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Going the distance: Breast cancer survivors claiming decades
Nov 02

By MICHAELA GIBSON MORRIS
Northeast Mississippi Daily Journal of Tupelo

TUPELO, Miss. (AP) _ Breast cancer survivors need to look to the future.

Women who are diagnosed with early-stage disease are expected to live full lives after treatment.

``Breast cancer screening has essentially transformed breast cancer care,'' said Tupelo radiation oncologist Dr. Benjamin Hinton. ``The vast majority are diagnosed at early stage and have excellent prognoses. People are living longer than ever.''

Gloria Cartwright, 68, of Corinth has logged 12 years after being diagnosed with breast cancer.

``I never thought I'd be able to say 12 years,'' said Cartwright, who credits a stubbornly positive attitude, prayer and good medical care.

Marsha LeBlanc, 68, of Amory has 17 years as a breast cancer survivor and seven years as an ovarian cancer survivor.

``I feel so blessed every day to still be here with my family,'' LeBlanc said.

Planning for future

Survivorship care plans are getting more focus as part of breast cancer care. For its recently completed National Accreditation Program for Breast Centers, North Mississippi Medical Center Cancer Care and breast cancer physicians refined survivorship planning, said Tupelo surgeon Dr. Danny Sanders.

``We've always had follow up, but it's much more standardized now,'' Sanders said.

When breast cancer patients complete treatment, they receive a packet detailing their treatment and laying out the recommended follow-up schedule.

``We tailor that to the individual,'' Sanders said.

Most recurrences will happen in three to five years, but they can occur further out, said Tupelo oncologist Dr. Pascal Wilson.

``When they clear the five-year hurdle, we think they're likely to stay clear,'' Wilson said.

Just as doctors stress screening to catch breast cancer is early stages, it is also important to catch recurrences at early stages, said NMMC Cancer Care oncology nurse navigator Abigail Farris. There have been tremendous advances in managing metastatic disease.

``If breast cancer recurs, it is treatable,'' Wilson said.

Breast cancer patients also have other health issues and risks that need to be monitored long term, Wilson said. A history of breast cancer increases the risk for some kinds of cancer. Some chemotherapy agents can have long-term impact on cardiac risk and bone marrow health. Hormone blockers can reduce the risk of recurrence, but they can increase the risk of blood clots or cause bone loss.

Women who had radiation treatment for breast cancer, especially before new techniques became widely used, need to be evaluated for ischemic heart disease, Hinton said. These side effects can take decades to develop, and affect a very small group.

``There's a lot of reasons to have cardiac evaluation,'' Hinton said. ``This is just one.''

As survivors go well beyond the five-year mark, sometimes surgeons and medical oncologists will hand off the check-ups to a primary care physician, but that doesn't mean it isn't important.

``You need to follow up with somebody,'' Farris said.

Difficult journey

When LeBlanc was diagnosed in 2002 with breast cancer, she knew she was in the fight of her life. Her mother died of breast cancer in 1982 at the age of 58.

``She had such a hard time with treatment,'' LeBlanc said.

LeBlanc had one of the most difficult, often aggressive, forms of breast cancer triple negative and doctors couldn't tailor her treatment to a specific receptor. As LeBlanc went through surgery and chemotherapy, she was carrying additional loads.

Her oldest son, then 23, was diagnosed with non-Hodgkin's lymphoma in 2001. The family weathered a business-related crisis while she was going through treatment.

``It added to the stress,'' LeBlanc said.

In November 2010, she was diagnosed with ovarian cancer that was at least stage 3.

``It was everywhere (in her abdomen) but my appendix,'' she said.

Staying focused on her family _ husband Ron, their three children and later three grandchildren _ gave her strength to face both of her cancer diagnoses.

``They really played a big part in keeping me mentally positive,'' LeBlanc said. ``They still do.''

LeBlanc has check-ups every six months with scans every year. She's had good reports since completing treatment for ovarian cancer. Her son also remains healthy.

Prayer has been a lifeline for LeBlanc. It helps her shed the fear and focus on what she can control.

``I really don't dwell on it,'' LeBlanc said. ``I'm going to do my part and trust my doctor. The rest of it, I've given to God to take care of it.''

Lessons in survival

Cartwright was diagnosed with stage 2, HER-2 positive breast cancer in 2006. She went through surgery and two rounds of IV-based chemotherapy and five years of an oral preventive.

A veteran high school social studies teacher, she continued to teach through her treatment. Her students and co-workers helped her by washing hands and adjusting around the treatment schedule.

``You can only do what your body lets you do, but do as much as you can,'' Cartwright said. ``I knew (teaching) was better than sitting and having a pity party.''

Not everyone going through breast cancer is comfortable sharing their journey, but for Cartwright, it was uplifting to be on prayer lists throughout the community. She and husband Terry leaned on their pastor at First Baptist Church in Corinth. A student gave her a special verse.

``I wanted it to be known and have the prayers,'' Cartwright said.

Because of her treatment, she waited three years for reconstruction surgery, Cartwright said. It was a really important step in regaining her sense of self as a woman.

``I couldn't look at myself without crying,'' before reconstruction surgery, she said. ``Since then, it's been much better.''

She retired from teaching in 2012 after 33 years in the classroom, but she continues to serve as a volunteer tutor, church dessert chef and grandmother of six.

``Service is my gift,'' Cartwright said. ``That's what God blessed me with.''

She tends her garden and raises chickens. She focuses on eating healthy foods, including vegetables she grows in her garden. The sweets she bakes usually go to church or grandchildren. Even 12 years out, Cartwright is careful to continue her follow-up with her surgeon, her oncologist and gynecologist.

``I'm more active since I retired,'' Cartwright said. ``We don't sit.''

Taking care

Breast cancer survivors need to move toward a healthy lifestyle to reduce their long-term risks.

Not smoking, limiting alcohol intake, increasing physical activity and focusing on healthy nutrition can make a difference.

``There are no absolutes, but you want to look back in 10 years, knowing you did everything to live the best possible life,'' Farris said. ``The rest is in God's hands.''

Obesity influences cancer risk, Farris said. The cells in fat tissues can secrete hormones, which is an added risk for those who were diagnosed with hormone-positive breast cancer.

In general, NMMC Cancer Care dietitian Leanne Davis steers breast cancer survivors toward a healthy diet with more vegetables, fruits, lean protein and whole grains. They need less red meat and pork, processed foods and sugar.

Myplate.gov is very helpful. There are apps and habits that can help guide good choices and help record food choices and exercise. Dietitians can help individualize plans.

``The goal is to get to a healthier weight and find balance in your diet,'' Davis said. ``It's not about eating perfectly, it's about being persistent.''

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Information from: Northeast Mississippi Daily Journal, http://djournal.com


By The Associated Press, Copyright 2018

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