Signs & Symptoms
Against the odds
Augusta Williams insists she is not a cancer survivor; she is a thriver. Williams battled both bone and breast cancers more than 20 years ago — and won.
Say this about Augusta Williams: she is fearless.
Like the time she faced down a robber who invaded the beauty parlor where she stopped to have her hair done.
Williams is equally combative when it comes to her health. Diagnosed with bone cancer in 1984 and breast cancer four years later, Williams plans to celebrate her 70th birthday — and almost 30 years of survival — next year in Australia.
But don’t ask her about being a “survivor” of two different forms of often fatal cancers.
“I’m a thriver,” she said. “I’m at a level of happiness and joy that I had not experienced before. I’m moving on with my life.”
Indeed, thriving appears to be an operative word these days when it comes to living with cancer. As one of the most feared diseases, cancer is no longer an automatic death sentence.
Because of significant medical advances, survival rates have improved dramatically over the years. As of January 2006, for instance, the National Cancer Institute (NCI) estimated that more than 11 million people — or almost 4 percent of the population — had survived cancer. Furthermore, roughly 14 percent of those survivors had lived 20 years or more after their diagnosis.
Cancer is still no joke. It is the second leading cause of death in this country and is now the leading cause of death in Massachusetts. Blacks are the hardest hit by the disease. The death rate from cancer in African Americans in Massachusetts is 10 percent higher than that for whites, and roughly twice the rate for Hispanics and Asians.
The numbers on disparity are similar across the country. Blacks have the highest death rates in the four most common cancers — lung, breast, prostate and colorectal — as well as several less common cancers. The causes of the disparity are many — lack of access to good care, lack of insurance, delayed diagnoses, fear and denial.
And, unfortunately, misperceptions. A recent survey conducted by the American Cancer Society found that as many as 41 percent of the respondents clung to myths that pain medications were ineffective in treating cancer; that surgery caused the cancer to spread throughout the body; and that there is a conspiracy to withhold a cure in order to allow medical institutions to continue earning profits.
Though generally considered to be more in tune with their bodies, women are also prone to misperceptions. Ask them to name the leading cause of death among women and they are likely to respond “breast cancer.” But that is incorrect. In fact, more women die of coronary heart disease — the leading cause of death — than the top ten cancers in women combined.
But heart disease doesn’t have the same negative cloud that surrounds cancer. It’s so bad that many refuse to say the word “cancer,” and prefer terms like “the Big C” or “the C word.”
Dr. Christopher Lathan, an oncologist at Dana-Farber Cancer Institute specializing in lung cancer, admits he gets a bit frustrated. What’s worse than the misperceptions, Lathan says, is that blacks are less inclined to seek timely treatment for cancer and are slower to recognize the symptoms or understand how to prevent it.
His recent research bore that out. Lathan and his co-researchers found that blacks are less likely to link lung cancer with smoking and think that pain or other symptoms must occur before a positive diagnosis can be made.
Christopher Lathan, M.D.
Dana-Farber Cancer Institute
There is one problem with these perceptions — they are all wrong. “At least 85 percent of all lung cancers are caused by tobacco,” said Lathan. “And lung cancer is the number one cancer killer.”
Furthermore, while many cancers are silent for years and grow undetected until a symptom appears, some cancers — colorectal, cervical, breast and prostate in particular — have good screening tools that can detect the tumor long before the first symptom surfaces.
The cause of cancer is not that straight forward. What is known is that there is a change in genes — the units that carry our hereditary information — but what causes that change varies. Culprits include lifestyle and environmental factors, such as smoking, radiation from the sun or exposure to chemicals in the workplace. Even diet is a contributor. Some genetic mutations are hereditary, but having a mutation in the family is not a guarantee that a person will be afflicted. It means only that the chance of getting that particular cancer is greater than that of the general population.
Such was the case with Williams. She had a real reason to fear cancer. Her mother had metastatic breast cancer and died at the age of 49 — one year older than Williams was when she was first diagnosed with breast cancer.
Williams was on alert from an early age, and relied on mammograms and breast self-examinations to provide her first level of defense. Her fastidiousness paid off when she discovered a lump during a self-examination. Although her mammogram proved negative, a biopsy of the lump confirmed a malignant tumor.
It’s a good thing Williams was blessed with a feisty gene. She didn’t have health insurance at the time and was denied a bed at Memorial Sloan-Kettering Cancer Center (Sloan) in New York — the NCI-designated Comprehensive Cancer Center where she received treatment for her bone cancer.
Desperate, she turned to Nancy Reagan — yes, that Nancy Reagan — for help. Williams said that she believed that of all people who could understand her dilemma, it would be the First Lady who a year earlier had been diagnosed with breast cancer.
Fortunately, her aggressiveness worked. Within minutes of her telephone call to the First Lady, the coveted bed at Sloan appeared.
To say the least, Williams is no shrinking violet. She looked at cancer as a personal invasion. “You’re not taking over my body,” she warned the cancer in one of many conversations she had with herself. “If I could stare down a robber, I certainly could face cancer.”
Williams is not alone in waging a successful fight. “If a person lives five years without the disease, that is considered a cure,” said Lathan. Even lung cancer can be cured. “Seventy to 75 percent of lung cancer patients survive if found early,” said Lathan. “But once it spreads, the overall five-year survival rate plunges to 15 percent.”
While there is not yet an adequate screening test, lung cancer is largely preventable by refraining from tobacco use although there is an increase in the percentage of nonsmokers who are stricken.
Other cancers are considered preventable as well. With the advent of the vaccine Gardasil, about 75 percent of cervical cancers can be avoided. For those who do not qualify for Gardasil (it is now not recommended for women older than 26) regular Pap tests can detect pre-cancerous cells that can be treated before the cancer emerges.
Colonoscopies, the gold-standard for colon cancer screening, can find pre-cancerous polyps — thereby avoiding the problem altogether.
The obvious and best solution, Lathan says, is to see a doctor on a regular basis.
“Try not to fear the information,” he advised. “Even when it’s unfortunate. Early intervention can lead to a cure.”
When it comes to cancer, knowledge really is power.
On that point, Williams is in total agreement. That’s her advice to others facing the same predicament. “Ask questions,” she advised.
If a doctor says something you don’t understand, Williams says, get his attention any way you can — even if that means pulling on his coat. “Tell him you don’t understand,” she emphasized. “For every medical term there is a lay term.”
Williams also stresses the need for support groups. She has been a member of the Pink and Black campaign, a program sponsored by the Boston Public Health Commission to draw attention to the disparities in breast cancer survival faced by black women.
Now a motivational speaker and author of a book on her experience, Williams credits her “thriving” to just four words.
“Speak up,” she says. “Speak out.”
To hear Augusta’s story in her own words, click here.