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Breast cancer survivors must look to the future.
Women who have been diagnosed with early-stage disease should live fully after treatment.
"Screening for breast cancer has essentially transformed breast cancer treatment," said Dr. Benjamin Hinton, a radiation oncologist in Tupelo. "The vast majority of cases are diagnosed at an early stage and have excellent prognoses – people are living longer than ever before."
Corinth's 68-year-old Gloria Cartwright was 12 years old after being diagnosed with breast cancer.
"I never thought I could say 12 years," said Cartwright, who attributes a stubbornly positive attitude, prayer and good medical care.
Marsha LeBlanc, 68, of Amory is 17 years old as a breast cancer survivor and seven years as a survivor of ovarian cancer.
"I feel so blessed every day to always be with my family," said LeBlanc.
Plan for the future
Survival care plans are receiving increased attention in breast cancer care. For its national accreditation program for newly completed breast centers, the North Mississippi Medical Center Cancer Care and breast cancer physicians have improved survival planning, said Dr. Danny Sanders, a surgeon in Tupelo.
"We have always had a follow up, but it's much more standardized now," Sanders said.
Once treatment is complete, patients with breast cancer receive a package detailing their treatment and indicating the recommended follow-up schedule.
"We adapt that to the individual," said Sanders.
Most recurrences will occur in three to five years, but may occur longer, said Dr. Pascal Wilson, an oncologist in Tupelo.
"When they cross the five-year mark, we think they'll probably stay free," Wilson said.
Just as physicians point out that breast cancer screening is in its infancy, it is also important to catch recurrence at an early stage, said NMMC's navigator in cancer nursing, Cancer Care. The management of metastatic disease has progressed considerably.
"If breast cancer recurs, it is treatable," Wilson said.
Breast cancer patients also have other health issues and risks that need to be monitored in the long run, Wilson said. A history of breast cancer increases the risk of developing certain types of cancer. Some chemotherapy agents may have a long-term impact on heart risk and bone marrow health. Hormonal inhibitors can reduce the risk of recurrence, but they can also increase the risk of blood clots or bone loss.
Women who have undergone radiation therapy for breast cancer, especially before new techniques become widely used, need to be evaluated for ischemic heart disease, Hinton said. These side effects can take decades to develop and involve a very small group.
"There are many reasons to have a cardiac evaluation," Hinton said. "It's only one."
As survivors go well beyond the five-year mark, sometimes surgeons and medical oncologists hand over medical examinations to a primary care physician, but that does not mean it's not important.
"You have to follow up with someone," said Farris.
Difficult trip
When she was diagnosed with breast cancer in 2002, LeBlanc knew that she was fighting for her. Her mother died of breast cancer in 1982 at the age of 58.
"She had a lot of trouble with the treatment," said LeBlanc.
LeBlanc had one of the toughest and often most aggressive forms of triple negative breast cancer and the doctors could not tailor his treatment to a specific receptor. While LeBlanc was undergoing surgery and chemotherapy, she was carrying extra charges.
Her eldest son, then 23, was diagnosed with non-Hodgkin's lymphoma in 2001. The family went through a business-related crisis while she was undergoing treatment.
"It added to the stress," LeBlanc said.
In November 2010, at least stage 3 ovarian cancer was diagnosed.
"It was everywhere (in her abdomen) except my appendix," she said.
Staying focused on her family – her husband Ron, their three children, and later three grandchildren – gave her the strength to face her two cancer diagnoses.
"They really played a big role in maintaining my positive mentality," said LeBlanc. "They always do it."
LeBlanc does health checks every six months and scans every year. She has had good reports since the end of treatment for ovarian cancer. His son is also healthy.
The prayer was a lifeline for LeBlanc. This helps to get rid of fear and focus on what she can control.
"I do not really linger there," LeBlanc said. "I'm going to do my part and trust my doctor, for the rest, I've given God to take care of it."
Survival lessons
Cartwright was diagnosed with stage 2 and HER-2 positive breast cancer in 2006. She underwent surgery, two rounds of intravenous chemotherapy and five years of oral prophylaxis.
A former social studies teacher in high school, she continued to teach throughout her treatment. Her students and colleagues helped her by washing her hands and adapting to the treatment program.
"You can only do what your body allows you to do, but do as much as you can," Cartwright said. "I knew that teaching was better than sitting and having a pity party."
All people with breast cancer are not comfortable sharing their experience, but for Cartwright, it was encouraging to be on prayer lists throughout the community. She and her husband Terry relied on their pastor at the First Baptist Church in Corinth. A student gave him a special verse.
"I wanted him to be known and pray," Cartwright said.
Because of her treatment, she waited three years for a reconstruction operation, Cartwright said. It was a very important step to regain his identity as a woman.
"I could not look at myself without crying," she said before a reconstruction operation. "Since then it has been a lot better."
She retired from teaching in 2012 after 33 years spent in class, but she continues to serve as a volunteer tutor, chief of church desserts and grandmother of six children.
"Service is my gift," said Cartwright. "It's what God has blessed me."
She takes care of her garden and raises chickens. She focuses on eating healthy foods, including vegetables that she grows in her garden. The cakes that she makes usually go to the church or grandchildren. Even after 12 years, Cartwright takes care to continue his follow-up with his surgeon, his oncologist and his gynecologist.
"I have been more active since my retirement," said Cartwright. "We are not sitting."
To take care
Breast cancer survivors must adopt a healthy lifestyle to reduce their long-term risks.
Not smoking, limiting alcohol consumption, increasing physical activity and focusing on healthy eating can make a difference.
"There is no absolute, but you want to look back in 10 years, knowing that you have done everything to live as best you can," Farris said. "The rest is in the hands of God."
Obesity influences the risk of cancer, said Farris. Adipose tissue cells can secrete hormones, which is an additional risk for those diagnosed with hormone-positive breast cancer.
In general, Leanne Davis, a dietician in cancer care at NMMC, directs breast cancer survivors to a healthy diet that includes more vegetables, fruits, lean protein and whole grains. They need less red meat and pork, processed foods and sugar.
Myplate.gov is very useful. Some applications and habits can help guide the right choices and record food choices and exercises. Dietitians can help individualize diets.
"The goal is to reach a healthy weight and find a balance in your diet," said Davis. "It's not a matter of eating perfectly, but of being persistent."
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