FOCUS ON HEALTH:Beating back breast cancer

A year ago, Danielle Norseen went in for her first mammogram and found out that same day she had breast cancer.

But the Newport Beach mother of two was determined to beat it. And she did, thanks to improved treatment.

Because of continued technological advances and earlier diagnoses, almost no newly diagnosed woman with breast cancer at Hoag Memorial Hospital Presbyterian Cancer Center dies within five years, medical director Dr. Robert Dillman said.

About a year ago, Newport Beach resident Danielle Norseen, the mother of two boys, became part of that positive statistic.

From the start, Norseen, 41, was determined to stay positive, and because she was diagnosed early, a full mastectomy made her cancer-free.

Because of a family history of breast cancer — two aunts on her father’s side had the cancer and her grandmother died of it — she was tested to see if she carried a breast cancer gene. Doctors found she had the Breast Cancer 2 gene, which enhances a woman’s chances of getting the disease. Five percent to 10% of breast cancer patients inherit the gene, Dillman said.

Since her mastectomy she’s also had a hysterectomy and her lymph nodes removed to help stave off any future cancer.

“My big saying through the whole thing was, ‘I had cancer, but cancer didn’t have me,’ ” she said, joking that she tried to think about losing her breasts as an opportunity to gain a new pair.

“It may sound really silly and maybe selfish and offbeat, but you have to have laughter through it or you’ll never make it. You’d just curl up in a ball,” she said.

Losing breasts and ovaries make it doubly difficult to fight the disease, said Sandy Finestone, a psychologist and coordinator of breast cancer services at the Hoag Cancer Center.

“Part of what happens is you feel out of control — your life is turned upside down,” said Finestone, a 23-year breast cancer survivor. “The physician is directing your clinical course, so you need something to hold on to and feel like you’re in control.”

Finestone leads various support groups and retreats for all levels of cancer patients — the newly diagnosed, survivors and those who have had a recurrence. Yoga, gardening workshops and tai chi can help the women relax and focus on what they can control. But more than that, the women in the groups, much like Norseen and her close-knit friends, laugh and share what they’re feeling.

“We have fun; we laugh all the time,” Finestone said.

According to the Hoag Cancer Center, about one in eight women will be affected by breast cancer and about 1,600 men are diagnosed each year.

In order to keep survival rates high, Dillman said every woman should become familiar with their breasts and do breast exams themselves starting in their 20s. At the age of 30 it starts to become appropriate to get a mammogram. Dillman warned that neither one is a replacement of the other and that both should be done regularly so any abnormality can be detected early.

“The smaller the cancer is at the time it’s detected, the lower the likelihood it’s already spread elsewhere,” Dillman said.

Once treatment is over — the most common are surgery, chemotherapy, radiation, hormonal therapy and biotherapy — men and women then play the waiting game.

“Unfortunately it’s really in the back of the mind for the rest of your life, and you don’t really know that the cancer was completely cured until you go to the grave without ever having cancer again,” Dillman said. “It’s a challenging situation. We don’t want someone to be crippled by their cancer because it’s always in their mind, and yet we in the medical community have to maintain vigilance and suspicions in a patient like that.”

Women who have had breast cancer are already at a higher risk for the disease because they’ve had it and because cancer cells may have already spread through the blood stream by the time of the original diagnosis. The cells may remain dormant or not growing in a way that would be apparent to doctors, but could begin growing rapidly in other areas later. The most common areas for cancers to show up are the bone, liver, lung and recently the brain.

Finestone knows what it’s like to have that fear, so she helps other women cope with it. She leads mixed groups, which she thinks help the women learn from each other.

“Having a recurrence is what every woman fears the most — once they’ve gone through that and feel things are back on track and things are going well, the thing they fear the most is it’s going to recur,” she said. “If they can sit across the table from a woman dealing with recurrence and are managing it … it’s like seeing their worst nightmare and thinking, ‘Oh my gosh, it’s not as bad as what we thought.’ ”

Besides genetics, it is unclear what exactly can cause breast cancer, Dillman said, but it seems that an increase in estrogen may increase the risk. The prevention tips read like a good-health regimen — maintain a healthy diet, stay physically active, don’t smoke and avoid excessive drinking. Dillman’s other preventive tip may not fit in that category. Because of the hormonal differences in women who have been pregnant and those who haven’t, it seems that bearing a child decreases a woman’s chance of getting breast cancer.

For more information or to join Finestone’s support groups, call (714) 764-8071 or visit www.hoaghospital.org.