First person

Friend’s breast cancer journey is not as fortunate

 

A 33-year-old graduate student has Medicaid instead of private health insurance, making her options more limited.

atorres@MiamiHerald.com

In the world of mastectomies, a world that Angela Lara entered in July at Miami’s Jackson Memorial Hospital, most women fear mirrors and tight clothes (among other things).

Lara and I have a lot in common. We both walked the hallways of the School of Journalism and Mass Communications at Florida International University with big dreams in our pockets. We were both diagnosed with breast cancer at age 33. With a stage IIIA (the most advanced is stage IV) diagnosis, we both walked through the valley of death. Having been born in beauty pageant country, Colombia, we are both determined to get reconstruction surgery.

Sometimes when she speaks, I feel like I am hearing myself.

“I have cried in the shower. Looking for what to wear in the mornings is very frustrating. I can’t wear the tank tops I used to wear. I have to wear loose clothing, cover the area with scarves,” said Lara. “I do the best I can not to think about it during the day ... I avoid mirrors and move forward with my life.”

I was lucky to have met Lara, who studied international relations. Her aunt and my mom met in college and have been best friends since. They both thought that Lara could help me since my diagnosis came a few months after hers.

Her journey has had more twists and turns than mine. Lara is the mother of a pretty 7-year-old named Gabriela. Weeks after reading a children’s book to her titled “My Mom Has Cancer” to reveal the news, her daughter was rushing to hide under a bed in tears, as Lara shaved her head.

“My job was to tell her that I was going to be OK. That everything was going to be OK, but I felt like I was lying to her,” said Lara. “It was terrible. I didn’t know if I was going to die.”

Lara has been unable to work. She was hospitalized for three days every time her chemotherapy was administered. Her nightmare during the recession: Her fiancée, a civil engineer, hasn’t been able to find work in his field and now parks cars at a Miami Beach condominium.

“He cried the day he read the diagnosis. He doesn’t talk about it much. He doesn’t complain. He has gone through so much. And has remained by my side,” said Lara.

The day of the mastectomy, Lara was horrified. She couldn’t stop crying.

“I was in a state of panic, so they had to give me drugs to calm me down,” said Lara.

On July 13, 2011, Lara lost her left breast. She wanted both breasts removed but Medicaid, her insurance, does not cover prophylactic mastectomies, as private insurance companies do. Medicaid, the federal government insurance for people with little income, also does not cover breast reconstructive surgery.

I was able to wake up with breast implants after my bilateral mastectomy. Thanks to a federal law — the Women’s Health and Cancer Rights Act of 1998 — private health insurance companies are mandated to cover both mastectomies and breast reconstruction. The federal law does not contain the same provision for Medicaid.

“This has been very hard. I haven’t been able to go to the gym. You can’t just wear any bathing suit ... I can tell my daughter can’t stand to look at me ... I feel very uncomfortable when it comes to sex,” said Lara. “The scars are engraved physically, in my heart, in my soul, in my mind.”

Lara completed radiation therapy at Jackson Memorial Hospital before Christmas. To disguise the missing breast, she has been using a prosthesis made out of fabric that she got from the American Cancer Society.

Unlike me, Lara has completed her treatment for breast cancer. According to her initial pathology report the breast cancer cells tested negative for the hormones estrogen and progesterone. They also tested negative for HER2 (Human Epidermal Growth Factor Receptor 2), a protein that promotes cancer cell growth.

Testing negative for all three means the cancer is triple-negative. Researchers say this type of breast cancer most commonly affects African-American and Hispanic women. Currently there are no medications to treat this kind of breast cancer, meaning the risk of recurrence is higher.

“In the meantime, I have to wait until my skin heals from the radiation and I will have to figure out what I am going to do to get the reconstruction surgery,” said Lara. “I really need it. It will improve my self-esteem and help me with this depressive body image issue. My body will never be the same, but I will at least feel more comfortable.”

My health insurance has allowed me to be under the knife of Dr. John Cassel, the former chief of the division of plastic surgery at Baptist Hospital, and the former president of the Greater Miami Society of Plastic Surgeons. I trust him, and know that when the day of my second reconstruction surgery comes, I will be in good hands. It hurts me to see Lara struggle.

In Colombia, the mastectomy and three surgeries would cost her at least $15,000. She has appointments to see doctors there in March. But she has to find a way to raise the money.

She will be applying to a few foundations that provide aid to uninsured breast cancer patients. She qualifies as a U.S. citizen, but the waiting lists are long.

When Colombians go through a difficult experience, and we want to motivate one another to remain strong, we use a popular saying, “pa’ atrás ni para coger impulso.” It was a military Spaniard phrase associated with a stubbornness to never back down. Lara and I have made a pact to do just that.

MY JOURNEY

Part 1: At age 33, I’m dealing with breast cancer

Part 2: Cancer treatment complicates dreams of pregnancy

Part 3: Hanging in when chemotherapy gets rough

Part 4: Tough surgery choices: Mastectomy vs. Lumpectomy

Part 5: Silicone implans are not the only way to go in breast reconstruction

Part 6: Rebuilding the breast from body tissue

Part 7: Body fat can be used to build breast

Part 8: Facing my fears after mastectomy

Part 9: Taking control of the fear that comes with breast cancer

Part 10: Doctor knows about being a breast cancer survivor

Part 11: Radiation therapy gives her hope

Part 12: Finding strength from others

Part 13: Facebook, medication help breast cancer patient deal with depression

Part 14: A new outlook on 2012

Part 15: Breast cancer patient faces genetic mystery

Part 16: Using diversion to cope with harsh reality

Part 17: After radiation therapy ends

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