Tracy Williams

It's 10:45 a.m. on June 2, 2004, a brilliant blue Arizona morning. At Mayo Clinic's campus in Arizona, Tracy Williams sits with Donald Northfelt, M.D., her medical oncologist, for a follow-up appointment. Tracy's hands are folded neatly in her lap, her business suit immaculately pressed. You'd never guess that for the past two years, Tracy has fought breast cancer.

"I'll see you next April," says Dr. Northfelt. Those simple words belied the weight they carried. Those words meant her treatment was at an end, that her next appointment would be a regular checkup.

Two years earlier, Tracy's life moved at a different speed, measured in minutes and seconds instead of months and years. She'd achieved a lot by age 34. Her position at a well-known financial services company had brought her from Ohio to Arizona. In addition to work, she juggled a full-time school schedule, finishing her degree in business management.

That fast pace slowed to a halt when a nurse from Mayo's Breast Clinic called to say, "There are some things we need to talk about." During the days that followed, Tracy would learn about her disease and the options available to her. During the subsequent weeks and months, she would learn more intimately about the care of the doctors and nurses at Mayo Clinic and the strength she found in the support of her family and friends.

A sign of trouble

One Friday night in April 2002, Tracy awoke at 3 a. m. and was unable to go back to sleep. Instead of tossing and turning for hours, she decided to watch television. But as she moved to sit up in bed, Tracy felt a sharp pain in her chest.

She first thought it might have been a sewing needle from a project earlier in the day. But when she felt around for sharp objects, she found nothing. Then, gingerly, she pressed on her left breast and a sharp pain lanced through the area.

First thing that Monday morning, Tracy visited her physician at Mayo Arrowhead Family Medicine in west Phoenix, who referred her to the Breast Clinic at Mayo Clinic in Scottsdale. Physicians there recommended a biopsy. While at work a few days later, Tracy received a call from a Breast Clinic nurse, Lana Busche. She advised that Tracy be in a place she was comfortable. "There are some things we need to talk about," she said.

Tracy had breast cancer. It was a difficult thing to hear, and just as hard for her to understand.

"I didn't know how I could get cancer," Tracy says. "I was 34 years old. I ate right, I exercised, I don't drink or smoke. And my mom and sister are both healthy."

Richard Gray, M.D.

One of Tracy's friends accompanied her to an appointment with Richard Gray, M.D., who would be Tracy's surgeon, to learn about treatment options. "She took notes for me," Tracy says. "I was so shell-shocked, all I could do was stare at Dr. Gray's hands."

He explained that the tumor in Tracy's breast was 2.5 centimeters in diameter. Fortunately, the tumor hadn't metastasized, or spread to other tissues. Treatment options included a lumpectomy with radiation therapy, or a mastectomy with or without reconstructive surgery. Tracy chose a mastectomy with reconstruction, so her treatment team expanded to include medical oncologist Michael Gornet, M.D., radiation oncologist Michele Halyard, M.D., and Edward Buchel, M.D., who was part of Mayo Clinic's Division of Plastic and Reconstructive Surgery.

One of the plastic surgery options included using Tracy's own tissue to fill out her breast area. A slender woman, Tracy didn't have much extra tissue to offer. "I had to gain weight in three weeks," she says. "I ate junk food like you wouldn't believe! I gained seven pounds, and they used it all. And then they gave me a tummy tuck."

Tracy's breast tumor was surgically removed May 21, 2002, about six weeks after she first felt that pain in her breast. Reconstructive surgery occurred at the same time. And a few weeks after her surgery, Tracy began six months of chemo- therapy treatments designed to clear any remaining cancer cells from her body.

"There were times when I didn't know whether I could handle the chemotherapy treatment," Tracy admits. "But I knew it would save my life."

Friends and angels

"I'm a people person," Tracy says. "I have to be around people." But there were times during her treatment that Tracy couldn't leave her house, because chemotherapy left her immune system quite low. So every week, Tracy's workmates would come to visit.

"They'd read to me, and I'd be so sick that I'd fall asleep. Then they would do the dishes and the grocery shopping," Tracy recalls. "When you have cancer, you find out who your true friends are, and you find out who your family is. They don't have to be biological."

One of Tracy's best friends was a new one that came through a support group called ChemoAngels. com.

Mary Bothe and Lana Busche, Mayo nurses and part of Tracy's support network.

"Mayo Clinic directed me to this support group," Tracy recalls. "And through them, I met Kristin. She lives in California. I told her what my treatment schedule was, and each time I came home from chemotherapy, there was a card from Kristin and her husband! My other friends were wonderful, but they had no idea what it was like to lose your hair from the chemotherapy, and be so sick you couldn't get out of bed. Kristin knew exactly what I went through. I feel like I've known her my whole life. We'll be best friends forever."

Mary Bothe, a staff nurse in Mayo's Breast Clinic, also introduced Tracy to other women in the Phoenix area who had battled breast cancer. "They'll be my friends for life," Tracy says. "Now we sit back and laugh about being bald together."

Chemotherapy ended in December 2002, and was followed by six weeks of daily radiation therapy. Tracy opted to receive both chemotherapy and radiation treatments at Mayo Clinic in Scottsdale instead of an outside facility closer to her home.

"I drove every day, an hour each way, because Dr. Buchel, Dr. Gray, and Mary and Lana in the Breast Clinic were my support group, "Tracy says. "I remember sitting with both doctors, and they would just hold my hand and let me cry. I really looked forward to seeing them, because I knew they wanted me to get better."

Tracy's time

Tracy's treatments were a success, as her follow-up evaluations at the Breast Clinic showed. Generally, follow-up exams are conducted every six months for the first five years, and annually after that. So when, at Tracy's biannual exam in June 2004, Dr. Northfelt said, "I'll see you next April," Tracy was taken aback.

"Don't you mean you'll see me at my next follow-up in December?" she blinked. After all, it had been only slightly more than two years since her diagnosis.

"Tracy," Dr. Northfelt said, his hand touching hers, "you've been through a very tough couple of years. But your postoperative recovery is complete, and you're no longer having any side effects from your chemotherapy treatments. You're doing great! So I'm going to schedule you out a year. And I'll be here for you to call if you have worries or concerns."

Donald Northfelt, M.D.

"I always try to remember that patients with cancer look forward to feeling normal and back in control of their lives at some point," says Dr. Northfelt. "By June 2004, Tracy had gained back her vitality and confidence. And it seemed to me that it was Tracy's time to regain control."

And gain control, Tracy has. "I'm a new person with a new attitude! I've made so many changes, including learning how to let things go," she says. "But you can't leave cancer behind and forget it, because it affects every decision you make in life."

One of those decisions involved Tracy's career. Although she is back at work and in school full time, her focus has changed. Now, Tracy plans to become a nurse.

"It was something I'd originally thought of doing after high school," she says. "Back then, I didn't think I could handle it, because I get really attached to people. But now I know differently."

"Having cancer has made me a better person," she says. "The care I received from my doctors and nurses was wonderful. And when I get my nursing degree, I want to work for Mayo. I only wish I'd gotten my degree sooner, so I could be helping people now."

"Tracy is the most important person that was on her cancer care team," says Dr. Northfelt. "She is the one who discovered her cancer originally and brought it promptly to the attention of her doctors. And she did everything right in working with her doctors to complete treatment successfully, even though it was not always easy for her."

"When my doctors said I was done, I broke down in tears," Tracy says. "How do you say, 'Thank you for saving my life?'"