ANDREW:
Hello and welcome to the American Cancer Society's Cancer Survivor's Network, the Service created by and for cancer survivors. I'm your discussion leader, Andrew Schorr, from Healthtalk Interactive in Seattle. I'm joined by our co-host, medical broadcaster Gina Tuttle. Gina, welcome.

GINA:
Thanks, it's great to be here.

ANDREW:
Today's topic, Living with Breast Cancer for Women Between the Ages of 46 and 55. On the phone with us tonight are three breast cancer survivors from across the country. Women who are all between the ages of 46 and 55 and have completed their treatment for breast cancer. Over the next few minutes, we'll discuss such issues as trying to keep life and routines normal throughout the treatment process, building a support network and getting help from the Reach to Recovery Program. Handling issues such as a change in body image for yourself and those around you, and ethnic and cultural obstacles in dealing with cancer. Let's begin by meeting Mary from Putnam, Connecticut. Mary is married, 49, and completed six months of chemo and radiation treatment just last year. Mary, I understand you found one thing that helped you most was keeping busy. Can you tell us a little bit more about what you did to try to keep your life and routines as normal as possible as you went through the treatment process.

MARY:
Well, I was very lucky to have a very flexible boss at work. He allowed me to basically set my own hours, I do a lot of computer work. I had chemotherapy on Wednesdays and if I was sick on Friday or Thursday, I didn't have to go in, I could go in on the weekend and do the work, so that really helped. What I tried to do was go to work every day, the same hours and just tried to keep a very regular scheduled. My social activities, going to the supermarket, if I wasn't too sick, I went. But if I was sick, my husband would go, butI just tried to keep everything the way it was.

ANDREW:
Now that's in treatment, so now, in life after breast cancer, if you will, how do you do that now?

MARY:
Actually now, it's almost harder, because of the fatigue and you know I had the radiation right after the chemotherapy and all my treatments ended the end of May and I'm still battling fatigue. That makes it really hard. But I'm doing the same thing, keeping my schedule at work, I still have the same boss so that's great, and if there's days that I don't feel well or I'm too tired, I can leave early and just finish it the next day. I'm very lucky in that respect.

GINA:
Is it difficult thing though Mary to say to your boss who's already been so helpful, I'm still tired, I've still got these things going on?

MARY:
Yes it is very difficult. You kind of feel like you're asking for a lot of favors. But you just have to do it. I mean I have to do it to survive.

ANDREW:
What about coworkers? Do they feel let down that Mary's not sort of a member of the team and she's supposed to be working here, she had that cancer treatment, let's go on, let's get going here.

MARY:
Yes they do, some of them do feel that way but others don't, so I just have to keep a positive frame of mind and so you know eventually I will get through this, and they're just gonna have to put up with it for now. I mean, there's nothing else I can say.

ANDREW:
How do you keep a positive frame of mind?

MARY:
Well, I'm just thankful every morning that I get up, I'm just thankful to be alive. I'm just very lucky. I consider myself lucky. You know, I could have had positive lymph nodes and I didn't, I could have had Stage 4 breast cancer but I didn't, I only had Stage 2, and that's the way I look at it.

ANDREW:
How do you build up your stamina now to try to get past this fatigue?

MARY:
I changed my diet. I don't eat whatever I want any more like I did during treatment. I had gained some weight. I'm eating more nutritiously, more vegetables and fruit and grains and I'm taking vitamins, and I try to walk every day, ten or fifteen minutes is about it for me. I try to keep that as a regular routine. And I am feeling better.

ANDREW:
And doing that, just putting one foot in front of the other and doing that, does that make you feel like you're getting in control of this?

MARY:
Yes, I feel like I'm more in control now, yes.

ANDREW:
And the exercise you talked about and the eating right, these are things that you didn't do before breast cancer treatment?

MARY:
Your right, I didn't. I didn't really think it was that important.

ANDREW:
Maybe there's a silver lining in what has really been not been a good experience at all, with breast cancer.

MARY:
Maybe, yeah. I look at life differently now than I did before.

ANDREW:
Let's bring in another breast cancer survivor, Margo who joins us from Garland, Texas. Margo is 47, single, and completed treatment which included a lumpectomy, chemo and a variety of chemotherapy drugs. Some pretty heavy duty ones. Margo one thing you feel is important to share with other women facing breast cancer and have gone through the treatment, is to have a strong positive network of people around you. Now, is that important to you as you are now a breast cancer survivor, and maybe is there a role for the American Cancer Society's Reach to Recovery program?

MARGO:
It feels very good to have positive people around you, even after you're through with your treatments. You just need that, because you can still get depressed because you are always wondering, is it going to come back and will I have to go through this all again? And you want to maintain a network of people that understood the first time, just in case it should come back a second time.

GINA:
How about Reach for Recovery? Did Reach for Recovery help you?

MARGO:
Yes, they did, because I'm new to Texas, I'm originally born and raised in San Francisco, my job transferred to Georgia, I stayed there three years, then came to Texas in August of 97 and was diagnosed March of 98 with breast cancer. So I was here, just me and my son with actually no one except the people who had relocated from Georgia with me.

GINA:
Wow, that must have been terribly difficult.

MARGO:
It was scary, it was terrible, but luckily we have had some friends from California through Georgia and they were like my network but I found out working in my new office that so many other women had had it but they'd never talked about it. I wanted to let everybody know and that's when other women started coming to me and giving me books to read and telling me about the American Cancer Society and asking if I needed a ride, which I did, several times, because everybody can't take off work, and they got me rides back and forth to my treatments.

GINA:
Margo, you moved into a different area, you didn't have a lot of people around you that you knew. What was that like when you were diagnosed?

MARGO:
Very scary, very lonely, very confusing. You just are at a loss. You don't think straight. You want to reach out but you have nobody to reach out to. So you have to go within yourself. I prayed an awful lot.

GINA:

And then you found Reach for Recovery and that helped?

MARGO:
I found Reach for Recovery toward the end. As a matter of fact, I called the American Cancer Society and they were the ones that told me about Reach to Recovery and where I could get rides back and forth, because toward the end I actually had no one to take me back and forth to my chemo, the last 2 treatments.

ANDREW:
Margo, you're a single parent. What role has the American Cancer Society's programs played for you now that you've completed treatment?

MARGO:
Basically I get their literature, which I read a lot, and sometimes when I have to refer other, two other women on my job have been diagnosed and I told them that they could call the American Cancer Society and they could assist them in many things that they may need. So, it's very helpful as a resource, if you're like at a total loss.

ANDREW:
Margo, are there any issues that you'd care to talk about as you're now a breast cancer survivor, as a single mother and also as an African American.

MARGO:
I think that Afro American women don't go get diagnosed or put it on the back burner, to say that it's not really a lump there, when they should. More literature should be put into the black neighborhoods, I believe.

ANDREW:
And for African American breast cancer survivors, do you think there's a role in being more active in helping younger women or women who have, could possibly have breast cancer but maybe haven't sought treatment or gotten mammograms, etc., to just be more proactive?

MARGO:
Yes, I do believe so, yes.

ANDREW:
What about being a single mom? You have a teenage son, I understand. What has this experience been like for him and how has your communication been while Mom has had treatment and now goes on with her life, having had a serious cancer?

MARGO:
Actually, I don't believe that he actually believed it was as serious as it could have been. I don't think that I could explain it to him, I don't think that the doctors couldn't explain it to him. I think that maybe they need to have a network for children of parents with cancer to enlighten them to what you have to go through, that you're going to be sick, you're not going to be able to take them to basketball games. You're not going to be able to go up to the school to do parent teacher conferences, and yeah, kids just don't understand that this is serious.

ANDREW:
And how about for the future? You as a single parent and your son as you go on together, is he pretty optimistic about the future? Or do you talk about it together?

MARGO:
Actually, we don't really talk about it. I still think he's in denial.

ANDREW:
And is that anything that you're trying to change or you just let will enough alone right now?

MARGO:
I'm kind of letting will enough alone.

ANDREW:
Well let's bring in Maricela from McAllen, Texas into the conversation. Maricela, I know you're 49, married, and you had a bilateral mastectomy in 1993 and then there were some lesions and you've been retested. Handling the changing body image for yourself and those around you can be difficult.

MARICELA:
Very traumatic.

ANDREW:
Has it been particularly traumatic being of a Hispanic background, or does that play a role at all?

MARICELA:
No role at all. I don't think being Hispanic plays a role in breast cancer for me and I don't think it does in any other woman. I think breast cancer in a woman crosses all ethnic backgrounds. What was more difficult was the fact that I went from having two breasts to not having breasts, and I think that was the hardest thing I had to do. I was very lucky. We consider ourselves very lucky that we did find the cancer that I had when we did, and had the positive attitude, had a positive network of friends and family and faith in God that He's going to help you through this.

GINA:
Maricela, you said that you had trouble with your self-image. It's been six years. Does that get easier over time?

MARICELA:
I think it's just getting easier.

GINA:
Just finally.

MARICELA:
Finally, like I say, losing the two breasts at one time was a little harder than I had anticipated. The decision to do that type surgery at the time was not a difficult situation when I had options of wait and see and maybe it'll spread, or lets take care of the problem now. To me, it was always wanting to see our children grow up. Taking the best odds that we had at the time and that's what I did. Do I regret it? No, I do not regret it. I'm thankful that I did that when I did do it.

ANDREW:
What's helped you cope with this now in your past? What's helped you cope with this better? Is it just the passage of time or are there specific things you've done to be able to move on?

MARICELA:
I think I'm a strong-willed individual, and basically what I had to do was put it behind me. It was something that I had in my path of life. Going through my path of life and I took care of it and then I didn't want to look back. I wanted to go forward. One of the things is that if we keep dwelling on it, it's going to be very hard for us to get past that stage.

ANDREW:
Were you always strong-willed or did you change at all from having had the surgery?

MARICELA:
No, I've always been strong-willed. I've always been taught that I've got to take care of myself and it's very important to take care of yourself before you can take care of anybody else.

ANDREW:
Tell us a little bit about - you talked about body image, now post bilateral mastectomy. How has this affected your relationship with your husband, if at all?

MARICELA:
Funny that you should mention that, because we were seeing something this past Sunday and it was something about women's sexuality and it brought out that the female breast - how sensual the breasts were. I made the comment like, well, since I don't have any, I wouldn't know and his comment was "Why did you even say that? We've dealt with it for six years, why did you even say that?" So his attitude has always been positive and very good for me, and he has helped me cope through that, so how has it affected it? I don't think it's really affected us sexually.

GINA:
Can you give any advice to other women who are trying to deal with this issue and are uncomfortable with their sexuality, maybe?

MARICELA:
Well, first of all, we have to let go, if there's any anger. We've got to let go of that anger and look at the bright side, look at - we were given a second chance in life and we've got to take advantage of that second chance. We've got to enjoy life, enjoy the little things. I think Mary said that since she's had cancer and has gone through her treatment, that she's looking at life in a different perspective and I think that we all have to do that. We cannot continue to dwell and say we "have" cancer. I think the word to use is we "had" cancer and we survived. I go back, my mother was a very positive woman and so I get that positive reinforcement just thinking about her. I also come from a family history that almost six out of eight females have had one form of cancer, so I've had to live with that. At some point I thought, my chances are, that I will get cancer at some time in my life, and I did, so I've looked at it okay, I've gotten it and I can now go forward and do as much as I can.

GINA:
Some women choose to have reconstruction. Was that something you considered?

MARICELA:
I did have reconstruction.

GINA:
Did it go okay for you? How did you make that decision?

MARICELA:
When I went in, I went in to have breast reduction, and that's how they found my cancer, and so I went through breast reduction, and a week or several days later, the doctor called and told us they had found cancer.

GINA:
How terrifying.

MARICELA:
And so at that point my husband and I talked about it. I don't think we really would have discussed it with our children at that time, it was something that we discussed between us. We consulted several doctors and decided to go ahead and go with the bilateral mastectomy and reconstruction at the same time. I think that if you had asked me maybe two months ago would I have done that, I probably would have said no. But today, I am glad that I did do it. I've encountered some other problems due to the reconstruction but I think that I'm past that, and I'm very happy with the fact that I did do reconstruction.

ANDREW:
Now for either of the other ladies, Mary or Margo, remind me, did that come into play for you? Any kind of reconstruction? Was that needed?

MARGO:
No. This is Margo. I chose the lumpectomy. I had the option of either a mastectomy or the lumpectomy and I talked it over with my family in California and they kept saying, just go on and you know, take it off. And I'm like, no I don't think I want to do that. So, I lingered. They only gave me like, you have to make up your mind in two weeks. And so I prayed on it and it came to me that I should go with the lumpectomy, which I did.

ANDREW:
And Mary, it was not an issue for you, you had chemo and radiation, right?

MARY:
That's correct. I went in for my surgical biopsy, and actually I wasn't given a choice. When I woke up from the anesthesia, the surgeon told me he did a lumpectomy when he went in there for the biopsy they found the cancer. So he said he felt while he was in there he would just do the lumpectomy. It made me a little angry because I thought about it, and I thought, gee if I had had a choice, I think I would have wanted a mastectomy. It would have made me feel safer. But I didn't have that choice and you know, I ended up having the chemotherapy and the radiation after that.

ANDREW:
Maricela talked about trying to let go of what went on in the past, yet we're talking about it and Mary, you're kind of reliving this experience now with that behind you. Mary and Margo, in particular, what do you do to try to put this behind you? Mary?

MARY:
I don't think I can put it behind me, it's a part of me. Cancer has just been a part of my life. My mother and father both died of cancer, my mother died of breast cancer when she was 55, and its just kind of been a part of my life, like I always knew that I would get it. I think Maricela said that. She had thought about it her whole life too that she would probably get it and so it's kind of been a part of my life. It's something that has happened and now I'm just kind of, I'm considering myself just recovered but I also know, I agree with what Margo said, is that I kind of live with that fear every day that it's going to come back. Not every day, some days I don't think about it at all but other days I do think about it.

ANDREW:
When that comes up for you, do you have something that triggers in your mind, okay I acknowledge this fear but today is today, I'm going to move on.

MARY:
Yes, I do say that to myself and I pray. Every morning I pray. Like I said I just try to get up in the morning and just be thankful that I'm here today and to not dwell on that it might come back.

ANDREW:
Margo, do you dwell at all on what's been in the recent past?

MARGO:
No, back to what both the ladies said that they had a history of it in their families, I'm the first in my family to have it. That's what we couldn't understand, that, it seems to come in families that already have it down the line, but in my family of females I am the first. So we're wondering now have I started a trend that's going to hit maybe my niece somewhere down the line.

ANDREW:
Have you had discussions with your niece or other relatives about that?

MARGO:
Uh huh, I've told them they need to go have mammograms done. Which is something they probably hadn't been doing.

ANDREW:
But you don't feel responsible like somehow you caused this for your family or this threat of cancer in the future.

MARGO:
No, no, no no. I don't feel like that at all.

ANDREW:
Ladies, do you have some ongoing continuing effects from the treatment you had? I think Mary you talked about still getting over the fatigue.

MARY:
Yes, that's correct, yeah.

ANDREW:
Any pain or anything like that, that you've had to deal with post-treatment?

MARY:
No, no pain or anything, just mostly it's just the fatigue. The only other thing, I still have occasional bouts of nausea and dizziness, from the chemotherapy, I guess. I'm hoping that that will go away. I developed something in my feet, I don't remember the name of it, but I've broken both of my ankles because I have lost feeling in my feet. It's hard for me to walk.

ANDREW:
Does it seem like that came from the radiation perhaps?

MARY:
From the chemotherapy.

MARGO:
This is Margo, that came from the chemotherapy. It happened to me too.

MARY:
Oh did it?

ANDREW:
Margo, tell us what affects have you had post-treatment?

MARGO:
Okay, from my lumpectomy, because they had to go in under my arm. Mine was situated in a very good spot, if you want to say it's a good spot to have cancer. Where my incision and everything was like perfect. But up under the armpit, where they took the nodes out, I didn't realize it would take almost a year for the feeling to actually come back. And so now the feeling is coming back and it's just a weird sensation that makes me think that, Oh my God, it's spreading all through my body, but in reality it was confirmed by my chemotherapy doctor that it takes that long for the feeling to come back because all the nerves and things were like dead. But now the feeling coming back and it's uncomfortable. It really is.

MARY:
Margo, are you getting feeling back?

MARGO:
Yes, it's coming back. Every day I feel more and more tingly. Which is a good thing, which it's a good thing, but it's also a scary thing.

MARICELA:
Hello, this is Maricela. I do not have feeling.

MARY:
This is Mary. I don't have feeling under my arm, either. It's a very odd sensation like we're saying and when I was talking about reconstruction that I've had pain. I've had a lot of excruciating pain.

MARGO:
Like the shooting type?

MARY:
Oh, yes, and mine's been six years after and I still do have that pain. And Margo, you were saying that sitting at the computer, working. They think that we all now work on computers that we do feel it more. I do feel pain.

MARGO:
And plus I have a part time job where I work a cash register, and I'm right handed and it was on my right side, so I'm using all my power on the side where my cancer was.

GINA:
Have the doctors given any of you any help with that, saying well, it's pain and your just going to have to live with it or have they had any suggestions?

MARICELA:
This is Maricela, and basically they told me to do stretch exercises. I do Reach for Recovery. I am a volunteer for Reach to Recovery so I do the Reach to Recovery exercises. I still do 'em and they still help me because they do stretch the areas where our surgeries were.

GINA:
And were any of you prepared for this? Did the doctors tell you that it might happen?

MARGO:
This is Margo. They told me but as Maricela was saying, she was given exercises, no one in the medical field out of my team of doctors ever told me I was supposed to do the walk the arm up the wall, no one. It was other survivors that told me. You mean that you weren't told you were supposed to walk the wall? And I'm like - no. So when ever I feel that tightness, I take it on upon myself to walk the wall and walk back down with that arm and it does give a little bit of relief. But no, I was not given any type of exercises.

ANDREW:
Maricela, you mentioned that you are active in the American Cancer Society's Reach to Recovery program. For women who are listening who have completed their treatment for breast cancer and may not be aware of this, would you say that that could be a resource for them, just like these exercises you're talking about and other issues that may come up as people have aftereffects of treatment or emotional or family issues?

MARICELA:
The Reach to Recovery program? Yes, I started doing Reach to Recovery one year after my surgery and personally I did not have Reach to Recovery when I went through my surgery. What happened to me is I came back home, I had my surgery out of town and then came back home. I had a physical therapist come and show me exercises. And that helped me.

ANDREW:
Maricela, do you think that there are some issues that come up in the Hispanic American community that are unique surrounding breast cancer that you'd care to talk about?

MARICELA:
I'll talk about it as a Reach for Recovery volunteer. In some instances I have found out that a lot of the women do not want to do self breast examinations because they don't want to touch their breasts. That has been the hardest thing for me to try to instill in women that have had breast cancer, let's say on the left side, they still have their right breast, is to continue doing self breast examination. I was not taught that, and I am from a Hispanic background, but there are a lot of Hispanic women, and not only Hispanic, I think women in general, that don't want to touch their breasts. A case in point, did a Reach to Recovery two weeks ago and told the lady to continue with self breast and she said, I don't want to continue doing self breast exams because I may find another lump in the other breast and I don't want to face that.

ANDREW:
Do you feel, each of you having gone through breast cancer one time, that you would want to be not proactive or almost in denial or not even or not doing breast exams, or do you feel that you, the three of you, would want to pursue it? Now Maricela, I know you had a bilateral mastectomy so maybe it's not an issue there, but for Mary and Margo, do you continue to do exams? Do you want to know, do you want to get it treated early if it happens again?

MARGO:
This is Margo, I still do breast exams, but I really don't want to know.

MARY:
This is Mary, I still do breast exams and I do want to know, because you know, I want it caught early. I'd like to live a long and happy life.

GINA:
You know, the breast exams aren't as easy as they sound like they should be...

MARGO:
They're not, they really aren't.

GINA:
I had a lump found and I couldn't even feel it, it was during an exam and I'm trying to feel what the surgeon was feeling and it turned out to be benign. I was lucky. But I'm thinking, I don't even know what I'm feeling for.

MARGO:
Oh, you'd know it was a lump if you could feel it. This is Margo, you would know the lump. Cause I found my own lump.

GINA:
Really.

MARGO:
I knew how you just know this is not right but it's gonna go away. And that was in November of 97. It didn't go away. I didn't go to a doctor til February of 98.

ANDREW:
So Margo, what will you do if you feel a lump next time?

MARGO:
I'm going to the Emergency Room. Somebody's going to see me at first feel. I wouldn't wait. People kept telling me, you need to go, you need to go. Oh no, no. It's going to go away. It's going to go away. It's going to go away. And it never went away. And plus, another reason like I said, we had just moved here, I hadn't found a physician, primary care doctor or anything, and my appointment was really scheduled for February but I went in immediately telling him I have a lump and he knew, even though he wasn't a surgeon, he knew, that's why he referred me immediately to a surgeon. We immediately did the biopsy by aspiration and he immediately told me you need to have the chest, to take the tissue out to see if it's cancerous, and it was.

GINA:
Margo, you said that once you talked about it at work you found other women who said they had been through something similar before. I'm wondering if that Mary and Maricela, if you've had similar experiences of women who didn't talk about it until you brought it up.

MARY:
This is Mary, yes, I have, as a matter of fact. My neighbor, I had no idea that she had had breast cancer and of course when I got sick and started going to treatments and everything, she explained to me about her breast cancer she had it like fifteen years ago and her treatments of course were different. You know now they have different drugs and she went through horrible chemotherapy and vomiting and everything afterwards and now they have drugs that can control most of that. So we kind of compared horror stories. I was just really surprised because she never talked about it.

MARICELA:
This is Maricela. I had friends that had had breast cancer that helped me cope that I used as role models. They had been very positive and they had done very well afterwards. I had one real good friend that had been through quite a bit of chemotherapy and I believe it's called bone transplant and she was very positive. And so I just always told myself I was very lucky, I guess, drilling it into myself every day that I was very lucky.

MARGO:
This is Margo and I feel very lucky, too, that I had coworkers that had lumpectomies and mastectomies with reconstruction in California as well as here, all with the same agency I worked with and it's like when I came out and let people know, it's like they contacted people they knew had it and nobody else knew had and through the e-mail you know, we just became like a network and like I say you have to have a strong support system somewhere.

ANDREW:
Margo, you just mentioned a magic word, there, e-mail and in this age of the Internet. How do you all keep current? Do you trade information e-mail with people, do you seek out web sites? I think Margo you said you read literature that comes from the American Cancer Society. How important do you think that is for women who've had breast cancer in their past to kind of stay up to date?

MARGO:
Oh, it's very important. You have to stay up to date. You have to, because if you don't, you're going to miss out on the "Magical Cure".

MARY:
This is Mary. Yeah, I stay up to date. I read Mamm Magazine and I go the library and read the latest books and just try to keep up to date on the new medications and I really want to know everything that's going on, because you know you just never know if it's going to come back again.

ANDREW:
Good for you! Maricela, what about for you about keeping informed and what do you do to do that?

MARICELA:
Well since I am a volunteer with the Reach to Recovery, I also became a trainer, a state-wide trainer. And so I get e-mail from the American Cancer Society and that helps me a lot. I also read my husband's medical journals. Which, maybe sometimes I shouldn't.

GINA:
They can be scary huh?

MARGO:
Very scary.

MARICELA:
But I do keep up that way. My friend that also had breast cancer helps me keep informed because she does get a lot more literature than I do on the subject.

ANDREW:
Maricela, is your husband a doctor?

MARICELA:
He's a surgeon, yes sir.

ANDREW:
Oh I see, so this has hit really close to home for you.

MARICELA:
It hits very close to home. I think it was at some times harder for my husband than it was for me.

GINA:
Why do you say that?

MARICELA:
Because he takes care of a lot of women with breast cancer and then all of a sudden his wife had it and I don't think he thought it was going to come that close to home.

ANDREW:
How has he dealt with that, the two of you together over time?

MARICELA:
Very well, very well. They say bad luck comes in threes or something like that and I was the third out, so, we were both just very very thankful that we found this when we did. And we keep going back and we think we were blessed. So I personally keep up although I did have bilateral mastectomies, I still go through mammograms. Believe it or not, there is still some breast tissue there. But they ask me to continue to do this. I don't do them every year, I do them maybe every two years and I also repeat my bone and liver scans, which is very important.

ANDREW:
That's related to metastatic breast cancer, right, if it's spreading somewhere else in your body.

MARICELA:
Exactly. Unfortunately I did repeat a scan in June and there is something in the lungs. We decided to wait three months to make sure that it is not metastatic disease. It was very minute and so they want to see if it's growing, and at the end of three months then at that point we'll find out if we need to do a biopsy or not.

ANDREW:
Maricela, whether or not this is, and please God I hope it is not. Do you think for any woman who's had breast cancer, the sort of other shoe that could drop, is always in the back of your mind?

MARICELA:
Always, I did say we kind of put it behind it us and we go forward, but as Mary and Margo have both said, it's very hard to put behind you. You basically think about it every day and I think about it. I thank God every day, I do pray, and I thank God. And they said you know you have a five-year period, waiting period and then after your five years basically that hopefully you'll be cancer-free. Well this, this hit me right at the sixth year. What I have done with that is I have tried to put it in the back of my mind and not really think about it. And continue as if it's not there at this point.

GINA:
We wish you the best of luck with that.

MARICELA:
Thank you.

GINA:
Mary, as we wrap this up a little bit, have got some advice for other women who have had their treatment and are now trying to get on with their lives? What would be the most important thing you could say to a woman in that position?

MARY:
Gee, I guess the most important thing would be to just try to be thankful for every day that you're alive. It's really the only advice I could even give to anyone. Just get up in the morning and thank God that you're alive today. And don't worry about tomorrow, just try to just live today and be thankful for it. That's really the only advice.

GINA:
Margo, what about you?

MARGO:
I say basically what Mary says, that you know, be thankful that you're here, and live each day to its fullest, do things that you thought you would never do because you may not be around to do it. Try to stay around positive people and keep negativity out of your life if it means abandoning family, friends, just, you know you have to be around people that are compassionate enough to understand what you're going through, because they never know, they still feel it too and they're going to need you.

GINA:
Maricela, how about you? What would you advise women?

MARICELA:
First of all, with what both Mary and Margo said, and I'd like to add before I continue that it's been an honor for me to be with these two women, talking. But I think I also wake up and I want to enjoy my family, my friends. It's very important to have that support group. Don't put off things for tomorrow. If you want to take a vacation that you never wanted to take, take that vacation. Go to the movies in the middle of the day instead of on the weekend. Enjoy life. I think we are given this wonderful life and God gave us a second chance or a third chance and what we've got to do is enjoy it. We've got to let go of any anger that we do have within us because anger is not good for us at all.

MARGO:
This is Margo, anger begets stress and stress can bring about recurrence.

MARICELA:
Let go of all our anger and be happy and enjoy life.

GINA:
Great advice for everybody.

ANDREW:
Enjoy those loved ones that each of you have in your family who are close at hand.

MARGO:
That's important too. Very important.

ANDREW:
Ladies, this has been a very rewarding discussion and we very much appreciate you sharing your personal experiences and your insights that can help benefit other women who've had breast cancer in their life and hopefully can go on and now have a long and healthy life. And thanks to my co-host Gina Tuttle.

GINA:
It's been a privilege.

MARGO:
It's been a privilege and a pleasure.

MARICELA:
It's been a privilege for me too.

MARY:
And Maricela, I want to wish you the best and I'll pray for you.

MARICELA:
Thank you Mary, thank you.

MARGO:
And I will too.

ANDREW:
For the American Cancer Society's Cancer Survivors Network, and from our Healthtalk Interactive studio in Seattle, I am Andrew Schorr.