A Journey Back

Two roads diverged in a wood, and I --
I took the one less traveled by,
And that has made all the difference.*


Catherine Mousel traveled to a place not everyone will experience. There were obstacles and roadblocks but also nice people who helped along the way, even during the darkest hours. Unlike other travelers, Catherine had little choice whether to take this trip. That decision was made for her when she was diagnosed with breast cancer in June 2005. "In some ways, my diagnosis was a blessing in disguise," says Catherine, 49. "If I wouldn't have gotten cancer, there are many nice people I never would have met."

Catherine's life-altering journey started in the shower with a lump she describes as "feeling like the top of a pencil eraser." Intuition told her this one felt different than past lumps. Like many women ages 30-50, Catherine has fibrocystic or lumpy breasts, a noncancerous condition.

Oncologist Jamie Rigden, MD, explains there is a rise in breast cancer diagnoses but fewer women are dying of the disease. She attributes the increase in survival to more effective screening and treatment methods.

With 180,000 new breast cancer cases each year in the United States, the overall cure rate is about 80 percent, according to Dr. Rigden, with Heartland Hematology and Oncology. Early detection, including mammography, is most important in achieving a cure. Generally health experts recommend yearly mammograms beginning at age 40.

Dr. Rigden explains there's still controversy using mammograms for women with dense breast tissue due to difficulty interpreting test results. In Fall 2006, North Kansas City Hospital began offering the newer technology of digital mammography for better interpretation of dense breast tissue. "This technology will enhance our diagnostic capabilities to find breast cancer when it's most curable," says Dr. Rigden. Digital mammography generates computerized images instead of the traditional film X-rays and gives the radiologist enhanced clarity to locate suspicious areas.

"Breast cancer can kill you," comments Catherine, "so you have to make the effort with mammograms and other tests. Today is never too late to schedule that appointment."

Once Catherine's lump was detected, surgery removed the ½ inch tumor. For any woman diagnosed with breast cancer, tests must be done to decide whether the cancer has spread to the lymph nodes. Lymph nodes, located throughout the body, help fight infections. When lymph nodes are affected, more aggressive treatment is required.

North Kansas City Hospital is among a select group of area hospitals with surgeons specially trained to perform sentinel node biopsy, a more conservative procedure that limits lymph node removal. Dr. Rigden says fewer lymph nodes removed means less chance of lymphedema or swelling in the arms, an extremely debilitating condition. For women who experience lymphedema, North Kansas City Hospital's specially trained occupational therapists assess and provide treatment.

A procedure called manual lymphatic drainage combines massage, bandaging and exercise to force lymph fluids back into lymph vessels. Success with this treatment is very high, but it's important to recognize symptoms and start treatment promptly. Symptoms of lymphedema include swelling in the arm, which may begin by feeling tight or heavy, a change in the color of the skin or pain in the arm.

Luckily Catherine needed only three of approximately 30 potential lymph nodes removed, so she didn't experience lymphedema. Chemotherapy and radiation therapy followed to give her the best chances of a full recovery.

Dr. Rigden says women like Catherine are benefiting from many gains in cancer treatment. The Hospital's radiation therapy program is one of the area facilities in a clinical trial to test if a shorter course of radiation is as beneficial as the current 30 to 35 treatments.

Other proven advances in treating early-stage breast cancer range from chemotherapy completed in eight weeks instead of months and newer anti-estrogen hormonal medications with fewer risks.

Beyond the treatments and medication, Catherine believes it's important to laugh when facing cancer. Catherine remembers the Mohawk-style haircut courtesy of her daughter to make her feel better about losing her hair from chemotherapy. Catherine donated 10 inches of hair to Locks of Love before treatment began and believes that gave her an improved outlook about her changing appearance.

Today Catherine is coming back from breast cancer, but she is a different person after her journey. She says, "I am more accepting that cancer has changed me from the person I was before. I am now what cancer made me which is a change in how I see myself."

*Excerpted from Road Not Taken by Robert Frost, a favorite poem of Catherine Mousel, a breast cancer survivor

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