ANDREW:
Hello, and welcome to the American Cancer Society's Cancer Survivor's Network, the service created by and for cancer survivors. In Seattle, I'm your discussion leader, Andrew Schorr. And I'm joined by our co-host, medical broadcaster Gina Tuttle. Gina, thanks for being with us.

GINA:
It's a pleasure.

ANDREW:
Today's topic, breast cancer survivors in their middle years, dealing with a recurrence of cancer. On the phone with us are four women across the country who are all between the ages of 46 and 55. Three have survived two bouts of breast cancer, and the fourth is dealing with a possible recurrence of cancer in her ribs. Over the next few minutes, we'll discuss issues such as: the fear that can come along with recurrence, complementary therapies to gain both physical and emotional strength, the results of reconstruction, having a buddy system or network of positive survivors, and taking a look at what you want to do with your life. Let me first introduce Clare of Rowley, Massachusetts. Clare, you're 52, and do you have children?

CLARE:
Yes, I have two boys.

ANDREW:
I see, how old are they?

CLARE:
31 and 28.

ANDREW:
I see. Now, I know you had breast cancer initially in 1985, and then five years later you found out you had it again, right?

CLARE:
Correct. That's correct.

ANDREW:
And you went through chemo and radiation the first time, and then later a mastectomy and breast reconstruction.

CLARE:
That's correct.

ANDREW:
So, despite all the medical procedures, you've told us that the hardest part is learning to live with the experience. So, tell us about living day-by-day, having had two bouts of breast cancer.

CLARE:
Well, I think that that, to me, is the hardest part of the whole experience. When I was first diagnosed, and you're seeing doctors every week, and you go for treatments... I was very fortunate that all of my treatments went fairly well so that I recovered from the treatments. But after it was all over, and I wasn't seeing doctors every three weeks or whatever, that to me was the hard part. Just learning to live with it. As it would be with any illness. Not just cancer, but I'd think any illness.

ANDREW:
Was it different the second time? Different than the first? The first time you thought, maybe, "I'm rid of this" and just moved on. When it comes back the second, do you feel like you're always sort of carrying it with you?

CLARE:
Well, I know when it came back the second time I really was devastated. I honestly thought, this is it, you know. I've had four and a half good years and this is it. That's what I really thought in the beginning. But I'm not sure that it was any harder to live with it afterwards. I just dug myself right into work, and just kept myself busy so that I would be trying to keep my mind off of the whole experience. To at least get through the day.

ANDREW:
Now, let me understand, though. Your recurrence was almost ten years ago, now?

CLARE:
Right. Correct.

ANDREW:
So there's been a lot of water over the dam. And a lot of good time after that time when you thought you were headed for the grave?

CLARE:
That's right.

ANDREW:
So what would you say to other women who are facing a recurrence? As far as knowing that life goes on, and there can be a lot of life.

CLARE:
Well, I think, basically, just to find a way to get through each day. Because it's on your mind, I think. It was for me, anyway. One hundred percent of the time. And you don't forget it whether you've had reconstructive surgery or not. It's on your mind all the time. You need to find something else to focus on.

ANDREW:
What do you focus on? How do you get through?

CLARE:
Well, I did focus on work a lot. Now that it's been ten years, I don't need to focus too much on the fear of it anymore, although, it could happen. But as time goes on, it's a little bit easier to live with it every day. Now I'm just very thankful.

ANDREW:
Specifically for you, looking back just a few years, and the years immediately after the recurrence, what would you do to focus? To be positive? You said work. Are there specific things that you did that you can recall that helped you get through the day?

CLARE:
No. My husband was very supportive. That helped a lot. Friends were supportive, and that helped a lot. But, I think just keeping myself busy. I read some things. I didn't read a lot... I didn't want to scare myself too much. I listened to talk shows or TV shows. I was very involved with that. I liked to listen to those types of things. I learned a lot.

ANDREW:
So, as someone who's dealt with breast cancer twice... As you recall when that was happening a second time... How do you guide people to let them know what's helpful and what isn't?

CLARE:
Well, I'm not sure that I can guide anybody as to what's helpful and what isn't. I really feel as though you have to do what you're comfortable doing. You have to find your doctors that you're comfortable with. Just because I might have gone into Boston, and somebody else might decide to stay at a local hospital, that's fine. As long as you like your doctor. So, everybody has to do their own individual day-to-day things, or their own individual treatments, or whatever the case may be, to get them through that.

GINA:
Claire, stay with us.

GINA:
I'd like to bring Roxanne Pratt into our discussion now. She comes to us from East Hartford, Connecticut. Roxanne is 55 and married. Roxanne, you had breast cancer three years ago, and now you may be facing cancer again. Explain what's going on for you.

ROXANNE:
Okay. Well, I did have the test, and I found out instead that I have cracked ribs. Thank God.

GINA:
Oh, congratulations. You were fearing that you might have a recurrence of cancer, but this time on your ribs?

ROXANNE:
Yes. It was the 34th rib, and I was very nervous about it. My main tool is denial. You know, I do the footwork, I'll do what I have to do. But most of the time I assume that everything's fine unless I'm told otherwise. So that piece of fear inside, I try not to focus on that.

GINA:
How did you cope with the uncertainty? It sounds like there was a while there when you did not know if you had cancer again.

ROXANNE:
Well, part of it is being busy. I'm a teacher, and second graders keep me very busy. And this is what I found the first time that I had cancer. That much of the time, being so focused on the classroom, on the children, contacting parents... that I really didn't even have time to even focus on my cancer. And consequently, the first time I took a leave of absence, because I like to do things well and I couldn't do everything well. I really couldn't keep focused in two areas initially. This time around it was a help not to think about the possibility of having cancer a second time. Previous to this test, I had had a tumor taken out of my breast, but this was pre-cancerous. But it still wasn't perfect tissue so I was a little nervous about that. But then again I didn't focus on that.

GINA:
So, having faced cancer, and then the fear of cancer again, how has that changed your life? And how you live it from now on?

ROXANNE:
Well, once upon a time, when I first got cancer, I thought I'd clean my house and have it perfectly clean. I was very, very scared the first time. I had a wonderful doctor who explained things not only to myself, but to my daughter. And I had two sisters who went with me to get information, because it seems like one person could not really receive all that information. It took a number of us to hear things that other people didn't. So, I was very supported then. And I have to say I was supported the second time that I was concerned about this, also. But the second time that I was concerned about it, I was in a teaching situation, and I didn't have a lot of time to focus. I found that I started doing things that I had let go. I started eating better. I had been taking some grape-seed pit before this and I started taking that again. I was a little careless in taking vitamins and I got better at taking vitamins again. So I started doing things I probably should be doing anyway, but I was a little bit more careful in following through than I had been before.

GINA:
Did you allow people in during this second time of uncertainty? To say, "This may be happening for me and here's what I feel about it?"

ROXANNE:
I did, with my husband. I didn't with my daughter. My daughter was just recently married, and my son was married also this past year, so I didn't want to include her in something that might not be a problem. I shared with my husband, I shared with a couple friends, but I didn't want to be involving people. And particularly my children, worrying about something that maybe wasn't necessary to worry about.

ANDREW:
Roxanne, did you have a way of reaching out and getting people to say or do things that were helpful for you? And did some people just say things that were inappropriate?

ROXANNE:
Well, the first time I had cancer, I told my husband that I will not listen to anything negative. I just decided that I was very clear on that. And there is a particular member of the family... When that person came in to visit me in the hospital room, I had other family members there. Because I felt that there was strength in numbers, and this person I found very depressing. I avoided her a lot, and when I was with her I made it a point... And my family was very supportive in that.

GINA:
How proactive! What a great idea to deal with things that way.

ROXANNE:
Well, one thing... When I did have cancer, I was scared and I wanted to do everything for myself that I could, and I like having control. Let's face it... with cancer, there are many things beyond your control. When I went into the hospital, my son even exchanged a picture that was in the hospital room that I did not like. I even brought in some rose scent, like aromatherapy. And when these particular relatives visited, I used that. I had flowers in there and I also had music. Something to make me relax, and something to make me feel at home. It was for me. I was the focus, and I was getting healthy. It gave me permission to really take care of myself, instead of putting my needs last after someone else.

GINA:
That's a hard thing for some women to do, isn't it?

ROXANNE:
Well, I think at that point I was very, very afraid, and it was like now or never. Now's the time to do it. And what I find more recently is I'm less vigilant for my own needs. And after talking to some of my friends... I need to be more positive and more proactive for my needs. Not just when I'm in the crisis of worrying about what may be a big problem. But do this work at my life when I'm not at that panic stage.

ANDREW:
Has this helped you? Going through these brushes, or fears, of recurrence? Do you think you'll be stronger? And, God forbid... I hope it never happens... but if it should ever come back and not be cracked ribs, but be an actual cancer?

ROXANNE:
Well, I think that this scare has made me... Well, first of all, I've lived my life pretty much enjoying it and enjoying my family. But I will be more assertive for me. I may not clean my whole house, but... I'm now deciding to do some counseling, and I think this may be helping. I'm doing something now called Rolfing, and I think that may be helping. I'm getting more in touch with my body. I'm very much in my head. I'm very much a thinker. I'm analytical, and there are a lot of strengths in that, but I think I need to get more in touch with my body. And this may help in the future... maybe make me a stronger person.

ANDREW:
Well, let's travel over to Hawi on the big island of Hawaii and bring in Ana. Ana, you have the blessing, or the curse, of also being a doctor. A pediatrician. So, when one night you felt a pain in your rib, you kind of knew that it was a recurrence. Or had a pretty strong fear...a knowledge that it may well have been, not a cracked rib, but a recurrence of cancer, right?

ANA:
Right.

ANDREW:
That was pretty devastating.

ANA:
It was very devastating. But I did go through a process of denial. The pain went away and my oncologist had said if it goes away it's not cancer, so I felt a little false sense of security. But then a physician I asked gave his opinion, and he said, "I'd go on the conservative side and check it out." And sure enough, I checked it out and it was cancer.

I think this is wonderful to be able to talk to other women who have had recurrences. Particularly those that have survived. Because I think that's one of the most important things to someone who's going through a recurrence. There's nothing more important than having that hope and knowing that other people have survived. That was one of the things I had to do. I read as many articles... women's journal articles, stories where people had survived this... Because I was told when I had my recurrence that there wasn't anything they could do. That it had recurred in my rib and in my spine, my lower spine. Initially I was in such shock that I just kind of accepted that. Then I kind of woke up, and a friend said, "Go get another opinion." So I did and I ended up finding a wonderful oncologist who was very aggressive. And I think he never took my hope away.

I think that's just critical, particularly with recurrence. But I eventually did six more courses of chemo and radiation. I did high-dose radiation and then I had a stem cell transplant seven years ago. I had to be in the hospital for two months, and that was pretty hard. But the first month while I was in the hospital, I still felt well. It was just in my bones and in my spine, and the pain was under control. I rode a bicycle, a stationary bicycle, in the hospital room to kind of keep my strength up. It was in the second month you're pretty wasted, and so you don't have quite the energy you have at the beginning.

ANDREW:
I think it's really important to point out that your initial breast cancer was in 1990, about ten years ago. Then it was two years later that you had the recurrence. So, you've had many years since that recurrence. And you went through very aggressive treatment and survived. You're back, I would guess, to practicing medicine. And you have a young son, right?

ANA:
He was, at that time, nine. He's sixteen years old now. He was just too young, and it wasn't time for me. I wasn't ready to go anywhere. I was determined to hang on if I could. So I guess I put everything I could into it.

GINA:
So you've got a good life now.

ANA:
Well, actually, I have to correct you... I am not working now. I think one of my problems the first time... I thought I was really tough and strong because, you know, I would have my chemo on Friday and be at work on Monday. "This is not going to bother me, it's not going to interfere with my life." And I didn't make any changes in my life. I was a solo practitioner working really hard and there were a lot of stresses.

I really didn't change anything, and it wasn't until I had my recurrence that I finally... It took time into the treatment and the time after that that I had to think about it... it was a slow process. But I finally had to let go of my practice. I couldn't do it physically. I'm on disability now, because of the residual damage that the radiation and the cancer itself did to my spine. I have chronic pain and had neuropathy in my feet. Just, multiple problems. I can't stand on my feet all day, so I couldn't be the owner and manager of a clinic. I had to stop that. So now I'm just starting to get back to where I'm doing fill-in work here and there.

But I had five years where...I'm very thankful for those years. There were lots of good times. I don't want to say it was all bad times. But it was definitely a real... I guess it was just part of the process. Like Claire had said, you're glad you have the time. But I really thought that I wasn't really living. I was living so much in fear. And I eventually got to a point... I was doing lots of journaling and doing a lot of complementary things to help me get through this. I really felt like my soul and my strong spirit that I had, it was like the light had gone out for awhile. And it's taken me five years.

It was finally this past year after going through multiple things that I've been working on. I said, "I just can't do that any more." Of course, having five years behind me helped make it easier. But I just said, that was it. I had to let go of that. And I want to enjoy, you know, everybody. When you have kids, you say smell the roses and live life to the fullest each day. But then when you're back to feeling okay, or you're having good times, or you're back to your work and stuff, oftentimes you forget to do that. So there's always little reminders to keep me back on track. To focus on really enjoying the time now.

ANDREW:
Roxanne talked a few minutes ago about some things she's doing for her body to get out of everything in her head. You mentioned complementary things. What are some of the things, specifically, that you've done, Ana, to help in that process. You've let go of your practice, but what other kinds of things?

GINA:
And I'm particularly interested in your answers since you're a medical practitioner yourself, so you've got both sides of this.

ANA:
Well, that's a double-edged sword for sure, because I couldn't have a headache without thinking it was a metastasis to my brain. Really, everybody does that, but with a physician there's a lot of other things. The physiology that I know. I would wonder if every little ache and pain was it. And I wasn't a hypochondriac. It was just that I knew too much. So, you know, I had so many little scares, just like what Roxanne just went through. I went through it again recently. I had a fractured rib. But luckily this had gotten to the point where I just knew intuitively that it wasn't a recurrence. Because I knew what it felt like when I had it before. I did have pain with this one, but I remembered. You know, I also have osteoporosis now, and so I remembered riding one of those crazy rides in California with my son where you're banging around a lot. I thought that was when I fractured it. So luckily, eventually I found out that it was just a rib fracture. It's kind of a little encouraging to know that I have osteoporosis, because then when I do have rib pains or whatever, I know now I don't have to jump to thinking automatically it's cancer.

But the things that I do: I get a massage weekly, and that really helps me a lot with managing my pain. And I see an acupuncturist whenever I need to. I see a therapist to help me with depression on and off and the chronic fatigue that I have. And I'm fortunate to be involved in a cancer retreat. A week-long cancer retreat that we have here in Hawaii, that's modeled after Commonweal. We put it on several times a year and it teaches us, teaches cancer patients, to learn all the other things that you can do for your body: good nutrition, vitamins, yoga, sandtrate therapy... You know, just taking care of yourself, basically. But exposing you to complementary medicine.

I've done a lot of that... done a lot more internal healing and spiritual healing. I think emotional healing, that's what I've been working on more, because I think that has a lot to do... I believe that phrase "our biographies are our biologies." And so I'm working on trying to keep my head as positive as I can.

Then I also became very involved in advocacy work. I spend a lot of time working with the National Breast Cancer Coalition and going to lobby. Trying to spread the word to the people here in Hawaii because we're so isolated from everything. To let them know about the need to get into the grassroots and vote for the things that are important to breast cancer survivors.

GINA:
Before we talk any further, I would like you to meet Sheila, 49 years old, of Woodstock, Connecticut. Sheila, you've dealt with breast cancer twice now, and gone through radiation and chemotherapy. You found support groups weren't always helpful for you. Why was that, Sheila?

SHEILA:
I think when I would go to the support groups that were held in hospitals or local towns... You would find women who would come at all various stages, some who were initially diagnosed, some who were fighting it and losing the battle, and others who were survivors. And I felt, as a survivor, that it was very difficult for me to sit there and experience with somebody the pain of the initial diagnosis and the fear of going in for the surgery. It just would bring that back home repeatedly, and I couldn't move on. I couldn't get past it and be in a positive mode when I would come home from those depressing experiences. That was difficult for me.

GINA:
So, how did you find support, Sheila? What worked for you?

SHEILA:
I think my family and my sister and my mother were very strong backbones for me. I would read different cancer survivor books of women who had experienced it... their stories. I could dialog very well with my oncologist as well as my surgeon. I became active in different activities where I felt positive that I was giving something back. I was involved with the "Relay for Life" for two years in a row. I chaired that in our local community the first two years that it came to Woodstock, and that was a very positive experience for me.

ANDREW:
I have a question for you, Sheila. Just to help us understand... how long ago was your first bout with breast cancer?

SHEILA:
I was young, I was probably 35 and that was about 14 years ago.

ANDREW:
And then the second one?

SHEILA:
The second one for me was approximately five years ago, so I was about ten years out.

ANDREW:
How are you feeling today? You're five years after the second recurrence. What's your mood now and do you have much fear of a recurrence yet again?

SHEILA:
I think you always have that in the back of your mind. I think when it came back for me the second time... Initially I was a little bit leery about doing the mastectomy. I did the lumpectomy initially, followed by the radiation and the chemo. When it came back a second time, I had no qualms. This breast is going! And then I took the second... The first breast that was involved, I took that off as soon as I got through that surgery. So I have a double mastectomy at this point, and I'm saying there's no way I can do it a third time. It ain't happening to me! So from that perspective, you know, if it's coming back, okay. It's coming back in a different way, shape, or form. But we're not gonna do it in the breast.

ANDREW:
Sheila, the entire time, you've had a man in your life?

SHEILA:
No, to be honest with you, no. A lot of it I've gone through on my own.

ANDREW:
And now, you do have a significant other, I understand?

SHEILA:
I have a significant other who's sometimes difficult for me to share things with, to really bring into that circle. I tend to be more able to do that with women friends than I am with him.

ANDREW:
And so, the fact that you've had cancer twice, and you have feelings that keep coming up, is that something that's a block between you?

SHEILA:
I think it perhaps is in my life. I don't think it necessarily has to be the case in everyone's life. I think that it probably is the personality of the significant other.

ANDREW:
Sure. It varies.

SHEILA:
Perhaps he has the same fear, and to verbalize that and to communicate that takes a lot of effort, a lot of work. You have to be able to really open up your heart and your soul to verbalize those fears. Some people, and I think the particular person in my life, maybe don't want to live with the fear. He doesn't want to hear that, and worries about losing me, perhaps.

ANDREW:
Sure, it's very natural. You mentioned you have some friends, though, that you talk to. How have you found people that you can share your feelings with?

SHEILA:
I'm pretty vocal as far as being willing to talk to my female friends about that. And some male friends. Talk about the horrible things that people say, with no breasts. I don't wear the prosthesis, so I'm totally flat-chested. Some people say to me, "When are you due?" I say, "No, I'm not pregnant. I just don't have any boobs." And they don't know what to do, they don't know where to run! So I laugh about it. But I say, "Well, that's just the way it is." Sometimes you just have to laugh with them, and say that's the way it is.

GINA:
And assume that maybe they aren't meaning it in the bad way that it comes out?

SHEILA:
No, no, not at all. I said I wish that I could be pregnant, but extenuating circumstances, you know... I went through an early menopause because of the chemotherapy and things just didn't happen that way. But, you know, there's always a flip side to it that can be very funny and very positive.

ANDREW:
Ana had talked about the effects she's had pain from. She went through some heavy-duty treatment including a stem cell transplant. You mentioned early menopause. Sheila, is there any pain, or any other things you've had to deal with, having gone through cancer treatment twice?

SHEILA:
I think that intercourse for me is difficult at times and I think that's possibly because of the dryness. That's an issue that's real difficult to deal with. Sometimes you go to physicians and you want to say, okay, here are some of the experiences I've had through life and the chemotherapy and the radiation. Maybe the way my digestive tract is at this point and swallowing. You never really know how that radiation has affected you when you've been radiated in the chest. So those are some of the health issues that I still deal with.

ANDREW:
Let's ask Ana. Ana, you're a doctor. Can you give some pointers to women as to how to talk to their doctor related to the aftereffects of treatment? Maybe surgery one time but also chemo, radiation, God knows what... where you've really been blasted. There are these ongoing effects and you don't always know how to talk about it or bring it up.

ANA:
Well, I think the biggest thing is finding an oncologist that you really trust and can talk to about everything. Like Sheila was talking about, having the difficulty with intercourse. I think that's a problem for all of us that are in that situation. For the women in my support group, they have complaints of the same thing... lots of problems afterwards. But a lot of them don't feel comfortable talking to their doctors about it. And I think it's critical. I've gone to these conferences where you get to talk to all these women. You know, we talk about everything. It's an issue for everybody. And I actually feel that they need to have a new nurse practitioner position that would be to help survivors. Because the oncologist, oftentimes, they work so hard to get you in remission. And your internist often doesn't remember about all the complications that can happen from all the things you've been through. I don't think there's enough people putting it all together.

But I think that some of us survivors, and not just as a physician... I think all of us, basically, really stay up on stuff... just read every article that gives us information about things. Because as we get older, into menopause and longer years of survival, they're not dealing with a lot of these issues. I think we're going to have to be the ones to get them to get it organized in such a fashion. That's why I think they need a follow-up care nurse that says, "Okay, now you need to be sure you get such and such this year, and I think that would be really helpful."

ANDREW:
Ana, how do you seek out information to keep you informed so that you can be an advocate for yourself as a survivor?

ANA:
I get a lot of my information from... I do a lot of reading, and the journals, and I get information from the National Breast Cancer Coalition. Their website has a lot of information. Or they will tell you where to go.

ANDREW:
What is that website address? Do you know?

ANA:
They just switched it to a new one. It's called www.beatcancer.com. They thought it would be easier to remember. Some people said it's in progress, and so it may still be www.natlnbcc.com, which is the National Breast Cancer Coalition.

ANDREW:
And so, Roxanne and Clare, what about aftereffects from treatment? And specific things you have done for that? Clare?

CLARE:
Well, I really have been very fortunate. I did go through menopause at an early age. I was 38 when I had chemotherapy and went through menopause at that time, and I've read, or tried, different things to help. I really have been fairly fortunate. I don't have any of the really debilitating problems with it. I do encourage my friends, and myself, to try to stay on top of what the tests are at my age and what I should be having done. The doctor that I have is wonderful and I think that is so important-to have a doctor that you do trust. Though I don't believe... and Ana, hopefully, will agree with this... that you should put al of your trust in your doctor.

ANA:
Oh, definitely not!

CLARE:
You have to really know something on your own. But he really is very good with my year-to-year. I have no problems with bone density tests. He tells me when I need to have those done, and he's not afraid to order those types of tests. And he also has a nurse practitioner that works with him. For the rest of the year, I would almost rather see her. Because she's more understanding of my women's problems. So I do find I really have the best world. I'm very pleased that I have the situation that I have and that I have the doctors that I have. I really have had a very positive experience.

ANDREW:
Roxanne, I just wanted to ask... Roxanne, would you agree that women who are dealing with breast cancer really do need to keep informed? That this sort of personal advocacy for yourself is important?

ROXANNE:
I think it's crucial and, unfortunately, it's really necessary to be constantly reading and seeing some of the updates. I was negative in terms of estrogen, and I think they have more things for people who are estrogen-positive. So I've been trying to read and find out what could be helpful for me. There are different types of breast cancer and there are different types of things that might be helpful. It may not be helpful for others with a different type

ANDREW:
So you've been actually taking a part to better understand your type of tumor. So as developments come along, you know what's right for you.

ROXANNE:
But unfortunately, as I believe Ana mentioned, you have to be your own advocate. You have to do your own reading. It doesn't just come to you. Not all the doctors may be informed about things, you know. Things are developing, and it's really the patient's responsibility in a lot of cases to be their own advocate and do their own research. Which is why I took off the first year, when I found out I had cancer. So that I could read as many books as I could to make an informed decision. Because I did have the decision of mastectomy or lumpectomy.

GINA:
So, it sounds like we're hearing from everyone that they need to research it for themselves. And they need to realize that the second time around there may be different effects, different treatments necessary, and to go out and get the kind of information they need. I want to also ask Sheila... You've talked about the importance of keeping positive people around you, and you went so far as to sort of educate your doctor about how to be positive. Explain that story.

SHEILA:
That's very true. When I initially started my chemotherapy, I felt like I was going into the office and... it felt like a production line. It was like, in the room, get the shot, sit for twenty minutes, and then you would leave. Each time that I would go back I was feeling more anxious. I said to him one day... I was sitting on the examining table and I said, "Do you know Dr. Bernie Siegel?" Now, I had my treatment done down at Yale New Haven where Dr. Bernie Siegel is, and he said yes. I said, "Have you ever read his books?" He said no, and I said, "Well, you know, you need to do that, because the bedside manner is very important." He sat down, and from then on anytime I went in, there was time for me. And I think that made a big difference in the way I approached going for the chemotherapy. In the mental attitude that I had when I was in his office at that point. I came away probably not as sick as some other people might have, and it just was a real positive experience for me once I did that.

GINA:
Clare, how about you? I understand your husband helped turn this into as much of a positive experience as possible. With lobsters, of all things.

CLARE:
Well, my husband has quite a sense of humor to begin with, so everything with him would be a positive experience. He really was a peach through all of this. Very helpful when I lost my hair. He's bald, so the two of us went to bed together with out little hats on, and I actually had less hair than him. So I still remind him of that, that I really understand how cold your head can get in the middle of the night. But what he did was, after my first treatment... It was right after Christmas and just before New Year's, and I hadn't eaten too much. I had been sick for a few days from the treatment, and we went to a party and they had lobster there. I love lobster, and I ate the lobster. He thought that this was so great, that every Tuesday after I had a treatment he would bring me home a lobster. Now, even fourteen years later, I'm still saying to him, "Oh, it's the month of November. I think I need a couple of lobsters this month." So we're still celebrating with lobsters. And my family teases me about that, too. You know, I celebrate everything with lobsters.

ANDREW:
Well, I hope those lobster dinners can be celebrations of survival for many years.

CLARE:
I hope so, too. But things like that do help. To make an occasion out of it, I think. I am surprised that some women that I talk with don't celebrate those types of things. You know, they kind of forget the date, and I don't. I remember the dates and I'm very thankful when they come along. That it's another year that I can knock off the calendar.

ANDREW:
Amen. Well, I hope it's many. Ladies, as our time is drawing to a close, I want to give you the opportunity to leave a final thought with women who are dealing with a recurrence of cancer... initially from breast cancer. What do you want them to know? One thing you want to leave them with. So, Claire, you wanna start?

CLARE:
Well, I'm not really sure as to what I could say about that other than just go through it with the same positive outlook that you took through the first time that you were diagnosed. It's very difficult when the second diagnosis comes along. But you just need to stay on top of it, and try to be as positive as you can be to get yourself through the experience. And there is life after going through a recurrence. It takes a few years, but you do bounce back and...

GINA:
And for you, it's been ten years, which is pretty encouraging.

CLARE:
It'll be ten years, that's right. And mine was the same tumor that grew back in the same spot. It wasn't like it metastasized to another part of my body. Mine was the same tumor that grew back. So, you know, there were a lot of anxious moments with the doctors as to why that happened. But we got through it all. And, like I say, there is life after a recurrence. There are so many treatments out there today to help women through.

ANDREW:
Ana Garcia, in Hawaii... Your final thoughts for women dealing with a recurrence?

ANA:
I think keeping hope is one of the most important things and, I think, working with a physician that you can communicate with. And realize that there's so many more... Therapies are changing; they've changed so much just from when I started this process in 1990. That's given me hope, knowing that they're coming up with new therapies. So if I get a recurrence, now I feel that there's more things I can lean on. At the time when I had it, with the metastasis, I wasn't sure. But I think hope is one of the most critical things, and to have positive people around you. And doing things that make you feel good. And also sharing your experiences with others and talking to people who have had it and have had a recurrence. I think this is a wonderful program for them, to give them hope. And I think that's just critical.

ANDREW:
Thank you. And in Connecticut... Sheila?

SHEILA:
I think I would like to remind people to keep the positive attitude, to have perseverance, and to look at yourself as a survivor, not as a victim. I think those would be my words of encouragement.

ANDREW:
Very well said. You don't go through each day being angry about all this?

SHEILA:
No, not at all. I think that I live with a little bit of fear that it might be there and may be in remission. But I'm not angry, no.

ANDREW:
Well, we wish you well. And also in Connecticut, Roxanne, your final thoughts?

ROXANNE:
I think probably the main thing is to enjoy life today and to enjoy as much of it as you can. I think, number one, that information is power. And certainly shared experiences of people who've already been there are a big boost. You're not alone, and for me, that's so helpful. You know, you're not fighting the battle in isolation. You've got people who've been there and they've experienced it and they can relate to what you're talking about. For me, relationships are the most important and supportive thing in life.

ANDREW:
Well, ladies, those were all very well-said thoughts, and I know they are all extremely helpful to women who are going through this same experience that you've had. So, with that comment I'll have to wrap up. I want to thank each of you for sharing your personal experiences and insights to benefit others. And Gina, thank you for being with us.

GINA:
Thank you for the chance to meet these wonderful women.

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