If they hadn’t been diagnosed with breast cancer, these four women may never have met. True, they are all employees of Capital Health, but their jobs are distinct enough that their paths may not have crossed. In the most superficial ways—appearance, ethnic background, age, personality, even dialect—they are emphatically distinct from each other. But breast cancer melts away all those differences not touched by the disease.
Within the last 2 years, Elizabeth Escalante, Marina Dexter, Dahlia Dobson, and Jackie Meyer were all diagnosed with breast cancer, and now they share with each other stories of mastectomies, reconstructive surgeries, radiation, and chemo treatments like war vets recounting battles and narrow escapes. Each understands what the others have been through in the months since they were diagnosed, and can convey in the coded language of cancer how it feels to fear for their lives.
While their circumstances aren’t unique (there are 2.8 million breast cancer survivors living in the United States today), these women took on their breast cancer with the mettle and determination we’d all aspire to should our own lives fall under cancer’s cloud.
Elizabeth Escalante {56}
Capital Health coordinator of interpretation and translation services
Even when her smile is only half lit, it has a tendency to warm the room a couple degrees.
And Elizabeth has plenty to smile about. Having moved here from Mexico when she was 30, she is in a loving marriage of 33 years to Trinidad Escalante, a special ed teacher at Trenton High. And they have three grown daughters who live close by. But her eyes cloud over when she talks about the mammogram and subsequent biopsy that changed everything in April 2013.
Doctors found a suspicious mass in her routine mammogram and sent her for a biopsy with Anne Moch, M.D., a diagnostic radiologist. But still Elizabeth had reason to hope it was benign—breast cancer didn’t run in her family.
On April 4, 2 days after her biopsy, Elizabeth was at work when she received a call from her family doctor, Sarah Sordo, M.D. who told her, regretfully, that the biopsy had shown breast cancer. She had stage 1 invasive ductal carcinoma (IDC), the most common form of the disease. “I cried when they told me—what could I do? I thought, what am I going to do now, am I going to survive?” she says. “My husband and one of my daughters came to the hospital to see me. So I had immediate support. When I stopped crying, I said, ‘This is my journey, and I will experience it.’”
Lisa Allen, M.D., director of the Capital Health Center for Comprehensive Breast Care, and oncologist David Schaebler, M.D. helped Elizabeth devise a treatment plan. She tested positive in estrogen receptors and a protein called human epidermal growth factor receptor 2 (HER2), which promote the growth of cancer, so Dr. Allen wanted Elizabeth to start chemo right away. She lost her hair after the first treatment. “Dr. Allen made me feel like I was the only person in the world. She told me, ‘We are going to help you through this,’ and her facial expressions, her words, and her body language—everything gave me confidence,” Elizabeth says. “I found out that I had a great medical team to treat my cancer along with the unconditional and loving support of my family.”
Dr. Allen and her plastic surgeon, Ernest Cimino, M.D., helped her weigh her options, which included a unilateral or bilateral mastectomy and then reconstructive surgery with implants, if she opted to do that. Last September, she had a bilateral mastectomy and successful reconstructive surgery, and Elizabeth was pleased with the results.
Her body is clear of cancer, but she recognizes how the disease has afforded her a fresh appreciation for life. “I will be happy every minute, hour, day, and week. There is no room in my life for sadness. I fight cancer with my body, mind, soul, and heart.”
Marina Dexter {55}
Capital Health Maternity Sonographer
In February 2013, Marina’s annual mammogram revealed “an area of interest,” which led to a biopsy, tissue sent to the lab, and a breast cancer diagnosis.
“My first thought wasn’t about myself. It was a done deal—I have it,” she says. “My problem was, how can I say this to my husband? I was shut down mentally.”
So her co-workers walked her down to Dr. Allen’s office, where her diagnosis was confirmed. But Dr. Allen said something that was an immeasurable comfort to Marina. “She said, ‘it’s just a bump in the road. We’re going to do surgery and chemo, and you’re going to go on with your life.’”
Before she could begin treatment, Dr. Allen discovered she had an aggressive cancer known as triple-negative. In that case, breast cancer does not respond to hormonal therapies (such as Tamoxifen or aromatase inhibitors) or those that target HER2 receptors, such as Herceptin. Only about 10 percent of breast cancers are triple-negative. What began as a bump in the road devolved into something more frightening.
So Dr. Allen changed the game plan. She wanted Marina to undergo 6 months of chemo to stop the cancer from growing, and then have the mastectomy. “The cancer is not just a physical trauma. It’s mental. That’s where friends and family keep you afloat. My husband, Igor, was with me all the time, he was incredible.” While she shared the burden with her husband and daughter, her parents are in poor health, so she opted not to share her news. In fact, they still don’t know.
Despite not having her parents as a source of comfort, one of her co-workers, Nancy Rossum, was with her for every single chemo treatment. “She would get me from my house, stay with me for 3 hours. She was amazing.”
Like Elizabeth, Marina didn’t have much of a family history of breast cancer. But since she has a daughter, she decided to undergo genetic testing to test for the BRCA1 and BRCA2 gene mutations, the same ones that prompted Angelina Jolie to have her breasts and ovaries removed. Marina tested positive for BRCA2, which lead to the most emotionally fraught moments of her entire ordeal, as she waited to see if she had passed this mutated gene on to her daughter. “She had a 50/50 chance to have this. It was the worst moment of my life when I recognized this,” she says. “I couldn’t sleep. I couldn’t function. I was going out of my mind.
“But thank God, my daughter tested negative.”
Marina had a double mastectomy last summer, followed by a second surgery to have her ovaries and uterus removed, a decision based on her positive BRCA2 result. The cancer and the recovery have allowed her to take time for herself. “I never had any time for myself,” Marina says. “But when you have cancer, you have to love yourself more than ever.”
Dahlia Dobson {41}
Capital Health Registered Nurse
Dahlia moved to the United States from Jamaica when she was 5 and grew up in South Jersey. She won a scholarship to a licensed practical nursing school, and after getting her license in 1999, she decided to go back to school to become a registered nurse (RN), gaining that distinction in 2008, which is when she started working for Capital Health.
And she was happily raising her daughter, Cynthia, now 13, working in the outpatient clinic as an RN, when everything changed.
Unlike the other three women, Dahlia went to the ER for something unrelated to breast cancer. She was having stomach pains, and a CAT scan picked up the mass. She had a follow-up biopsy, which showed ductal carcinoma in situ (DCIS), which is considered a pre-cancerous condition. But a lumpectomy would later show that she had IDC. “The whole situation was really hard because we thought it was going to be something simple, but it was a lot more than they initially thought, so we were devastated,” Dahlia says.
However, the news was more positive on other fronts. She tested negative for BRCA1 and BRCA2, a relief because that meant Cynthia would be negative as well. Her lymph nodes tested negative, so the cancer hadn’t spread. Since the cancer was not aggressive, the doctors recommended a 7½-week course of daily radiation, although she did not require chemo or a mastectomy. The radiation left Dahlia with open wounds and exhaustion, although she had to continue working to maintain her health insurance. But while the pain of the treatment was difficult to tolerate and she felt tired all the time, questioning Cynthia’s well-being was what kept her up at night. “Hearing that diagnosis that you have invasive cancer, you just think, I’m going to die,” Dahlia says. “That was the most stressful part, having to think about who is going to take care of your child if you die.”
They started her on Tamoxifen in September 2013, a hormone therapy drug that patients take for 5 years in order to lower their risk of developing more serious breast cancer down the line. While it’s effective, its side effects can be difficult to tolerate. Dahlia has suffered some of these effects, including joint pain and hot flashes. While she considered going off the Tamoxifen, her oncologist recommended she stick with it to avoid a more serious cancer forming down the road.
Despite being an RN and dealing with breast cancer patients fairly often and having two aunts who died from breast cancer, Dahlia felt ill equipped and undereducated when she was diagnosed, and she suggests women learn as much as they can. “I always thought, I’m young, that won’t happen, but it doesn’t even matter,” Dahlia says. “Because really, it can happen to anybody.”
Jackie Meyer {45}
Capital Health Operating Room secretary
In August of 2012, Jackie called her gynecologist to tell him she had found a lump. He told her to schedule a mammogram and an ultrasound right away. “They took one picture after another. I said to the tech, ‘They are concerned aren’t they?’ She said, ‘I want Dr. Moch to take another look.’ I fought the tears on the table—I knew it.
“Dr. Moch came in and said, ‘I am sure it’s cancer,” Jackie says, wiping tears from her eyes. “I went to Dr. Allen’s office right then. I will never forget this. She stood at her doors waiting for me. I have a lot of respect for her. She took me in and said, ‘It’s going to be OK. You’re going to be OK.’”
Jackie was diagnosed with stage 3 IDC, and she tested positive for estrogen, progesterone, and HER2—known as triple-positive. The lump had only been there for 4 to 6 weeks, but the birth control pills she was on had likely been feeding the cancer.
A September 11, 2012 removal of the sentinel node showed the cancer had spread to her lymph nodes, and just a week later she had a bilateral mastectomy and had 17 lymph nodes removed.
Following Jackie’s surgery, performed by Dr. Allen and her plastic and reconstructive surgeon, Gary Tuma, M.D., she began chemo in November 2012. On Thanksgiving, she woke up with her hair falling out by the fistfuls. She asked her husband, Jerry, to shave her head, and while her sons Matthew and Billy were shocked by her baldness, her daughter Shannon, just 7 at the time, was nowhere to be found. “She was hiding,” says Jackie, wincing from the pain of the memory. “I found her, and I asked her what she was feeling, and I started to say, ‘When my hair grows back… ’ and I realized I had never told her it was going to grow back. She just thought I was never getting my hair back. I never told her.”
Jackie finished her eight rounds of chemo in February 2013 and then began radiation, which she says has been incredibly tough. “The radiation kills all the good cells as well as the bad cells. So the skin doesn’t adhere or heal properly, which has caused additional surgeries.”
Jackie is still struggling to shed the weight gain caused by her cancer treatments, and as a result of having her lymph nodes removed, she battles lymphedema, a swelling in her right arm that she prevents by wearing a compression sleeve as often as possible.
But despite her surgeries, the hair loss, the pain of the chemo and radiation, and living with the fear of dying, cancer has also shown her how much love and support she has around her. “Anytime I was having a bad day, the support from home and the support from the hospital was huge,” Jackie says.
Her eyes fill with tears at just the mere mention of how caring her children and her husband have been. Not because she’s weak, but because she has so much to lose.
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