Breast cancer's changing face

Moses Lake woman Jan DeBeaumont confronts cancer through chemotherapy

Editor's note: This story follows up with Jan DeBeaumont, who was featured in a December article about three women and their battles with breast cancer. When we last spoke with Jan, she was just beginning her first round of chemotherapy. Jan has allowed the Columbia Basin Herald to continue following her progress as she undergoes treatment for breast cancer. We catch up with her after she has been through three doses of the powerful drugs. And though we hoped to present this story in January, medical setbacks have delayed interview sessions.

After three rounds of chemotherapy to treat her breast cancer, Jan DeBeaumont has not lost her fighter's mentality against the disease, but the effects of the battle are showing.

"Now the reality of it has set in," Jan says while sitting in a Moses Lake restaurant on a cold but sunny day in late January. "It's a hard road."

Jan, a 54-year-old mother of four from Moses Lake, is wearing a fuzzy white hat with a thick elastic headband underneath to keep it from slipping on her now hairless scalp. Her cuticles are turning black, as though she's hit every one of her fingers with a hammer. Though the initial mouth sores have gone away, her tongue remains raw. She also has a metallic taste in her mouth most of the time, one of the many side effects of the powerful chemotherapy drugs which are injected into her body once every three weeks. She has a nearly constant feeling of nausea, a sensation she describes as similar to if you felt the flu coming on. And most days, she doesn't have the strength to make phone calls, let alone leave the house. But today is a good day.

Jan has enough of an appetite to enjoy a slice of pizza and salad, and energy enough to stop by the grocery store after lunch to pick up a prescription.

"Some days I feel really good," she says. "I don't know when it's going to hit next."

On other days, common chores require an enormous effort to accomplish.

"You can't appreciate even any visitors," Jan says. She says she feels terrible when people call to check on her or stop by with a casserole, and she doesn't have the energy to talk with them or send a thank you card right away.

"That's hard for me because I can't show how grateful I am," Jan says.

As someone used to being a care giver, not recipient, it's hard for Jan not be able to do everything she is used to doing.

A lot of things about cancer are hard, as Jan is finding out.

The physical cost

Jan's hairloss began within a couple weeks of her first chemotherapy session. "It's just more of an annoyance than anything," she says. "It's not an emotional thing with me."

But she still hates having to wear a hat.

"Imagine wearing something on your head all the time," she says. Covering her head becomes a nuisance for someone used to being able to just run out the door, and also mandates a constant concern for others. "You have to be aware of what other people's comfort zones are, I guess."

Losing her hair was inevitable, and Jan was prepared long before it started falling out. Other side effects of the chemotherapy drugs have been more surprising.

Today, Jan is sporting a huge blister on her foot. She's found her eyesight has not been as clear. The drugs have re-awakened some symptoms of menopause she thought were over, she often has hot and cold flashes again. She says her memory is "shot," and often finds herself repeating a story within the same conversation.

"They're telling you all this before, but when it hits you, you just go, 'Whoa!'" Jan says.

Jan has also had continuing troubles with her white blood cell count, which started to drop after first her chemo session.

"It dropped about as low as you can get," Jan says.

Jan's white blood cell count plummeted steadily from 1600 to 900 to 400, relegating Jan to being, in her words, "grounded." The first time, she was ordered to stay home for two weeks. She couldn't leave the house, and no one was supposed to come see her. Her teenaged daughter had to move out of the house for four or five days because she had a bad cough which Jan couldn't be exposed to.

"The worst part of this is being grounded at home because I'm a really social person," Jan says. "I'm used to being out and amongst my friends and doing things."

But when she's not grounded and her energy levels are up, Jan takes full advantage.

"On days that I feel good, I just go for it," she says. "That counteracts the days when I'm down."

The emotional cost

Jan endured the first two rounds of chemo, but by the third time, she'd had enough.

"I said, 'I don't want to do this anymore,'" Jan says of her plea to her doctor that day. "I asked her if there was a way to kind of wrap it up."

The doctor assured Jan that the chemotherapy was not a preventative measure. For the aggressive type of cancer Jan has, infiltrating ductile carcinoma, the drugs are a necessary treatment.

"When they said, 'No, you have to go through with it,' I cried," Jan says. "I was weepy that whole chemo session.

"But that doesn't happen very often," she says resolutely.

Jan lost the debate about continuing her chemotherapy.

"It's hard to argue with people when they're doing everything they can for you to save your life," Jan says.

Jan's chemotherapy began with what she calls the "heavy hitters," followed by injections of Taxol, which is supposed to be less severe than the first half of her treatment.

"The first four were the killers," Jan says. She had the last dose of such, Adriamycin, on Jan. 24.

She will undergo a total of eight chemotherapy treatments, and expects to have her last one by May.

The financial cost

"I had heard that chemo was going to be very expensive," Jan says. "Of course, I didn't really know."

The cost of Jan's chemotherapy treatments is $5,000 every three weeks. The day after each injection of the drug, she's given another shot, Neulasta, to rebuild her white blood cell count. Without it, her count plummets to a dangerously low number. Each Neulasta shot costs $3,000.

The DeBeaumonts have Premera Blue Cross insurance, but they still end up paying about $1,700 a month for Jan's chemotherapy and Neulasta treatments.

"That doesn't include any prescriptions," Jan says. "I can't imagine how people do it that don't have primary insurance. We do, and our out-of-pocket is still very high."

Jan says she now has a real understanding of how such expensive treatments can force someone into medical bankruptcy.

The DeBeaumonts are able to dip into their own retirement fund.

"My husband has said we'll do what we have to do," Jan says. "I feel tremendously guilty about taking our savings."

Healing herself

Jan's treatment also includes physical therapy, both to help the healing of the scar tissue which extends across her entire chest, the result of a double mastectomy in September, and to prevent lymphedema.

Lymphedema is a common ailment for women treated for breast cancer. Lymph nodes are often removed during surgery, and then analyzed to determine if the cancer has spread. Other times, they are removed because the cancer has spread into the nodes. Jan had 14 lymph nodes removed from her right arm and two from her left arm. Without them, it becomes increasingly difficult to circulate fluids to other parts of the body and swelling may result in the arms.

Jan had a port placed within her chest wall on Nov. 4 before starting chemotherapy. The port acts as an insertion point for injections in an attempt to prevent lymphedema.

But the port alone can't alleviate all other possible causes of lymphedema. Jan must also take other precautions, such as having her blood pressure taken around her leg and avoiding infection in her hands or arms. Her biweekly physical therapy sessions, with Vi Gautam through Moses Lake Clinic, include gentle lymphatic massage as a preventative measure.

Vi, an occupational therapist with 30 years of experience, says lymphedema "can trigger at any time. It is a constant battle then afterwards."

The healing is a slow process, especially as Jan's body does so while undergoing chemotherapy. "She is taking it very well," Vi says.

"She is going to make it. She is a strong woman."

Helping others

Once Jan has conquered her own cancer, she wants to help others.

"I still want to be an advocate for other women going through it," she says. Jan is interested in becoming a Reach for Recovery volunteer, which pairs breast cancer survivors with breast cancer patients in need of support.

Jan did not use the program herself.

"I have women that I can call that have been through it," she says.

She also continues to find strength in the Breast Cancer Support Group which meets monthly at the Pioneer Medical Center in Moses Lake.

"They've all been through it and they all know how you feel," she says.

"It was sad to see two new women at our Breast Cancer Support Group that I knew in town," she says.

This is not the pretty side of breast cancer. This is not all noble perseverance and pink ribbons. This is hard.

"You have to tell that side of it, you have to be honest," Jan says. "I'd say overall I've maintained a pretty positive attitude, but it's harder than I thought it would be.

"The whole thing is about having a positive attitude, and I don't always have one," she says. "I do feel so focused on the negative at times, but it doesn't last."

Jan began her battle with breast cancer with many questions on a major learning curve. She approaches visits to her oncologist like a reporter at a press conference, prepared with notebook in hand.

"It was so important to me in my personal journey to know what I was going to go through," Jan says. "It was so important to me to know all the answers."

But now, she's become the expert in understanding what she's experiencing.

"It gets to the point where you've learned as much as you can and now it's just me going through it," Jan says.

"This is where the strength comes in. You have to pull from every place to have the strength to just keep going."