Joan Bolin Betts realized the news was not good when her best friend, who was a radiologist, cried as she looked at Betts’ mammogram results.
She had breast cancer. Betts had discovered a lump while doing a self-check in the shower, so she had a follow-up mammogram and then a biopsy, where the cancer was confirmed. This was in 2002. She was 56 years old.
“It was a very, very tough moment for her and for me,” Betts says as she recalls sitting in her friend’s office.
The two friends did what they always did — they joked around with each other. The doctor friend also performed the biopsy, and Betts remembers telling her: “If I’d known you were going to be doing that, I wouldn’t have become friends with you.”
Her doctor friend told Betts not to make her laugh while she was trying to do the biopsy.
Breast cancer runs in both sides of Betts’ family. Her grandmother had it and died when she was in her 70s. An aunt had also had the disease but had been in remission for 15 years at the time Betts was diagnosed. Another aunt had also died from breast cancer.
It was her cancer diagnosis that made Betts realize just how much her body was in control, but she knew her mind and attitude could be stronger.
“You have to say ‘OK, I have this, and I can handle this, and I will succeed,’ ” Betts says. “I think that’s what you have to do.”
Betts was a law school graduate and had dealt with litigation in federal court. She knew how to work her way through anxiety and tough times. She took the same approach with her cancer diagnosis and treatment.
“Some people will say it takes courage,” she says. “I’d rather use the term determination. It was really ‘Let’s go.’ I really think that saying ‘It’s a battle’ is more negative than I like to look at it. I really like to look at it as you’re facing work; you’re facing what needs to be done to survive. ‘Battle’ is too negative.”
Telling family, handling their reactions
The good news was that Betts’ cancer was caught early: It was described as stage 1, beginning stage 2 at the time.
But there were two very difficult times.
The first was telling her daughter, Meg, who was a junior in high school at the time. She screamed when her mother told her she had breast cancer. Betts told her it wasn’t a death sentence. The cancer had been caught early, and her aunt also had survived it.
As Betts began treatments, she was walking in the skywalk into work with a co-worker. The man told her she had hair on the back of her jacket. It had started to fall out.
That was expected. Betts went home and shaved her head. She hadn’t told her husband at the time (he died eight years ago) what she was doing. The second difficult time was her husband’s reaction. He walked around the corner into the bathroom and uncomfortably laughed from the shock. Betts remembers his reaction, while unintentional, made her cry.
“I do think that losing your hair is huge,” Betts says. “The advice I got from other survivors was to get a wig before I had a risk of losing my hair.”
Her hair eventually did return, but it came in pure white, which she didn’t know was the case because she had been coloring it for years. She decided to keep the white hair.
Betts credits medical science with survival, battles through chemotherapy
Betts underwent a single mastectomy that same year.
“I felt more secure that way,” that the cancer would be completely removed, she recalls.
Her daughter still had many life events ahead of her that Betts wanted to make sure she saw, even though her prognosis was good. Years later, she watched Meg graduate with honors from Georgetown University and walk down the aisle on her wedding day.
“My life is continued,” she says. “I’m very gifted.”
She waited several years to have reconstructive surgery. In hindsight, she wishes she hadn’t.
“I think I made a mistake that way,” Betts says. “I think that everything I’ve seen from other women is that you feel better about yourself, and you feel more whole. It’s amazing what doctors can do.”
The cancer had not spread, so radiation was not required. She underwent six months of chemotherapy treatment, followed by taking anti-cancer reoccurring drugs for several years afterward.
The chemotherapy made her progressively weaker, but Betts still worked as long as she could.
“People didn’t expect me to work, but I wanted to work,” she says. “The fact that breast cancer isn’t a death sentence is a big deal.”
Chemotherapy made her sick after the first treatment, but Betts says mostly she became extremely weak. By the fourth month, she had to quit working. She found it too difficult to concentrate, which made it difficult to perform a job where she was required to research and write.
She also fought lots of emotions, specifically feelings of vulnerability.
“I needed people around me,” Betts recalls. Friends came to sit with her. Her doctor friend brought her audio books to listen to because even watching television was too much.
In one instance she remembers becoming hysterical when her husband and daughter went out of town for a wedding, and she was too weak to travel. Her brother-in-law rescued her and took Betts to stay with his family.
Betts credits her survival and recovery with the advances in medical science. These advances were not available for her grandmother and aunt, who died from the disease. She says there is not a time when she goes to the doctor or has a test performed that she does not thank the individual for what he or she does.
She also doesn’t underestimate the strength of women.
“Never ask ‘Why me?’ ” Betts says. “Life is hard. There are lots of issues we go through. It’s our health; it’s our family’s health. It’s losing parents. It’s raising children and dealing with their issues. Women are much stronger than they realize.”
Beaverdale woman finds calling in assisting breast cancer patients
Jen Witt of Beaverdale has worked for the past 17 years as an oncology nurse, with the past five years as a cancer care coordinator with John Stoddard Cancer Center in downtown Des Moines.
Witt’s grandmother had died from breast cancer, and her mother had a different type of cancer when Witt was a child.
“I knew there was a way I wanted to help and be of service,” she says. “I was just always drawn to (working with cancer patients) and felt like it was something I was supposed to do.”
In her role, Witt meets with a woman immediately after her breast cancer diagnosis. She answers any questions about surgery or treatment options and provides information about various services that are available and ways they can receive help with various aspects of their life from how to tell their children about their cancer diagnosis and how to find a wig to how to connect with various support groups that can help them receive meals or help cleaning their house.
“There’s a lot of an emotional aspect because they’ve just been through a cancer diagnosis,” Witt says.
Witt stays connected with the woman throughout her entire cancer journey — surgery, treatment (chemotherapy and radiation, if needed), reconstruction and even post-cancer.
“What I’ve loved about this role is, as a nurse, it really allows you to spend the time needed with patients as much or as little as they need… and to validate what their feelings are and give them the time and space they need to share those, but empower and give them the support they need moving forward,” she says.
Witt meets up with her patients when they come in for radiation or chemotherapy treatments. She also provides guidance once the woman transitions into what is referred to as “survivorship.”
“For some women, when they’re all done with therapy, that’s when it all hits them,” she says. “Why do I feel depressed? Why do I feel anxious?”
Many women feel anxious about medical bills, how their job may have changed during the time they were going through treatment or about whether they can even return to work in the same capacity.
Free service is available to all breast cancer patients
The cancer care coordinator program is free to all breast cancer patients. Patients can be referred by their doctors or another medical professional, or they can even inquire about services themselves.
“We can be that one constant that can answer questions and tell them where to turn to next and just to support them as they keep journeying along and be an advocate for them,” Witt says.
About 280 women received service through the program last year, which represents the majority of women who were treated for cancer through John Stoddard.
“I am always humbled by and touched by the courage and the grace that these women show,” Witt says. “I think many women underestimate the strength they already have. I always tell patients: ‘You are doing the heavy-lifting. I’m just here to be your cheerleader. You already have the strength to do this.’
“It’s not a sorority they want to be part of, but it’s a beautiful connection they develop and they give us the privilege to walk beside them.”