Bothwell Nurse Shares Story Of Battle With Breast Cancer

Judy Kramer
County Reporter
Joan Kelley is a popular nurse practitioner at Bothwell Health Center – Truman Lake, in Warsaw and sees many patients during her working hours. Some of these patients have breast cancer and Kelley is very familiar with how traumatic the disease can be for them. She is especially empathetic now that she has been diagnosed with breast cancer herself and will have to take time off from her practice to receive treatment. 
She has always recommended regular mammograms as a powerful means of early detection of breast cancer, and it was at her regular yearly mammogram in July that a suspicious area was detected, leading to magnification of the area and biopsy of a lymph node. 
“When the surgeon did the biopsy, it was the first time I really thought that I might have breast cancer, and I was upset,” said Kelley. “The biopsy results took a few days and the diagnosis was that there were several rows of thickening cells in the breast. Then the cells changed shape and looked irregular. A lymph node had the same reading. Although the surgeon wasn’t sure of a diagnosis of cancer, it looked like it might be developing and a mastectomy was recommended.  I wanted to have reconstructive surgery at the same time, but a plastic surgeon was not available so I referred myself to the University of Kansas where I could have mastectomies of both breasts and reconstruction together. KU Medical Center is home to the University of Kansas Cancer Center, a National Cancer Institute-designated Center. It is highly regarded in its cancer treatments.
“It was already close to Labor Day, when I had to have another mammogram and biopsy at KU” said Kelley. “I was seeing patients at Bothwell when my surgeon called and asked for the original biopsy.  After the surgeon had the tissue and took a closer, deeper look, breast cancer was found. A follow-up biopsy found invasive breast cancer. I also had an MRI and was told that there were three different masses in my breast, and one lymph node and two tracers that needed treatment.  The surgeon planned to do the mastectomies after chemotherapy.” 
“After this plan was discussed with me, I saw an oncologist who gave me a differing opinion on what treatment I should have, and I didn’t agree with it. I requested that every specialist on my tumor board review my case and give me an opinion of what was recommended. I wanted the most aggressive treatment.”
Late in September, Kelley heard from the tumor review board. Two-thirds of the members said that she should not have chemotherapy because of her blood disorder and enlarged liver. One-third of the members suggested chemotherapy only if a hematologist sees that it is carefully done. At present, surgery is scheduled and radiation will be performed if the tumor is large.
A test will be done assessing the risk of cancer returning, or of new cancer developing after surgery. If there is a low risk, then no chemotherapy is recommended.  If there is a high risk, then it is recommended that a full dose of chemicals be administered the first time, with modified doses afterwards.
 Kelley is scheduled for a long-planned, ten-day trip to Israel on October 2, and will have her mastectomies when she returns. It will be nearly three months since her July mammogram by the time treatment is started.
“This really impacts my life,” said Kelley. “I am a professional person, and I will probably be gone from work for I don’t know how long. I can’t work in my clinic before and during chemotherapy (if I have it) because I will be exposed to germs. However, I may be able to do telemedicine.”
Kelley said that she went from having one doctor and one mammogram a year, to having many doctors and many appointments with them.  She said that the Cancer Center at KU is helping as much as they can by scheduling appointments with different doctors on the same day so she is not traveling to Kansas City so much. 
“Since I have been diagnosed with breast cancer, many of my patients have shared stories of their experience with the disease or that of someone close to them,” said Kelley. “At first I felt that I was on a journey by myself. I wanted to curl up in a shell. I didn’t know where to draw energy from to get through this. Then, I found that I was not alone. There are so many survivors!” 
“Get mammograms early,” Kelley advised. “Until now I have said that if I lived to be 102, I would still get mammograms. Of course, I won’t need them after getting my breasts removed. 3-D mammograms are now available for screening purposes and many insurance companies are covering them. Breast Cancer Survivor statistics are better now. A tumor is not always the first sign of breast cancer. If something feels different, maybe a thickening in the breast, get a breast exam by a provider.”
The National Breast Cancer Foundation reports that one in eight women in the U.S. will be diagnosed with breast cancer in her lifetime, and that breast cancer is the most commonly diagnosed cancer in women. Each year it is estimated that over 252,710 women in the U.S. will be diagnosed with breast cancer, and more than 40,500 will die. However, there are over 3.3 million breast cancer survivors alive in the U.S. today.
There is some good news about breast cancer trends. In recent years, perhaps coinciding with the decline in prescriptive hormone replacement therapy after menopause, there has been a gradual reduction in female breast cancer incidence rates among women aged 50 and older. Death rates from breast cancer have been declining since about 1990, in part due to better screening and early detection, increased awareness, and continually improving treatment options.