According to the World Health Organization, breast cancer is the most common cancer among women worldwide, claiming the lives of hundreds of thousands each year. While one in eight U.S. women (approximately 12 percent) will develop invasive breast cancer, the most significant risk factors are merely inevitable for all women: gender and aging. In 2014, an estimated 232,670 new cases were expected to be diagnosed, amid another 62,570 cases of carcinoma in situ (CIS)—or the earliest form and non-invasive—cancers.
While about 85 percent of breast cancers occur in women who have no family history of breast cancer, a woman’s risk approximately doubles if she does have a first-degree relative also diagnosed; about 15 percent of women with breast cancer have a family member also affected.
I could be one of those women.
But right now, there are more than 2.8 million breast cancer survivors in the United States. Loretta Houlis-Ward, my mother, is one.
I get frustrated with her all-too-often, always making the quick assumption that she’s lying to me about her health—probably because she sugarcoats most things. Fear fuels my frustration, and I will live and cope with it until the day my fear is justified. But my mother never shows fear, herself. She doesn’t pretend to be brave, but is nevertheless resilient. For that reason alone, she is the bravest woman I know.
“This was the first year that I put that survivor pin on my shirt and let people know. I always talk about it—it’s not that. I don’t know why, I just never wore it,” she said of the Carnegie Mellon October 4th annual Breast Cancer Football Fundraiser. “It was the first year I felt just comfortable feeling like it’s over. It’s over. I’m done. It’s been 14 years; I have a lot of other health issues, but I’m done.”
It was unpredictably bitter that day—hailing with freezing rain and the looming threat of evacuation due to the impending storm. The Carnegie Mellon Tartans, my brother, were tied to the Westminster Titans 24-24 with little time left on the clock. They kicked a record-breaking 50-yard field goal to win the game 27-24—in the same way my mother beat breast cancer; no one would say that being diagnosed with cancer is a win, but with what could have been no time left on her own clock, my mother didn’t let cancer beat her either.
Her battle, however, has lasted longer than mere hours. Rather, it’s an ongoing fight of nearly twenty years. And at its kick-off, she wasn’t wearing the Carnegie Mellon Tartans jersey she wore on October 4th, but instead the Pompton Lakes Cardinals. She worked the football field snack stand at Carlo field, where both of my brothers grew up playing.
“I would be down at the football field in the snack stand and would literally have to go into the bathroom, throw up, wash up and come back into the stand as if nothing was happening,” she said. But something was happening—cancer was happening.
My mother began going for mammographies regularly when she was just 30 years old, and when she was 35, the doctor noticed a shadow on her left breast. She, too, saw the shadow, but they opted not to do anything about it. “Five years later, after all the kids were born and I nursed everybody, everything was normal,” she said. That was until she started bleeding from her right nipple. “That’s when I went in for a biopsy, and was told I had severe atypical hyperplasia in the right breast.”
Atypical hyperplasia describes an accumulation of abnormal cells in a breast duct; it’s a precancerous condition, though can be a forerunner to the development of breast cancer if left untreated. And two years later, she had bleeding again—this time from the left breast.
“They found three granule-sized tumors that were Stage 1 cancer. I didn’t feel them. I just had this odd bleeding again. When I first went in, they did a lumpectomy—where they took out the cancer and surrounding tissue to make sure they got clean margins…After that, I had to make the decision as to whether or not to have a mastectomy,” she said. She debated also having a bilateral mastectomy, which would remove both breasts because of her history of atypical hyperplasia on the right side.
“At that point in my life, I chose to just have the treatment,” she said. “Though, thinking back, if it ever happened again I’d absolutely have the mastectomy. At the time I was only 40 years old and I was very conscious of my breasts being part of my sexuality. Because I was so young, it was a really tough decision to make. I remember somebody saying something to me one time—this jerky guy saying to me, How selfish of you—you have children, why wouldn’t you just have the mastectomy? But having a mastectomy does not mean that you’re 100 percent, that you’ll never get breast cancer. It’s a huge decision. I thought that was a really ignorant comment, especially because it was a man. I felt like he had no idea what I was going through, what a big decision it was; it was a part of who I was.”
After talking to a gamut of doctors, she decided to have treatment rather than surgery. “You have to put your heart and soul into your decision, and I was just positive about having the treatment and being done with it,” she explained. “Once I made the decision, I was confident that it was the right one…My doctor was strong when I didn’t feel so strong. He and I felt that it was best for me at the time at that point in my life.”
Because her cancer was estrogen-positive, my mother underwent radiation and subsequent medication for seven years to stop its production and put her body into early menopause. “The treatment was exhausting and nauseating; I was nauseous all the time,” she said. The nausea ensued as she worked the snack stand at Carlo field. And it ensued for years even after that.
The side effects were exasperated because of the price tag that came with her medication. “I remember I took Kytril, which was not entirely covered by my insurance at the time. It was $50 out-of-pocket, per pill. I remember breaking them in half to take them only when I really needed them for nausea. It seemed like for a while I was on so many medications because I was still getting my period and that meant I was still producing estrogen; they had to stop it. It was difficult. It was really hard. I was sick to my stomach all the time and I was exhausted.”
But neither the nausea nor the exhaustion was the hard part, she admitted. “The hardest part was telling you…being afraid that something was going to happen to me and I wasn’t going to be able to be with my kids. It felt like somebody hit me over the head with something. It was hard. It felt like I was spinning, like I was, I don’t know, like I just got hit in the head with a brick,” she explained. “The problem was you guys were really little. I remember sitting down on the couch and talking with you, but again, you were too little to understand any of that.”
I was just five years old when my mother sat me down on that couch.
“I couldn’t really explain it to you guys. I just told you I was sick and I was going to be fine. I don’t think I said cancer. I think I said that I had a boo-boo, but the doctor was going to fix me and I was going to be fine…But you didn’t know what it was. You didn’t know what was wrong. You didn’t know it was a deadly disease.”
But whether or not I knew—whether or not my brothers or sisters knew—my mother knew that her breast cancer was a deadly disease.
“One time I was talking to grandma, everyday she would get on the phone with me and say, Oh, the doctor said you were going to be fine, right? The doctor said everything is going to be okay, right? And there were times I just wanted to say to her, and I finally did, Could you just let me complain for five minutes and just let me feel sorry for myself? I needed to be able to go through that process of feeling like shit and allowing myself to feel like crap about it because everybody around me was telling me to be fine and that we were going to get through it. But I was the one who was actually going through it. It was my body, and as much as everybody wanted to help, and they wanted to talk positively, and they didn’t want to say anything that was going to scare me, I did all the research; I knew what the statistics were. Sometimes you need to just be able to say, This sucks. Cancer sucks. And I’m mad that it happened to me…I had to say, Stop saying ‘we.’ It’s ‘me.’ Allow me to just feel scared. I wasn’t being negative and I didn’t want everyone to be sorry for me. But I needed to feel whatever I was feeling, whether it was sad that moment or scared. If you don’t have anything to say, don’t say anything; just listen to me. Just be there.”
She asked her friends and family to allow her “to feel like shit for a little while, to cry and realize how much it sucked for a little while.” And then she said she picked herself up and pulled it together. “I knew I had to be positive and I had to get through all of this stuff if I wanted to be there to watch my kids grow up and that was it. But there were still moments when I’d be sitting in the hospital or going through a test and feeling shitty. And so I stopped trying to pretend I wasn’t feeling that way, and allowed myself to feel the emotion, and then just get over it and get on with it.”
My mother never pretended. She understood the reality of breast cancer, the reality that it’s simply, indubitably terrifying.
Death rates have been decreasing since 1989, particularly for women younger than 50, and by two percent per year since 2001 due to early detection, education and ensuing early diagnosis’s and treatment advances. Still, however, 40,000 women are still expected to die each year, of an estimated 220,000 women who will be diagnosed.
Exceeded only by lung cancer, breast cancer death rates are higher than those of any other cancer in the U.S. The chance that breast cancer will be responsible for a woman’s death is about one in 36 (about three percent). Perhaps this is because breast cancer is the most commonly diagnosed among American women, after skin cancer; just under 30 percent of cancers in women are in the breasts.
Despite the high numbers, women all-too-often don’t recognize breast cancer soon enough. You have to be your own advocate, my mother said. “If you have a feeling that something just isn’t quite right, go to another doctor. Get a second opinion. It’s up to you to take care of yourself…Because I had a feeling at 35, when I saw that mammography with the shadow on it. Even though they told me it was fine, it haunted me. Five years later, it was cancer-positive.”
For those like her—those who are on the field with a running clock, playing defense in their own zones, their own bodies, she said you just have to face it. Fight back with the support of your team—your family and friends, or another cancer patient who understands.
“Allow yourself to feel shitty. Allow yourself to go through all of the emotions. And then get on with the healing. But you need to have one person in your life—even if it’s just one person—who you can pick up the phone with and you don’t have to pretend, who you don’t have to always be positive with that you’re not scared or you’re not upset,” she said. “Anytime I know someone has cancer, I always tell them, Let me be that person for you. Let me be the person that you call at 2:00 am when you just want to say, This sucks, and I hate it. You don’t have to pretend that you’re not scared.”