By Dr. Venita Lovelace-Chandler
I knew I wanted to be a physical therapist when I was 8 years old. Very quickly, I also knew that I wanted to work with children. I got the opportunity to go to college and then to physical therapy school, and I began to work with children with special needs. I specialized in pediatrics and practiced for several years before I earned a PhD and became a professor of pediatric physical therapy. While I limited my practice to pediatrics, I certainly learned about other diagnoses while in school and during many years of practice. I had listened to presentations on breast cancer by students and colleagues. I had learned breast self examination (BSE) while in my physical therapy coursework, and I did BSE every month for 26 years until I found my breast lump in March of 1996. A colleague of mine once stated “Nothing I could have learned in a classroom would have taught me more about the complexity of treating cancer patients than my own experience living as one.” I could not agree more.
I had no history of breast cancer in my family, and I was not really worried about breast cancer when I performed BSE as a student. However, I found a mass which later proved to be cystic, not a cancer, but I realized in 1970 that I could understand my breast tissue through BSE. Luckily for me, I continued to do the monthly exam. I started mammograms when I was 40 years old, and I had a mammogram in August of 1995 before I found my lump in 1996. The mammogram showed that the old cyst had changed a little, and so I had a more definitive mammogram which revealed nothing more suspicious. As it turns out, the cancer was growing then and had grown into the old cyst, but I had a type of breast cancer which did not show on mammogram. In March of 1996, the tumor was large enough for me to feel it, but it was still too small for my physicians to find. I would find the mass, have my physician place his fingers over my fingers, then slip my fingers away. Then my physician could feel the mass. So having done BSE for all those years and knowing my breast tissue better than anyone else could know, probably saved my life. I would recommend that all women learn and perform BSE as a part of Breast Health just as they have regular clinical breast examinations and mammograms (as appropriate).
I knew almost immediately that the mass was a cancer because I could actually detect the lobular edges of the tumor. The official diagnosis did not come until May, after several other diagnostic tests and a lumpectomy. I was worried, but I used my ability as a professor and physical therapist to begin to study breast cancer. I read hundreds of articles and went to conferences while I waited for the official diagnosis and treatment plan. Many other women assisted me by sharing their stories and even allowing me to see their reconstruction so that I could make an informed choice.
The type of cancer I had, invasive lobular, was not considered to have a good prognosis at the time I was diagnosed. One oncology in May of 1996 said that I would probably not live until August and that I should get my affairs in order. Instead, I found a more aggressive oncologist who was willing to do more. I had a bilateral mastectomy and a TRAM reconstruction. I had chemotherapy for the remainder of 1996 and finished my reconstruction in early 1997. My hair grew back, my strength returned, and I went on with life. But, I continued to do BSE because I knew that the mastectomy might not possibly have removed all cancer cells. In March, yes March (I always need to get past March each year), of 2000 while conducting BSE, I found a new tumor. I had lumpectomy, chemotherapy, radiation, and a year of herceptin treatment, finishing just before the holidays in late 2001.
My hair grew back, my strength returned, and I went on with life. I continued to do BSE. In March (can you believe it) of 2005, I found a level three lymph node mass. At that time, I had extensive chemotherapy first to shrink the tumors (two had formed but looked like one), and I had surgery in October of 2005.
My hair did not grow back quite as well that third time, my strength took about 3 years to fully return, but got better the entire time, and I went on with life. I continue routine BSE and visits with physicians. Someone once asked me if I thought I was the unluckiest woman in the world to have had cancer 3 times. In fact, I am the luckiest woman I know. I found a physician who would fight hard with me the first time, and I lived long enough to have cancer again. I found all of my tumors early enough to be able to receive effective treatments. I have 4 wonderful children who are adults now, but the youngest was 10 years old when I found my first tumor. She is 23 years old now, and my ability to watch her become a competent, beautiful woman has been wonderful. I have 5 grandchildren who I would not have known if I had not survived the initial cancer. I married a physical therapist who was a student in PT school with me and who was my best friend. He and my children and my grandchildren and my colleagues and my friends have given me support that cannot be adequately described. I demand a lot of attention when I am sick, and they always came through.
Who could be luckier than me? Well, maybe you – because maybe you will become interested in your own breast health because I am encouraging you to do so. Maybe you will learn and routinely perform BSE. Maybe you will obtain clinical breast exams from skilled practitioners and mammograms at the appropriate age. Maybe you will never have breast cancer, but if you do find a mass, you will find it early and have it examined quickly to receive good treatment, if necessary. Maybe you will work to raise money to fight breast cancer or to support women who have breast cancer. Maybe you will encourage your daughters, mothers, friends, including me, to do BSE. To other survivors, I would tell you to be proud of yourself and to keep taking care of yourself. As a physical therapist, I would advise us all to keep exercising and keep our weight to an appropriate level, because exercise and the absence of obesity reduce the risk of having breast cancer and increase the ability to survive if you do have cancer.
Personally, I still do BSE. I hope I never have to fight cancer again, but I will try to do my part by walking, eating right, and doing BSE. Finally, I enjoy the great faculty, staff, students, friends and family that I have around me, and I try not to care about small problems, like bad hair days!