: Not only has Liza Fues twice survived breast cancer, but her journey took place in 1980s and 90s, when the health care community knew far less about curing the disease than it does today.
Liza was 20 years old and attending college when someone taught her how to do breast self-exams. One day she did one and detected a lump. She went to a gynecologist who told her to wait 30 days and return. When the lump was still there, the gynecologist sent Liza to a breast surgeon.
In the following year, 1985, Liza left school at Northwestern University and moved to Dallas, Texas to be with a friend. It turned out the friend was a nurse at Baylor University Medical Center, where her uncle was a physician. The uncle assembled a care team of a breast surgeon, a plastic surgeon and an oncologist. She felt like she was in good hands and felt calm throughout the process.
Liza is originally from Pittsburgh. Her experience with cancer has led to her becoming a technical assistance coordinator at the George Washington University Cancer Center in Washington, DC. One who loves theater, she really enjoys being in Washington and taking advantage of its theater scene.
Liza underwent a biopsy in 1985. Doctors knew that her tumor was rather large, so they chose to perform a surgical biopsy, thinking there was nothing for Liza to worry about. However, she was diagnosed with breast cancer and when on a regimen of chemotherapy.
Liza had plenty of support from friends in Dallas, and for six months, her mother flew down from Pittsburgh once a month. Nonetheless, she had to deal with chemotherapy by herself. She said it made her really sick, which she expected. Once a month she would go in for the treatment on a Friday, feel really sick well into Saturday, a little bit better on Sunday, and go to work on Monday. That she was able to bounce back so quickly was aided by her being 25.
Hair loss was a problem for Liza, as it is for many women dealing with chemo. She did buy some wigs, but hated the way they made her look.
In 1990, Liza was again diagnosed with breast cancer, and again, had to deal with chemotherapy. With the first diagnosis, she remembers having heartburn all the time and being restricted to eating extremely bland foods. With the second diagnosis, she experienced a great deal of nausea, which she said was worse. With both experiences, there was constant fatigue.
The second diagnosis for Liza Fues was capped by a mastectomy with reconstruction. This included a procedure called leptosome torsi, also known as a backflap, in which an incision was made in her back and part of her leptosome muscle was removed and tucked under the skin and anchored in the front to provide a new blood supply to the reconstructed breast. Her breast cancer surgeon said this was an ambitious procedure, but that she was 25 and healthy, enhancing the possibility of her healing in full.
Liza Fues is glad she is not getting diagnosed today, but if she were, there are questions she would ask that she didn’t think of in 1985.
She would ask to have all her treatment options explained, what they entail and what life would be like after treatment, everything from the biopsy to the recommended treatment. Liza also suggests getting a second opinion, not out of distrust for her doctor, but just to get input from multiple points of view. She also says unlike 1985, there are ways to get educated online from reputable sources like the National Cancer Institute or the American Cancer Society.
By way of advice, Liza says hope is very important, to learn how to ask for help, and when it is available to accept help.
Additional Resources:
The George Washington University Cancer Center: https://www.cancercenter.gwu.edu
Transcription:
Bruce Morton: Greetings, and welcome to the Cancer Interviews podcast. I’m your host, Bruce Morton. You know, there are many different types of cancer and for each of them there are different sorts of treatment options, but we can agree that a lot has changed in how cancer has been treated since 1985. That was the year our guest was diagnosed with breast cancer. She is Liza Fues of Bethesda, Maryland. She is going to share with us her cancer journey and the ways in which the treatment of breast cancer has evolved since 1985. So, now let’s get started and Liza, welcome to Cancer Interviews.
Lisa Fues: Thanks so much, Bruce, I am happy to be here.
BM: Now it is our custom on Cancer Interviews that we like to learn a little bit about our guest, so if you would, tell us a bit about yourself, where you are from, what you do for work and what you like to do when you are not working.
LF: Sure. As you mentioned, I currently live in Bethesda, Maryland. I am originally from Pittsburgh, and I have to say, “Go, Steelers!” I am married, have two daughters who are both in their twenties. One has graduated college and is out working, and the other is a senior this year. For work, I am a technical assistance coordinator at the George Washington University Cancer Center. I work on an award from the Centers for Disease Control that funds our support of comprehensive cancer control departments across the country. When I am not working, I really love theater and the DC area is a great place for that, and I also actually do a lot of cancer advocacy work in the area as well.
BM: I am somebody who knows a little about western Pennsylvania having briefly lived there, and you mentioned you are from Pittsburgh. I have to say, it sounds like you have lost your accent.
LF: I am told I have never had an accent. My mother is from the Bronx, and I think her accent tempered the development of my western Pennsylvania accent.
BM: Now, let’s talk about your life prior to your being diagnosed. You were diagnosed in 1985, but there was a time in say, 1983 or 1984, when cancer wasn’t a part of your life. What was your life like then, and how was your health?
LF: My health was great. I was only a couple years out of college. I went to college at Northwestern University, loved it. I actually stayed there for one year, and after a snowy winter, I was ready for a switch and chose to move to Dallas because my best friend from high school lived there at that time, had been there and was working. I moved to Dallas and was working in the human resources department at an accounting firm and was really sort of off on my own, being independent for the first time since college.
BM: So now your life has changed. You have moved from Evanston, Illinois to Dallas, Texas, your winters are a little bit warmer. I am guessing that at some point, Liza, you learned that something wasn’t quite right. Describe what that sequence was like when you learned that something might not be normal.
LF: First, I have to refer back to my Northwestern experience. I visited the infirmary for a routine matter and luckily, somebody taught me to do breast self-exams. At that point, I was probably 20, and I wasn’t regularly doing breast self-exams, but one day in 1985, I did one just randomly and I did find a lump. I went to my gynecologist and encountered my second piece of luck because he had me wait 30 days, then come back for a re-check. When the lump was still there, he at that point sent me to a breast surgeon. I say I was lucky because, given my age and given the fact that there was no family history, his choosing to send me on to a surgeon rather than wait longer was remarkable, so that was the initiation of the sequence of events.
BM: Now, this is quite a few years later, but you sound as though you were calm through this entire chain of events.
LF: I had luck on my side. I had mentioned my friend who lived in Dallas who was a nurse at Baylor University Medical Center. Her uncle was a physician there and had been for many years. When we found the lump, we of course spoke to him, and he really put together my medical team of a breast surgeon, a plastic surgeon and an oncologist, and I felt I was in really good hands, with him and the people who were taking care of me. I really sort of trusted the process, and being young, and subconsciously having that feeling of invincibility that 20-something people have, I think it all came together and not causing as much distress as one might expect.
BM: Now, today, there are many ways to learn about the cancer that you have, or the cancer you may have. Those options, I am guessing, did not exist in 1985, or, if they did, it was a small fraction of what is available and what is out there today.
LF: Yeah, for the original biopsy, it was in 1985, and I don’t think I was offered any options. The other issue was they knew this tumor was rather large, so my surgeon decided to proceed with a surgical biopsy, keeping in mind that they really thought this wasn’t going to be anything worrisome. I think that the thinking was we would go in, do a surgical biopsy, and that would probably be it for any treatment necessary.
BM: You had mentioned your best friend and her uncle. I am guessing that between the two of them, consciously or subconsciously, that formed sort of a calming influence for you.
LF: They were. I had tremendous support. I mean, from them in Dallas, from friends in Dallas. My family was in Pittsburgh, and down the road when we did get to chemo, my mom luckily was able to fly down every month for six months. I had a lot of support.
BM: One thing we have learned at our end with these interviews from people who have undergone chemo is that it is never pleasant, but it affects different people to different extents. Describe how chemo affected you. How acute was the effect on you, and what were things you couldn’t do in your day-to-day life?
LF: To start with the first question, it made me really sick, which we knew it would. The drug regimen that I had was, to use one of my doctor’s favorite words, was, “rigorous,” so it was a rigorous cocktail of drugs that I had, so I would have my treatment on a Friday, once a month. Then I would be sick into the next day, into Saturday, maybe afternoon. I would start feeling better by Saturday evening, rest up Sunday, then I was able to go back to work Monday. Again, the benefit of being 25, and healthy and overall having a pretty good immune system. The regimen lasted for six months.
BM: One of the things that happens often with chemo is hair loss, and one might say that this is more traumatic for women than for men. Was it traumatic for you, what was the extent of the hair loss and how did you deal with it?
LF: I will say that was traumatic, and I was surprised, but you grow up with your face, right? You know how you look every day for your whole life, and when suddenly you have no hair on your head, it was really a shock. Again, with my trusted buddy, we went to a wig store, and I am naturally a brunette. We tried on every color wig that they had. I thought it would be fun to be blonde. My complexion unfortunately did not allow for that, so I ended up with an auburn wig, which was just lovely, so that was fun. I will say that during the time this was happening, remember, I was 25, there was this very edgy nightspot in Dallas, I think it was called the Stark Club. It not the type of place I would normally think I was cool enough to go to, but, as a woman with no hair, when we got up to the waiting line and the red velvet ropes, I left the wig in the car. The bouncer took one look at me and said, “You! How many people are in your group? Come on in!” So, there was my silver lining for hair loss.
BM: One of the other effects of chemo can be loss of taste and/or appetite. To what extent did that affect you?
LF: With my first round, because I was initially diagnosed in 1985, as we have been talking about; but then I was diagnosed with a second primary breast cancer five years later, and the side effects were different. The first time I had heartburn virtually nonstop. So, for the time I was on chemotherapy, I ate a very bland diet. I had a lot of plain pasta, just about anything would set off the heartburn, so it wasn’t so much that I didn’t have an appetite, it was just that I ate, I would get tremendous heartburn. I lost a lot of weight with the first regimen.
BM: When you got to the second regimen, in a sense were you better positioned to deal with it because you had gone through it once, or was there this additional layer of dread because you knew what you were going to be going through?
LF: Both. I would say both in equal measures. I thought I was so well prepared. I went out, I bought a wig, and I thought I would lose a little weight. I did not lose my hair and this time instead of heartburn, I had low-grade nausea the whole time and I ate constantly. I was always eating Saltine crackers, so I gained weight, so, so much for being prepared.
BM: This almost sounds like choosing your poison, but which was worse, the heartburn or the nausea?
LF: I am gonna go with the nausea.
BM: So, we talk about the hair loss and in some cases, appetite. When you were going through chemo, what were some of the things you couldn’t do that you would otherwise do in a pre-chemo world?
LF: The only thing I really think of, other than the lost weekend immediately after my chemo, I actually had a Hickman catheter implanted for the chemo treatment as opposed to using the veins in my arms because I have tiny, thin veins, and they weren’t going to work for chemo. The catheter is implanted into a large vein in the chest and the end of the catheter is external, so when it was time for chemo, there was a clear dressing. They would remove the dressing and take the catheter tip and they would insert the needle for the treatment. Because of that dressing that was on my chest, something like swimming was not possible for the period of time that I had the catheter. There was certainly a little more fatigue, but I am not a mountain climbing type of person, not that there are mountains in Dallas, but other than that, I can’t think of anything else I couldn’t do when I was on chemo.
BM: Our guest is Liza Fues of Bethesda, Maryland, who was originally diagnosed with breast cancer in 1985. By the way, if you like what hear on this segment, we invite you to subscribe to our podcast, available on the links below. There you will see a bell icon. If you click on that, you will be notified anytime we post a new interview. Liza, getting back to your cancer journey, in addition to your good friend and your parents and perhaps by extension, your friend’s uncle, the physician, was there any other source of support for you helped you get through this?
LF: Yeah, there actually was. I met a few other young cancer survivors primarily through my doctors, and I tried a support group at the hospital that was initially recommended by one of my doctors, but I went to the meetings twice, I think, and I was the youngest person in the room, by decades. I was 25. So the other two young people that I met who had had cancer, we sort of banded together and we formed a support group for young people and were able to meet with folks from the American Cancer Society and they supported us in the effort and arranged to have a social worker facilitate the meetings, so we weren’t just lay people who really didn’t have any training, trying to shepherd along a group like that, and it was very useful. There were young people to talk to, and I found it was a lot easier to talk about the darker side of cancer and your worries about cancer with strangers, with sort of disinterested third parties as opposed to talking to my mom about that. She was not the person I wanted to talk to about that stuff. I think we all found that really helpful.
BM: There had to reach a point in which you felt you were starting to get the upper hand on cancer. Describe what that was like, I would have to think that this was a source of encouragement that you are close to getting over the hill.
LF: Were you talking about the first or second diagnosis?
BM: I would say the second diagnosis.
LF: I would say the feeling of getting over this is based largely on the time that passes because cancer survivors all know that when you finish treatment you’re still being checked fairly frequently. You have got those oncologist appointments, then you go in every three months, then it stretches to every six months, then you get to once a year. I was at once a year for many years, and by this time I had moved. We had left Dallas, and we were in the DC area, and the oncologist I was seeing who had no part in my treatment because it had been so many years, he finally said to me, “You know, Liza, I am not doing anything for you. You can come in, I am happy to see you. We do a lab workup, we check your blood, but we really don’t have to do this every year.” At that point, I felt this is good, this is encouraging that my oncologist is firing me, so that is probably when it was most apparent to me.
BM: Was your feeling one of relief or being elated or little of both, something in between?
LF: Definitely something in between because, again, I think this is experienced by a lot of survivors, you feel like you are doing something, that the medical folks you are working with have their eyes on you and it is sort of a layer of protection. So being cut loose also has its scary moments, which is why I know that today often, or sometimes, depending upon where you are, survivors receive a survivorship care plan, sort of a roadmap as to which tests are needed, and hopefully a medical provider will follow up on each one of those tests, that didn’t exist in 1985 or 1990. So, ending regular care from a medical care team makes you nervous, but as I said, time goes on and that’s what you do.
BM: So, let me ask you, in terms of your physical life now, how close are you in terms of your physical life, how close are you to say, how you were, pre-diagnosis the first time. How much of what you could do then can you do now?
LF: I am 60 now, and I was 25 then, so we have to take that into consideration. The one thing that my plastic surgeon told me before my initial mastectomy and reconstruction, the reconstruction that he chose to so at that time in 1985 was leptosome torsi, it’s called a backflap, where they made an incision on my back, cut away a portion of my leptosome muscle, tucked it under the skin and anchored it in the front to provide a new blood supply to the reconstructed breast. What my plastic surgeon told me was after this, I would not be able to climb a rope, hand over hand. Since I had never done that, it wasn’t a big deal for me. Other than that, I can’t really think of anything I am unable to do because of the surgery.
BM: You had mentioned reconstruction. Was that the plan all along or were you sort of on the fence about as to whether to go that route?
LF: I have to say, given that I was very young, I felt like I had good doctors, I felt like I had good advice, and I did not question a lot of what was happening. My plastic surgeon reminded me I was 25. He said it would be rigorous to do the mastectomy and the full reconstruction of the breast, but that I was young, and I was going to heal well and that’s what he suggested. I said okay, and that was always the plan.
BM: Two other questions I want to ask you, Liza. You had mentioned briefly that you are a cancer advocate. Exactly what does that entail?
LF: Well, it has evolved over the years. When I was initially diagnosed and I was hospitalized for my surgery in 1985, I was in the hospital for eight days and the American Cancer Society had a program then that continues today called Reach To Recovery, and at that time because people were in the hospital for so much longer, a woman who had also been through a breast cancer diagnosis and surgery would actually visit a newly-diagnosed patient and bring some information, some pamphlets, some very simple exercises to do after surgery to help with range of movement. I was so impressed by the woman who came to visit me that I became a Reach To Recovery volunteer and I did that for a number of years. As I moved to different places, I went from Dallas to Chicago to Washington, DC, I stayed as an American Cancer Society volunteer in different capacities. Once I had my kids, we started doing an American Cancer Society event called Relay For Life where you put together a team, it’s an overnight event where you are walking a track. The idea is that someone from your team is always on the track to mimic the concept that cancer never sleeps, and in the last five years or so, maybe a little longer, I have moved more into volunteering in the policy area because making a change at the policy level, whether it is local, state or federal, has such a large impact at a broader level. I also went to law school in the interim, which also spurred some interest in policy. So that’s what I am doing with the American Cancer Society and also with the National Coalition for Cancer Survivorship, two fabulous organizations that advocate for cancer patients and survivors.
BM: Along these lines, Liza, I want you to put on your advocate hat, and try to enumerate a few questions that somebody who has been diagnosed or somebody who thinks they might be diagnosed, questions they should ask today that you would not have thought of in 1985.
LF: I think I would definitely ask about options for everything, just so you have the information, which I think is very important. That might not be the case for everyone, but were I in this situation today I would ask about options for everything from the biopsy method to the recommended treatment. I think I would also ask about getting a second opinion, not out of distrust for my original doctor, but to make sure I was receiving input from different points of view. I think the other thing I would do is significant online research with reputable sources, like the National Cancer Institute, like the American Cancer Society and try to educate myself so I could ask educated questions.
BM: We’re going to wrap up now, Liza. We always start off our interviews from the same place and we try to end at the same point from interview to interview. You are in an almost unique position as being someone who is in her fourth decade of survivorship if you will, and against that backdrop, by way of not just education but inspiration, if you had a private audience with somebody who had just been diagnosed, what would you tell them?
LF: I would tell them that hope is very important. I personally think that is in equal measure with everything else you are doing. I would say learn how to ask for help and accept help. The idea when I was 25 and having my mom come visit me every month for six months when I was out in my apartment living independently was not something I would have expected, but it was great. Find things that make you laugh and if it feels right when you get far enough removed from your personal cancer journey, see if you can give back in any way that feels good to you, whether it one-on-one support for the newly-diagnosed, whether you support policy measures that would increase funding for cancer research, any of those kinds of ways to be engaged, I think are all terrific.
BM: All right, Liza, thank you very much. Our guest has been Liza Fues of Bethesda, Maryland, who was originally diagnosed with breast cancer in 1985, and went on to be a two-time survivor. Liza, thanks so much for being with us.
LF: A pleasure, Bruce, thanks for having me.
BM: And again, we want to remind you that on Cancer Interviews, that as you go through your cancer journey or as to you perhaps contemplate going on one, that you are not alone. We are with you every step of the way, as are our various guests who have shared the story of their cancer journeys. So, until next time, take care and we’ll see you on down the road.
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