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. Our topic, breast cancer for women over 55. On the phone with us are four breast cancer survivors from across the country, women who are all over 55 and are either currently in treatment or have recently completed it. Over the next few minutes we'll discuss issues such as dealing with the impact of treatments on your daily life, how having support helps you tolerate the treatments better, making treatment choices, reconstruction as part of treatment, and the importance of getting out and not sitting at home. Let's begin. Joining us today is Pam from Lansdale, Pennsylvania. Pam, I know you're 62. You're a widow with three kids who are grown up and out of the house, and I know one of those children is dealing with breast cancer herself. Is that right?

PAM:
Yes, that's right.

ANDREW:
She's in California. You're in Pennsylvania. I understand that, initially, you were diagnosed with breast cancer in 1996, had a mastectomy, and chemo.

PAM:
Right.

ANDREW:
And then, six weeks ago, three years after the initial diagnosis of breast cancer, you found out that in the scar tissue there's malignancy, and you have cancer again. How are you doing?

PAM:
A little better than a couple of weeks ago, because, Andrew, they've decided that this is just a local recurrence and not a whole new invasion, and that some radiation ought to be quite effective in clearing this up. And this also makes me feel better, because while there are side effects to radiation, my normal daily routine will not be interrupted. I can still go back to California to help my daughter out when she has reconstruction. So, I'm feeling much more positive now.

ANDREW:
That's great. Now I understand that when you originally were diagnosed your family doctor said you would tolerate treatment better if you joined a support group, and you found this to be true. Tell us, what role a support group has played in you feeling better and doing better?

PAM:
When I went to support group, Andrew, I didn't go to one strictly for breast cancer, because it's a general group. And, I found people who had much worse cancers than I did, and they were coping with it and joking and you know, looking forward to the next meeting. And, they were pretty positive.

ANDREW:
Now, have you kept in touch with that support group?

PAM:
Yes, I still attend.

ANDREW:
Now, with your daughter going through this, nobody would wish that on a child or on anyone, of course, but do you speak with her in a different way now that you're having the same experience?

PAM:
I was afraid to tell her because I was afraid of depressing her. But, once I finally knew the better news and that I didn't have to have chemo, I told her over the past weekend and we talked some more because she's in radiation and I'll be starting it.

ANDREW:
Do you think honesty in communication is really important when you're dealing with breast cancer?

PAM:
I think it is, but my first instinct was to protect her so that I didn't pull her down.

ANDREW:
Yes. A lot of people want to protect their children, whether they're dealing with an illness themselves or not, and I can understand, anyone can understand, why you didn't want to give her the news that was affecting you.

PAM:
Well, when I was first diagnosed, Andrew, everybody rallied around me and she flew out from California to help me and now I feel like, hey, we've had this already. It's not necessary all over again, and yet I've been hesitant to ask, really, for as much support, for very much support, and I don't want her to be impeded in any way in her progress. Because hers is a much more serious cancer than mine.

ANDREW:
Pam, what are you doing now that you have this recent diagnosis? What do you do to ask for help from people there?

PAM:
I've asked for people to put me on the prayer list and I've confided in a few friends and a few people from support group. And I'm planning on putting a new kitchen floor in.

ANDREW:
So, you're thinking of the future, of course.

PAM:
I'm thinking of the future, but I'm going on with my life.

ANDREW:
And, is that a key thing you would advise other women dealing with this to do?

PAM:
Yes.

ANDREW:
Not to sit around.

PAM:
Well, for some the treatments just wash out all the energy. But keep going.

ANDREW:
Keep going as best you can. Now that you have a more recent diagnosis of breast cancer since 1996, what are you doing to gather information to make decisions about how to proceed? Do you simply go with the advice of your doctor, or are you seeking out information from others or other sources?

PAM:
My doctor is affiliated with the University of Pennsylvania. Even though I'm out here in the suburbs, my treatment is in Norristown. I asked him to consult, he suggested to consult, and he already has, but I asked him to consult a little bit more so that I would feel very comfortable. I'm not tracking down a whole lot of information at this time. I'm working and busy with other things.

ANDREW:
What are you keeping busy with, Pam?

PAM:
I'm working in a mental health center and, as I mentioned to you, I was planning on putting a new kitchen floor in. And, I'm involved in several community organizations and I don't have time or energy to chase down a lot of different alternatives.

ANDREW:
But, it sounds like you don't have a lot of time to be depressed about this, either.

PAM:
That's true. I was at first. I felt like I'd stepped on a hoe and the handle came up and hit me between the eyes.

ANDREW:
How do you feel about it now?

PAM:
I feel much better. My pastor's wife came out and told me she was going to bathe me in prayer, and after that I felt better.

ANDREW:
Well, we'll have a pastor joining us in just a minute. But. I think that that has certainly helped a lot of people. Let's be joined by Roxie who's in Tampa, Florida. Roxie, I understand you're 56, married, and you have three kids who are grown up and four grandchildren. Is that right?

ROXIE:
That's correct.

ANDREW:
And it was on your birthday, your 56th birthday, just earlier this year, that you were diagnosed with breast cancer.

ROXIE:
Right.

ANDREW:
That was a pretty lousy birthday present.

ROXIE:
It was. I think the worst thing was that I found out it was genetic and I worried about my daughters more than myself.

ANDREW:
And my understanding is that your treatment has been lumpectomy, chemo and radiation?

ROXIE:
Correct.

ANDREW:
Which you're just in the process of completing? Or, you are just about to complete the chemo, right?

ROXIE:
That's right.

ANDREW:
And, then radiation comes after that?

ROXIE:
Right.

ANDREW:
Okay, let's talk about your daughters. So you get this diagnosis and more than worrying about yourself, you worry about your daughters. What communication have you had with them about all of this?

ROXIE:
We're very close, and they talk to me every day, and the doctors would like to have them checked. They're both under 30, but I was not aware that there was a genetic breast cancer versus a hormone breast cancer, or whatever.

ANDREW:
Right, well, it's not the major cause of breast cancer but it certainly has significance for some people.

ROXIE:
Right. And I was really surprised. But, I have a very good doctor. I had good relationships with my doctors, and the chemo doctor is fantastic. I feel like I've had some of the best care, and prayers help.

ANDREW:
Well, how have you gotten past the initial shock of being diagnosed and the initial fear for your daughters? How have you gotten to move on with this so fresh in your mind?

ROXIE:
With friends and support groups and help from everywhere. I found a distant cousin who was very active in Reach to Recovery. She had been active for 20 years and I just happened to meet her just before my surgery. So, support groups have been very important to me.

ANDREW:
How did this diagnosis take place on your birthday? How was it discovered in the first place?

ROXIE:
I found the lump. I happened to have an appointment like, the next week, with my gynecologist, and just went from there. And it was diagnosed as cancer on my birthday.

ANDREW:
Must be a shock for the whole family. Were you planning a birthday celebration or anything and then this put a damper on everything?

ROXIE:
I think so. Everything just happened so fast and so quickly and I was in surgery before I knew it.

ANDREW:
So, tell us about what you've gone through. You were diagnosed, you had surgery, and it sounds like it moved very fast through this process of lumpectomy and then chemo and now it's about to move on to radiation.

ROXIE:
Extremely fast. And, I have a very good friend who has leukemia, and she was diagnosed last year, and I think I was trying to help her get through her diagnosis, so she was there for me when this happened to me. So, you know, the support of friends, and family, has been terrific. And like I said, I have very good doctors. And I will search the Internet for questions and answers and then I'll go to my doctor with a list of everything, and he answers all of my questions, sometimes before I ask them.

ANDREW:
Well, good for you. It sounds like you have someone who really cares there. Roxie tell us about your life now. I've been told that as you've lost your hair through chemo, you've chosen not to cover that up, and that you go out with a completely bald head. Why that decision? It's not the decision that many other women make. Why that?

ROXIE:
Well, we're motorcycle riders, and most of my friends are from the motorcycle group. We go on a lot of trips together and it's kind of hard to wear a wig under the helmet. So, I used to wear my head covered up, you know, with just a bandanna, and the first time I took my helmet off the bandanna came out with the helmet. I had people come over to me and say, "I have been through the same thing." Or, "I really admire you. I have a friend who's been through cancer and chemotherapy." And, it has opened so many doors, and I've met so many people, by just not covering my head.

ANDREW:
Do you think it promotes, if you will, a sisterhood of women who are concerned about this or who have dealt with this in their lives and that that's a positive thing?

ROXIE:
I think so. And I have had men come up to me, also. So, they didn't know what kind of cancer it was, they just knew I was going through chemo.

ANDREW:
Roxie, I've heard when breast cancer is discussed, where someone is a cancer survivor dealing with it, that sometimes there are friends or acquaintances who just can't handle it because of their own fears. Here, you've been very out front about it. How has it affected the people who have been close to you over the years?

ROXIE:
I have had nothing but positive support from everybody, and you know, I hear of people who have friends that can't talk about it. That has not happened to me. I've been very fortunate. In fact, I have heard from people that I haven't heard from in years, who've heard through the grapevine that I've had cancer. And, I've been on prayer lists of people I didn't even know. They would send me cards, so I just, I just feel so fortunate. And, it's opened so many doors for me that it's just unbelievable.

ANDREW:
What about with your husband, though. Certainly, it was a shock for him, but then you've been very out front about it looking different, so how has he reacted to all this?

ROXIE:
Oh, he's wonderful, anyway. So, this has strengthened our marriage more than anything, but then we had a strong marriage to begin with.

ANDREW:
You've had to talk about a lot of things, though certainly, with this sudden diagnosis.

ROXIE:
Oh, very much so.

ANDREW:
And you've been married how many years?

ROXIE:
Thirty-five years.

ANDREW:
So, when a shocking illness, a diagnosis like this comes after so many years of marriage, what do you think the key is? What's your experience that's making it, as you say, be closer, even strengthening your marriage? What's at work there? Because, it would seem like it could be a blow to many marriages.

ROXIE:
The main thing, I'm sure, is that we had a strong marriage to begin with. And our faith, and trying to work through this together. And he's diabetic and I think he always thought something would happen to him before it would happen to me. And I've been very healthy and I think this was a shock.

ANDREW:
Let's be joined by Donna who's in Lawrence, Kansas. Donna, I understand you're 58, married, and you had a bilateral mastectomy and also some lymph nodes were removed. And, you chose to have your breasts reconstructed. Now, why did you decide to do that?

DONNA:
Well, the diagnosis was certainly a complete surprise. In fact, I had gone in to the doctor to talk about knee surgery, and it was time for a mammogram, so that diagnosis certainly took priority over the knee situation. And, it was such a surprise that all I could really handle, when I realized that mastectomy was probably what I was going to have, was the thought of that one surgery. So, when my surgeon told me of a new plastic surgeon who had recently started practicing in our town, who really specialized in reconstruction after mastectomy, he indicated that he wasn't encouraging or discouraging me to talk with him, but he just wanted me to be aware. So, my first reaction was, "No." I wasn't interested, but it didn't take many days of thinking more about it to become interested and at least hear what he had to say. So, we made an appointment and heard about my options and at the time I was 54. And, I thought and hoped that I would have many years of life left and I decided that I would like to consider that rather than dealing with a prosthesis for the rest of my life.

ANDREW:
And so this was immediate reconstruction?

DONNA:
It was, the implant, or the first step of implant reconstruction, which was to insert tissue expanders, took place at the same time as the mastectomy. The other option I had was something called a transflap. That utilizes your own skin but is much more of a drastic surgery, and the immediate recovery is a little more difficult. Whereas, the implant reconstruction does take place a little more slowly and actually it takes about six months to complete it all.

ANDREW:
And did your insurance cover the reconstruction?

DONNA:
Oh, that's an interesting question, because, in the end they did. But, well, the nature of my cancer was that the side that showed up on the mammogram was an insight to cancer and nothing showed up on the other side. My surgeon felt a lump on the other side and the biopsy showed that that was the more invasive cancer, the side that did not show up on the mammogram. So, when it came time to talk to our insurance company about reconstruction, they were willing to pay for the side with the invasive cancer but not the other side in which I had a choice between a lumpectomy and a mastectomy. I chose to go with the mastectomy, because the chances of recurrence were quite high had I gone with the lumpectomy. So...

ANDREW:
So, you had a fight.

DONNA:
I did, and I had a wonderful doctor who, in the end, went to bat for me and was on hold for about a half hour with the insurance company, but they did agree to pay for both sides.

ANDREW:
Donna, reconstruction maybe isn't for everybody, but do you recommend it to women you talk to who may be dealing with breast cancer?

DONNA:
Yes, I would recommend it but I am careful to say, as you did, that it is not for everyone. What I do do is let them know that the option is out there and to think about it and if they're interested at all to learn more about it.

ANDREW:
Body image is important to everyone, male or female, and I've heard women breast cancer survivors talk about it often. Was this an important factor for you?

DONNA:
Not so much, because I feel that with prostheses, you know, body image with clothes on probably doesn't look that much different. It was really truly a matter of convenience.

ANDREW:
Well, let's be joined by our fourth and final member of our discussion. I told you we had a pastor with us, and we do. Toni is a pastor in Chester, Connecticut. She's 56 and married with two grown children. And Toni, too, is a breast cancer survivor and Toni had a modified radical mastectomy in 1997 and then continued in treatment with Tamoxifen. Toni, you've dealt with this with members of your congregation and then you find that it affects you. That had to be a shock.

TONI:
Well, it was a shock. Mainly because this wasn't something I expected. I mean, you know, I thought that in time something would happen to me, but I didn't really think of breast cancer, since it's not in my family and that's not the kind of thing we had a history of. But, it was extremely touching to have a parishioner call who had had breast cancer maybe two months before I did. And, I had gone and visited her and I had gone with her, to be in her home with her after her first radiation treatment. And, when the word got out that I had been diagnosed with breast cancer, she was one of the first people to call me to give me her experience. We'd both gone to the same hospital. We had different surgeons and different oncologists, and her husband happens to be the chaplain at the hospital. So, there was a lot of connection there.

ANDREW:
Toni, often someone who's in the clergy tries to encourage people dealing with a life-threatening disease to talk about it, if they are able, and I'm sure you did. Was it easy for you to talk about it as these people approached you?

TONI:
Actually, it was. It was really very easy.

ANDREW:
And what role, both professionally and now that you've been dealing with this personally, do you feel that talking about it has and in having somebody do as well as they can as they go through these treatments?

TONI:
Well, for me I think it was very helpful to be able to talk with friends and colleagues openly about it and not try to pretend that, that I wasn't afraid, or that having faith somehow makes you immune to fear. I wanted to be very clear that just because I'm a pastor and believe very strongly in God and in Jesus, that does not mean that I'm not afraid, or that I've had it all together all of the time. I feel that sometimes people can feel that about clergy. And I wanted to be up front about it: "No, I'm also afraid."

ANDREW:
So, how are you doing now, as you've been going down this breast cancer road? What's your mood about it now?

TONI:
Well, I'm very, very optimistic and feel very lucky. In fact, I feel that of the four of us talking, you know, I mean I'm the one who's had the least to deal with. And, so I feel very optimistic and very positive. But I made some very sort of radical career decisions because of this. I stopped doing a certain kind of work in the ministry that I was doing.

ANDREW:
Tell us about changes you made, decisions you made based on this.

TONI:
I had been an interim minister for 13 of the 20 years that I've been ordained. I've been an interim which means that I've been in different churches working with churches in conflict. And, I decided to stop doing that work, that it was too stressful, and that I was no longer called to be in those kinds of situations. So, my ministry now is called supply pastoring, which is a sort of technical difference. And doing spiritual direction. So, I literally just said, "I'm not doing this. It's too much stress."

ANDREW:
When something touches your own life, personally like this and then you have conversations with others in your congregation or in the community who are dealing with illness or perhaps even with breast cancer, is it a little different conversation now, and if so, how?

TONI:
Well, it's because I can relate to them. You know, I can say, "Yes." Not that I understand everything they're going through, but I can say, "Yes, I know what you mean." I had one woman who's, I don't know, in her 70s come into my study at the church when the word had gotten out, and she said, "Nobody in the church knows this, but I had a mastectomy 24 years ago." I mean, somehow she felt, you know, that she couldn't say that in the church, for whatever reason, but she could say it to me. Which made me feel very privileged and very touched. That now I could talk with her in a different way. I mean not that we owe it to my breast cancer, but I mean somehow she felt she could share with me something that she had felt, I think. Because of her age and the time she had it happen, people didn't talk about it much. And nobody in the church knew about it, but she could talk to me about it because I'd been diagnosed. Not just because I was the pastor. I mean, that's not what brought her in. What brought her in was that we now had something in common.

ANDREW:
We were talking with Donna a moment ago about reconstruction. Now, I understand you have a prosthesis. Tell us about the time that you were swimming at the Y and things got a little out of whack.

TONI:
I swim at the Y every day, six days a week, and have been swimming for years. I'm really very addicted to it and those of us who swim at a certain time, we all know each other. And I was swimming along and I suddenly realized that my left breast was no longer where it should be, that the prosthesis, the swimming suit, the sort of little cup thing they have for you to stick the thing in, had obviously disintegrated or broken and my prosthesis was now in the middle of my stomach. So, I sort of looked around at who was swimming with me, and realized they were all friends and that if any of them noticed this that it probably wouldn't bother them and so I just kept swimming until I'd done my thing. Then, I sort of pulled it up and walked out of the pool with my arm over my left side.

ANDREW:
That must have had some people looking funny at you.

TONI:
Well, I mean, I did mention it to a couple of the women at the pool. They just laughed. I just said, "I have this left breast that seems to have a mind of its own. Goes wherever it feels like!"

ANDREW:
Toni, do you think that humor has a place when someone is dealing with an illness such as breast cancer, that there is a place for humor?

TONI:
Well, I think, I mean, I think not in the initial stages. In the initial stages it's pretty hard to laugh at anything. But as time goes on, and I think being the age I am is an advantage. And I don't know that I'd think it was very funny if I was 35. You know, it would be, but I'm sort of now, two years in, and I'm sort of used to not having a breast and being sort of a one-breasted person. You know it's okay, and everybody who knows me knows that, and so to make jokes about it or to, you know, sort of be light about those kinds of things, is helpful to me.

ANDREW:
Now, I understand that you feel it's important for women to get information from the experts, Pam was talking about the trust she has in her doctor, to get information, but also seek out information from others. And also Pam had talked about her support group. Do you feel that sort of sisterhood is really important?

TONI:
It has been for me. I actually switched support groups. I actually left one that I'd been in because I met somebody at an occasion who said, "Oh, we have a great one." Whereas, the one I had been going to really had not been, I didn't think, very helpful. Although the women were great, the leader was really not very good. And, so I changed support groups and was very glad I did.

ANDREW:
That's an important point about knowing what's right for you, and I'd really raise that question for anybody to answer and that is, how do you figure out which relationships--whether it's a support group or a friendship or an acquaintance--that are helpful for you and where you may have to change direction?

ANDREW:
Toni changed support groups. Maybe somebody else found there was a friend that was just a downer for them or negative or, you know, how do you change relationships like that? And have the courage to do it and not feel guilty about it. Anybody want to take a stab at that?

PAM:
Every year, I go to a conference, a glass collector's conference and usually a lady who has stayed with me for years and years, complains and complains and complains and complains. And, I said, "This year I just can't listen to that. So I made different arrangements."

ANDREW:
And, no guilt about doing that?

PAM:
Well, I have to think of myself. I can't be there for her all the time.

ANDREW:
Anyone else?

DONNA:
I think that the experience of having this disease possibly gives us another dimension of courage, if you want to call it that, or permission, perhaps, to do sometimes what we feel is best. Whereas, perhaps in the past we haven't always put ourselves first.

ANDREW:
Roxie, have you found it to be true?

ROXIE:
Oh, very much so. She said it just perfect.

ANDREW:
And, Toni, you didn't have any guilt when you changed support groups, did you?

TONI:
None at all. And, I really had no guilt in telling the church hierarchy that I would no longer be available for a certain kind of ministry. And, they had called me a number of times and said, "Wouldn't you like to reconsider this and go here, and go there?" And, I just said, "No." And I think part of the freedom is, I mean everybody only has the time that you have at the moment. You know that intellectually, but somehow this makes it much more precious. And, I'm not going waste, however, I may have 40 years left, but however much time I have, it needs to be used judiciously, and to bring me joy.

ANDREW:
Well, let's talk about that, the age group that you're all in, 55 or older. Are there some things, some thought processes that you go through when breast cancer intervenes at this age, that are unique to this age? I mean, certainly it'd be scary and Toni you talked about that if you'd been 35, maybe it'd be different. But, are there some things when you're in this age group that come into play? Anyone?

DONNA:
One small, I guess relatively small thing, having to do with my reconstruction was there are several phases to implant reconstruction. Once the permanent implant was inserted, the next step would be to reconstruct nipples, and you know, I felt, I'm not going to be breastfeeding any children. My husband doesn't really care. I don't have to wear a bra, if I don't want to and can wear t-shirts, and so forth, without a bra, and why bother? So, that was one decision that probably my age had an impact upon.

ANDREW:
Now, one of the things for those of you who have children, and three of you do. In that you're older and your kids are grown and are adults who worry about you and maybe even want to parent you a little bit because they worry about you. How have you dealt with that?

ROXIE:
My children try to take care of me, but I've always treated them as adults, and we're more like friends than we ever have been, and I think this has made us even closer. I have one daughter who works with me, and she's constantly telling me to go home and take a nap. But, this, like I say, has brought us closer, made us talk more about our lives and what we expect from it, and our health.

ANDREW:
Is there any pushback, if you will, from any of you where you have to tell your child, "I'm okay, I've got it handled. I'm all right." Because they may be worried or they may be saying, "Mom, you should do this," or, "I think you," whatever.

TONI:
After I made the decision to have a mastectomy instead of a lumpectomy, our son called several times and my daughter-in-law and they kept sort of pushing me about why I made the decision, even though I explained it a couple of times for medical reasons why. They wanted me to get a second opinion. And I just said, "No." I said, "I trust this surgeon. I've done some research on my own, and I appreciate your care, but this is the decision." And, then they accepted it, but, for whatever reason, they were not comfortable with it. But, I was comfortable with it.

ANDREW:
And again, no guilt about having to tell your son, "This is the way it is."

TONI:
Right.

ANDREW:
Now, you mentioned research there, Toni. How did you make an informed decision on what way you wanted to go?

TONI:
Well, I read Susan Love's Breast Book, of course. That's the first thing I got my hands on. My daughter is a nurse practitioner. She's a pediatric nurse practitioner, so this is not her field or anything. But, she's Internet savvy, which I'm not, so I got her on the Internet and I got her to go to the Columbia School of Nursing in New York where she graduated and get information. And I just read voraciously, but that is the way I cope with feeling out of control. I need to get information and I trusted her to help me understand how on the Internet. Some things you just don't listen to. It's not like everything on the Internet is a good thing. And, I had her actually talk to colleagues of hers, and say, "You know, this is my mother's cancer and situation and this is her decision. What would you think?" So, that's how I got information. And, I read lots of books. I read books from the traditional medical field as well as the complementary or alternative medical field, and got friends who were internet savvy to get me stuff off the Internet.

ANDREW:
Now, Pam, you had spoken earlier about the trust you put in your doctor at the University of Pennsylvania there, and Roxie, you spoke about your wonderful doctor in Florida. For any of you, Roxie, Donna, did you do other research beyond what you were hearing from your doctor to make decisions? Because I know, like in your cases Roxie and Donna, I imagine there, too, treatment was moving along pretty quickly.

ROXIE:
I also searched the Internet and have books galore from alternative medicine. I searched everything. And it just made me feel better about my decision.

ANDREW:
Donna, how about you?

DONNA:
Yes, the first thing my husband and I did almost directly from the doctor's office was to go directly to the bookstore and we spent hours the very first night reading, reading, reading, everything we could put our hands on, and buying several books. But, I also asked for a second and third opinion from an oncologist and a second surgeon.

ANDREW:
Well, we may well have a woman listening who's your age, a little younger, a little older, who was just diagnosed with breast cancer. What are some of the things you want to say to her in that you've been down this road a little while now. Let's start with Toni. What would you say? There they are, listening. Some words of advice?

TONI:
Well, first I would say, this is not a death sentence, and that if you're just recently diagnosed, this may be the most frightening time for you. Once you get started in making decisions and figuring out what's going to happen, and allowing people to care for you, it will actually get better. Which is not to say there won't be very dark moments in the days and months and weeks ahead, but that there's real reason for hope. That I think medically there's reason to hope, and I think new things are happening all the time. And, let people love you and care for you, and ask for the help you need. And, know that there's a sisterhood out here, of, you know, millions of us, I guess, who have been through it, and who are urging you on.

ANDREW:
Before we go on to the other ladies, Toni, I want to ask you about asking for help. And, that is, there may a woman who just doesn't want to talk about it. Maybe, it's denial. She does the treatment almost as privately as she can, and deals with the effects of treatment and just tries to be strong, but not talk about it, if that's her nature. Do you think that they're really missing a gift that other people could give them if they were open to it?

TONI:
I think so. I mean, I realize that not everybody is as vocal and outspoken as I am, but that if you can, let somebody in, you know. If you have faith of any kind and you can let God or a higher power in, at least do that. At least allow the spirits or however you would name that for yourself, allow that to come in and see if perhaps you don't want to reach out to somebody else.

PAM:
And, even if you don't want to reach out in your immediate circle of friends, there are people, say, on the Internet. My daughter, who has inflammatory breast cancer, met a whole group of ladies with the same kind of cancer, and got support in that arena.

ANDREW:
So, to know that she wasn't alone.

PAM:
That's true. And I also believe in God and Jesus Christ, and I'm trusting Him either to bring me through or to bring me out.

ANDREW:
Pam, what would you want to say to a woman your age who's recently been diagnosed with breast cancer on how to, how to get through this experience and move on?

PAM:
Well, first spiritually. Now's the time to really take a good look at where you're standing and what God has in store for you, and to pare down unnecessary things in your life the same way that Toni got rid of that very stressful part of her ministry. And, you don't have, you might not have as much, make your years quality.

ANDREW:
Donna, what about you? Advice you'd have for a woman listening who's recently diagnosed?

DONNA:
Well, my faith also was certainly paramount and was the first thing I turned to. I would say that probably the time between diagnosis and treatment and or at least between diagnosis and decision about a treatment is maybe the hardest time. I remember hearing vaguely about the Reach to Recovery program and I asked my doctor for a referral but at that time there was no one in our community trained to do that, and that was something I felt very strongly about, the need to talk with somebody who had been through it. It didn't take long, as someone else said, for the word to get out, and then all sorts of people came forward, people I'd known for years that I didn't know had had breast cancer. And, this was just extremely helpful. Try to focus as much as you can on a balanced life, activities other than your breast cancer, and certainly realize that the medical advances are just amazing out there and that always, very very often, there seems to be some treatment for everyone. And, it is certainly, as someone else said, not a death sentence. But if you can look at it and it's very difficult to do in the early days, but look at it as an experience that once you get through it, you will have grown immensely as a person and probably have a new appreciation for life.

ANDREW:
And what about in using this as an opportunity to communicate with spouses and children and close friends about what's really important?

DONNA:
Absolutely. It's the perfect opportunity. And you know, I guess the challenge there would be for the others to see things like you do, but you can certainly express the changes that have gone on within you, and then they deal with those in their own way.

TONI:
My husband had a very hard time, and he's a wonderful man and he had a very hard time talking about it. And I frankly, at one point, I mean really about four days after the surgery, I said, "Look, you've got to find someone to talk to. I can't take care of you emotionally at this point. I'm trying to take care of myself, and I can't you know, be someone you lean on, because I'm not strong enough at this point." And, we found a wonderful therapist, who actually happens to have a wife who has cancer, and it was very, very helpful to him.

ANDREW:
Now, did you go with him at all to any of the sessions?

TONI:
No. I called a colleague and said, "Who's the best person you know in New Haven?" And, she did some research and I got a name. And he was willing to get help. I mean, that's the difference, that's important. So, no, I never went with him. That's completely his thing.

ANDREW:
And, as you went through that process and as he learned about himself, what sort of communication then took place with you? How did it change?

TONI:
Oh, immensely different! I mean, it's just much, much more helpful, because he can say sort of what he needs and what he's thinking and I can say more freely what I think. I mean the communication is just, I mean, a hundred percent better.

ANDREW:
Was it hard at all to tell him to go get that kind of help?

TONI:
Oh, very hard. Because I was like two days, three days out of surgery. You know, the drains weren't out. You know what I mean? Just feeling just about as physically vulnerable, I guess. as I've ever felt. And emotionally, sort of bewildered and trying to figure out what's coming next, and I'd just say, "Look, I can't help you. Now I can love you and I can appreciate you, but I can't help you."

ANDREW:
Sounds like Toni, you've given yourself permission, and you may have been this way before, but to speak your mind, really say what you were thinking and be direct about it.

TONI:
I'm much more direct. I'm much more direct. I don't fool around as much. I mean I've always been fairly outspoken on issues, you know issues in society and in the church, but I haven't been as outspoken about my own needs and issues. And now I am.

ANDREW:
Roxie, tell us your final thoughts.

ROXIE:
As everybody said, my prayer and spiritual life have helped me through this and the helpfulness of friends. And I was, I'm a very shy person, and this has made me more outgoing, because I've asked for help. And Reach to Recovery has really helped me. I was afraid to go there at first because I had a lumpectomy and I thought most of these women have lost a breast or both, and I did not know that they match you up with someone who's had the same type of problems you've had, and my husband goes with me, every month, and it has been a great help to me.

ANDREW:
And that support of your husband and him being a part of this process has been helpful, too.

ROXIE:
Oh, absolutely.

ANDREW:
So, being direct like Toni has said and coming out of your shell or shyness, maybe that's been a gift of this too.

ROXIE:
Absolutely, it has.

ANDREW:
Well, I have this image of you on your motorcycle and taking off that helmet, and I know that hair will grow back, but we'll have to get a picture of that, Roxie.

ROXIE:
Oh, I'll send you one.

ANDREW:
That would be great. I do want to mention for our listeners, of course, that the Reach to Recovery program that we're talking about is not in every community, but it is an American Cancer Society program in many communities. Correct me if I'm wrong, ladies, but it's where someone, a breast cancer survivor, comes into your home and helps you get started as you're dealing with the shock of this diagnosis. Is that right?

ROXIE:
That's correct.

ANDREW:
Well, I know it's a great program and it sounds like it's benefited several of you. I want to thank each of you for sharing your personal stories, your insight, your comments today, and on behalf of the American Cancer Society and the Cancer Survivors' Network, we want to wish you all the best and thank you again. And from our HealthTalk Interactive Studio in Seattle, I'm Andrew Schorr.