Learning from adversity – a breast cancer survivor’s story

‘’Sweet are the uses of adversity, Which, like the toad, ugly and venomous, Wears yet a precious jewel in his head’’. – Shakespeare’s ‘As you like it’.

“He who learns must suffer. And even in our sleep, pain that cannot forget falls drop by drop upon the heart, and in our own despair, against our will, comes wisdom to us by the awful grace of God”. – Aeschylus Agememnon.

For Norma Moller, a successful 42-year-old psychologist in private practice and mother of two lively pre-teenagers, life was rolling along quite happily with all its usual ups and downs. She was, to quote the popular US family TV soapy, ‘’Mostly Happy’’.

Then almost intuitively, she went for a cautionary check-up in November 2010, the routine kind we’re all urged to do every few years by our more conscientious friends. A sonar showed an irregularity in her breast, something an initial mammogram had missed entirely. There was no history of cancer in her family, so she managed the initial minor anxiety fairly easily. However, two subsequent needle biopsies showed it to be cancer. “I went from total shock and disbelief to a strong realisation that I might die,” she recalls.  And so she strapped herself in for what turned out to be 11 months of chemo and radiation therapy, followed by five years of daily oral meds and once-monthly injections. It was to be an ultimately successful roller coaster treatment journey that left her wiser, more disciplined and with an unprecedented determination to nurture and take care of herself.

“I really believe you can do a lot in terms of managing your immune system in life by looking at what you put into your body, and by getting enough sleep and exercising. Before I was diagnosed, it wasn’t so much that I was eating the wrong stuff, but that there wasn’t enough of the right stuff,’ she says with the benefit of hindsight.

Slowly, with the help of an empathic and decisive surgeon who engendered confidence, she realised it wasn’t a death sentence at all.  “Once the emotion settled I got more pragmatic and in a strange way I was quite motivated to deal with it. I decided I was going to throw everything I had at it; a positive attitude plus all that modern medicine, homeopathy and naturopathy had to offer,” she recalls.

After the lump was surgically removed (lumpectomy), Norma had a Mamma-Print done (a tissue sample of the tumour was sent off to the Netherlands for precise genetic sampling of the cancer). This armed her breast surgeon, Professor Justus Apffelstaedt, with more precision in choosing a treatment protocol. Because the MammaPrint showed the cancer to be of the kind that has a high risk for recurrence, full chemotherapy and radiation treatment was indicated, giving Norma what he assured her was the best possible prognosis. Hers was an oestrogen-receptor positive cancer, making it possible to add a five-year protocol of daily tamoxifen and monthly zoladex which suppress oestrogen production. The downside was that it brought on early menopause, resulting in hot flushes and little sleep. A small dose of a very specific anti-depressant was prescribed; not for depression, (though that couldn’t have hurt), but because one of its side-effects was to prevent hot flushes. Much to Norma’s relief and enhanced recovery, it worked. Sleep deprivation, just when she was getting over the turbulent nausea and immunity challenges, together with the cortisone side effects, was not exactly welcome.

The minimum six-month cycle of four chemo treatments, during which her all hair fell out, took two months longer than expected as her body struggled to adapt to the dosages, constant blood counts the norm to check when it was safe to return for chemo. “People need to be aware that in all your treatment there could very possibly be delays,’ she warns. With chemo done, she finally got a couple of weeks ‘’off’’ to get her strength back in preparation for the radiation treatment which took just over a month and a half.

“You’re supposed to go at a specific time daily, but the radiation machines sometimes break down – it can take far longer than you expect,’’ she warns

Norma recalls practicing mindfulness while sitting in the blue Lazy-Boy chairs in the chemotherapy room, taking in all her fellow patients around her. She noticed with fascination and some irony, that the dispensing machine just outside the treatment room carried everything from sugar-laden fizzy drinks to chocolates and crisps.

Today she’s at “about 70%” of her in-treatment discipline of daily “green juicing” (a high-alkaline drink of mainly green vegetables and herbs with a bit of green fruit) and the cutting out of sugar and dairy. She’s also back to her daily jogging.

Norma recounts what helped her stay determined and positive. Her surgeon, “took control, was firm, always available and caring. He never left me with any uncertainty and would draw pictures to make sure I understood. He was punctual and never let anything interrupt a consult,” she recalls. Her husband, Francois, who works in the financial industry, had just landed in London on business when she originally called him to say she had tested positive for breast cancer. He climbed on the next plane home. ‘In my whole life, I’ve never been as cared for as I was by my husband when I had cancer; he was such a super-star”.’ He chuckled alongside when she took him up on a dare to use her hair loss as an opportunity to have a henna tattoo emblazoned on her bald head. The husband of a cousin of hers, who happens to be a paediatric oncologist cousin at the Red Cross War Memorial Children’s Hospital called her upon hearing the news. Rendered sage by his heart-wrenching day-job, he gave her an unforgettable piece of advice; ‘’let other people carry you, [especially because] you’re used to doing the carrying”. Says Norma contritely; “I had to learn to deal with that”.

The oncologist friend had more to offer; “He said that when those around me wondered what to say or do, “tell them to bring food”. I’ll never forget that. People literally worked out a schedule to bring us food. We had these amazing suppers. Their generosity and love carried me a lot. You could taste the love in the food”.

Financially, a combination of their initial Old Mutual plan, followed by a conversion to a Discovery Hospital Plan in 2015 (with an oncology benefit) covered nearly all their expenses, except for part of the hospital bill and the Mamma Print, homeopathy and naturopathy treatments.

How would she advise anyone going through a similar experience (with hindsight)? What, could have softened her journey? “It’s certainly a wake-up call to have a thing like professional indemnity cover in place. If I had taken out a professional provident society policy, I could have covered the 30% of time I couldn’t work. I have a friend who went through the same thing and she had a PPS policy. It paid her out a huge sum of money which made it possible for her not to work for several months,” Norma says. She also did not have Gap cover in place, so the differences between the Discovery rates and the service provider rates impacted, but not in a debilitating way.

Then there was the large oncology practice that cancer patients inevitably end up at for chemo and radiation therapy. Norma had difficulty adapting to her hard-pressed oncologist whose expertise was in huge demand – Norma’s patient-experience being almost the antithesis of how she dealt with her own (psychotherapy)patients. “I expected to be given full attention, because after all, I had cancer!” she says with a wry grin. “It was humbling, confusing and a bit disappointing, but I have no hard feelings,’ she adds. Unlike with her surgeon’s smaller practice, the telephone answering service was computerised, adding to the depersonalised ‘feel”.

“It’s been a very personal journey. “I’m glad I took the treatment options I did. But I really believe you can do a lot in terms of managing your immune system by looking at what you put into your body and your lifestyle. I believe my cancer was just what happened when my immune system conked in. I now have a new awareness about eating the right stuff. Eating organically can affect your wellness – and also with how mindfulness can affect your wellness. During her nerve-wracking chemo and radiation spells, she read; “Anticancer: a new way of life, by Dr David Servan-Schreiber,” highlighting the value of sleep, stress reduction techniques, nutrition and exercise, which she recommends very highly. Post-treatment, Ariana Huffington’s ‘’Thrive,” is next on her supportive literature list.

Norma sees her cancer as something that has taught her the need to love and look after herself, to be her own expert and to seek out good, supportive people.

“But things still fluctuate. It’s not like you had cancer and you didn’t learn. It’s just that it’s hard to maintain the learnings. My annual check-up is still the worst day of my year, [because of the fear of relapse]. But they got all the cancer surgically [a 13mm diameter tumour)- and there was no spread to my lymph nodes. Ever since my surgery six years ago, I’ve been ‘’clean’, if you can call it that. I also have no scar on my breast,’’ adds Norma.

She counts herself much more grateful today – and perhaps even a bit more than “mostly happy”.

Treatment tips from a cancer pilgrim

Here are a few valuable tips Anneke Coetzer offers anyone who finds themselves beginning a similar journey.

  1. Get any persistent niggles that might indicate cancer checked out asap.
  2. If you have a suspicion that you might have cancer, [she didn’t, but luckily happened to have a friend with her], take a companion along for the test results. This can prove invaluable, because the moment you hear the news, “you don’t hear a word after that”.
  3. Do all your research on cancer while you’re (even relatively) healthy. It’s hard to absorb detail and complexity when you’re in shock or undergoing chemo-therapy.

She recommends reading the book “Cancer Research Secrets” by Prof. Keith Scott-Mumby (http://www.cancerresearchsecrets.com/#buy http://www.cancerdefeated.com/cancerconfidential/ )

This will assist with knowledge when close family and friends are dealing with their cancer journey.

  1. Get a broker. She belated used one of her company’s medical aid brokers in her second year of chemo. She succeeded where Anneke had failed in getting medical aid bills approved. “There were admin mistakes, dates were captured wrongly – all of which result in claims being rejected. If it wasn’t for that broker I’d be a lot more out of pocket,’’ she says. (Discovery paid out R200 000 in the first year, but she exceeded this limit by R31 000 that year, which was an out of pocket expense).

Surviving against all the odds – Anneke’s story

For ‘miracle survivor,’ Anneke Coetzer, 50, the pressure of being a globe-trotting retail clothing and textiles quality manager was excuse enough to ignore what felt like a ‘tennis ball,’ under her arm – for nearly four months.

When she got so sick that she was constantly coughing, hardly able to walk up a flight of stairs and sweating profusely at night, she finally went for a check-up – in Shanghai where she’d just begun a ‘dream’ new job as the retailer’s Quality Assurance Manager for their China office.

“I thought my travel exhaustion had brought on very bad flu or pneumonia or some kind of chest illness- perhaps set off by the Shanghai pollution,” she says. It was winter and she was sweating so badly she had to change her pyjamas and move to the dry side of her bed. “I knew something was badly wrong. I was obviously very irritated, having just started a new job and now getting ill,’’ she confesses.

When medical aid cover and logistical complications in Shanghai led to her head office in Cape Town insisting she fly home for diagnosis and treatment, it was almost too late. She had Stage 4 Non-Hodgkin’s B-cell lymphoma. She had told her life partner, Craig, just six months after they met, that if she was ever diagnosed with cancer, she didn’t want chemo. Luckily for her Craig didn’t buy the latter admonition. He met her head-on.

If you want to make God laugh, tell Him your plans.

Anneke’s resistance finally turned to surrender in a Johannesburg haematologist’s waiting room. She had just asked another patient about the chemo-treatment side effects. The man spoke of finger nails falling off, the loss of feeling in his finger-tips, the nausea, metal taste in the mouth and the loss of any sense of taste. Anneke’s opposition reached its zenith when he told her that, “the chemo stays in your body for at least 10 years”. She burst into tears, and reiterated her ‘no-chemo’ stance to Craig. “He eventually calmed me down and told me there was no way he was going to let me die in three months’ time – especially when he’d just met me a year ago. Anneke firmly believes that were it not for Craig, and her having added complementary medicine to her mainstream treatment regime, she’d be long gone.

“I agreed to take the chemo, but under protest, with scepticism and a lot of anger”. So, the first of what were to be two chemo regimes began. “The first session was the worst thing I’d ever experienced in my entire life. The oncologist said it was a good thing my cancer was so aggressive. It was so fast moving that it would respond well to the “poison”’’. Back home at 2am after the first one-day drip session, she had a virtual out of body experience. “It felt like I was standing outside my body looking at someone dying…I was burning, aching, and nauseous. The worst was the burning. It felt like I was on fire from the inside

Life – but not as we know it

In the days that followed, everything changed for Anneke, who up until her cancer was a regular half-marathon runner. “The way food tastes, your urine smells metallic – they’ve poisoned you to the point where you only just don’t die. Then they give you cortisone to prevent you from going into complete shock. The cortisone prevented me from sleeping and I was exhausted, I lay in bed for a week, feeling like I wanted to die. By the seventh session of chemo-therapy, she’d had enough. “No more,” she cried.  Her oncologist couldn’t say with certainty that stopping chemo one session short of the eight scheduled sessions would be enough –because the [clinical] jury was still out. So, she capitulated, under protest and against her better judgement. Three months passed and she celebrated Christmas 2013 with her nearest and dearest, feeling relatively well and believing remission was a distinct possibility.

However, the respite was short-lived. In February 2014, she felt a painful lump near her collar bone and her oncologist confirmed it was the cancer. He told her she’d probably never been in remission. Second line chemo-therapy was indicated – and her second nightmare began. Her hair had only just begun to grow back. Explains Anneke; “my body had an adverse reaction to the second (different) chemo-therapy – it was even worse than the first one. Not even the doctor anticipated it.

Another down side; was what Anneke calls ‘chemo-brain,” more commonly labelled by doctors as straight fatigue. “It affected my ability to communicate,” she adds. Depression set in. The oncologist, by now desperate, and with fast-diminishing options, suggested radiation. Anneke says she and Craig looked at one another and almost wordlessly agreed that “if this doesn’t work, I must get my stuff in order. In other words; prepare for the ultimate’’. She had 23 consecutive daily radiation sessions, all in her shoulder area. Her skin felt like it had been micro-waved and turned angry and red, but the physical side effects were not nearly as bad as before. “At least I was able to sleep (no cortisone). Intermittent scans continued and the outlook once more turned positive.

Then she developed Radiation Pneumonitis and her fears came rushing back. The doctor told her to relax, a mixture of steroids and cortisone was all that was needed.

Called it all off

“I went home and thought to myself – I’ve been listening to doctors for two years now. And it’s getting worse and worse. I’m done, I’ve had it. I’m not taking a single tablet more. How can I take these alternative medicines if you put all this poison into my body?”. She decided to ‘detox’’ entirely; not easy because no cortisone meant her lungs stayed swollen, making breathing extremely difficult. Craig begged her to swallow the cortisone, fearing she would literally die of oxygen starvation, but she held fast, pleading with him to ‘trust her’ Her holistic route took the form of a GP doctor who focused on Cancer treatment. She administered several Ozone-enriched blood transfusions and intravenous Vitamin C. But Anneke was simply not getting better fast enough.

Her practitioner referred her to another healer in Durbanville, this time a spiritual one; “I went thru a process of spiritual understanding and dealing with the emotional side that caused the cancer in the first place”. She repeated the one hour-long sessions twice more over three weeks. The woman refused to charge her a cent. Since then, to use Anneke’s words; “I’ve been as healthy as can be”.

She’s not so naive as to believe this alternative treatment was solely responsible for her recovery. In hindsight, she wouldn’t change anything. “It’s hard for me to say just one thing worked, but every incident brought me to the place where I went to God and just said; I surrender”.  She believes healing is a “medical, spiritual and emotional thing. “God brings you to the point where you’re on your knees – and then He can heal you”. Anneke is also convinced that willingness to stay alive and having “hope” are the biggest factors in getting better.

She says her GP advised her to address her cancer on four levels; lifestyle/diet, emotion, chemical toxicity, plus any trauma in her past which could have impacted on a cellular level.

She tried it all and is still busy with a lot of inner work. Her oncologist believes her recovery to be a miracle, especially after she refused the bone marrow transplant recommended after her radiation and repeated chemo treatment seemed to fail. She never had the very high-risk bone marrow transplant – and lives to tell her tale.