With her radiation treatments behind her, Karen Moore was getting back to normal.  The tired feeling that dogged her at the end of the radiation therapy was still hanging on, but it was hard to determine if it was simply related to the hot, humid Houston summer or a residual aftereffect of radiation.  Whatever the cause, Karen took it as her body’s way of telling her to slow down and get some rest.

“I never really ‘listened’ to my body before all this happened,” Karen explained.  “Oh, every once in a while I’d feel an ache here, or a twinge there, but I have always been so healthy that feeling good is the norm, not the exception.  I think we all get so tied up in our day-to-day activities that, unless something smacks us right between the eyes, we tend to ignore the little symptoms and just keep on going.  Perhaps that’s why when we do finally admit that there’s something wrong, we’re really sick.”

“Strangely enough, I have some mixed feelings about the treatments being over.  Let me see if I can explain it.  For a little over a month, I had to arrange my schedule to be at the radiation therapy center every day at a certain time.  I got so good at this,” Karen chuckled, “that I could leave the office, get radiated, and be back at my desk within an hour.  I did finally schedule the treatments for later in the day when I began to get tired, however, and then would go on home instead of back to work.”

“Every day, I got to see my team of professionals who provided the therapy along with a healthy dose of encouragement and support.  They were kind and considerate, and helped me to feel I was taking charge of my health.  They were, as I have described them before, my safety net.  I had a real sense of fighting this disease...that I was actively doing something to be cancer-free.  All through the treatments, I kept waiting for changes.  I don’t know, I guess I thought I would be able to tell if the cancer was all gone.  I can’t.  I just don’t feel like it has disappeared.  Maybe that will change in time, but for right now, I’m concerned that I’m not doing enough to make it go away...that I ought to be doing something more.”

“This may all be a kind of separation anxiety from the therapy.  I understand the psychology of what I have gone through.  I realize that in addition to helping my body, the therapy also helped my mind because it gave me something to do and a sense of action against the disease.  It would be natural, under these circumstances, to miss the support when it was over...and I do.  But, now I want to get on with something constructive to help other women in similar circumstances so I can perpetuate this feeling of positive action.”

Truth has a way of being stranger than fiction.  As Karen’s battle with cancer was becoming common knowledge throughout the Harris County system, other offices began referring employees diagnosed with breast cancer to her for some informal support and “counseling.”  Then, another case was diagnosed closer to home.

“My husband’s cousin called me last month and said her doctor just told her she had breast cancer, too.  As she told me about the circumstances of her diagnosis, a light went on in my head.  By the time she finished her story, I was almost speechless.  Basically, her doctor called her into the office, and told her she had breast cancer -- the same kind as mine, DCIS, only a little smaller and low grade, rather than aggressive.  Then he said that, if she were his wife, he would recommend a mastectomy!  He did not give her any information to read, and sent her home to ‘think about it,’ and said to return the following week with a decision.”

“She came to our house and I shared all the information I had accumulated on breast cancer, and showed her my pathology report, as well.  Now, I know you can’t compare cancers -- every single one of them is different and unique to that individual -- and I understand that the philosophy of treatment may differ, doctor to doctor.   But, on the surface there were some similarities in our two cases.  Anyway, I consider what happened next to be appalling.  Her doctor asked her what her husband and she had decided to do about her breast.  Now, I rely on my husband for support and encouragement, but when it comes to MY breast, it’s MY decision.  She was furious that her doctor had phrased such a question, and became even more committed to seeking another opinion before deciding on treatment.”

“Now, what’s wrong with this picture?  Here is a mature woman being told by a doctor that she has one of the most dreaded diseases on the face of the earth.  She is given no information about her disease or treatment options that she can read at home, and she is talked down to in a patronizing manner which implies that she is not competent enough to reach a decision that affects her body and her life without her husband.  This is certainly no progress from the old ‘don’t worry little lady, I’ll take care of you’ mentality that women have been rebelling against for years.   Maybe we can’t do anything about a patronizing bedside manner, but it dawned on me when I heard this story that we just might be able to do something about the lack of information about breast cancer at the critical impact of diagnosis.  And, I decided it was something I wanted to try to accomplish.”

Typical of Karen’s style, she jumped into a breast cancer awareness/education effort with both feet, and began assembling a cadre of people who might be counted on to help define a mission and then to get involved.  Logically, she reached out to women who were also breast cancer survivors, and included Pat Eversole, the wife of Jerry Eversole, Commissioner, Pct. 4, and Peggy Mason, who works in the office of the Harris County Tax Assessor.   Coincidentally, Karen talked with Karen Rice, a friend connected with the Susan G. Komen Breast Cancer Foundation and the Race for the Cure, and also contacted the American Cancer Society to begin identifying information and programs available to women upon diagnosis.  State Representative Peggy Hamric offered to get involved and to lend her support to Karen’s outreach effort.

“I know that there is a lot we can do to help promote even better awareness about this disease, and it appears that there is a real need to provide help at the time of diagnosis.  I’m sure we are not the first group of people who have been concerned about a perceived lack of information on a particular topic,” Karen said, “and I’m equally sure that there are some education and support organizations active today that were conceived and established to fulfill similar needs.  I don’t want to reinvent the wheel or duplicate any viable programs, so we are in the process of identifying areas in our community where we can make a difference, and that’s where we are focusing our research.”

While Karen’s team continues researching several possible program areas, they have agreed that one of the first challenges they will tackle is to persuade County employees to get involved with Houston’s Race for the Cure, to be held at The Galleria Saturday, October 2. County Attorney Michael Fleming is pursuing a proclamation of support for this important event.
 

“We have learned that of the County’s 13, 845 employees and retirees, just over 6000 of them are women.  If you extrapolate the statistic that one in nine women gets breast cancer during her lifetime, it could be that 683 women who work with Harris County have or will be diagnosed with breast cancer at some time in their lives.

“Everyday someone tells me that because they read my story, they or someone they care about has gone to get a mammogram.  I’m also hearing women over 40 begin to complain that their doctors are not reminding them to get one.  This seems like a huge problem to me.  That’s sending a message that, ‘I don’t think mammograms are important enough to remind you to get one.’  Taken another way, this omission might be interpreted to indicate that women are so well informed enough about their bodies that they don’t need to be told what to do to protect their health.”

“Just about every major health organization -- from the Komen Foundation to the American Medical Association -- now agree that women should have their first mammogram at or before age 40, and some doctors are insisting on a baseline at age 35.  One of the areas my task force is exploring has to do with an effort to promote mammograms, so we’ll keep everyone posted on our progress.”

On a more personal note, Karen is back to walking three miles every morning, has been boosting her diet with vitamins, and says she feels terrific.  She will go back for a follow up visit with her surgeon and oncologist and for her annual mammogram over the next month or so.  She is taking Tamoxifen, the first drug to be approved for preventing breast cancer for women with a family history of the disease or other risk factors.  The drug interferes with breast cancer cells’ “access” to estrogen, which has been shown to play a role in about half of breast cancers.

Earlier this year, the American Society of Clinical Oncology suggested that millions of healthy women and women who have abnormal cells that may or may not develop into cancer could also benefit from taking the drug.  In the past month, however, major news stories report that Tamoxifen may lose its effectiveness in preventing breast cancer after 2 to 5 years of use.  The reports suggest that in some cases, after a period of time, Tamoxifen stops blocking the contact with estrogen and may actually stimulate cancer cell growth.

“Yes, I’m concerned about these reports,” Karen said, “and I’ll be interested in following the research as it continues.  But, for now, I’m comfortable with taking the medication and have no plans to discontinue it.”