For Cindy Fowler, life at age 48 was nearly perfect. She loved her job in business development and marketing and was involved in community activities. Her daughter, a college student, was spending her junior year abroad, and Cindy planned a trip overseas.
But after she returned from Europe, Cindy felt something strange in her left breast.
Her previous mammograms were normal, but this time, there was a new ridge of tissue. A biopsy showed abnormal cells.
Her primary care physician, Dr. Kimberly Tibbs, referred her to Dr. Ingrid Sharon, a surgeon at Memorial Health System’s Breast Surgery Specialists.
“I was lucky enough to have a primary care physician who said, ‘I am not an expert in breast cancer, and I want you to see somebody who is.’ I credit her for saving my life.”
Cindy was diagnosed on Feb. 11, 2008 with multifocal cancer of the left breast.
“It was well hidden,” Cindy says. “The typical diagnostic tools did not indicate it.”
A team approach
Cindy and her husband decided to learn everything they could. They talked with Dr. Sharon about Cindy’s treatment options and met with Dr. Dax Kurbegov, medical oncologist at Memorial Health System Cancer Center, who headed the multidisciplinary team that would focus on Cindy throughout her treatment
“From the moment of diagnosis, we mobilize everyone who might be needed,” Dr. Kurbegov says. The team included experts with extensive experience in all facets of breast care, from radiology to complementary therapies.
“The Breast Center concept has dramatically changed how breast cancer is treated,” says Chris Bartlett, M.D., Medical Director of the Memorial Breast Care Center and diagnostic mammography services. “Once the patient is identified as having a problem, we try to move them through the system as quickly as possible and as inexpensively as we can.”
Cindy’s team laid out a framework of options and choices she might need to make. A nurse navigator helps guide patients through treatment, coordinates care, schedules appointments and referrals, answers questions, and connects patients and families with resources such as Memorial’s extensive library, complementary care, rehabilitation, or support groups, at no charge.
Partly because of a family history of cancer, Cindy chose to have a double mastectomy. She had the surgery, which included insertion of skin expanders for eventual reconstruction, on March 18.
After the surgery, Cindy’s team reviewed her pathology and developed a plan for further treatment with chemotherapy, radiation, and endocrine therapy.
Cindy begins chemotherapy
Before beginning a 20-week course of chemotherapy, Cindy talked with Dr. Kurbegov and his nurse about the side effects she might experience and how to relieve them.
“One of the differences between chemo now and 10 years ago is that we can manage side effects well,” Dr. Kurbegov says. “We try to be proactive. The most effective strategy is to have medications there on your shelf waiting for you.”
In Cindy’s case, her treatment included medication to manage stomach pain and cramping, since she had a history of peptic ulcer.
“I thought chemo would be a lot worse,” she says. “I didn’t have the traumatic things that I had heard about. I would leave the treatments feeling kind of dizzy, but OK. I was tired, but I managed to raise record-breaking amounts of money while I was going through chemo.”
Continuing treatment for Cindy
Cindy’s chemotherapy was completed in late summer. Radiation therapy was the next step. Her treatment plan called for a five-week course of daily radiation treatments to clean up any tiny leftover cells and reduce the chance of her cancer coming back. Radiation oncologist Dr. Jane Ridings guided her treatment and helped manage side effects including redness, irritation, and fatigue.
The final stage of Cindy’s treatment was therapy to erase any cancer cells that might have survived. She has taken several medications, including a couple of drugs as part of a clinical trial. Cindy had reconstructive surgery in March 2009. She still visits Dr. Kurbegov about once a month.
For her part, Cindy decided to focus on what she could do to improve her health.
“For me, that is much more of a positive focus than the cancer,” she says. “I know I am in the best hands possible. I totally trust my doctors, and I’m confident they are doing everything they can. Every single person at the Breast Care Center knows your name, remembers things about you, and treats you like you’re special,” she says. “For me, that was huge.”
Cindy hopes her story will help other women face breast cancer with courage and spirit. She has had low days, but she has accomplished much during her treatment. In addition to her regular job, she created a special event called Cowboys and Cocktails that raised more than $8,000 for three local organizations, including two local breast cancer charities. Now in its third year, Cowgirls and Cocktails most recently had 280 participants and raised $23,000.
“I don’t think you can go into this dreading everything,” she says. “I decided this was a journey—you learn from it. I learned how strong I am, and that the busier you can keep yourself, the better. I learned I could still have fun. You just really have to be graceful. Nobody but you knows how much you can do. You do not have to stop your life."