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

GINA:
Thank you, Andrew.

ANDREW:
The topic we'll be discussing is breast cancer, for women between the ages of 40 and 55. On the phone with us are two breast cancer survivors, one 43 and one 48, in the midst of their treatment. We'll also be joined by a third breast cancer survivor who has completed her treatment and is now considering what the next steps are. Over the next few minutes we'll discuss some very important issues, such as: Facing mortality when you're in your forties. Finding others to talk to when you have complex or perhaps even metastasized cancer. Talking to doctors and figuring out what can be done, and what to believe. Menopause that begins earlier in life than you expected. And many other issues.

Let's start. Joining us today is Diane from Ashland, Massachusetts. Diane is 48, has breast cancer that metastasized to both her lungs, and she is currently in treatment. She had a lumpectomy, and then had chemo and radiation. Diane is married with four children. Diane has lots of questions about getting support, and some confusion about to what to do regarding treatment. Diane, have you found it hard to make decisions about what treatment to have?

DIANE:
In the very beginning I did not make too many decisions. I just went along with whatever the doctors told me to do and I didn't question anything. Now, as I've gone further into it, I wish I had looked into it a little bit more.

Trying to find information... I'm not an expert going online, and I wish I could know more about that. I think it would make it easier, because unfortunately... I don't know if it's just my generation, but a lot of us close to 50 and over were not brought up on computers. And I do understand there are so many ways out there to learn so much.

ANDREW:
You have grown kids. One, I think, is married, and the others are in college. Is that right?

DIANE:
One just graduated from college, so there's only going to be two in college now.

ANDREW:
I see, four kids altogether. They're in this sort of computer age. And also you have a husband. Have they been playing a role in helping you make decisions on how you go about having the best possible care, as you have this battle going on with breast cancer?

DIANE:
Well, that was one of my mistakes right there. I did not want to have the family worry about me so it was like, "I'm okay, don't worry about me. I'm perfectly fine." So it has not been a major thing in the house. It has been a major thing. Don't get me wrong there. But they knew I didn't want to discuss it because I had a very hard time accepting it. But I am now to the point where they have taught me to go online. I'm on an Internet list-serve for breast cancer so I'm just now getting into that. I regret that I wasted all this time not getting into it right away.

GINA:
What about your family? Are you talking with them now?

DIANE:
Yes, I am. It's taken me a long time, because when I was first told I was just devastated and wouldn't really even accept it. I went through my chemo, my radiation, and continued working. I just refused to accept the fact that I had breast cancer. I finally really accepted it when I found out a couple months ago that it had metastatized. I had thought, "I've got one shot. I'll do what they tell me, and that's it. That will be the end of it." But, when it came right back so quick it really set in as a reality and really changed my attitude completely.

ANDREW:
It was like the other shoe dropping in a very big way.

DIANE:
A very big way and very quick. I wasn't expecting anything like this to happen. I guess that's what really woke me up. I realized that, you know, this is real.

ANDREW:
Diane, what's your attitude about all this now on a day-by-day basis? And about the future and your relationship with your family, too?

DIANE:
My attitude? It's time to share with them, bring them in, give them much more information than I was willing to in the beginning. Because they know me. I've never been the type... I don't get sick, period. I've just always been there for everybody, but now it's time for them to be here for me.

ANDREW:
That's what I was going to ask. Are you giving yourself permission to accept love and caring and communication and help from your family? And maybe from friends that you're used to helping, but now you could use their support?

DIANE:
That's the turn I'm making right now. Which I didn't make a year and a half ago.

ANDREW:
Is there anything you would say to women who are going through this who maybe aren't at that point? Advice you would give them as to the benefits you're finding of becoming open like that?

DIANE:
There are a lot of benefits of becoming open. You no longer have to try and handle everything yourself, hold everything in, and try to make sure that no one else is worrying about you. Because I was very fearful of my girls in college, saying, you know, "Jeez!" I thought, "They don't have to worry about me. I don't want them to be away worrying about me. There is food. They need to do good, they need to take their finals and do well in college. And if they're worried about me, that's not going to help them." Well, I guess I've come to understand that that's not true, because they worried anyway. Being left out in the dark may have even made it worse.

GINA:
What kind of support is best, do you think? What's helped you as you've opened up to other people and let them help you?

DIANE:
In my forty-some years of life I'd never opened up to anybody, but I've learned to open up. I've had a wonderful social worker who's worked with me. She was probably the first person I ever really spoke to of all my feelings about this. Since working with her I have joined a support group. I've learned that people who don't have cancer really truly cannot know what you feel like. When you're in a group, and you've had these feelings, everybody else in the room can understand exactly what you're going through and what you mean. Whereas somebody else might not understand that. And I find it very comforting.

ANDREW:
Let's bring in someone else who's going through some of the same things. Carolyn is in Pittsburgh, Pennsylvania. Carolyn, you're a little bit younger. You're 43, had a mastectomy and reconstruction, chemotherapy, and then probably the most aggressive treatment for breast cancer you can have, a bone marrow transplant. Carolyn, you are married and have two much younger kids, a 4-year-old boy and a 6-year-old girl. And I also understand that the type of breast cancer you have is called inflammatory breast cancer, a rare and very aggressive form.

CAROLYN:
Yes, extremely aggressive.

ANDREW:
So tell us about how you have made it this far. Because I understand, with this diagnosis, a lot of people didn't think you'd be talking to us today.

CAROLYN:
That's very true. I had a decent working knowledge of breast cancer prior to my diagnosis, so I was somewhat familiar with it. Of course, you don't expect it to hit you, and when I was diagnosed I knew right away how serious inflammatory breast cancer was. I knew the prognosis was poor and, of course, my kids were four and two. So there was about a week where I really floundered and cried and worried myself sick.

ANDREW:
This was two years ago, right?

CAROLYN:
Yes. What helped me is the fact that because my cancer was so aggressive there was no time wasted. From the time I was diagnosed I immediately went into tests, and treatment, and boom, boom, boom, boom. I had a new puppy that I was housebreaking and two toddlers, so I was busy all the time. Having something to do all the time really helped me, especially with things related to my disease. Because I felt like I was doing something, I wasn't just sitting helplessly while I was being victimized by the disease. I was going to treatment, taking tests, making plans, and my family was wonderful. My friends, the support system, was outstanding. And, unlike Diane, I have a need to talk. So I talked to my family about it, I talked to my friends about it, I talked to my children as much as I thought they could understand. I didn't moan and wail and complain, but I talked.

GINA:
What did you say to your kids?

CAROLYN:
Well, you know, they were four and two, so basically we told them that Mommy was sick. And it wasn't like a cold where you're sick for a week and you get better. This was going to be a long time, and I was going to be at the doctor's a lot and at the hospital a lot. And I would lose my hair. But that they were trying to make me better, and so I had to do all this.

ANDREW:
I'd like to share something. I have a less serious form of leukemia, and I haven't had any of the kinds of treatment that you've had. But when I was diagnosed my oldest of three children was five years old. And his first question was, "Well, are you gonna still be alive when I'm a teenager?" That seemed to him to be a long time away. And with this particular disease, I said, "Well, yes, I expect to be." But that would be an issue for kids: You're sick, so how do they see you in their future? I don't know if that's come up since then, Carolyn, as you talk with your 6-year-old. I'm just thinking about events that are important to them, birthdays... Do you ever talk about it-does it come up at all?

CAROLYN:
I don't think it ever occurred to them that I might die. I never told them I would definitely get better. I just said that the doctors were trying to make me better. But I don't think it ever occurred to them, and since I was in treatment, I didn't feel the need to discuss the fact that it might not work. I thought I would cross that bridge if and when I needed to. So I don't think it ever occurred to them that I wouldn't be around. When I went to the hospital and was gone for quite awhile for the bone marrow transplant, that frightened them. Every time I went to the doctor's after that, they would ask me, "Are you going to be home tonight? Will you be home when we go to bed?" Because I'd spent a great deal of time in the hospital with the high-dose chemo, and the bone marrow transplant, and that was always an issue. "Will you be home, will you come back?"

DIANE:
I was just going to ask Carolyn... How long were you actually in the hospital for that?

CAROLYN:
Well, I was in about four days for high-dose chemo, then eleven days for an infection, and then twenty-three days for the transplant.

DIANE:
All at one time?

CAROLYN:
They were closely grouped. Like in a period of, say, eight weeks.

ANDREW:
Talking about the kids for a second... Carolyn, I've heard of some women being treated in the hospital would call their kids, or read bedtime stories, or anything like that that they could. Was there any interaction you had like that with your children?

CAROLYN:
Oh, yeah. I called them every morning at breakfast. They were both in preschool, so I knew when they'd be up and eating breakfast. I called them every morning at breakfast, and then every night at bedtime, and we would do hugs and kisses on the phone. And they came to visit me. Bone marrow transplants, now, you can have visitors. Not too many, and they have to be masked, and they have to take precautions. But they did visit me two or three times. They were fine. I thought they might be scared because of the masks and all the paraphernalia that goes along with being in the hospital. You know, the tubes and stuff. But we prepared them ahead of time that this is what they were going to see, and this is all part of trying to make Mommy better.

ANDREW:
How did you know what to say? What resources did you have for advice?

CAROLYN:
Well, I'm a pretty verbal person, so I just did what came naturally. You'll hear mothers say this about their kids. You kind of have a feel for what your kids can grasp and how to say it.

GINA:
Carolyn, when the prognosis was not very good, when you didn't know what you were facing... Even though you knew how to talk to them, and what they needed to hear, how was it to talk to them?

CAROLYN:
Well, you know, the first week, the week that I told you I was pretty off the wall... I would talk calmly, but I would always end up crying. I would cry while I was talking calmly, and tell them I was scared and this made me sad. But we were going to do whatever we could to try and make Mommy better. And I never, ever, ever, guaranteed them that I would be. But I always said they're going to try to make Mommy better. It's going to be hard and I'm going to feel sick and I'm going to need you to help me. And understand sometimes when I'm too tired to play. But I would always cry while I was talking.

GINA:
Diane, what about you? Your kids are older. How do you talk to your kids now that you're discussing things more openly with them?

DIANE:
How do I talk to them? I just let them know what's going on and what the doctors are doing. When I was listening to Carolyn... I only had to spend five days in the hospital when they gave me high doses of chemo. But as you said, I was very fortunate, because I could have visitors and my family and friends could come in. I was on the same floor and, obviously, the same setup as you were in because everybody wore masks and gloves, and very few kids came in for the other ones. I was put on that floor by mistake. I shouldn't have been put in with the people who had bone marrow transplants. But I could imagine how scary it would have been for kids to come in, because when I saw those people... Oh, I felt so bad for them.

ANDREW:
And with your kids now, your grown kids, how do you talk about this?

DIANE:
As a matter of fact, shortly before you called, I was talking to my 17-year-old. She was asking me about what I was doing because she had heard that you had called and would be calling me back. I was trying to explain to her, "Remember, Danielle, when this first happened we didn't talk to you about it?" And she said, "Yeah, Mom, because I knew it would make you cry if we talked to you about it." "But now I can," I said. "Now you know that this is not working and they're doing this to me." I explained to her that sometimes I would be very sad if they didn't ask me how I was doing or how everything was going. But then on another day if they did ask me I might burst into tears and not want to discuss it. So now the fact that I can actually openly explain all that to them... Even though they're adults, I was never an open person and I would get very upset and cry if they even talked to me about it. Now my maturing, my growing, my whatever... Being able to discuss it and being able to communicate with them, they do find it very helpful now. And I can sit and talk to anybody about it. But a year ago if you asked me a question, I wouldn't have even answered you, period. I think it's the support group I'm going to. And I think it's the social worker that I've worked with that has managed, somehow, what nobody else has managed in forty years. To get me to be able to talk about it.

ANDREW:
Maybe there's a silver lining in this, as far as being able to be open like that.

ANDREW:
You're moms, of course, so your communication with your children is very much on your mind. But you're also each married. So what about communication with your husbands? Also, what role have they played in helping support the kids through this?

DIANE:
Carolyn, do you want to go first?

CAROLYN:
Okay. My husband has always been very involved with the children, although he works a lot of hours. He spent more time than he usually does with them. Obviously, I wasn't around, or I was sick, but he was a rock. I knew he was scared and I knew he was worried, but we openly discussed that. He went with me everywhere I went, and they could do almost anything to me. It didn't matter as long as he was with me. I mean, it could hurt, it could be awful, but if he was there with me, I could handle it. And, I think it was like that for the kids, you know.

I can remember when I was in the hospital for three weeks with the bone marrow transplant; my whole family was taking care of my children. Taking turns being there in the day, at night. My husband would call me and say, "I'm going to come down after work." And I would say, "You can't, you can't. You have to go home and be with the kids." So I was alone a lot, because I would just tell him, "You can't come down here. You have to go home and be with them."

ANDREW:
Diane, how about you?

DIANE:
As far as my husband goes?

ANDREW:
Both as a dad and as your husband.

DIANE:
As far as being a dad, he was the one that would talk to the children and explain to my children what was going on. He's the one who kept them informed because, as I said, I couldn't talk about it. I couldn't discuss it. As far as being my husband, I went nowhere without Charlie. Charlie was like my rock of Gibraltar.

CAROLYN:
Me, too.

DIANE:
Anything that was going on, he was right there. Whether it was scans, or it was doctors' appointments, or all kinds of tests and surgeries. And he still does go everywhere with me.

ANDREW:
Carolyn, what about you, in the present tense? What's your husband's name?

CAROLYN:
Keith.

ANDREW:
So, Keith, as far as being of support to you... You're still taking tamoxifen. All this has been within the last two years. Who knows what the future holds? I hope a very bright future. Though as you said, you were diagnosed with a very aggressive form. What about your relationship with him now?

CAROLYN:
Well, you know, we talk about the silver lining, and it sounds very clich&#eacute;, but in some respects it helped us communicate. He's not a super-open person, and I am, but he needed to be. For me. He needed to be able to communicate clearly with me and be close to me. So in a lot of ways our relationship has become much stronger. He no longer comes with me to the doctors, he's self-employed. I normally go by myself because we don't expect anything horrendous to happen. You know, I go, I sit there, we talk, I leave. But still, our communication is very clear, very supportive, very open. It improved it.

ANDREW:
And, some tips for other women going through this from both of you? Diane, you said you went to a social worker and that helped you a lot.

DIANE:
Right at the facility where I had my treatment, they had social workers there, yes.

ANDREW:
So that would be advice for other women, to look for that as a resource. And for both of you, Diane and Carolyn... What would you say to other women going through this, as far as how to accept support and perfect communication within the family? With children and husbands.

DIANE:
Children can really understand a lot and they can be very supportive. They can be there for you. And if you don't include them, I think they probably imagine the worst. I think it is very important, no matter how hard it is, to try and open up and express your fears to your kids. As I said, I didn't want anybody worrying about me. So I didn't express my fears.

ANDREW:
And with your husband?

DIANE:
Oh, Charlie is very much like me. He's not a very open, verbal person either. Charlie was probably just as much in denial as me the first time around. That attitude of, "We're gonna handle this. We can get through this. We get through everything that happens." But as I said, when the recurrence happened it was like a whole new ballgame. It actually opened up our communication even more.

ANDREW:
So, for a woman who finds out that there's some continuation of the cancer, or metastasis, or recurrence, and needs her husband as support... And maybe with a husband, such as Charlie, who's not a particularly loquacious person talking about everything they're feeling. Any tips on how to help the husband get to a better place?

DIANE:
Well, I guess I just expected him to know exactly what to say and what to do for me. Now, if I ask a question or I state a fear he's right there to tell me how he feels, or why this or that. If I don't ask, I'm not going to hear. Because he doesn't know the million things going around in circles in my head.

ANDREW:
Carolyn, any tips, from your point of view, to women who may be going through this? As far as tactics or specific things they can do with kids and with husbands?

CAROLYN:
Yes, I have very strong opinions on this. At least I know that this worked for me. Let everybody who wants to, who shows an interest... Now some people do want to back off and that's fine, you have to respect that, but that would be friends, really. You can't let your family back off. Let people in. Let people help you. My family needed to do something. My older brothers would show up on my chemo days and sit with me. I didn't even know they were coming, but they needed to do that. My kids went with me to get my blood tests and my shots, and they were always part of it. They always shared it with me. We talked openly. We didn't talk constantly about it. I mean, we did talk about the weather and politics and stuff, too! But I let them in and I let them share it and they needed to do that. It lessened their fears, number one, to be involved. And number two, they felt so helpless. You know how frustrating that is, to feel helpless? So if they could take me to treatment or if they could hold my hand while I got a shot, they felt better. Now, maybe in some families that would not work, but I feel strongly that it would work more often than people think.

DIANE:
Actually, Carolyn, it took me about a year to realize that. So that's why now I think it's very important for anybody just getting into this to realize that what you are saying is so very true. Don't waste that time.

ANDREW:
But you both ended up at the same place and it's worked for both of you.

ANDREW:
Let me bring in a third participant to our discussion. She is a member of the advisory board of cancer survivors who are devoted to this project. Sonia is in Roswell, Georgia. Gina, tell us a little bit about Sonia.

GINA:
Sonia has completed six rounds of chemotherapy. You had your cancer a little bit ago. You had a mastectomy and reconstruction, and you've been through a lot. You've dealt with issues of fertility and are still dealing with some of the aftermath of that. With a little bit of perspective, a little further out from your initial treatment, what can you suggest to women who are right in the middle of it?

SONIA:
The key is just willing acceptance. There's no point battling the fact that you have the cancer. Now that you have it, just accept it and move on. You know, don't waste the energy on "Why me?" Because you're not going to get any answers. The key is to be very positive, and as Diane and Carolyn said, be open to people wanting to help you. That's the key. Families do feel very helpless sometimes. My husband felt very helpless after I started getting my chemo. Right up till the chemo he felt that he was in charge. He got me the best doctors, the best surgeon, the best hospital. Everything was the best. But once I was infused with the chemo, and I had very aggressive chemo, he could see the way I was reacting. He really felt helpless. But he got to feel involved by being there every moment for me. He was my Rock of Gibraltar. He was there at every treatment, and in fact the nurse and the doctors used to kid around... If they didn't see my husband or my parents around they'd ask, "Where's your advisory team? How come we don't see them today?" We would go as a group of four, for every treatment.

ANDREW:
I mentioned at the outset that you've had treatment in the past, and reconstruction, and now you're trying to consider what's next. You just spoke about your husband as your advisory team. Are you together trying to decide... Do you need further treatment for breast cancer? Or various drugs that may help prevent the danger of metastatic cancer? How are you working together on this?

SONIA:
Well, we talk a lot about it. We try to do some research on the Internet. On the pros and cons of going in for further medication, because they still don't have any answers. Nobody can tell me definitively that tamoxifen will guarantee you that the cancer won't return. All they say is you may want to consider taking it but it's up to you. That's a very difficult decision that we've been facing for the last four months. It's three months since I last saw my oncologist, and I'm still in the deciding mode. It looks like I might go in for it. But I don't know. There's something holding me back right now.

ANDREW:
What's that?

SONIA:
I have no idea. It's just a fear of going through treatment again, you know. And just the idea of being tired, all over again, scares me.

ANDREW:
So, with Carolyn, with the type of breast cancer she had, it was... do not pass go. You're going through a very significant treatment, a bone marrow transplant, etc. With Diane, it's shown up in her lungs, so she has no question. You're in that gray area where maybe there will never be a recurrence, and you're wondering if there's something you should do. It's not nearly as clear cut.

SONIA:
Yes, it's very confusing. I cannot get a straight answer.

ANDREW:
Okay. So normally, we would look to doctors to advise us, even though as you said your husband and other ones close to you are your advisory board. What advice would each of you ladies give to others as far as how to gather information and how to deal with doctors? Both yourselves, and your husbands? How does the family unit get the information it needs, from your doctors or perhaps the Internet as well? How do you make these informed decisions? Because your lives are on the line. Carolyn, do you want to start?

CAROLYN:
I found the Internet helpful. I had someone else research for me because I don't know how to use the computer, but the Internet was very helpful. Because I had information going in, I knew what questions to ask. It's kind of important to know what questions you want to ask before you go in. I had one doctor in particular who would patronize me a little bit, and not give me direct answers. I would just ask again. "I need an answer to this. You're not being straight with me." And you know, eventually I got them. But I think persistence is important, and getting enough information before you see your doctor so that you have some idea what you want to ask. But if you go in completely cold, it's hard.

ANDREW:
How about you, Diane?

DIANE:
Unfortunately, I went in completely cold, but the doctor I had was not the type that would... You know, he would explain everything to a "T" and I'd say, "Well, why this? Why that." The thing is, I went in under protocol. The protocol is, either you went for the bone marrow transplant or you went for the high-dose chemo. Everything was spelled out for me point blank there. But, because the way my lymph nodes were involved, we felt very strongly that we had to take this through and go all the way.

GINA:
Would you recommend taking somebody with you to just listen, so that you don't miss anything the doc says?

DIANE:
I never went without my husband. He heard everything. I would ask him a question a day or two later. He could say, "Well, this is what the doctor said. This is what this is... And so, yes, you should. You should always." If for some reason Charlie was not available, my sister would go with me, or my daughter would go with me.

CAROLYN:
I agree completely.

ANDREW:
Bring someone with you. Sonia brings her advisory board, her husband. So Sonia, what about you? You go home and think about a lot of stuff. What do you do to try to weigh things? What are your information resources? Do you go for second opinions? Do you go in with a list of questions? What do you do?

SONIA:
Well, you have to understand that in the country I came from you really never questioned what the doctor said.

ANDREW:
India.

SONIA:
Yes, India. You accepted it as if it came from God. But I soon learned in this country that you had to ask questions. And I did take a second, I took a third, opinion when I was first diagnosed because I was very confused. One doctor would say, "Well, we recommend a lumpectomy." The other one would say, "Well, you're a perfect candidate for a mastectomy." So I just read a lot of books, and we researched the net. I would definitely agree with Carolyn and Diane that when you go you take somebody with you. And do a little homework before you go so that you have some questions to ask. Very often, the doctors don't like that. But I've learned to be very persistent, and I don't give up until I get a straight answer.

ANDREW:
So with all those opinions, Sonia, how do you decide?

SONIA:
It's a very difficult call. I guess you finally follow your heart. When you're by yourself, and you reflect on everything, you finally have to go with what your heart tells you to do.

GINA:
Carolyn, how about you?

CAROLYN:
I had no choice. I mean, I didn't have a rough decision to make. There was not really a choice. If I didn't try the bone marrow transplant, they told me I would probably die.

ANDREW:
So Carolyn, looking to the future, though, you've been treated for breast cancer. You're alive today talking to us. Should anything come up, what process would you go through?

CAROLYN:
Well, I would do exactly what Sonia said. I would do my homework, research it a little bit, talk to the doctor, and be as persistent as possible until all my questions were answered. Probably discuss it with my husband, and then go where my heart says.

ANDREW:
We've talked about how to take care of your head. Diane, especially, has talked about the changes she's made. You've talked about working with the traditional medical establishment. Drugs, bone marrow transplants, various treatments, etc. We haven't talked about whether alternative therapies have come into play. Sonia, has there been anything there for you? Any new approaches that support you in any way? What's your view of that?

SONIA:
Well, I really haven't gone that path. I've just left it to modern medicine. I feel that if I go for my follow-up checkups, and just do what the doctor says, and follow my heart, that will help.

CAROLYN:
I'm a believer in holistic medicine in addition to regular medical procedures. I think that it can't hurt. But it should never be used in place of traditional treatment.

GINA:
Have some of those things helped, with the changes that your body has gone through? With some of the menopausal-type changes that come much earlier than they should have?

CAROLYN:
Oh, what a nightmare. And my husband tells me that they told me that. But again, this is why you take somebody with you. I never heard that. I never heard them tell me I would probably be in menopause. Now, he said they did tell me. So I was unprepared. I didn't even know it was going to happen. I do a little bit of relaxation. And I do some tea kinds of things. But, you know, I have to use vaginal suppositories, I have to take calcium. I have to do traditional things. It was a shock. It was rather a big adjustment.

ANDREW:
Setting aside any ongoing uncertainties, you are all here today despite breast cancer. Today you are all survivors. What's your attitude about the future? Sonia, how about for you?

SONIA:
Today is good and tomorrow will be good. That's my motto. I'm just a very upbeat, positive person, and I don't like to think negatively. If it has to come, I'll cross the bridge when I reach there. But I'm just grateful for being here today, and I would like to be a role model for other, newly diagnosed, cancer patients. The world does not come to an end. There is life after cancer, and you have to make the most of the time given to you.

ANDREW:
Diane?

DIANE:
Well, I agree. There is life after cancer. I do my best to keep a very positive attitude and I look at my diagnosis of cancer as a wakeup call. To really go with things that are important to me. If it's not important, forget it. I mean, I've changed my whole attitude. My whole attitude has changed about life.

ANDREW:
Yeah. It was a wakeup call and a chance to live a fuller life.

DIANE:
Definitely a fuller life. And little minor things don't bother me any more.

SONIA:
I agree with that totally.

DIANE:
It's just not worth worrying about.

ANDREW:
Carolyn?

CAROLYN:
Well, everything they said, it's true. You have a different perspective. Little things do not bother me. I have a pretty positive attitude. Like Sonia said... if, God forbid, something comes down the road, I will deal with it. But right now I'm here and I'm happy.

DIANE:
Relatively speaking, any one of us could be run over by a car tomorrow. But, since we have cancer, we realize that every day is an important day now.

GINA:
Are there any last thoughts, something that you would say to another woman who is in your position? Something she really needs to know? Carolyn?

CAROLYN:
I would say what Sonia and Diane both said. Life goes on. You still have good days. You still have happy moments. It doesn't end. There's still a lot of good there.

DIANE:
I would have to say that the world of medicine is working so hard in finding cures and extending our lives. Just go out and enjoy your life as much as you can. Have a very positive attitude and don't let it get you down, because there's millions out there who'll be with you.

ANDREW:
Right. And it's important to note what Carolyn said at the outset. That with the form of breast cancer that she was diagnosed with, we wouldn't have thought she'd be on a panel as a survivor two years later. And here she is.

SONIA:
I have something to add. When I was first diagnosed, the first thing I asked my doctor was, "Should I stop dreaming my dreams now?" I've always been a dreamer, building castles in the air. And I would tell everybody, just keep dreaming your dreams, they can come true. Don't give up. That's the key.

ANDREW:
Well, you've all been so eloquent and inspiring. And very gracious in sharing some very personal things about your life, and your thoughts, in dealing with this condition. With this comment, we have to stop and wrap this up, but I want to thank you all for a very rewarding discussion. Thanks to each of you who've shared your personal experiences and insights. It will certainly benefit others who will listen. And thanks to my cohost, Gina Tuttle.

GINA:
It's been a privilege, Andrew.

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