryl called her mother, who connected her to oncologists and surgeons in New York, San Francisco and Atlanta. She contacted the American Cancer Society for more information, and for days simply soaked up as much knowledge as she could.

Through it all, Dr. Cooper made daily phone calls, asking about Cheryl's decision.

As Cheryl talked to doctors around the country, who were usually men, she often ended the conversation with one final question: "If it were your wife, what would you do?"

About a week went by before Cheryl finally had an answer for Dr. Cooper: She'd have a lumpectomy.

"I ended up choosing the lumpectomy because I had a gut feeling. I just knew that it had not gone to my lymph nodes. I just knew it," Cheryl says.

She was right. The cancer hadn't spread to her lymph nodes, but doctors found that the tumor was ductile infiltrative, meaning it wasn't encapsulated and could infiltrate the rest of the breast and even the rest of Cheryl's body.

"Even though they said it wasn't in the lymph nodes, they couldn't guarantee me that it wasn't in the bloodstream," she says.

Six weeks of radiation was a given. The added fear of a recurrence led Cheryl to make a second radical decision: She decided to have chemotherapy.

After surgery, Cheryl began three rounds of chemo, one every 21 days, followed by six weeks of daily radiation, followed by three final rounds of chemo.

Cheryl knew she was lucky. She took three months off after the surgery to recover and go through her first chemo regimen. Comparatively speaking, the treatments were light; she never lost her hair, although it did thin. She was able to eat small amounts of fruits during the treatments and looked so healthy that many people didn't believe she was undergoing cancer treatments.

She returned to work at Walton Rehabilitation just in time to start her daily radiation treatments.

"I would schedule my radiation treatment at like 3 or 4 in the afternoon, and they would let me leave work early. That would give me the whole evening to rest and recoup and then go to work the next day," she says.

Radiation, which can have side effects similar to a sunburn, affected Cheryl even more than the chemo treatments, mainly because they were daily rather than every 21 days, and she continued to work.

From discovery to the end of treatments, Cheryl's ordeal lasted nearly seven months.

For a Stage 1 cancer.

Dawn

Robert returned to the couple's Evans home when he got the news.

A Stage 4 cancer diagnosis was tantamount to a death sentence: It meant that the cancer had spread to other organs. Dawn was immediately put on heavy chemotherapy.

The couple quickly became immersed in the world of breast cancer. Words that previously had no meaning, took on a life-or-death importance; toxic cocktails of chemotherapy, medicines such has Herceptin and Taxotere, radiation and metastatic.

Robert researched the disease. He found that the Internet can be a useful tool but that it also easily points out the harsh realities about cancer, including its survival statistics. The statistics for Stage 4 cancer were not good.

Dawn was unwilling to give up without a fight, and for two years she endured repeated rounds of chemotherapy.

Doctors tried every variation of chemotherapy in their arsenal: If this doesn't work, we'll put you on something else. If that doesn't work, we'll try something else. If that doesn't work, we'll try a combination of this, that and the other.

Early in her treatments, a friend gave Dawn an obviously expensive, hardbound book of cancer survivor stories. It was meant to be an uplifting look at the possibilities of modern medicine, but while reading the book, Dawn discerned a disturbing trend.

"Robert, this is the most depressing thing I've ever read," Robert remembers her saying.

"Why?"

"There are only Stage 1 and Stage 2 cancer patient survivor stories in here; maybe one Stage 3."

Through it all, Dawn's positive attitude astounded doctors, friends and family members, and inspired more help then the Roses could possibly handle.

Immediately after Dawn was diagnosed, members of the couple's church, West Acres Baptist Church, started providing the family with meals three days a week. Robert's co-workers took up the slack on additional days and people would randomly stop by to drop off even more meals.

During the first year of treatments, a neighbor came by every week in the summer to cut the grass. The following year, church members paid a landscaper to do the work. Church members also paid for maid service and five gift certificates for massages. Later in Dawn's battle, the masseuse came on her own time every other day to give Dawn some relief from pain. Cards came by the basketful, and the household was inundated with items emblazoned with Dawn's favorite poem, Footprints in the Sand, by Mary Stevenson.

Dawn and her family needed that support as she continued with treatments that literally chased cancer around her body: Tumors spread throughout her liver; cancer showed up on her bones; she had radiation treatments for spots on her brain.

The latter devastated Robert, but Dawn took it in stride: "It's just another road to go down. Now, where are we going to go eat?"

With two years of continuous chemo treatments, it would be accepted and almost expected to find a patient bitter and frightened, but Dawn repeatedly surprised doctors with her stoicism and grace. She endured the usual chemotherapy side effects such as hair loss and blackened fingernails, but Dawn just found a wig, filed the nails down a bit and carried on.

Dawn and Robert could have carried on like this for years, and would have gratefully, but eventually, even the strongest soul wears down.

In late July, her liver failed. For the first time since she'd been diagnosed, Dawn was admitted to the hospital. As she lay in the bed, surrounded by family and friends, Robert paced the corridor with the doctor, pressing him for the next step in Dawn's treatment.

Overwhelmed by Robert's entreaties, the doctor stopped and leaned against the wall: "Robert, I'm just going to tell you. Dawn's dying."

Other people in the corridor began crying and the couple's 12-year-old son, Ryan, ran into the bathroom to vomit before going to his mother's side.

"But who is going to take care of us?" the boy asked.

Dawn's response was simple: "Your dad will."

STATISTIC: A woman's risk for developing breast cancer increases if her mother, sister, daughter or two or more other close relatives have a history of breast cancer, especially at a young age. However, 85 percent of women who develop breast cancer have no known family history of the disease.

Source: Breastcancer.org

Cheryl

Six years later, Cheryl's personal and professional life have been profoundly changed by her experience with cancer.

She knew at the time that she was blessed with understanding co-workers and a family that provided all the support and love that one person could handle.

During her treatments, she made a list of things she wanted to accomplish before she turned 40, an incentive to make it through the next grueling treatment. She wanted annual mother-daughter trips; she wanted to quit biting her fingernails; she wanted to learn about roses and grow them.

Atop the list was an overwhelming need to get involved, to make a difference.

Before her bout with cancer, Cheryl was oblivious to the disease and its devastating effects on victims and their families; she didn't do much volunteer work.

Now, Cheryl is the Reach for Recovery coordinator for Richmond and Columbia counties for the American Cancer Society. Her job? To match newly diagnosed patients with a survivor mentor. She tries to match them by age and cancer type to give the patient a new perspective on living with cancer.

She also teaches a dance and movement class for breast-cancer survivors, to work on strengthening the survivors physically and emotionally.

Cheryl finds that she can empathize more with the stroke patients she works with at Walton Rehabilitation, and, though she concedes wholeheartedly it's a clich, she really does try to live life to the fullest each day.

In January she had a scare when she felt a lump; she immediately called Dr. Cooper. He thought it was just fatty tissue, but they took no chances. A quick trip to day surgery confirmed what Dr. Cooper had suspected.

"I joke around and say if ever there was a time a woman prays for fatty tissue - that was the time," Cheryl says with a hearty laugh.

Six years after her diagnosis and five years after her treatments, Cheryl still is immersed in the medical community. Her surgeon has said they will grow old together; she sees her oncologist every six months and her gynecologist every three or four months.

"Be as overcautious as you want to," Cheryl says. "I'll be seeing doctors for a long time, but that's OK."

Dawn

The end, when it finally came, was swift.

Dawn left the hospital and went home to stay. There were no more chemo treatments. There was no need.

Robert took time off from work, determined to spend every moment with Dawn. If he left the couple's bedroom, he made sure there was someone there to hold Dawn's hand.

In the two weeks after leaving the hospital, toxins continued to build in Dawn's brain until she couldn't complete even the simplest task. Still, Dawn just smiled gently, patting Robert's arm to let him know that it was OK.

The house became a place of vigil. Family, friends and church members kept watch over the woman who had touched so many lives, unwilling to let her slip away without knowing she was loved, that she had people who believed in her.

On Aug. 3, before the sun came up, Dawn struggled for breath as her mother kept watch on one side, Robert on the other.

Dawn's mother began to pray, asking God to deliver Dawn from her suffering so that she could be in peace.

At that moment, Dawn took a breath, and the woman who had tirelessly fought tooth and nail for her life finally came to rest.

Hundreds attended Dawn's funeral that Friday morning. Photos from her life flashed through the West Acres Baptist Church chapel as people remembered the wife and mother.

Robert was heartened, but not surprised, by the outpouring of sympathy from the congregation, and when the family drove to the cemetery, cars were still entering half an hour later.

In the weeks since Dawn's death, Robert has had to create a new existence for his family.

Robert isn't much of a leisure reader and never read to 8-year-old Alex. That was Dawn's job. Now Robert reads every story that Alex requests.

Robert has to get up at 4:30 a.m. to be at work at 6:30, so Dawn's mother comes by the house at 5:30 to get the boys ready for school. Every weekday, Dawn's father picks up three boys from three schools at three different times.

Robert knows he's going to have to learn a lot of new skills, take on a lot of new tasks. He told Pam Anderson, the breast-health specialist at University Hospital's Breast Health Center, that it recently took him two hours to go grocery shopping.

He knows that he'll never be able to replace Dawn in his or his children's lives: "I would rather have willingly stood in front of someone throwing knives at me then have to go through this."

Robert doesn't like to dwell on the cancer that took his wife. He prefers to remember his wife the way she was both before and during her battle with the disease.

"She never lost that positive attitude, never lost that smile, and that's why people loved her."

BREAST CANCER AWARENESS MONTH EVENTS

UNIVERSITY HOSPITAL

For information about any of the events, call 774-4144.

MOBILE MAMMOGRAPHY DAY: Tuesday, Richmond County Health Department, 950 Laney-Walker Blvd.; Thursday, South Augusta Center for Community Health, 1448 Linden St.; Saturday, Oct. 16, Antioch Baptist Church, 1454 Florence St.; Monday, Oct. 25, Daniel Village, 2803 Wrightsboro Road; Tuesday, Oct. 26, Sam's Club, 596 Bobby Jones Expressway.

DINNER PRESENTATION: Dr. Randy Cooper discusses breast cancer, 5:30 p.m. Tuesday, Oct. 12; Wesley United Methodist Church, 825 N. Belair Road; free.

FUN WALK: Annual Miracle Mile Walk, three-mile fun walk; registration is at 8 a.m. Saturday, Oct. 23; Augusta Common.

CUT FOR A CAUSE: Haircuts for $10, with the proceeds going to University's Breast Health Center; noon to 6 p.m. Sunday, Oct. 24, Dillard's at Augusta Mall.

DINNER PRESENTATION: Dr. Mark Keaton discusses breast cancer research and treatments; 5:30 p.m. Tuesday, Oct. 26; First Baptist Church of Augusta, 3500 Walton Way; free.

SURVIVOR LUNCHEON: Comcast breast cancer survivor lunch, open to area breast cancer survivors; noon Tuesday, Oct. 26; Julian Smith Casino, 2200 Broad St.; free.

DOCTORS HOSPITAL

LUNCH AND LEARN EMPLOYEE PROGRAM: Breast cancer facts and information presented by the American Cancer Society, featuring talk by Dr. Wendy Davis and nutritional information by Nicole Fulton; noon Tuesday, Oct. 26; Classrooms 1 and 2.

DINNER AND LEARN EMPLOYEE PROGRAM: Breast cancer facts and information presented by the American Cancer Society, featuring talk by Dr. Jack Feldman and nutritional information by Nicole Fulton; 5 p.m. Thursday, Oct. 28, Classrooms 1 and 2.

FUND-RAISING EFFORTS: Throughout the month, the hospital will collect Yoplait yogurt lids; 10 cents from each lid will go to the Susan G. Komen Foundation.

The hospital will sell pink scrubs with hospital logo imprinted with pink bow and pink bow magnet.

MEDICAL COLLEGE OF GEORGIA

  • Throughout October, pink ribbons will hang throughout MCG Health System's campus to recognize Breast Cancer Awareness Month.
  • Every Friday at MCG Health System will be Pink Ribbon Friday, and employees will take part by wearing pink or pink ribbons. Each Friday, mammogram appointments can be made at MCG's Terrace Dining.
  • Reach Erica C. Cline at 828-2946 or erica.cline@augustachronicle.com.