JOPLIN, Mo. —
It’s a disease that affects everyone differently.
Talk with doctors who work each day with patients who have been diagnosed with breast cancer, and they’ll say that no two patients’ stories are the same. They can differ because of the type and location of the cancer. They can differ because of hereditary factors and treatment options.
Because of advancements made in the field of breast cancer research, treatment has become more and more targeted, focused on finding a positive ending for each patient’s story.
Raeann Cully’s story differs from others in how young she is. And it’s a story that is still very much in progress.
The 30-year-old Joplin resident was diagnosed on July 19 of this year. A lump was discovered in her right breast during a mammogram, and she was immediately sent to have an ultrasound and biopsy.
A week later, doctors informed Cully that she had Stage 3 breast cancer.
“It was very shocking,” said Cully. “My mouth dropped and I cried.”
She said she had no family history of breast cancer, and genetic testing came back negative.
“Not knowing why or how I got it is even more mind boggling,” she said. “I’m just one of the few unlucky ones.”
But in a way, her young age has played to her advantage when it comes to treatment. The cancer was not tied to any lymph nodes and it was not hormone-related.
“Because they found it early enough, my oncologist put me on the most aggressive treatment because of my age and my health otherwise was good,” she said.
Her doctors put her on an aggressive schedule of chemotherapy, which requires six cycles, one every three weeks.
Her fifth round will take place the day before Halloween, and the last in November.
After that, she’ll likely have surgery to remove the tumor, though she said those details haven’t been worked out yet.
There have been days, said Cully, when the going has been rough.
“This morning, I didn’t think I was going to make it,” she said. “There have been a few times when I thought, ‘I don’t want to do this chemo treatment. I don’t want to do any of it.’ And I didn’t want to lose my hair. I’m stronger than I thought I would be, though.
“You just have to fight for it and have that motivation. My kids are worth it. I have to be here for my kids.”
Her daughters, Haylee and Makayla, have been a constant source of support, as well as her aunt and uncle, with whom she lives.
“If it weren’t for my aunt and uncle, I don’t know how I would have got back and forth to all of my doctors appointments and to school. They’ve just been wonderful.”
She’s studying at Vatterott College to become a medical assistant, and her instructors have been accommodating with her treatment schedule.
Though she will have to take a leave of absence around the time of her surgery, Cully said she will still be able to graduate with her classmates this fall.
She said that while some of her peers have been hesitant to broach the subject of the disease, she said they have been supportive of her. And when the topic does come up, she has one important message about breast cancer to share with others.
“It can happen, obviously, to anybody,” said Cully.
Individual stories, individual treatment
“No two breast cancers are alike,” said Dr. Walter Dandridge, director of the Breast Cancer Center at Mercy Hospital Joplin. “It’s a very individual situation.”
In the past, “cancer” might have been considered something of a catch-all term, said Dr. John Vu, an oncologist with the Freeman Cancer Institute. But in 2013, doctors are much more familiar with what makes the disease tick.
“You can say someone has breast cancer, someone has colon cancer or someone has lung cancer, but molecularly, deep down, they have a different kind of natural history.
“What we traditionally looked at was the histology. Was it adenocarcinoma, was it mucinous? Nowadays, we’re actually looking at cancer based on the type of receptors.”
The three main receptors that doctors look for in a patient with breast cancer are estrogen, progesterone and HER2. Those receptors signal certain types of cells to grow.
Based on which type of receptor a patient has, doctors can use them to help create a targeted treatment.
Before treatment became much more targeted to both the disease and the patient, Vu said that someone with HER2 positive breast cancer faced the worst-case scenario.
“Nowadays, we’ve flipped that around,” he said. “With very good targeted therapy, patients are surviving for a long time, even with advanced disease.
“If a patient doesn’t have any of those receptors, they would be classified as what we call having triple negative breast cancer. That is actually the worst prognosis because it’s usually the most aggressive type and doesn’t have a targeted treatment. The patient is stuck with standard chemotherapy.”
Dandridge said there are other factors that play into designing an individualized course of treatment, such as the tumor’s size and whether the lymph nodes are involved.
“That gives us an idea of what we can do ... what treatment (the patient) will receive and what the ultimate outcome may be,” he said.
“We present all of our breast cancer patients with a conference. They sit down with the oncologist, mammographers and surgeons to talk and map out what we think is the best individual treatment based on their history and other factors.”
Advances made in the field of breast cancer treatment over the past five years have resulted in a much different experience for many patients.
“The drugs are more and more sophisticated,” said Vu. “And because (the therapy is) targeted, it causes less side effects. You don’t have the common side effects like hair loss, nausea, vomiting or those kinds of things because we’re more focused on targeting the receptor on the cancer as opposed to kind of indiscriminately killing cells in the body.
“Patients with breast cancer are having a better and better prognosis than they used to have, and more and more treatments are available that are effective.
“Each cancer is unique and a patient needs to be fully assessed about their medical problems and what would be the most effective treatment for them. We really have to tailor the treatment to the disease and to the patient. It can be quite complex.”
JOPLIN, Mo. —
It’s a disease that affects everyone differently.
- Breast Cancer Awareness
Finding strength: 30-year-old patient learns to fight
Talk with doctors who work each day with patients who have been diagnosed with breast cancer, and they’ll say that no two patients’ stories are the same. Raeann Cully’s story differs from others in how young she is. And it’s a story that is still very much in progress.
Carl Junction woman credits quick mammogram for positive outcome
One year ago this month, Mercy Hospital’s mobile mammography unit pulled up at the Carl Junction Community Center. Amy Graskemper was persuaded by her sister to drop by for a checkup.
Upbeat attitude helps Baxter Springs woman handle whatever comes her way
When Marcia Trease was declared free after a bout with uterine cancer 13 years ago, she never thought she would have to face a diagnosis of breast cancer more than a decade later.
Writer finds hope in struggle
Kathy Gronau's book, “Eat Ice Cream for Supper: A Story of My Life with Cancer/A Guide For Your Journey,” published by Morgan James Publishing on Oct. 8, not only chronicles the couple’s experiences with the diagnosis, the treatment and facing end-of-life decisions, but also serves as a faith-based, practical guide to coping — both from the perspective of a caregiver and a patient.
Breast cancer buddy: Joplin woman uses experience to help others battling the disease
Jane Obert had a history of benign cysts, so when a mammogram and ultrasound turned up a cyst in her left breast in June of 2000, she wasn’t too alarmed.
Survivor stresses importance of early detection
“It’s never going to happen to me.”
The mindset about breast cancer is one that Joplin resident Shanti Navarre said she’d had until her diagnosis in January of this year.
A different outlook: Cancer treatment entering final phase for Joplin woman
With about two weeks remaining in her radiation treatments, Sandra Friend has her fingers crossed that it will be smooth sailing.
Should mammograms begin at 40?
New breast cancer research has revealed a significant death rate among women younger than 50 who do not get regular mammograms.
Groups provide support, hope
Area foundations and organizations are working to educate people about breast cancer and the importance of screenings, and to get treatment and other help for those who have been diagnosed.
Breast Cancer Awareness Calendar
JOPLIN: Muffins and Mammograms, 8 a.m. to noon, Women’s Pavilion at Freeman Women’s Center, 1532 W. 32nd St. Call to schedule an appointment. Details: 417-347-7777.
- More Breast Cancer Awareness Headlines
- Finding strength: 30-year-old patient learns to fight