Information for Women: Be Proactive About Your Health

Both breast cancer and heart disease affect many women, and new treatment techniques are improving outcomes considerably. Learn why it’s important to see a doctor about sketchy symptoms, and what you should do when something seems out of the ordinary.

To the outside world, Lisa Larkin appeared to have a normal life. She worked as a teacher’s aide, drove her two teenage children to their various activities and took the family dog on a walk every day.

But in truth, Lisa was a nervous wreck as she waited to hear back from her doctor.

“I felt a lump in my left breast when I was taking a shower, which prompted me to call my gynecologist,” she says. “I was living this normal life, but in the middle of it all I kept imagining that I had breast cancer.”

Lisa admits she was six months late to schedule her annual mammogram appointment.

Dr. Irene Wu, a general surgeon specializing in breast diseases at Presence Saint Joseph Hospital, in Elgin, describes a mammogram as an X-ray screening of the breast that indicates signs of abnormalities. She recommends that women get mammograms annually starting at age 40.

“There are different ways to screen for breast cancer,” Wu says. “There are mammograms, ultrasounds and MRIs, and what you get and how often depends on your risk factors individually. But, a good rule of thumb is to get a regular screening mammogram once a year.”

Since Lisa had a family history of breast cancer, she was prompt about getting her first mammogram after her 40th birthday. Nothing looked out of the ordinary.

The results were different 18 months later. Lisa was only 41 years old when she was diagnosed with stage 3 breast cancer in February 2015.

According to Wu, stage 0 of breast cancer is known as ductal carcinoma in situ, which means abnormal cells are found in the lining of the breast milk duct, but they’ve not invaded the breast tissue. Stages 1 and 2 are differentiated by the size of the cancer. Both indicate the cancer has spread to the breast tissue, but not the lymph nodes.

In stage 3, the cancer has spread to the lymph nodes. In stage 4, the cancer becomes metastatic, which means it’s spread beyond the breast.
“I tell my patients that a 10-year survival outlook for stage 1 is about 80 percent, and it goes down from there,” Wu says. “Early detection is the key. If you’re going to get cancer, you’re going to get cancer. But diagnosing it early makes all the difference.”

That’s why Lisa wishes she had received her mammogram more promptly. She may still have been diagnosed with stage 3 breast cancer regardless, but potentially, if the cancer had been detected earlier, her diagnosis may have been less severe and treatment less aggressive.

And, as Lisa was soon to discover, chemotherapy was brutal.

“I wish I hadn’t waited so long to get my mammogram,” she says. “It’s crazy because you’re so busy with life. You’re running around, and raising a family, and cleaning your house and you’re not thinking of your breast exam. If there’s anything I could tell women, it’s to do those self breast exams and don’t miss those appointments like I did.”

Lisa scheduled 16 rounds of chemotherapy at Presence Saint Joseph Hospital’s Meadows Cancer Care center. Each session lasted five to six hours.

“They really take care of you,” she says. “They sit you in this recliner chair, they have a little TV in there, and they give you pillows and blankets if you want to sleep. You just sit there while the medicine drips into you through this IV above your breastbone.”

Lisa’s mom went to every treatment for moral support, and her husband, Kevin, an employee of Presence Saint Joseph Hospital, would periodically pop in to visit.

“I couldn’t have gotten through chemotherapy without their support,” Lisa says. “No one should have to go to chemo alone.”

Lisa was given Adriamycin, a strong chemotherapy drug known colloquially as “the red devil.”

“It’s this bright, Christmas red-colored medicine,” Lisa says. “It really attacks the cancer.”

The effects of the drug left Lisa feeling tired, nauseated and weak. Her hair fell out after the second treatment. Although Lisa focused on the bigger picture, she missed her long, brown locks.

Lisa’s social life drastically changed, as she could no longer muster the energy for long periods of activity.

“My husband and I like to go to movies and out to restaurants, but we really stopped doing that for a while,” Lisa says. “If we went to see friends, we wouldn’t stay long. I just didn’t have the energy.”

With each round of chemo, Lisa became more and more exhausted.

“When you get chemo, you’re tired that night, but then you’re fine for the next two days,” Lisa says. “But when the third day hits, your fatigue is really bad and you just want to lay in bed. So, all of a sudden, you have this sickness that comes over you. Almost like you have the flu. And that’s for a couple of days, and then you’re OK. But right when you get to feeling good, it’s time for another round.”

According to Wu, each breast cancer patient has individualized treatment. Chemotherapy isn’t always necessary.

“We work with a team of surgeons, radiation oncologists, medical oncologists, pathologists and even specialized breast radiologists to decide what the best treatment would be,” Wu says. “You might need chemo, you might need to take an anti-hormone pill, you might need radiation. Typically, if the cancer is smaller, you’ll get a lumpectomy, which is just taking part of the breast tissue out. If it’s larger, you’ll typically need a mastectomy, which is when the whole breast is taken out.”

Lisa completed 12 of her 16 rounds of chemo when her illness suddenly became worse. Seemingly overnight, she contracted a rare virus that escalated into double pneumonia.

“You have to be very careful of germs when you’re doing chemo because your immune system is weaker,” Lisa says. “I had to stop teaching during my chemo because I couldn’t be around kids, where germs are flying. But this virus I caught could have happened anywhere – I could have been standing in line at the grocery store.”

Lisa’s double pneumonia landed her in the Intensive Care Unit for 15 days. At one point, the doctors thought she would only live for a few more hours.

Of course, Lisa remembers none of it.

“They put me into a coma so my lungs could heal,” she says. “I developed Acute Respiratory Distress Symptom, when I was under, and went into sepsis. It was pretty scary for my family.”

Fortunately, Lisa pulled through and woke up rambling on and on about cats. It was a beautiful moment that made her family cry and laugh simultaneously.

“The breast cancer was one part, but the pneumonia was the worst,” Lisa says. “I had to do physical therapy to learn how to walk again, and I developed gangrene in my fingers from a medicine they had to give me to save my life. I had to have partial finger amputations on my left hand. But I’m back to full capacity, so it was worth it.”

Even though Lisa’s pneumonia was cured, she still had breast cancer to contend with. Her doctors decided to stop chemotherapy treatments and focus on getting Lisa strong enough to have a mastectomy surgery.

Lisa had a double mastectomy – meaning she had both breasts removed – two months after she got out of the hospital. Though the cancer was only in one breast, the risk of it coming back in the other was too high for Lisa to take any chances. After the surgery, she needed 30 rounds of radiation over the course of six weeks. She’s currently undergoing reconstruction surgery to shape her breasts back into their normal shape.

Though Lisa still needs to see her oncologist every couple of months, she’s currently cancer-free and feeling back to her old self. The difference is, now, she lives life more fully.

“I don’t miss anything,” she says. “If it’s somebody’s birthday, we go. If my son has a football game, I go. You can’t just say, ‘Oh, I’ll go to the next one,’ because you never know what’s going to happen. We take vacations; we do it all. I also love to just walk my dog or sit outside on my deck and listen to the birds. The little things mean more now.”

Women’s Heart Health

When it comes to heart health, Dr. Elizabeth Retzer finds that women are typically underrepresented in the media. The interventional cardiologist with Centegra Health System, in McHenry County, says women should take heart disease just as seriously as men.

“In all of the commercials you see on TV, it’s always guys out golfing and all of a sudden they have crushing pain in their chests,” Retzer says. “Women don’t necessarily get that because symptoms can be much more atypical and sometimes much more subtle. But the truth is, women are just as much at risk for heart disease as men are.”

With her own patients, Retzer finds that equal numbers of men and women present with heart conditions, but women tend to present symptoms further along in the disease process, when the disease is typically worse. Common early symptoms of heart disease, such as fatigue and shortness of breath, are often written off as a lack of exercise or a gain in weight.

Retzer also finds that high blood pressure and blockages, which can lead to heart complications, are occurring more frequently in patients who are only in their 30s or 40s.

“It’s a product of our current culture,” she says. “People aren’t exercising as much, their diets are worse, they still smoke, and this all leads to having problems earlier on. There’s a mentality of, ‘Well, I’m too young to have this,’ and so things go ignored. Women especially also tend to take care of others over themselves, and that’s also how things can be missed.”

Retzer advises women to prevent heart disease from occurring in the first place by controlling risk factors such as a poor diet, lack of exercise, obesity and smoking. When symptoms do arise, such as chest pain, dizziness, shortness of breath, nausea, or even back or neck pain, Retzer urges women to take these symptoms seriously. If something feels off, talk to your primary care doctor or speak with a cardiologist directly if there are appropriate symptoms or a strong family history of heart disease.

“People know their bodies far more than you give them credit,” Retzer says. “You can tell when something’s not right. A lot of times fear and denial can be amazing motivators to not come in and seek treatment, but we would rather people come in for symptoms and have it be nothing than think it’s nothing and have it be real.”

Though patients may feel frightened about the prospect of having surgery, Retzer says the risk of not undergoing surgery is often much greater. As an interventional cardiologist, she focuses on minimally invasive surgery techniques, which carry less risk than open procedures.

In particular, catheter-based valve replacement, a minimally invasive surgical approach, is becoming more available. With this procedure, damaged valves do not need to be removed. Instead, replacement valves are delivered to the damaged site through a catheter, pushing the old valve out of the way.

This technique is slowly becoming more prominent and replacing open-heart surgeries, Retzer says.

“Instead of it only being about the arteries of the heart, interventional cardiology is about doing procedures to help the other structures,” Retzer explains. “If there’s a hole in the heart, we can usually fix it without having to do surgery. Or, if there’s a problem with the aortic valve, we can sometimes take care of it with catheters, as opposed to doing an open surgery.”

While minimally invasive procedures still carry some risk of potentially life-threatening side effects, such as a stroke or heart attack happening during the procedure, these side effects are largely uncommon.

“Let’s say you’re driving in your car and you get into a crash,” Retzer says. “You have your seatbelt on and you have airbags that go off.

Those safety features can cause all sorts of trauma and internal damage, but you’re glad they were there. While they can do harm, the fact they were there reduces the risk of worse things happening. That’s how I compare surgery to my patients. Bad things can happen, but it’s much riskier to not get the surgery, just like it’s much riskier to not have a seatbelt or airbags.”

But regardless of whether surgery is needed or not, women are starting to have better outcomes, Retzer says. The change is largely due to an increase in awareness.

“Women are starting to represent their symptoms earlier to a cardiologist, and that’s just a testament to the push to get information out there,” Retzer says. “There’s a push for women to be more proactive about their heart health, which is, overall, a great thing.”