Photograph by Donovan Roberts Witmer
Catherine Marshall
Catherine Marshall has changed.
Yes, her hair is gone, as well as her eyebrows and many of her eyelashes. Her torso and left arm are swollen, and her chest is asymmetrical because there is a gap where one breast was removed.
But she says she is OK with all of that. “It’s strange because I’ve always been tremendously vain.”
The changes, however, run deeper.
“This is going to sound completely bizarre. I am actually grateful that I got breast cancer because it brought everything into focus.”
For the first time, Marshall says, she gave herself the permission to take time for what she wanted to do, not what, in the past, she felt she had to do.
The laundry, the dirty floor? “That laundry’s going to be there tomorrow. It is not going anywhere, sadly,” says Marshall, 60, of Lewisberry.
“Death is really staring you in the face. You focus and you decide how you want to spend the rest of your life, who you want to spend the rest of your life with, how you want your grandkids to remember you, what’s important and what isn’t. In the last analysis [it’s] relationships. [Cancer has] completely changed how I view life.”
“I’m fine. I’m fearless.”
Marshall’s view of life no longer includes what society dictates as female beauty.
“If I hung onto society’s definition of beautiful, which is perfection, what is happening to me would be devastating. I’m alive. I really hope my eyebrows grow back, but if they don’t, it’s OK. I’m alive, and I’m OK,” says Marshall.
Most of the time, Marshall says she doesn’t wear a wig. “It’s too hot,” she says during an interview in mid-summer. “Most of the time, I walk around bald. I usually wear a scarf.” She forgets about her lack of hair until she finds someone staring at her.
“I refuse to be ashamed,” she says, her spunk rising.
Holding onto the notion of perfection will make the experience of breast cancer hell, she says. “If you embrace the journey and learn from it, [it’s easier].”
Marshall realizes it was not a good idea to let 20 years go by without having a mammogram. “I was cavalier about my excellent health,” she says. “It was dumb. Had I caught it earlier, [it] wouldn’t have been as extensive.” In addition to a mastectomy, performed by Dr. Lisa Torp with Pinnacle Health in Harrisburg, Marshall has had chemotherapy and radiation treatments. “My chances of living are good,” Marshall stresses.
This mother of two and grandmother of five is outgoing and uplifting. And she finds humor everywhere.
Chemotherapy funny? She sat next to many brave people, but also a few whiners, she says. She admits to this thought: “If your attitude doesn’t kill you, then I might in the course of the next five hours.” She laughs exuberantly as she retells the story.
She sees her experience with cancer also as somewhat spiritual. She believes God was sending her a message in the way she discovered her breast cancer.
“At 2:26am, I woke up in excruciating pain in my armpit. I reached under and felt the lump there. Immediately after the biopsy, the pain went away. People talk of having a ‘come to Jesus moment.’ I had to laugh and say, ‘I hear you loud and clear.’ ”
Marshall owns up to being a bit stubborn.
“I’m so strong-willed, I need a lightning bolt to hit me across the face,” she says.
With that bolt out of the blue, Marshall knew there was a reason she needed to stick around.
She also knew, “I’m fine. I’m fearless."
Denise Neely
In October of last year, Denise Neely’s regular mammogram showed calcifications in her left breast. She had a biopsy, and it was negative. Yet, five months later, Neely, 50, underwent a bilateral mastectomy.
How was it that Neely went from a false alarm to having both breasts removed?
It could be seen as chance. Neely sees it as a blessing.
She believes an older sister was looking out for her.
That older sister, who lived in Florida, died of breast cancer at age 62 in the same month Neely had her mammogram. The next month, November of 2011, another sister, 65, was diagnosed with breast cancer.
These things were on Neely’s mind the day Dr. Rena Kass walked into the surgical oncology department at Penn State Hershey Medical Center where Neely works as an administrative secretary. Kass asked if she could use Neely’s computer.
“I began to tell her about my sisters and was worrying,” says Neely of Palmyra.
Kass, who is a surgeon and co-director of the Breast Center at Penn State Hershey Medical Center, suggested that Neely have an MRI, which is a more sensitive test than a mammogram. About one week after that chance encounter, Neely learned she had cancer in her left breast.
“Whatever comes, I’m going to beat it.”
“It was so subtle, a long line of cells more toward my chest wall. The cancer was so small, it looked like a fibrocystic change,” says Neely. She chose to have both breasts removed to reduce the chance of the cancer returning. Kass was her surgeon.
Within eight months, these three sisters were diagnosed with breast cancer, but it wasn’t until her sister in Florida died that Neely learned there was a family history of breast cancer.
Neely suggests that women look into their family’s medical history and stay on top of what they need to know to take care of their own health. “You have to know what’s going on in your body,” she says.
Breast cancer has not been Neely’s first brush with facing her mortality.
In 1996, at age 34, Neely had a kidney transplant. She had three young sons at the time and had been on dialysis for a year. One of her brothers was a perfect match and donated a kidney to Neely.
Always physically active, Neely started bicycling after her transplant.
“I chose to pick myself up. I like to exercise; I like to get out there and take care of my body. Whatever comes, I’m going to beat it. I’m proactive with my health, making sure I get proper food and exercise,” Neely says.
But Neely took her athleticism further after she learned about the Transplant Games of America.
“I went to my first games in 2000,” says Neely. She has won nine gold medals so far in running and biking as part of Team Philadelphia.
Her surgery for breast cancer will keep her from the fall 2012 Transplant Games, but she would like to be in training by the spring of 2013, she says, so she can compete again.
“Life is crazy; people don’t always treat you right, but I keep my chin up. My brother gave me a second chance at life. I’m thankful for what God gave me in life. I can’t be negative. I wake up every day and say, ‘Thank God for another day.’”
Rebecca Roda
It can’t happen to me.
Many people have that thought when faced with the possibility of a life-threatening illness.
Rebecca Roda was no different.
Even her insurance company had determined the probability of her having breast cancer was low, so it denied coverage of the MRI, a magnetic resonance imaging test, which her radiologist wanted to have done.
It would have been easy to “blow it off” as Roda says, with her busy work schedule that included a lot of travel, with the insurance company saying the probability of her having cancer was low, and with her human desire to believe “It’s not going to happen to me.”
She could have waited another six months to be retested. Roda is happy she didn’t.
“It can happen to you,” says Roda, 61, of Landisville.
“You really get your priorities straight”
Confused about how to proceed, Roda called her long-time gynecologist Dr. Enrico Martini of OBGYN of Lancaster. He had delivered her two children, and she trusted him for guidance. He suggested she see Dr. Ann-Marie Hugh of the Breast Health Center in Lancaster.
After twice having a mammogram and ultrasound, six months apart, and twice being denied coverage for an MRI by her insurance company, Roda had Hugh check her tests, and Hugh also believed an MRI was necessary. Again, it was denied by insurance.
That’s when Hugh suggested a biopsy. Roda could have waited six months, but her daughter, a nurse, pushed her not to ignore it. And Roda herself had a gut feeling that she should pursue more testing.
Her gut was right. The biopsy showed Roda had ductal carcinoma in situ, DCIS. This time the request for an MRI was approved. And the MRI discovered even more, a suspicious area surrounding the DCIS.
Hugh wanted to do another MRI and biopsy, but Roda decided she wanted to have the breast removed. She’d already decided not to have a lumpectomy because she had hoped to avoid chemotherapy and radiation, which often follow the less invasive procedure.
After her mastectomy, performed by Dr. Ann-Marie Hugh at Heart of Lancaster Regional Medical Center, Roda was feeling positive.
“I came out of surgery and I could go on with life. It was such a relief.”
A week later, after her breast tissue had been tested, the story was much different.
That suspicious area the MRI had detected was invasive ductal carcinoma. It also turned out to be a type called HER2 positive. About 20 to 25 percent of breast cancers are this type, which tend to be more aggressive and faster growing, according to WebMD.
Chemotherapy and radiation became part of the plan to fight Roda’s cancer, and she is healing now from the radiation treatment. The final phase of treatment is to take Herceptin until the end of December, which is to help prevent a recurrence. After that, her physicians will monitor her with more tests.
Roda is grateful to the physicians who helped her get to the point of diagnosis: Martini and Hugh. She is grateful that Hugh wanted to do the biopsy on the off chance there could be cancer.
She thanked Martini in person the last time she saw him.
“I told him, ‘Thank God, Dr. Martini, that you suggested Dr. Hugh. You saved my life. Who knows if we would have waited another six months [what would have happened]?’”
Roda passes on what she and many women learn as they are pushed head first into the deep end of the medical system:
“You have to be proactive about your health. [Health-care providers] are not going to come to you. Do research so they don’t control the whole thing,” she says.
Another important point that Roda stresses about mammograms is that if you have dense breast tissue, cancer is more difficult to detect.
Roda used to lie awake at night worrying about her work. It is different now.
“You do have new appreciation of your life and family. You realize you are one phone call and one diagnosis away from your whole life changing. The silly little things you worry about are not important anymore. You really get your priorities straight,” she says.