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A Brave Battle

by Alicia DiFabio

In honor of Breast Cancer Awareness Month, these local women open up about their survival stories to help raise awareness and hope for others.

It’s a sobering statistic: One in eight women will be diagnosed with breast cancer at some point in their lives. While death rates have been steadily decreasing, particularly for women under 50, it continues to be the second leading cause of death among women. That is why early detection plays such a crucial role in survival.

That’s something the following seven South Jersey women (click here for their photos) know all too well. Standing among the 2.8 million breast cancer survivors in the U.S., they are like most; they battled through and are now stronger than ever. Here they share with us their stories and how the support of their loved ones, a positive spirit, the right doctors and early detection saved their lives.

Breast cancer risk doubles if a first-degree relative has been diagnosed. For Karen Prendergast , having a grandmother with breast cancer meant regular mammograms starting in her 30s. She remained diligent and each year she was rewarded with unremarkable mammograms. Then in 2010, she noticed an outward change in her breast, something she thought was the result of breast-feeding her last child. Though exactly one year earlier her mammogram had been clear, a biopsy confirmed she had breast cancer. “That’s when the ball dropped,” she says. “In one year, I grew a 7-centimeter mass.”

Prendergast was a 44-year-old mother of six when she was diagnosed with stage III breast cancer. She had been a typical mom carting kids to after-school activities, and now life came to a screeching halt.

She had six rounds of chemotherapy in an attempt to shrink the tumor prior to surgery. This was followed by a double mastectomy and reconstruction. “I chose a double mastectomy because I had six kids,” she says. At the time of her diagnosis, her children were between the ages of 2 and 19.

Due to her increased risk of developing ovarian cancer, she also elected to have her fallopian tubes and ovaries removed in a procedure called an oophorectomy. She received radiation treatments and will likely take medication for the rest of her life.

As a resident of Washington Township, Prendergast wanted to be treated close to home, so she received all of her care, with the exception of her reconstruction surgery, at Kennedy Cancer Center in Washington Township. “When I was first diagnosed, everyone said, ‘Go over to Philly.’ I thought, ‘Why not go where I’m close to home?’ Plus I loved the people. ... When I see them, I get a hug whenever I walk in the door.”

She is especially full of praise for social worker Abagale Hassel at Kennedy who runs a support group and email chain connecting newly diagnosed patients with breast cancer survivors. She owes much of her emotional recovery to that support network. “People go through it with you, but no one understands like someone who went through it themselves. ... You pull strength from people like that.”

Her family and community are a wellspring of support and love. Her children’s coaches have organized breast cancer fundraisers and promoted awareness in her name. One year, her son’s wrestling team wore pink shirts with the breast cancer awareness symbol in her honor. “It was one of the most touching things,” she recalls.

Prendergast says she’s doing well now, yet some days are hard. “It does mentally wear you down. ...You don’t ever lose the fear of it coming back, especially when you lose a friend,” she says, reflecting on the recent loss of a fellow survivor.

“Everyday I’m lucky to be here,” she says. “You just can’t quit.”

Jennifer Fleischmann of Cherry Hill also began routine mammograms in her early 30s. Both Fleischmann’s maternal grandmother and mother were diagnosed with breast cancer. Her mother lost the battle with ovarian and breast cancer in 2009 but, before she died, she underwent genetic testing which was positive for the BRCA 2 gene mutation. “I knew in the back of my head I’d eventually need to be tested,” Fleischmann says. But it wasn’t until November of 2012 that she got the extra motivation she needed to do it. She had a scare on her mammogram, which ended up being nothing, but it prompted her to get the test.

Most inherited cases of breast cancer are associated with abnormalities in either the BRCA 1 or BRCA 2 genes, which account for up to 5 percent of hereditary cancers and up to 10 percent of all breast cancers. Women with these gene mutations have anywhere from a 45 to 65 percent chance of developing breast or other cancers, such as ovarian, pancreatic, fallopian tube and melanoma.

In February of this year, Fleischmann, 37, tested positive for the BRCA 2. “My doctor told me I had an 85 percent chance of developing breast cancer and a 25 percent chance of developing ovarian cancer.” If she had the mastectomy and oophorectomy, her chances would reduce to less than 5 percent. As a wife and mother to a 9-year-old and 8-year-old twins, Fleischmann faced a very difficult choice, but one she felt confident in making. “I felt like a ticking time bomb. ... If I got cancer in a month or two, I would kick myself.”

Fleischmann chose to be proactive and have an elective double mastectomy and oophorectomy this past May. “The double mastectomy wasn’t as horrible as I thought it would be. ... I had time to prepare myself for it. My situation was different than someone with cancer.” Her biggest fear, she says, was losing her ovaries and getting thrown into menopause at such a young age.

Prophylactic surgery was not only a difficult personal decision, but also difficult to explain to others. Some family and friends questioned why she would choose to remove healthy tissue, though “once they knew the statistics, they were supportive,” she says. Her 9-year-old daughter couldn’t understand how her mother wasn’t sick but still needed surgery, and was scared her mom was hiding something. While breast cancer awareness has increased, Fleischmann believes awareness about the BRCA gene has not necessarily caught up.

She knows the BRCA gene mutation could affect her three daughters and/or her future grandchildren one day, but she firmly believes that despite the anxieties it may raise, knowledge is ultimately power.

When her mother had her genetic testing, it allowed Fleischmann and her children the opportunity to make proactive health choices. She knows other women don’t get the luxury of time or choice.

Though her mother is gone, she has given future generations that awareness and hope. “I feel like it was my mother’s last gift to me.”

Julie Wills was 39 years old and in the best shape of her life. The Mullica Hill resident was a dance instructor, CrossFit enthusiast, wife and busy mom of two young children. Despite her great health, one day Wills felt something different in her breast—not necessarily a lump, but thicker tissue. “I just knew it didn’t feel right.”

She scheduled a mammogram to be on the safe side. “I wanted peace of mind that it was nothing,” she says, and peace of mind is what she got. Though Wills left her mammogram with a huge sigh of relief, she kept an eye on the area of concern. “It didn’t grow, but it didn’t go away,” she remembers.

Last January, Wills raised concern about the area again at her annual appointment. Her follow-up mammogram was still normal, yet her doctor recommended she meet with a breast surgeon just to be sure. Wills scheduled an appointment with Dr. Anne Rosenberg, a breast surgeon with Jefferson University Hospital, who found it suspicious and said she’d be shocked if the biopsy came back benign. Her inclination was right.

Wills was diagnosed with ductal carcinoma in situ, or DCIS, a non-invasive cancer that starts in the milk ducts. “I actually cried tears of joy because even though it was cancer, it was the best possible scenario,” she says.

Due to her smaller bust size, she required a mastectomy. She opted for a double mastectomy with reconstruction because with DCIS, there is a greater risk for developing invasive cancer in the future.

Post-surgery, some minor cancer infiltration was indeed detected, moving Wills from a stage 0 to a stage IA, leading her to undergo six weeks of daily radiation treatments at Cooper University Hospital.

Wills feels blessed that she caught everything early and is glad she trusted her intuition and sought expert advice and multiple opinions. Even so, it was a difficult six months. Post-surgery, she was not able to lift her kids, let them curl up in her lap or take them to their various activities, which was heartbreaking as a mother. “As I move on from this experience, I never want to forget to appreciate those little things.”

Wills recently returned to work as a dance instructor at Jazz Unlimited in Marlton. She also reached a major milestone when she returned to her CrossFit training. She attributes much of her physical and mental healing to CrossFit for strengthening her core and giving her an incredible support system. She describes her husband, extended family, co-workers and friends as amazing and helpful. “I never felt alone and that’s important,” Wills says.

With cancer now behind her, Wills encourages women to do self-exams, get mammograms and surround themselves with the best doctors. If she had accepted her two normal mammograms without consulting a specialist, her cancer might have progressed much further. “My prognosis is so good,” she says. “I feel good about the decisions I made.”

Although family history doubles the risk of breast cancer, approximately 80 percent of breast cancer occurs in women with no family history at all. Not knowing that statistic, Patty Hoffman, of Cherry Hill, never felt any need to worry. At the age of 46, she still had not scheduled her baseline mammogram.

“There was no reason I would ever think I’d get it,” she says. Even still, Hoffman would do self-exams with enough regularity to know when something felt different, which ended up happening last January when she noticed a lump during a shower. “Checking regularly and knowing what’s normal probably saved my life,” she says.

On Valentine’s Day, Hoffman was diagnosed with stage II breast cancer. She underwent a lumpectomy in March followed by chemotherapy.

Through her treatments, Hoffman never stopped working as an occupational therapist, scheduling her chemotherapy on Fridays and using a three-day weekend to recover. She kept working because she didn’t want cancer to change her life. “Keeping things as normal as possible was important to me,” she stresses. Her work kept her distracted and appreciative; helping others get well was another way for her to stay optimistic about her own life.

Her husband and two daughters, ages 19 and 15 at the time, were a huge source of comfort and support throughout her diagnosis, surgery and chemotherapy. “Everybody has a breaking point, but I had such strong, caring people around me.” For Hoffman, going public with her diagnosis allowed her to be uplifted by others. She recalls making a post on Facebook right after her diagnosis. Almost immediately, she received 100 encouraging comments on her Facebook wall. “That support was unbelievable,” she says. “It was a huge reason my spirits stayed high.”

During chemotherapy, Hoffman’s hair began falling out in ribbons. She called her hairdresser on Memorial Day to “bite the bullet” and shave her head. She was told to come right over. When Hoffman arrived to her hairdresser’s home salon, she saw it was set up with candles, a bottle of champagne, a bouquet of flowers and other personal touches. “It made a challenging day really nice,” she remembers. “It was people doing these very special things that made me smile.”

Along with an amazing support system, Hoffman’s life philosophy helped guide her through the toughest days. She describes herself as someone who always looks on the bright side—even breast cancer wouldn’t change that. “I’ve always been optimistic,” she says about herself. “I never felt like it was something I wouldn’t get through.”

Twelve years ago, Barbara Dinger was a 47-year-old Washington Township mother of three when a routine mammogram found something suspicious. Like Hoffman, Dinger had no family history of breast cancer, but as a nurse, she knew the importance of regular mammograms. She wasn’t too concerned about the small spot seen in her right breast and the doctors decided to simply watch it and see if it grew over the next year. “I never thought it was malignant,” Dinger says, and so she pushed it to the back of her mind over the next two years.

When she returned for a follow-up mammogram, the spot had grown larger and it was biopsied. Dinger was diagnosed with stage II breast cancer and had a unilateral mastectomy at Our Lady of Lourdes Medical Center in Camden. Surprisingly, a total of five malignant masses were found in the removed breast.

Following surgery, Dinger went through 12 weeks of chemotherapy, during which time she had a swell of support from her family and friends. Her three children were 12, 14 and 21 at the time. People helped clean her home, ran to the store, brought her meals and just spent time with her. In the days following her diagnosis, The American Cancer Society came to her home and breast cancer survivors spoke with her. “I was scared,” she remembers. “That brought me hope.”

The chemotherapy was tough and Dinger is still affected by its aftermath. She developed secondary musculoskeletal problems and a common phenomenon—dubbed “chemobrain”—which affects memory, attention and the ability to focus.

Since her chances of developing breast cancer again were now significantly increased, Dinger opted to have an elective mastectomy on her right side about six months later. They found three masses in that breast that were undetected on a mammogram. “Your mammograms don’t always show everything,” Dinger cautions.

Dinger later tested positive for the BRCA 2 gene mutation and as a result chose to have an oophorectomy.

“[It was a] hard time in my life but I’m better now,” Dinger, now 59, says. She has spoken at a fundraiser for breast cancer research and she and her family participate in the Susan G. Komen walk on Mother’s Day.

Sadly, Hoffman’s husband was diagnosed with terminal esophageal cancer two years ago. Now she is caring for the man who took such good care of her during her own battle.

Dinger is a huge advocate for early detection. “People really need to go for early mammograms,” she asserts. Yet, like Wills, Dinger knows first hand that mammograms don’t always show everything. Therefore, it is important for women to know their own bodies, trust their instincts and seek out experts when necessary.

At 71 years old, Vicky Casdia of Cherry Hill enjoys her nine grandchildren and traveling with her husband. You would never know that almost seven years ago she began her fight with breast cancer.

Casdia had no family history of the disease. However, she was seeing a breast surgeon due to a history of fybroids. In March of 2004, at the age of 63, Casdia’s regular annual mammogram caught something suspicious, yet she was not worried while awaiting her biopsy results. “I was confident this was going to be OK,” she says. When the results came back malignant, she was in utter shock.

Casdia was advised to have a unilateral masectomy since two different areas of cancer were detected.

She recovered well from the surgery and reconstruction and no chemotherapy or radiation was recommended as they believed they removed all of the tissue. She remained on a cancer drug for five years and was diligent with her mammograms. In 2009, about five years cancer-free, Rosenberg’s keen eye detected something during a routine follow-up visit—something that looked like a pimple high up on the same breast that had been removed and reconstructed. A biopsy of the area revealed a malignancy, so Casdia was back in the operating room to remove any traces of remaining tissue in that breast. “The second time was more of a shock than the first time,” she says.

The support of her family and friends along with her own optimism kept her positive through the entire process, both times. “My husband was amazingly supportive,” she says, along with her three adult daughters and the community. “My hairdresser was an angel,” Casdia recalls. She accompanied Casdia to a wig store, helped her select the right one, then styled it so it would be ready before she even started losing her hair. “It was not as traumatic as I thought it would be,” she says.

Casdia is now in her second five-year period of being cancer-free and says she owes her life to her annual mammograms and her exceptional team of doctors. Though she recognizes her risk is higher for getting other cancers, she stays positive. “It’s in the back of my mind, but I keep it there.” She chooses to live life fully and travel with her husband.

Casdia strongly encourages women of all ages to keep up with their annual mammograms. “That’s what can save your life.”

In addition to family history, age is also a significant risk factor for breast cancer. Namely, the older one gets, the higher the risk. However, as Joanne Ferrara discovered, breast cancer doesn’t always follow the rules.

Ferrara was only 34 years old when she felt “a little something” on her right breast. She describes it as “...not a lump. It [was] more long than a lump.” After a biopsy, the Mantua mother of two young children was diagnosed with ductal carcinoma in situ, stage 0, at Virtua Fox Chase Center. Though she could have had a lumpectomy, Ferrara says they were pushing for a mastectomy. “The chances of it reoccurring were high so I chose to do the double mastectomy.” As part of the 14-hour surgery, her lymph nodes were also tested to ensure the cancer had not spread. Unfortunately, it had. “I went from a stage 0 to a stage III,” she says. Ferrara started chemotherapy followed by radiation at the Hospital of the University of Pennsylvania.

She describes the first round of chemo as awful. “I had two kids, and trying to be a mom ... I was crying to my husband, ‘How can I do this?’” But the support of her family and friends helped her through. “I had a ton of help [from] neighbors. It was hard, but I had a ton of support.”

Her best advice for people who want to help but don’t know how is to not ask or offer, just do it. “You don’t really know what you need until people do it for you,” she says. Her daughter’s dance class organized a meal brigade, friends and family took her kids to their activities, and her husband had a Caring Page which kept everyone updated on her status. “He was amazing through everything,” she says.

During her sixth round of chemo, Ferrara’s mother was diagnosed with breast cancer and had a double lumpectomy and radiation treatment. “She is great now,” Ferrara says. She and her mother underwent the genetic testing for the BRCA gene mutation. Ferrara’s came back positive, but her mother’s was negative. It turns out Ferrara inherited the gene mutation from her father. The BRCA gene mutation can be carried and inherited by both males and females and it increases a male’s risk of developing certain cancers, as well. Knowing her risk was increased for other reproductive cancers, Ferrara opted for an oophorectomy to remove her ovaries and fallopian tubes in 2010.

Ferrara is three years cancer-free, back to work as a teacher, eats healthy and has resumed exercising. Yet, after battling cancer, Ferrara admits things never truly return to the way they were before. “There’s never a day that goes by that I don’t feel scared. I always have that in the back of my head. ... I try to be healthy and not dwell. I’m a positive person and I attribute a lot to that.”

Eight rounds of chemotherapy and 31 treatments of radiation concluded on Aug. 14, 2010—a day of great significance for Ferrara. “That’s the day I considered myself a survivor.”

Published (and copyrighted) in Suburban Family Magazine, Volume 4, Issue 8 (October, 2013).
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