For Angela Morgan of Jacksonville, it started in 2007 with twinges in her right breast. With no family history of breast cancer, her doctor thought it might be only fibrocystic changes.
The American Cancer Society recommends women begin routine mammogram screenings at age 40. Angela was only 36, but just to be on the safe side, her doctor sent her for one.
“As it turned out, it was my one and only mammogram,” she said.
The radiologist recognized patterns in the mammary ducts and informed Angela’s gynecologist.
“He ordered a biopsy and didn’t try to hide his suspicions from me,” Angela said. “He explained what the patterns meant.”
She was worried when she left his office, but determined to learn more and arm herself with knowledge.
The biopsy results revealed cancer was in the mammary ducts — Ductal Carcinoma in Situ (DCIS) — and a lumpectomy was needed.
A teacher of history and science at Ohatchee High School at the time, Angela scheduled the surgery to coincide with spring break. Her husband, Chris Hill, was also a teacher and the only other person who knew about the cancer diagnosis.
Angela didn’t consider it to be a scary experience because of the research she had dutifully conducted. “DCIS has an extremely high survival rate,” she said. “And I was optimistic that it hadn’t spread.”
During the lumpectomy procedure, which was outpatient surgery, two lymph nodes were removed to check for evidence of cancer.
Afterwards, the surgeon told her she didn’t need a drain, which surprised her. As part of her research, everything she read indicated she would.
Angela and Chris headed home, where they prayed for clean margins.
‘I want a second opinion’
One week later, Angela was surprised to learn that she did not have clean margins. It was her surgeon’s recommendation, after he had consulted a “cancer board,” that she undergo a mastectomy.
Angela was suddenly filled with questions and was frustrated that this particular doctor was not as forthcoming as her gynecologist had been.
“I asked what stage my cancer was in and he gave me an odd look,” she remembered. “‘Stage zero,’ he told me.”
Angela was confused.
“So there wasn’t cancer in the lymph nodes?” she asked.
She sensed the surgeon’s impatience with her questions. “No,” he said.
“He then told me I was healing well and that I could ‘put a sock’ in my bra if I felt uncomfortable,” she said.
Angela didn’t know how to respond to that. As she quietly got dressed, she had one more question.
“What is a cancer board?” she asked him.
With that, he snapped in annoyance, telling her if she wanted a second opinion, she could get one. “Yes,” Angela told him. “I want a second opinion.”
He promptly left the room, leaving Angela alone with a nurse, who confided that she would want a second opinion, too.
‘God was taking control’
The following day, Angela met with her boss, the school principal, to let her know what was going on.
“That was when I knew God was taking control,” she remembered. The principal told her about a surgeon at St. Vincent’s hospital in Birmingham — a female surgeon who was an oncologist and a breast specialist as well as a former nun.
Angela called St. Vincent’s and explained her situation. She was told to bring all her documents and they would see her in two days. “I was encouraged by such a quick response,” she said. “I went into fighting mode and gathered all my information.”
At St. Vincent’s, she underwent an immediate sonogram and could see fluid inside her breast. She thought back to her (old) surgeon saying she didn’t need a drain. At that moment, her (new) surgeon asked for a full recount of everything Angela had gone through up until that moment.
A frank and detailed discussion ensued, in which Angela and Chris were given an abundance of information to consider. The cancer had positive receptors for estrogen and progestogen and would most likely respond well to treatment. In order to get clean margins, however, a great deal of tissue would need to be removed.
“She was brutally honest with me,” Angela remembered. “She said it would leave me with only half a breast and that was a concept I’d have to wrestle with.”
‘You will survive this’
Although it was a slow-growing cancer, there was a chance it would invade the left breast at some point in the future. Those odds grew with each passing year, and that was not acceptable to Angela. She decided to opt for a bilateral mastectomy with transflap reconstruction.
“This woman didn’t make me feel hopeless,” Angela said. “She looked me in the eyes and said, ‘You will survive this,’ and the weight I’d been carrying lifted from my shoulders.”
After choosing an early summer date for the surgery, the only thing left for Angela to do was tell her friends and family, specifically her daughter, who was only 11 years old at the time. “Are you going to die?” the little girl asked her mother.
“Not today,” Angela responded, with a jovial tone.
At that moment, Chris left the house and wandered a field out back. “He was, and is, so easy for me to read,” Angela said. “I knew to leave him alone, that he was angry at a situation in which he had no control. It only strengthened my resolve to endure what was to come.”
Angela’s best friends were shocked, but quickly recovered, telling her crude — “but very funny” — breast jokes. “They knew I’d rather have humor than sympathy,” she said.
Speaking of humor, Angela had been told that the St. Vincent’s surgical team enjoyed a good laugh, so she wrote a message to them on her stomach before going into the operating room.
What did it say?
“That’ll just have to stay between us,” she replied, with a smile.
‘I no longer fear death’
In the days that followed, Angela learned humility, having to allow others to care for her. “My husband and sister-in-law took turns cleaning my drains, feeding me and helping me walk,” she said. “They remain angels in my eyes.”
Today, Angela has a very busy life. She works for the Alabama Education Association as a UniServ director. She represents teachers, support staff and even administrators when they have issues. She attends school board meetings, reviews policies and budgets, provides professional development opportunities and facilitates meetings with legislators.
Eleven years have passed since her surgery. In that time, she has had only one moment of concern. “I felt a lump in my right (reconstructed) breast and went back to St. Vincent’s,” Angela said. “It turned out be a cyst, but it was a moment that gave me pause.”
Angela knows how fortunate she is that her cancer was cured with no radiation or chemotherapy. “My battle wasn’t nearly as serious as most folks, but it was enough to make me realize life isn’t for watching from the sidelines. I no longer fear death. It will come,” she said. “What I fear is wasting the time God has given me.”
Angela’s advice to anyone facing a serious diagnosis is to trust your instincts. From the twinges she felt in her breast that led her to see a doctor to the lack of communication she experienced with her first surgeon, she knew something was off.
“Don’t be afraid to ask questions,” she encouraged. “Your health belongs to you, and it’s your job to be your own advocate.”
Donna Barton’s column regularly appears Sundays in the Life & Arts section. Contact her at firstname.lastname@example.org.