ANDREW:
Hello, and welcome to the American Cancer Society's Cancer Survivors' Network, a 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, thank you for being with us.

GINA:
A pleasure, Andrew.

ANDREW:
Our topic, breast cancer in women in their early thirties to early forties. On the phone with us are two breast cancer survivors from across the country. They are in that age group, and are currently in treatment for their breast cancer. Over the next few minutes, we'll discuss issues such as: being in the prime of life and having breast cancer; the importance of doing your own research and keeping up with the latest information; fears associated with the ending of your treatment; and the role of a healthy lifestyle. Let's begin our discussion. Joining us today is Marijayne from Arlington, Tennessee. Marijayne, thank you for being with us.

MARIJAYNE:
It's my pleasure.

ANDREW:
Marijayne, I know you're 35, you're a teacher of seventh graders down there in Tennessee, and you began your year of 1999 with a diagnosis of breast cancer. I understand that, since then, you've had a mastectomy and chemo. And I believe you're going through radiation currently, is that right?

MARIJAYNE:
That is correct.

ANDREW:
Tell us about the diagnosis. Obviously it always comes as a shock. How did it happen for you?

MARIJAYNE:
Well I think, in the back of my mind, I knew that what was going on with my right breast was not good. My mom passed away in November of '98, and in December, around Christmas, it began to grow and change. So I went to the doctor and told him I thought I had a cyst. But I really do believe that I knew it was breast cancer.

ANDREW:
How long had you been feeling that lump?

MARIJAYNE:
Not very long, probably since about September, but it never did anything. There was no pain associated with it. I read a book from the Mayo Clinic, and there was no pain, no discharge or anything, and I thought, "Oh well, it's probably a cyst." Because I've had them before.

ANDREW:
Had you had a mammogram anywhere along the way?

MARIJAYNE:
Oh, no, never. There's no breast cancer in my family, so a mammogram never entered my mind until my breast began to change.

ANDREW:
So you went back to your doctor. What happened then?

MARIJAYNE:
Well, they checked to see if it possibly was a cyst. They didn't draw any fluid off, and then we went to the mammogram and the sonogram. They found, I mean, it was just white.

ANDREW:
Plain as day.

MARIJAYNE:
Oh yes. They actually had to do a biopsy. They thought it possibly could be inflammatory mastitis, or some other things, but they had to rule everything out. So they did a biopsy and, in fact, it was inflammatory carcinoma.

ANDREW:
Now, was this Christmas time or was it already into January?

MARIJAYNE:
We were already into January and, as a matter of fact, it was January 23, the day after my 35th birthday.

ANDREW:
And, of course, all the while where you were thinking, "Breast cancer does not affect women so young."

MARIJAYNE:
Right. Oh, most definitely.

ANDREW:
So, there you are in a school where there are a lot of women. Did you mention this at all to the other teachers or your colleagues? Did you tell them about what you were going through?

MARIJAYNE:
Not until I actually found out what it was. I had not talked about any of it with them. Because I've had a lot of cysts in my life, and I really just thought it was another cyst. I think the stress of my mom's passing helped to set it all in motion. Because the month of December and January, it grew rapidly. Before, there had been no growth at all except, you know, I just felt this little knot.

ANDREW:
Tell us your reaction. How were you told? I know you're married, but with no children. How did you cope with the shock of this diagnosis?

MARIJAYNE:
Well, my doctor walked in and said - he told me before the biopsy actually - he said, "I really believe that this is inflammatory carcinoma, and these are the steps that we are going to take. You need to go ahead and discuss this with your husband so if the diagnosis comes back like I think it will, we can go ahead and get started. Because this is not something we can play around with." And I said, "Okay."

ANDREW:
Were you able, you know it's often said when somebody hears the word cancer...

MARIJAYNE:
I was ready for it, though. Actually, in the back of my mind I knew it was cancer. Just because, in a month, it had doubled in size.

ANDREW:
So were you able to think clearly about the treatment options that he was discussing for your mastectomy? And then likely chemo and radiation?

MARIJAYNE:
Oh sure. Whatever he needed to do. He's the doctor. I trust him totally. He was new to me. I'm new to this area.

GINA:
And you didn't get a second opinion on that?

MARIJAYNE:
No, I did not. Because according to the information I read, inflammatory carcinoma is not something that you can wait around with.

ANDREW:
Did you have this feeling, as many women do, that there's this cancer in your body and you just want it cut out?

MARIJAYNE:
That's right, get it out. Whatever you have to do, get rid of it.

ANDREW:
So you had the mastectomy...

MARIJAYNE:
Well, actually I had to have surgery before that. When the biopsy came back positive they sent me to the oncologist. He said, "We know you have breast cancer. We need to check and make sure you do not have cancer elsewhere." They did a bone scan, a CAT scan, a chest x-ray. Everything was negative except the CAT scan. It showed a tumor on my ovary, which they had to go ahead an remove. Even though they didn't think it was connected, they had to make sure that it wasn't.

ANDREW:
So this was a hysterectomy?

MARIJAYNE:
Yes, in February. And then I started chemotherapy.

ANDREW:
Chemotherapy, and then the mastectomy.

MARIJAYNE:
In May.

ANDREW:
The idea of the chemotherapy was to shrink the tumor?

MARIJAYNE:
Yes. And then I took chemotherapy after my mastectomy.

ANDREW:
And now you're continuing with radiation.

MARIJAYNE:
Yes. I just had my sixth radiation treatment today, and I'll have 33.

ANDREW:
Marijayne, you had to get educated in this whole cancer world.

MARIJAYNE:
I did!

ANDREW:
How are you doing? How's your head doing, and how are you doing physically?

MARIJAYNE:
Physically, I'm doing well. My thyroid has stopped, so they put me on Synthroid. They don't think it has any connection. So far everything, my chest x-ray and all, has been clear. As well as my lymph nodes in the upper area...because 13 of 18 of mine were positive.

GINA:
You sound good.

MARIJAYNE:
Oh, yes! I'm feeling good. I work every day. I take my radiation every afternoon. And then I come home and fool around in the yard, and it is just piddly.

ANDREW:
How's your head? You sound upbeat.

MARIJAYNE:
Well, I talk to people. Elizabeth and I chat every now and then. We just call and make sure each other's doing well.

ANDREW:
This is a friend of yours who's a breast cancer survivor?

MARIJAYNE:
Yes. I e-mail lots of my friends. I talk to them about it. They are all interested. The school where I was in Georgia, they send me e-mails all the time. They've been out to visit, my students have been to visit. And there are the prayers, and my church, and of course my husband. You can't say enough about my husband.

ANDREW:
He's a champ through all this?

MARIJAYNE:
Oh, yes.

ANDREW:
It must be very hard though, Marijayne. You've lost your mom, who I get the impression you were very close with. Now you're going through this and she's not there.

MARIJAYNE:
Yes.

ANDREW:
I can understand that.

GINA:
And on top of that, you've evidently had a move. When did you move to Tennessee?

MARIJAYNE:
About two years ago. I married in '97, and I've been here since then. Actually, things were going well. My mom was ending her chemotherapy the month after I got married, and everything was looking good with her. And then it recurred.

ANDREW:
Did she have breast cancer?

MARIJAYNE:
No, she didn't.

ANDREW:
I see. What cancer was that?

MARIJAYNE:
Colorectal. But you know, my dad has been a good support for me. He comes out a lot to visit. Fortunately he's been able to do that with his job.

ANDREW:
He comes from Georgia?

MARIJAYNE:
Yes. And my sister and my brother and his wife. So it's nice. My parents-in-law, you know, everybody's just been really good about it.

ANDREW:
We want to bring into our discussion Kristi, who is 41, and is in Kennewick, Washington, not too far from us here in Seattle. Kristi, I know you were treated for breast cancer initially in 1991. And then you were treated again in 1998 with a recurrence of breast cancer. In between times, not long after the first cancer diagnosis, you were diagnosed with another kind of cancer. Melanoma, skin cancer. So, there you are. You've had a mastectomy, you're taking tamoxifen. You've been having chemo and radiation. We were just talking with Marijayne, who's been missing her mom who's gone now. You've been going through this as a single person. It must be really difficult.

KRISTI:
It has. But there have been so many more positive things that have come out of it. I've had so much support from coworkers, and my family and friends, like Mary Jane said. You can't go through this without a support system, including cancer support groups, along with the church and the prayers of everybody. So, I haven't been alone.

ANDREW:
One would expect, though...there you are Kristi, with three bouts of cancer, and this plague, almost, that you've had over these years of the nineties...one would expect that you would have a lot of anger, or feel like a victim. Do you? I 'd also like to hear from Marijayne about that. But you first, Kristi.

KRISTI:
No. I don't know if I've ever been angry. Well, I'm sure I have, but I don't feel a victim. I know that the statistics say one in three people will get it in their lifetime. I didn't expect to get it at 33.

ANDREW:
One in three people would get cancer, you mean?

KRISTI:
Yes, that's what I've heard or read. By the time they're 90 years old, one in three people could have cancer. So I knew that there was a possibility, but I never thought it would happen in my thirties. You think, of course, that it only happens to women or men over seventy. But each time, you deal with it. I thought I would never have to go through it again, and you get it again, and you deal with it. So. It's called the Survivor Syndrome.

ANDREW:
Kristi, one would think that when you're hit with cancer three times, that's just almost too much to bear.

KRISTI:
I believe in early diagnosis, so I believe there's always been hope for survival. I've never been told, "You have six months to live. You have two years to live." There's always been a treatment available, and I just go for it and believe I'll get through this. If it happens again, there'll be a treatment available and I'll go through it. I've never lost hope of surviving. I just take one step at a time and live with it.

ANDREW:
What treatment are you currently having?

KRISTI:
Right now, I'm on tamoxifen. In a couple of weeks, I have an appointment with my doctor and he will discuss new treatment options. I've been on tamoxifen for five years, which is the recommended treatment. You shouldn't need to take it beyond that. So he's looking at two other drugs to put me on, and he'll maybe take me off tamoxifen.

GINA:
It sounds like you do a lot of your own research, too. You aren't just relying on the doctors.

KRISTI:
Right, I try. The first time through in '91, I did not have a computer. I did not have access to the Internet like I do now. But I checked out every book in the library on breast cancer. I read what I could and then brought my questions to the doctor. If he told me something, I'd go look it up in the book, or I'd bring in a question. So, when he described the treatment, I was as familiar as I could be with it in order to make the right decision.

GINA:
One of the things that we find out as we do some of the research, though, is that there is no clear-cut answer for any particular woman. There are options and benefits and problems with each kind of treatment. Do you find that?

KRISTI:
Right. In breast cancer, you have the choice. I did have the choice of a lumpectomy or a mastectomy in 1991. I chose the mastectomy just because, like Marijayne said, I wanted to get it out. After a lumpectomy you automatically have six weeks of radiation, daily radiation treatments, and I didn't care to go through that. I ended up doing it a year ago, which was fine. But at the time, I chose the mastectomy. But I did have the option of a lumpectomy.

ANDREW:
And, as you move forward, there's no sure thing. So, as you make these choices, do you ever worry about thinking in hindsight, "God, I should have done this, or I should have done that. My life was on the line." How can you make these decisions with some confidence?

KRISTI:
That is tough. I've thought, "Should I have had chemotherapy the first time I had it?" I just don't look back. There are so many new options coming up. I hear about monoclonal antibodies. I think they're going to find a cure soon, and if it ever came back, there would be a treatment much easier to go through than chemotherapy. I just know that down the road there will be better and easier treatments. So I just go forward that way.

ANDREW:
Marijayne, I have a question for you. We were just talking to Kristi about whether she felt like a victim. How about you? You went through this terrible time with the death of your mother to cancer. Then you get this diagnosis. Did you have anger about all this? What were you feeling initially? And how about now?

MARIJAYNE:
Well, I was kind of like Kristi. I never felt like a victim. We, my husband and I, talked about it. Not being able to have children, that bothered me and still does. But obviously the Lord has something else in mind for me, whether it's adopting, or just all the kids that I've taught through the years.

ANDREW:
You have a lot of kids.

MARIJAYNE:
That's right. So, we've kind of set that on the back burner for right now, about adopting. But that is something that we're looking at.

GINA:
And Marijayne, that's not a light issue to just say, "Oh well." For a women your age, that's a lot to deal with, your fertility.

MARIJAYNE:
Right. You know, I kind of felt worse for my husband there for a time, thinking, "Well, he'll never have a child of his own." But he has assured me that that is not a problem.

GINA:
And he has you.

MARIJAYNE:
That's right. "I have you and that's all I want."

ANDREW:
Is breast reconstruction something you've thought about?

MARIJAYNE:
Maybe, in a few years. Right now, I'm not really gung-ho in that area. I guess I'm scared that, if it did recur, maybe they would have a problem finding it. So that's not something that either one of us wants. We've talked about it and it doesn't bother my husband, and it certainly doesn't bother me.

ANDREW:
You've had two parts of your body taken from you with the hysterectomy and the mastectomy. I imagine, with the hysterectomy, it throws you into early menopause. How are you coping with all these issues? And, as you think about it long-term, you're in your early thirties, what do you think of your ability to cope with all this for, hopefully, many many years?

MARIJAYNE:
Well, I don't think that the Lord gives you anything more than you can handle. Whatever the reason, there is a reason for this. Maybe I just needed to, I don't know, walk in my mom's shoes. I definitely see life in a different way now.

ANDREW:
How do you see it?

MARIJAYNE:
Well, every day is a gift. Every day I have, I cherish. I thank the Lord every day when I wake up.

ANDREW:
Kristi, is it that way for you, too?

KRISTI:
Yes, definitely. When opportunities come up, I jump at them. Two years ago, a friend of mine invited me to her vacation home in Mexico. I'd never been to Mexico. "Okay." I didn't have to think twice. And maybe ten years ago I'd have said, "Oh, should I go?" Take the chance when you have it. You never know.

MARIJAYNE:
You're right.

GINA:
It sounds, Kristi, like it's changed your lifestyle another way. That you're eating more healthy.

KRISTI:
Yes, I have tried. I watch what I'm eating. I'm not always good about it, but I eat more fruits and vegetables. I could do better on the exercise side of it, but I do watch what I eat. I don't eat fast food like I used to. I treat myself once in a while, but I don't drink a lot of soda pop or caffeine or fatty foods. I try to watch what I eat.

GINA:
Marijayne, what about you?

MARIJAYNE:
Well, right now, I just finished my Taxol. I guess I'm making excuses, but the energy level just hasn't quite been there. I'm like Kristi. The exercising needs to be much more than it is, but I just can't seem to make my legs go sometimes.

GINA:
And I wouldn't think you'd want to add guilt to everything else you're dealing with.

ANDREW:
Right, give yourself a chance to recover. You said, Marijayne, that it was certainly a very tough end of the year with your mother's death, and everything you were going through. And then you were saying earlier that this cancer grew within you almost as part of the stress.

MARIJAYNE:
I most definitely think that.

ANDREW:
So, you are getting past a lot of your treatment now, and hopefully going on to a very long future. What are you doing to think positive, to make sure those cancer cells don't reappear?

MARIJAYNE:
Well, I try to take it one day at a time, and worry only about the things that I can change. The things that I cannot change, I can't let bother me.

ANDREW:
So, are you a more patient seventh grade teacher now?

MARIJAYNE:
Oh, yes. I've always been patient with my students. I've found some outlets and some ways of coping with my stress, I hope. I talk much more now than I used to. I'm a much more open person.

ANDREW:
You've come out of your shell a little bit with your feelings? You really talk about what you're feeling?

MARIJAYNE:
Right. I talk about my feelings much more. Much, much more. As a matter of fact, I got home from the doctor's office last night at seven o'clock. We had a nice long chat.

ANDREW:
Marijayne, there is one other thing I wanted to ask you. I understand, from your discussion with our producers, that you have some lingering fear about when treatment ends. What is the basis of that fear? Maybe you could tell us more about that.

MARIJAYNE:
Well, so far, I've gone three months protocol of chemotherapy. And with the radiation, everything so far is clear. As far as they know, and can see from running tests, everything is clear. It's when I don't have any radiation or any chemotherapy in my body, that I worry about it coming back. And I guess for awhile, every little twinge I have, I'll be running to the doctor. I'll feel like a hypochondriac, saying, "Is this something to be worried about?" You can't really tell sometimes, until it gets to the point like when mine began to grow. It didn't hurt, there wasn't anything that the book said was a sign, "This is what you would see with this type of cancer." I don't know. I didn't see any of those signs, so I assumed it wasn't cancer. And that was a bad assumption, until, of course, it started to grow. So, it makes me wonder if I'll catch it, like Kristi does, early. That's the scary part for me.

GINA:
Kristi, I'm wondering about your perspective on this, having gone through breast cancer first and then finding two more times that you had cancer. Was it difficult? How did you know it was cancer? Did this worry you? Does it worry you about the future?

KRISTI:
I've learned not to worry about the future. I know things happen for a reason. Like Marijayne said, when I had breast cancer, that made me go to the doctor more than I had been. Of course I've never had many diseases, so I haven't had to go the doctors until I was diagnosed with cancer. And because of that, I think that's why I found the melanoma. I'm more aware of looking for things on my body, and changes. In one way it may have been a blessing, because I was in the doctor's office for a checkup and I said, "Oh, could you look at this mole?" He said, "Oh, sure, I think we need to cut that out."

GINA:
I'm wondering about your support system, Kristi. Marijayne talked a little bit about family, e-mail, coworkers. Tell us more about your support system.

KRISTI:
The first time I was diagnosed I had a coworker, who has since passed away. She had had breast cancer. I didn't know that until I was diagnosed, because she was new to our company. She was a tremendous support. She explained what the surgery was like. The doctors couldn't tell you how to go find a prosthesis, you know, or how long your arm would be sore. You need someone who has been there to comfort you, and to explain all the feelings or different things you will be going through. I've had tremendous support from coworkers. I ask them to ask me any questions they have. They can come to my office and say, "Oh, so and so has cancer." I'm more open, like Marijayne is. I would never have discussed this ten years ago, but people at work know that I've gone through cancer. So I'm just more willing to discuss it with anyone who has questions.

GINA:
You talked about some of the practical issues coming up, and it sounds like you kept a sense of humor, too. Tell us about going bra shopping.

KRISTI:
Oh, yes. Well, I was shopping with my two older sisters. They have not had breast cancer, thank goodness. We were in a store and they were having a sale, bras half off, and I said, "That's the one for me!" And then, I was shopping in a catalog. They had double-breasted suits, and I said, "That's exactly what I need!" You have to keep your sense of humor. That's how I get through life.

GINA:
I'd like to talk to both of you since the women who are listening are probably in much the same position, maybe fairly recently going through all of this. What about shopping for lingerie, and what about all the practical aspects of it? Marijayne, are there things that you were surprised to find out after this came up?

MARIJAYNE:
I don't know. I'm still not.

GINA:
Are you comfortable shopping for lingerie?

MARIJAYNE:
Not really. But only because I don't feel like I need anything to make me look beautiful now that I've kind of been disassembled, in a manner of speaking, but...

GINA:
But you feel good about yourself anyway.

MARIJAYNE:
Oh, yes. I do. I do. I'm just not to the point of thinking about lingerie. I get the basics that I need. I look at it more that way. But the people that helped me with my prosthesis were just so helpful. They all were breast cancer survivors and began the store because of that. There was nowhere in Memphis to shop. And they began their own store to help other cancer survivors.

ANDREW:
Kristi mentioned that she talks openly about it at work. Marijayne, do you talk openly about it? I think you said that since your diagnosis you've talked about it with other teachers at school. How much do you share about this in the hope that other women will have early detection, should breast cancer be a factor in their life?

MARIJAYNE:
Very much so. I didn't talk to my students about it so much.

GINA:
Seventh graders, that's a challenge.

MARIJAYNE:
Well, they're at that stage where they really want to know a lot, and some of them know about it because they've had family members with cancer. But they don't want to know a whole lot; just, "How are you doing, what are you doing, what type of cancer was it? Well, hope you get to feeling better." You know, they do care about you. And my eighth graders come back now and see how I'm doing, "What's going on, where are you now?" They're interested, and they're still in that caring stage. They don't want anybody to know it, but they are.

ANDREW:
There may be some women who will be listening to us who think maybe it's better to keep it bottled up inside. Both of you talk about it. What would you say to those women who just say, "This is very private. I have my own fears about it. I'm going to be a trooper, and I'm going through this treatment, and maybe have a mastectomy." And as you said, Marijayne, "My body is being disassembled a bit." But they don't feel comfortable talking about it. It sounds like both of you have found benefits in talking about it.

KRISTI:
Right. I found the first time I went to a support group, I couldn't talk about it. I could talk about it with other coworkers, but when it came to talking about it with other cancer patients I just broke down. It kind of hits you right then. But I continued with the meetings. It becomes easier to talk about it, and it just makes it easier to go through. I know that there are people that find it hard to discuss, and they're private people, and I respect that. But it just is easier if you can find someone, at least one person, to discuss it with. Another survivor would be the best.

ANDREW:
So, when you broke down with other patients, it sounds like that was a healthy thing.

KRISTI:
It was, it was. I needed that, because...I'm breaking down right now. I thought I was doing fine. It was about two months after my surgery. I'd gone back to work, and I was feeling good, and I was exercising, but I didn't know that it was still hitting me inside until I went to that support group. And you just need to let it out.

ANDREW:
Marijayne, I know you have a friend in South Carolina, Elizabeth, who's been dealing with breast cancer. I think you said you correspond frequently with her. Does that kind of bond with somebody else going through the same thing really help you? It's different from the communication with your husband, or friends who are not going through the disease.

MARIJAYNE:
Oh, most definitely. She feels the same type things that I feel, whether it be, "Have you felt this?" "Oh yeah." So you can talk about what you've been going through, because that person has been there as well. And I think you really need to talk about it. You need to face that this is part of your life now, and ignoring it is not going to make it go away, or make it any better. But, otherwise, it would just eat me alive. There's no doubt.

GINA:
I have a question about that. You go through the grief, and the acceptance, and you find some help. But Marijayne, you've been dealing with this only for this year. It's been a rough year. Kristi, it's been longer. Do you find that every once in a while, some of these feelings come back, that you need to deal with some of these same issues again?

KRISTI:
They do. I experienced the same feelings from about a year ago, right now. But it is easier to deal with because I've been there three times. It does get easier. That's all I can say.

GINA:
Marijayne was talking about how she felt about her body. How do you feel about yours? Are you comfortable with yourself?

KRISTI:
Yes, I am. I chose not to have reconstructive surgery also. About the same time I had my mastectomy, they had the silicone breast implant scare. I'm one that has to research everything, and I thought, "I'll get through the mastectomy, and then I'll research reconstructive surgery." Well, that was the same time as the implant scare. So I thought, "Oh, forget that." And then, since it recurred on the same side, if I'd had reconstruction I may not have found it. Marijayne may fear that also. It was a lump about four inches above the original scar, and I don't know if I would have found it if I'd had reconstruction.

ANDREW:
Well, Kristi, one of the things people keep looking for when they have cancer, is "What did I do, or what was I exposed to that could have led to this?" You live in Kennewick, Washington, which is an area of nuclear cleanup. It's an area where many years ago they originally developed the atom bomb. I also know that you work for the Department of Energy. So, you have to have asked yourself, as any of us would if we were in an area where anything unusual is going on, "Did this have some role in my cancer?" And I'm sure your family members have wondered too. What do you think?

KRISTI:
I thought that but then, four months after my diagnosis, my mother was diagnosed with breast cancer. I didn't grow up in this area. I grew up in Montana, and my mother lives in Montana. She's doing fine, she hasn't had a recurrence. After she was diagnosed, I decided it must be somewhere in our genetics. I can't blame the area where I'm from. I don't believe there's any higher incidence of cancer here than anywhere else in the United States. Yes, there's nuclear waste in this area, but I don't think cancer is any more prevalent here than anywhere else. So, I look back to childhood. I mean, was I exposed to DDT or anything like that? I look forward too, because I had two grandmothers who died in their nineties. So I look forward to living to 95.

ANDREW:
Kristi, you mentioned that you have sisters. And you mentioned that you have this first degree relative, your mother, also with breast cancer. We know that in some small percentage of women there is, in fact, a breast cancer gene. Has that been investigated in your family? Have you had that test for breast cancer?

KRISTI:
Yes, I had it when it recurred last year. The HER2/neu gene was just on the market.

ANDREW:
No, not that one. There's a test for, I think what they call BRCA1 or BRCA2. Not everyone has it, but it's a test to see whether there actually is a breast cancer gene that you've been born with. I don't know if you've investigated that?

KRISTI:
No, I haven't.

ANDREW:
The reason I ask is, if it's in the family, has that been a discussion with your sisters or other women in the family? That maybe some special efforts should be made at early detection?

KRISTI:
Yes, we have talked about it. And also whether or not they should take the drug tamoxifen, because it is available now for family members with a history of breast cancer. But I keep looking down the road and thinking, "There will be a cure. There will be something better." So, I will be the last in the family to go through this.

ANDREW:
Is there anything special your family members are doing at this time?

KRISTI:
Yes, when I was first diagnosed, all of us sisters were in our thirties. So I said, "Okay, I'll come visit you as soon as you've had your mammograms." They immediately had them. One had a regular mammogram, and the other one had her first mammogram. They have annual mammograms and they have regular checkups with their doctors, because they do know there's a strong history.

ANDREW:
Marijayne, how about in your family?

MARIHAYNE:
Well, my sister had gone to her doctor and, since mine is a bit of a rare cancer, they were going to go ahead and do a mammogram to get a baseline. She's 29. And he said, "Well, we could go ahead and do a mammogram so we'll have a baseline." And then she found out she was pregnant, so the mammogram was canceled for the time being. But she will have one, probably by next March or April.

ANDREW:
Well, let's try to draw this discussion together, and maybe sum up some points that you want to leave with other women who might not feel as comfortable talking about it. What are some of the points you want to emphasize?

KRISTI:
I think that cancer is not a death sentence. We've seen too many TV movies where the person dies at the end. And that isn't true. I look at Betty Ford. I look at Nancy Reagan. They've lived over 20 years with breast cancer. There's always hope for survival, so never give up. I heard five years ago about monoclonal antibodies, and now they're using them. Just live with the hope that they will find a cure, and enjoy life.

ANDREW:
Marijayne, your final thoughts?

MARIJAYNE:
I would pretty much reiterate what Kristi said. No one is guaranteed a tomorrow. And you have two options: you can live your life and enjoy life, or allow the cancer to overcome you. I believe that is where the fight is. It's really not with the medications, or with anything going on out there. It's that fight within yourself. "Do I want to be here tomorrow?" And if you do, then you will live many, many, more years than what you ever, ever thought possible. That's the way I feel.

ANDREW:
Well, I say amen to both of you. We greatly appreciate...and I know the American Cancer Society does, and certainly our listeners...you sharing your thoughts and your personal stories with us. We wish you, and of course our listeners, all the best. On those comments, though, we will have to end our very rewarding discussion. Kristi in Kennewick, Washington, thank you for being with us. And Marijayne in Arlington, Tennessee, we appreciate you and wish you the best. Thanks also to my co-host, Gina Tuttle.

GINA:
It's been fun and a pleasure to be here.

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