The Tribune Democrat, Johnstown, PA

October 1, 2013

RANDY GRIFFITH | Boosting survivorship: Knowledge is power in breast cancer fight

Randy Griffith

— A few years back in my previous life, I spent a week of several summers leading a church youth work mission in Appalachia.

As we prepared the teens from Grace United Methodist Church of Rocky Grove, Venango County, for the work in West Virginia, Kentucky, Virginia or Tennessee, every training session introduced them to the culture of the region – and the culture of rural poverty.

Appalachian Service Project, which administers the mission, describes itself as a “people mission that does home repairs on the side.”

While we spent our week of the two-month summer program helping make one family safer, warmer and drier, we also built relationships with the families and each other.

When we returned home and gave our presentation at Sunday service, I always cringed when some youth would say, “I learned to appreciate the things I have.”

I was afraid he or she didn’t get it.

I know it was what their parents told them to expect, but the message we wanted to instill was not that our culture is better because we have more “things.” It’s just different. And in some ways, maybe, not for the better.

What does this have to do with breast cancer? Probably nothing.

But I think it illustrates how I feel about survivorship.

As I prepare stories each year for the The Tribune-Democrat’s Breast Cancer Awareness project, I have met and talked to dozens of breast cancer survivors. I have never failed to be put in awe of their courage, their strength and their passions for life, family and fellow-survivors.

It is not that I wanted to be a poor Appalachian working man, but I envied their fortitude, dedication and ability to seize the moment. It is not that I want to get cancer, but I strive for the character that I find in survivors.

This year, that association was driven by three amazing sisters I met while researching genetic factors for breast cancer.

The story of identical twins Gwynne Martin and Stephanie Smith and their younger sister, Tara Gowarty, is included in the Breast Cancer Awareness section in today’s paper, but I saved a few details for this column.

Martin and Smith are breast cancer survivors. Now, they were only diagnosed with breast cancer last year, but as nurse navigator Sue Majoris at Indiana Regional Medical Center says, they are considered survivors as soon as they are diagnosed.

Survivorship should become a state of mind.

After she was diagnosed last year, Martin said she was given a questionnaire to see what lifestyle factors could have put her at risk: Obesity, lack of exercise and hormone use are among the options.

“I couldn’t check one block,” she said. “I eat healthy; I exercise; I got my mammograms. I did everything I was supposed to.”

Now she’s doing everything she can to fight the cancer and get the word out about genetic testing for those with several close relatives who have the disease.

Smith is embracing the same determination, including the public awareness mission.

Women should not only learn about their genetic risk for cancer, she says, they should look at their individual risk factors, including the risk from having dense breasts.

Martin’s cancer was apparently missed on two mammograms because her breasts are dense and had some fluid-filled cysts in them. Both can obscure cancer on mammograms. Nobody suggested a second look with ultrasound or MRI, which may have at least raised suspicions.

All three sisters said they have since learned that they have dense breasts, but were never told that as part of their annual physical breast exam or mammogram.

Dr. Michelle Cacek of Cambria-Somerset Radiology also urges women to understand the risk factors, including the risk from having dense breasts. Mammogram reports to the primary care doctors should note if the patient has dense breasts, she added.

Gowarty and Smith have become avid readers of lab and doctors’ reports and encourage all women to learn as much as they can about their own bodies, medical treatments and risk factors.

“Knowledge is power,” Gowarty said.

That’s where we come in.

While I consider “Survivorship” as the central theme for The Tribune-Democrat’s Breast Cancer Project this year, I made sure we hit all the important aspects of breast cancer prevention and treatment. I wanted to showcase the dedicated health care workers and supporters right here in Cambria and Somerset counties.

One doctor put it best after I gave him a good-natured jab about hospital politics: “I’m going to take care of my patients. I tell the administration to just make sure I can do that.”

Randy Griffith covers health care for The Tribune-Democrat. Follow him on Twitter at