ANDREW:
Hello and welcome to the American Cancer Society's' Cancer Survivors Network, a 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. Welcome, Gina.

GINA:
Thank you, Andrew.

ANDREW:
Today's topic, living with cancer recurrence after breast cancer for women who are fifty-five and older. On the phone with us are three breast cancer survivors from across the country, women who are all over fifty-five who have had treatment or are still undergoing treatment for a cancer recurrence. Over the next few minutes, we'll discuss issues such as dealing with daily thoughts and fears, how attitude affects fear and sense of control, ways to combat ongoing soreness and side effects, and the importance of taking part in ongoing support groups. Let's begin and meet Marty. Marty has had more than her share of cancer. She joins us from Lawson, Missouri. Marty, I know you're 71, had breast cancer back in 1990 and then you were diagnosed with bone cancer in 1996. How do you have normalcy when your friends and family are terrified of that word "cancer" one time in their life? If it comes more than once or here, you've been going through these other treatments, they're just scared, and so you say, well let's go on and be normal. It must be difficult.

MARTY:
It is difficult. About the only way I got through it was with prayer and other peoples' prayers that were helping me. That becomes a big thing in your life, it really does. I'm not what you would call a real religious person, but I certainly have become one in the last couple of three years because of all of this recurrence.

ANDREW:
So there you are, you see people maybe haven't seen in a while and they hear through the grapevine, well, Marty's got cancer again, they must find it very difficult to talk. How do you strive for this normalcy? What do you say to them?

MARTY:
Well, you try to carry it off as normal as you possibly can in the conversation. Most people are very understanding and sympathetic and you don't want 'em to be too sympathetic, because that just doesn't help you at all. It really doesn't.

ANDREW:
You just feel sorry for yourself.

MARTY:
That's right, and you don't want to do that. We could all become, you know feeling sorry for ourselves the rest of our life, but you can just try to get a normalcy in your life with every day things, just doing your everyday duties, like your housework or just anything like that. If you had a hobby, take it up at that time, if it's not too demanding on you. Bring these things back into your life to get this normalcy and to cooperate with yourself in that, I think that's important, I really do.

GINA:
Marty, you talk about not wanting to talk too much about your problems or getting too much sympathy, and yet with all that you've gone through, you must need to talk to somebody.

MARTY:
Oh, well, I do. I think it helps to have one important person in your life that you can go to at any time, and if you don't then you would have to depend on what we're doing now, you'd have to go to an organization to get this help. But if you have one person that you can always go to and say this is my special person that I can talk to with this, it might be your doctor, it could be a nurse where you're going to get your treatment, it could be anyone that you relate with that you can talk to and they understand what you are going through. Sometimes, it's another cancer patient, which a lot of times it is.

GINA:
I would think that would help. It must be hard to find someone else who really understands.

MARTY:
Well, it is in my case because I don't have anyone who's had bone cancer around me. We've had a lot of cancer in our family, but I came up with bone cancer on my recurrence. They had to do surgery on my back, which really curtailed my activities, and for a long time I was in a wheelchair. For about I guess a year and a half and I'm just now getting where I can walk normally out of the wheelchair without help. Sometimes I use it but not very much. You know any progress that you see of course helps you. Then you relate that to another person and that helps them, and its like a chain of dominoes, your helping, like we are doing now, trying to help other people. But this also helps you dramatically, I think, because you're sharing what you've gone through and that helps them to know they are not the only person in the world that this is happening to.

GINA:
Marty, how did you feel, what did you think about when you first heard you had a recurrence of cancer?

MARTY:
Well, I almost went to pieces on everybody. I was just a mess. I was having a terrific amount of pain, and this certainly didn't help any. After they did the surgery, which was a very iffy thing, whether I would ever walk again or not, then I really went to my lowest ebb at that time and couldn't seem to bring myself back and that's when the special person in my life came along, and then I had a lot of help in the family, also. But you need something there someone like that, whether it be your pastor, whoever, your doctor. My doctor was very, very good about this and would sit and talk with you about it and your condition and how you were handling it.

ANDREW:
Tell us the story about this special person.

MARTY:
Well, it happens to be my daughter. She had surgery the exact same kind as I did, ten months after I did. But it just worked out that it was my daughter. I mean it could have been you know, a friend, someone that I had known for years. We have a great group of people in this little town, and they have helped, too. As they've come forward and, you know, said well, they'd do anything they could for us, or for me, and they did. And neighbors are great help, they were really a great help and they want to help, and this makes them feel better if you let them help. Just don't turn any help down any help that you can get, is my motto.

ANDREW:
Let's bring Ann into the discussion. Ann is from Pocono Pines, Pennsylvania. Ann, you are 61, married, and I know you have some children as well who are not at home any more, but I know they worry about you and I'm sure they are a support to you. I'd like to talk about that. My understanding is that you had a modified radical mastectomy in 1990 and then a year later you were diagnosed with skin cancer and you've had some chemotherapy for that.

ANN:
I had the breast cancer in 1990 and I had chemo at that time as part of my treatment. The skin cancer recurred just about two months ago.

ANDREW:
Oh goodness, and have you had treatment now for that?

ANN:
It's superficial so it just requires some scraping and removal of the surface tissue and does not require any further treatment. I have two spots, one on my arm and one on my back. It's totally unrelated to the breast cancer but obviously related to the fact that as we were all exposed to the sun when we were kids, we pay for the price for it later on in life.

ANDREW:
To have another cancer, though, after going through what you did with breast cancer, must have been not what you wanted to hear, for sure. What were your emotions at finding that you had to go through saying or did you feel it was unrelated and not a big deal?

ANN:
Well, I guess the first reaction you have is that sinking feeling in your stomach and it feels like your feet are just going out from under you. Cause the word is there again and you do remember what you went through the first time and I guess you do question whether it was related. But in a case like this, where it's just basal skin you know it really is related to the sun. Many people have that problem without having had any other cancer besides. So the good news is that it was superficial basal skin cancer. The bad news was that it was cancer.

ANDREW:
And having had that diagnosis of any kind of cancer twice, does that change your personal perspective on things?

ANN:
In a sense it does. There's a feeling that when you go through cancer, I know maybe some of the others have had the same feeling. You feel like you've paid your dues and well, now it's not going to happen to me again. It's somebody else's turn. Let's spread it around; let's share this. And then when it happens to you again you get a little bit of that feeling of, something's not right here, this isn't fair. Ok, I mean, you know and so there was that, there was a slight depression in the beginning, but then as Marty was saying, you kind of say, OK, fine, you know, it's happening again, I've been through it before, I survived it, I'm going to go through it again now. I'll do what I have to do. I'll find out the most about the particular cancer, I'll find out how to get the best treatment, what the prognosis is long-term, or what kind of availability there is for services, and I go on from there. I think Marty made a wonderful point when she said trying to put as much normalcy in your life as possible, because the one thing about cancer that really hits you is the fact that you feel your life is spinning out of control. You don't have control of what's happening. Anything you can grab onto that is normal and things that you are used to doing and enjoy doing is to grab on to them, because then it gives you that feeling that you have control back in your life again. That is very important I think to anyone who's been diagnosed with cancer.

GINA:
Ann, what helps to provide some sense of control in your life?

ANN:
Well, in my life in particular, it sounds kind of strange but I was a very avid tennis a player and the thought that I might not be able to go out and play and be with my friends, was not a happy thought, particularly with summertime and I was going through treatment. But, you know, for the two or three days I was taking chemotherapy, and then I was down in the woods because I wasn't feeling well, to be able to then get up and go out and run around and play a game and be treated as if there was nothing wrong with me. Just like I had always been treated. I mean I was just Ann on the tennis court, having a good time. That's the feeling of control and normalcy.

ANDREW:
Ann, Marty talked a few minutes ago about her relationships with others, her daughter and people she knows. What about you then? You've talk about normalcy, how have you worked on normalcy in your relationships with other people? How have you had normalcy in your relationships?

ANN:
Well, as I said, for one thing, that part of my life there were volunteer organizations that I participated in, I was very active in our church. I am a churchgoer on a regular basis; I was on church council, so all of that became support. People were there for me and helpful. Prayer is very definitely, and I hear that a lot, but it is true, it really is a big support. We have a prayer network at our church so your name goes on a list and you know there are a lot of people praying for you. Just try to do as much as you can; go out to dinner with friends, go on vacation, do all the things you can do and say ok this is a little blip in my life but I'm going to work around it, and friends do that for you and family does. I have 3 children who were tremendously supportive, I can't say one any more than the other, but my daughter in particular, I mean, we had a lot of laughs with, it sounds strange, we had a lot of laughs with the breast cancer, with the wig and the prosthesis and all the rest of it and I'd like interject I think humor, if you can get it in there, plays a big part. It keeps you healthy. A smile is a lot easier to handle than a frown.

ANDREW:
Now let's talk about your routine. I think Ann, you were talking about playing tennis and looking forward to that as a regular part of your life, right? Marty, how about you? You mentioned a daily routine, you mentioned hobbies. What keeps you going?

MARTY:
I did a lot of arts and crafts and then I sew, and it's something I can continue on with, even when I was at my sickest. I could still get up and do a little bit of that, or I could prop myself up in bed and do it and it just helped. It filled my day and made me think about other things other than the cancer continually.

ANDREW:
Christine, what work do you do?

CHRISTINE:
I own a restaurant now. So I do a little bit of everything.

ANDREW:
So, for each of you, Marty with your hobbies, Christine with your restaurant, Ann with your tennis, would you say that this makes you feel like you're in control?

VOICES:
Oh absolutely. Yes a little bit, yes.

ANDREW:
Ann, how about you?

ANN:
Oh, yeah, absolutely. Yeah, I mean there are more things besides that but at that particular time when I was going through it that was a big part of my recovery and being in control.

ANDREW:
You've all mentioned about support, from a daughter or a friend. Let's talk about actual support groups. Sort of official support groups or unofficial that you may form and maybe we could start with Ann. Has this played a role for you as you've been down this cancer road and what would you recommend to others?

ANN:
Well, I never officially joined any kind of a support network, organized or informal because I had, as I said before, enough support between family and friends. But there was one woman a tennis buddy of mine particularly, who came to visit me who I 'd never known, that had breast cancer. That was the another thing I found, all the sudden people came out of the woodwork that you never even knew about and would say, yeah, I had the same thing happen to me three years ago or what have you, and they would share their story, and that was really helpful. But this one woman in particular came and she had become active in the Reach to Recovery program for the American Cancer Society and I was able to talk to her. She answered a lot of questions and also I had spoken to someone from Reach to Recovery before I went into the hospital, she called me and then came to visit me and brought me literature and materials and just a real pump-up talk. I have since myself become involved with the American Cancer Society. I was on my local board and am now also a Reach to Recovery volunteer. So I find that's helpful for me to give back and help other women and it also helps me in the process.

GINA:
Marty, what about you? Have you worked with support groups at all?

MARTY:
No not really. I haven't been in any organized group at all as far as cancer organizations I haven't.

ANDREW:
But it sounds like your own network and with your daughter and help like that...

MARTY:
Yes, with the friends and my family and my husband, they all should get credit you know. They all have done their part and I've had some people along the way because I have had a such history of this in the last nine years that they all come to me and want to know how did you handle this. Well, like I told you the best way is just to try to stay as normal as possible. If it recurs, it's going to recur, it's gonna happen to you and that's just all there is to it. But you can still be the same person you were, and I think that's important. You need to not let it engulf your whole life. It's got to be important, of course, and right up front. You would have to know that people were helping you. But you still; you have to do it yourself.

GINA:
Christine, what about you? Did you go to a support group?

CHRISTINE:
Yes, I did. We formed one in our church and also the doctor that I went through chemo with, they always having meetings there and so I would join those and we had the Cancer Relay I wouldn't miss for the world. I try to get in front of those, because it helps.

GINA:
Did you find you kind of needed to redo that periodically, since cancer has recurred for you and there's a concern it could happen again?

CHRISTINE:
It does, it helps me you know. I don't know if it would help someone else, but it sure helps me. You always meet someone. Just like, is it Marty, I'm sorry, that her cancer recurred? You know, just like listening to her talk you know, helps me. You know, I'm very, very fortunate.

ANDREW:
Marty was talking about just going on with her life and I think you said, Marty, a minute ago, well if it's going to recur, it's going to recur. Christine and Ann, do you live in fear of that?

CHRISTINE:
I do. I'm Christine. I do, I do live in fear of it. And I try, I really try not to because, you know like you said, if it comes back, it comes back, and you just fight it again. That's all you can do.

MARTY:
That's the best you can do, that's right.

ANDREW:
Ann, how about you?

ANN:
I was going to say I agreeing with Marty and Christine, I can't say I live in fear of it. It's totally something that's always in the back of your head, it's not always, especially when you hear about it happening to someone else, it kind of brings it all up again. But I think if you dwell on it you really limit your lifestyle and what enjoyment you get out of life, so it's kind of there. Just like a cold, I mean, you can get cold again, get a cold once and it can come back again. But you don't wait and think about it.

GINA:
I have a question as a mother for Marty and for Christine. Cancer seldom exists in a vacuum, everybody, knows somebody else who's had cancer and you've had children or grandchildren who've had cancer. How has that affected how you deal with it? Is it different in what you see them doing and how you feel about them and how you feel about your own cancer?

CHRISTINE:
This is Christine, I tell you what with my grandson getting the cancer now just a few months after mine. When I saw how that little fella, not quite nine years old, fought to come back, it kind of puts your perspective to where it makes you a little bit stronger you know, and even today, he's 12 now, and to watch him, he doesn't feel sorry for himself, he can't walk, he tries to walk, but when I watch him, I just kick myself once in awhile. The things I can sit back and worry like I do, when he's managed to carry on and whip this thing. He's my rock, that boy is.

GINA:
Marty, how about you?

MARTY:
Well, I think it makes you stronger like she said. You just, you have to stand up for what you know, you want to help them, is what the whole thing amounts to and in doing this you're helping yourself. You may not realize it but you really are, you're helping yourself, too. Because it's so important that you hold up and stand up for what you think you should be doing for this other person, for this little boy. You should be trying to do what you think is right and what will help him. And I think that's so important and in the long run, it helps you.

GINA:
And you had a daughter with breast cancer as well, is that right.

MARTY:
Yes, that's right. Now I have a niece. So it's just running rampage through our family. They say it isn't hereditary, but you know you begin to wonder after four or five in the same family, and all the same type of cancer. Now I'm the only one who's had bone cancer and I'm still under treatment and I guess I always will be, the way they talk.

ANDREW:
Ladies, you've been through trying times and as you've told me, each have husbands. How does this affect your relationship, this recurrence of a cancer with your husbands? I hope they were by your side as you went through the initial treatment for breast cancer, but now cancer yet again. Talk a little about your relationship with your spouse. You've talked about support, you've talked about other members of the family but I haven't heard husbands come up yet. So, what would you say about that? Just anyone, please chime in.

MARTY:
This is Marty again and I would say that it made our relationship stronger. Maybe not physically, because you have to give up some of your physical ability when you're dealing with cancer, but emotionally and support from him, it has been so much greater than what I ever envisioned, it really has.

ANDREW:
And how to you ask for support when you need it, or is it just volunteered?

MARTY:
I cry a lot and then he comes to console me and then, you know. He's just there, always.

ANDREW:
Ann how about you?

ANN:
I would probably pretty much have to ditto what Marty was just saying. First of all, my experience has been with couples, it either makes it stronger or breaks it, and in our case I think it definitely made the relationship stronger. I think a lot of what Marty said, I mean, I didn't always have to ask it, it was just right there. He could see it and he knew when I needed help.

ANDREW:
Christine, how about for you, with your husband, how has it worked out?

CHRISTINE:
He's great. I've got such a good husband; I made him marry me again, too. When we were making our vows again, he said, I meant it the first time. I said, this time, the "obey" goes out! He was just great. When I had, I don't know how to say it, the drain, the tube thing, the draining from the breast, he would get up at three in the morning to check the bag to make sure it wasn't running over. It's just made us much closer. But I've got an excellent husband; he's the greatest.

ANDREW:
Ladies, you are all 60 or above now. If this second bout of cancer had happened when you were younger, do you think you'd have a different view of it?

MARTY:
Absolutely. My daughter did. She had a different attitude altogether and she's almost 25 years younger than I am and it made a big difference. She still had children at home and it makes a difference when you have young people who depend on you. I didn't have.

ANDREW:
Ann, any difference for you?

ANN:
I think, I think you know, a little bit of what Marty was just saying is that you know that there are no little ones anyway at this point that are dependent on you, so you really can focus in on yourself if you will, and not feel selfish about it. You can do what you have to do.

ANDREW:
Christine?

CHRISTINE:
Same thing. And by the way, my younger daughter, she did have a lump in her breast here about four months ago and needless to say, I was scared to death and she was, too. You could see the worry. There is a small lump there however right now they're just watching it and hopefully, it won't be what I had.

ANDREW:
All of you talked about how you're trying to have normalcy in your lives, go on with your life, try for normalcy, not dwell on whether there could be yet more cancer or more serious concerns and just Ann like you said, skin cancer is no big deal, somebody gets older and if you've been outdoors a lot, so maybe just go on and it was totally unrelated and the breast cancer and all the effects of that hopefully are well behind you. But is there an anger anywhere in the back of your mind that you've had to deal with this not once, but twice?

ANN:
Initially, yes, I would say Andrew. As I said before, kind of like there's some kind of a score card and you know once you get it on your score card, then it should go on somebody else's. So I think a little bit, but at the same time you say to yourself, well you know, I've been through it and I think I can handle it again, I found that I was a stronger person than I thought I was. So you get past the anger. Anger is not productive, it doesn't do anything. If anything, it makes a situation worse.

ANDREW:
Marty and Christine, would you agree about sort of the negativity if you will of anger?

MARTY:
Yes, I had it at first but I don't have it now.

ANDREW:
Christine?

CHRISTINE:
I don't know as I've felt anger as much as just being scared. I'll tell you, I think losing my hair hurt worse than having the cancer. Oh, I cried!

ANDREW:
Well, if you saw me I have a bald head. I went through that a long time ago, and it didn't take cancer.

CHRISTINE:
It didn't make your hair come back, huh?

VOICE:
Mine came back pretty. That's what they say. I never lost my hair so I was fortunate in that department. I did but I was fortunate enough to find a nice wig.

GINA:
This has been so helpful. I have one final question before we wrap up. What's the most important message you would have for other women like you, what would you want to share? What would be most helpful? Ann, let's start with you.

ANN:
Well, first of all, learn a lot, about whatever the diagnosis is and find out what the best treatment is and talk to other people who have been through it. And again, just take control of from that part of it and make sure that you don't have negative people around you. I think that's very important. You need to have people around you who are positive and upbeat and can give you hope. Because negatives as far as I'm concerned defeat your success and recovery.

GINA:
Marty, what about you?

MARTY:
What you said is very very true, especially about negative people. You don't need that in your life, especially at a time like this. I think the thing you need to lean on the most is the help you're getting and the other people who are trying to help you. Then a lot of prayer, just a lot of prayer, because it does help.

GINA:
And Christine, what can you share with other women who are going through the same thing?

CHRISTINE:
Well, I'll go along with the other two ladies and get in there and fight, because there's just not much that can't be beaten these days with the treatments and all that they have out there. Find out about it and if you can find someone who's been through it, talk with them. Just talk with 'em and fight, because it's worth it.

ANDREW:
And Christine, as you look to the future, whether it's tomorrow or next month or next year, are you hopeful and positive?

CHRISTINE:
I'm sure trying to be, yes. As the days go by, like I said, it'll be five years before long. I'm getting more of a positive attitude. I'm a health nut, too. I take a lot of vitamins. Whether they help or not I don't know.

ANDREW:
Well, I want to thank you for your discussion and really sharing your thoughts and an upbeat attitude as well. We will have to end this very rewarding discussion now, but really, thank you so much for sharing your insights and your experiences within your family as well. And Gina, thank you for being with us.

GINA:
It's been a privilege. Thanks.

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