Surviving breast cancer
Team of supports played key role in coping, health and wellness
|Sandra Dudych's story is a tale of one woman's battle against breast cancer. But her journey also provides some insight into the types of breast health services and supports that are available to women.
BY ANDREA BODIE
Winnipeg Health Region
Published Wednesday October 5, 2011
Sandra Dudych's life changed when she found a lump on her breast.
A phone call to her doctor resulted in a quick mammogram. Because of a shadow that was concerning, Dudych was referred to the Winnipeg Health Region's Breast Health Centre for a biopsy. Within a month of finding the lump, she received news that confirmed what she already suspected: she had stage two breast cancer.
That was 18 months ago. Since then, the Winnipeg woman has waged a war against breast cancer that included a mastectomy. It's been challenging, painful and at times heart wrenching. But so far, it's a battle she's winning. Dudych currently has no evidence of disease in her body.
"I've been given the gift of a second life. There were so many moments during treatment when I could have died. But I didn't. I've asked myself what I want from my second chance. Some don't get that," she says.
Dudych's story is a tale of one woman's battle against breast cancer. But her journey also provides some insight into the types of breast health services and supports that are available to women.
Breast cancer is one of the most common cancers among women. Each year, 810 women are diagnosed with breast cancer and about 210 die. But there is good news. More and more women like Dudych are winning their battle against breast cancer. Over the last 20 years, the number of women dying from breast cancer has fallen by more than 35 per cent. Much of that success can be attributed to the cohesive approach to early screening and diagnosis and treatment. Within the Region, for example, there are three main centers focusing on breast health, all working together to provide the best care possible.
The Breast Health Centre on Tache Avenue across from St. Boniface Hospital plays a key role in delivering breast health services. Centre staff co-ordinate assessments, diagnostic tests, treatment, education and support through a variety of programs.
BreastCheck Manitoba, located on Sherbrook Street across from Misericordia Health Centre is another important centre. It provides free mammograms to women over 50 years old and is actively involved in education and outreach.
The third major centre in the city is the Breast Cancer Centre of Hope (BCCH). Located on Wolseley Street, the BCCH provides education and support to individuals and their families from the moment they receive a breast cancer diagnosis by explaining complex medical terms and encouraging people to get actively involved in their medical care.
Most people aren't aware of the services available in the Region until they need them. And even then, some people do not access a fraction of the services and programs that are available to support them through their breast cancer journey. Knowing about these services, and having a grasp on who does what can empower individuals and families touched by this disease.
Dudych started to benefit from these services when she was referred to the Breast Health Centre. After her biopsy, she met with surgeon Dr. Brent Zabolotny, who diagnosed her with breast cancer. Along with an information package each newly diagnosed individual receives, Zabolotny offered this advice: he told Dudych to surround herself with a sisterhood of women who could support her.
Dudych took the advice to heart. She also made two key choices when she received her diagnosis: she decided to fight the cancer. And she decided to create a powerful team that would help support her mental, physical, emotional and spiritual health.
Reading through the information package and attending a pre-surgery education session helped create a feeling of empowerment for Dudych while she considered things with respect to her health and wellness.
To help her understand her diagnoses better, Lori Santoro, a nurse educator with the Breast Cancer Centre of Hope, was an integral addition to Dudych's team soon following her diagnosis. Santoro was instrumental in helping Dudych sort through the medical terms and understand her diagnosis. Santoro was a helpful resource for Dudych throughout the gruelling treatment journey that included surgery, chemotherapy and radiation.
"I believe knowledge is power. The more I knew, the better able I would be to work with the medical care team and manage my disease. I built a team of medical professionals whose job it was to help reduce my fears, teach me and give me the ability to hope and cope," she says.
She enlisted her former boss, a breast cancer survivor, as her mentor through the experience. Neighbours whose lives were also touched by breast cancer were able to offer her support, along with her family and friends.
Before having a mastectomy, Dudych decided to hold a Bye Bye Boobie party. About 20 of her friends joined her in marking this first leg of treatment.
"The doctor's wisdom really rang true," she says. "Surround yourself with strong women. I learned there were great people waiting to be there for me if I let them and told them what I need."
A post-surgery education session helped her understand what she could expect when she started chemotherapy and radiation.
After recuperating from a mastectomy, Dudych enlisted dietitian Beth Szuck from the Breast Health Centre to help her prepare her body for chemotherapy. It was interesting to discover the nutritional choices she could make that would help her fuel her body to prepare it for the fight ahead, and help it heal from chemotherapy.
"I met with Beth before chemo. It was an important weapon in fighting. I learned how to tweak my diet so I could boost my immune system," she says.
A sense of empowerment resulted for Dudych that helped her face a daunting treatment regime with numerous complications along the way. From numerous infections to thrush, from a blocked port to extreme exhaustion after treatment, Dudych took comfort in the fact that Santoro was a phone call away, ready to answer her questions and help her understand what her body was experiencing.
Chemotherapy nurses were supportive, knowledgeable and compassionate when Dudych was in that phase of her treatment. Days after her first treatment, Dudych was scheduled to attend her daughter's wedding. The advice she was given? No crowds, no hugging and no kissing.
While some may consider that easier said than done, Dudych was determined to be there. She donned a wig, an evening gown and opera gloves - which served not as a fashion accessory but as a germ barrier to protect her fragile immune system. And she was there to celebrate this important day in her daughter's life.
"I had no control over how my body reacted to the treatment. Cancer didn't make me feel sick but the treatment did. I was more afraid of treatment complications than cancer," she says. "I knocked down the fear with information. Don't be afraid to ask questions."
Dudych sought emotional support from social worker Irene Shapira, who works with Patient and Family Support Services at CancerCare Manitoba. Along with being there for Dudych, she also helped her fill out complex medical forms. Shapira offered to meet with members of the family to discuss the complicated cancer maze and its impact on their lives.
When Shapira took a leave, Dudych asked Stephanie Howard, a social worker from the Breast Health Centre, to join her team. Howard offered information, insight and support to Dudych. She met with Dudych, offered telephone support during some really tough days, and suggested programs and workshops to consider.
Dudych considers the practical help Howard offered her invaluable. It also helped her avoid getting lost in the complex world of cancer.
Meeting with a spiritual counsellor at CancerCare Manitoba was also a choice Dudych made. After one point, her white counts were low and the next chemotherapy treatment had to be postponed. She felt lousy physically and was overwhelmed at the prospect of another round of chemo on the horizon.
"It's overwhelming. You have the mirror of mortality in your hand. I kept the image of boxing gloves in my mind. It was a war and I was fighting it till the final round. I refused to get beaten down. I refused to give in. I wasn't finished living," she says.
Education sessions and workshops were integral to creating Dudych's sense of feeling empowered about things to consider with respect to her health and wellness. Along with pre and post operative education sessions, the Eat Well, Get Fit & Live Well program (sessions that encourage managing your health with food and exercise after treatment) and Bone Health After Breast Cancer programs offered through the Breast Health Centre and CancerCare Manitoba were all helpful in supporting Dudych in her battle against cancer.
Dudych gained valuable insight about how to cope and learned how to manage her disease. She describes herself like a sponge soaking up all the available knowledge.
Along with receiving important information about how nutrition and exercise can help her heal after treatment - and reduce her risk of the cancer coming back by 50 per cent - the Eat Well, Get Fit & Live Well program has introduced Dudych to dynamic women who have all been there. Even after completing the six week program, the women gather regularly. Joy and laughter come much more easily - and more often - than tears as they celebrate the powerful fact that they made it.
"I will do anything I can do to eliminate my risk of the cancer coming back. I'll be damned if it's going to beat me," she says. "Not a lot that scares me after this."
Dudych's relationship with her body has been a tough one. She worked through stages of grief at the feeling that her body had let her down. Treatment and the disease have affected more than her body and energy level; it's also impacted her mind and the way she processes information.
Being compassionate with herself while she navigates this new reality has created different priorities for her. Exercise is not an option but something she now builds into her day. Regaining physical strength and mobility are ongoing goals, supported by physiotherapy and regular rehabilitation efforts. Managing stress is also something she's mindful of.
Whether people ask for help or not depends on their personality, Dudych observes. She chose to tackle this challenge like anything else she would - learn what you can, talk to the experts and make decisions. She recognizes that accessing a variety of services helped her navigate a scary and life-threatening situation without ever feeling helpless. She credits being a seeker - who looks for information, instead of a blocker who doesn't want to know - with helping her find the answers and supports she needed.
When all is said and done, Dudych's team of supports totals over 100 people who played some role in her cancer journey. Along with oncologists and the nurses who work with them, she also recognizes the input from workshop facilitators, chemo nurses and even the volunteer drivers who picked her up on blustery winter mornings for treatment.
To women who may be facing similar challenges or received a diagnosis of breast cancer, Dudych offers this advice: access the services. People are there to help you and all of the programs are free.
"Being diagnosed with breast cancer doesn't mean you're gonna die. You can fight and live. It's scary but it's not life threatening because of advancements. Cancer baffles patients and doctors alike but improvements are being made. People are living longer because of those improvements," she says.
Dudych fought the war of all wars for her life and for her health. As a result, she wakes up each morning grateful to see another day and experience the love and support of the people in her life.
"I took my life for granted before I got sick. I was in good health but at 51 I was faced with the reality that I could die. I walked through it - I couldn't run and hide - through the darkness to the light. I'm grateful I have a second chance."
BreastCheck CancerCare Manitoba
5 - 25 Sherbrook Street
Phone: 788-8000 or toll-free 1-800-903-9290
BreastCheck CancerCare Manitoba offers free mammograms to women 50 years of age and over who do not currently have symptoms, breast implants, or a personal diagnosis of breast cancer. BreastCheck works to eliminate barriers to accessing screening by offering information and resources in 19 different languages, providing mobile screening units that travel throughout the province, and arranging transportation for women in Winnipeg.
They also offer extensive community outreach through mailouts, posters, community meetings and delivering presentations to help educate women about the importance of mammograms, breast health and awareness and early detection.
About 5 per cent of women screened at BreastCheck have an abnormal screening result. These
women are referred to a diagnostic centre such as the Breast Health Centre. BreastCheck also refers women to the Breast Cancer Centre of Hope.
Did you know?
- Between 2008 and 2010, 56 per cent of Manitoba women age 50 to 69 are regularly screened for breast cancer.
- Brandon has the highest screening rate in Manitoba (61.5 per cent).
- In Manitoba, breast cancer deaths have been reduced by 23 per cent in women who attended BreastCheck.
- Additional funding between 2008 and 2010 helped provide resources to meet the demand for screening.
- BreastCheck has fixed screening sites in Winnipeg, Brandon, Thompson and Boundary Trails. Mobile services are offered to 13 locations in Winnipeg, as well as 80 rural and northern locations.
- Because of a direct referral initiative that includes family physicians, diagnostic clinics and the Breast Health Centre, the amount of time between mammogram to the first diagnostic test has improved.
Reduce Your Risk Video
Breast Health Centre
100 - 400 Tache Avenue
Phone: 235-3906 or toll-free 1-888-501-5219
The Breast Health Centre delivers services to women and men with breast health concerns by providing them with rapid diagnosis, timely assessment, education, support, advocacy and treatment planning.
A multi-disciplinary team - the staff of about 30 includes surgeons, nurses, radiologists, technologists, lymphedema/physiotherapists, a clinical nurse specialist, dietitian, social worker, administrative staff and volunteers - is housed out of the Tache location. The coordinated focus on a patient's journey ensures services such as pre-operative tests like lab and blood services can be arranged on site - sometimes the same day of an appointment with a surgeon. Other tests and appointments are all referred through the Breast Health Centre to ensure there is a continuum of care.
Opened in fall of 1999 based on what breast cancer survivors identified as a need - seamless, coordinated treatment in a nonclinical setting - the Breast Health Centre's experts work with women in Manitoba, Northwestern Ontario and receive referrals from Nunavut and Saskatchewan.
People with breast health concerns can call the centre directly. The centre receives referrals from physicians, nurses, nurse practitioners and also accepts self-referrals. The centre's work is equally divided between diagnostic services and surgical consultations to patients.
Education is a significant part of the centre's work. Along with education sessions offered twice a month on preparing for surgery and participating in post-surgery sessions, the Breast Health Centre also offers regular Bone Health and Nutritional programs. Breast Health Centre offers each women diagnosed with breast cancer an information package and the opportunity to meet with a social worker for initial support and guidance.
Partners in education are BreastCheck Manitoba, the Breast Cancer Centre of Hope, CancerCare Manitoba, the University of Manitoba and Osteoporosis Canada.
Did you know?
In 2010- 2011, the Breast Health Centre had:
- 5035 visits with a surgeon
- 5091 visits for a diagnostic imaging exam
- 1295 visits for lymphedema/physiotherapy
- 532 visits or consultation for nutritional services
- 1221 visits or consultation with the social worker
CancerCare Manitoba Breast Cancer Centre of Hope
691 Wolseley Avenue
Phone: 788-8080 or toll-free at 1-888-660-4866
The CancerCare Manitoba Breast Cancer Centre of Hope, affectionately referred to as "Hope", opened its doors in 1997. This is a resource centre which provides information, education, support and resources that focus on breast health and breast cancer. Built around a healing garden, Hope is like a homelike setting away from the treatment area. Someone with breast cancer and their family can receive support to navigate screening, diagnosis, treatment, survivorship and end of life care.
A nurse educator is available onsite and plays an integral in offering patient education and information so people can make informed decisions and participate in their cancer care. She also helps them develop questions to ask their health care providers and meets with family members who are supporting someone diagnosed with breast cancer.
Other services offered include: a lending library, education sessions and peer support, where someone with breast cancer is matched with a volunteer who has had a similar cancer experience. In rural areas, a community contact program provides information and support close to home.
As part of patient education, the Breast Cancer Centre of Hope provides a range of information sessions. Regular sessions are offered on Moving Forward after Breast Cancer and additional information sessions on Preparing for Surgery, After Surgery and Breast Construction are offered through a collaborative partnership with the Breast Health Centre.
Did you know?
Hope also hosts the Manitoba Breast & Women's Cancer Network, a province-wide network of stakeholders who collaborate through a coordinated approach to ensure access to information and support with over 70 members.