Part 6: Chemo in the offing
July 11, 1996
Cancer cells have been found in Episcopal Bishop Geralyn Wolf's lymph nodes, a strong indicator that cancer may exist elsewhere in her body and that she likely will require chemotherapy.
The bishop, wiping away tears, shared the news during a news conference yesterday afternoon at her home in Providence.
She'd just come from seeing her doctors, who told her that of 15 lymph nodes removed from under her arm, cancer was found in 2. The number is low enough that her prognosis remains good, but Wolf was nonetheless disappointed.
"I was expecting that there would be no lymph node involvement," said Wolf, 49, who underwent a modified radical mastectomy and breast reconstruction last Wednesday. "I knew that was a possibility, and every doctor I consulted with said that it was a good possibility, but they could offer no promises. So I chose to hear that I wouldn't have lymph node involvement. Why not hope for the best, right?"
Lymph nodes are microscopic glands that help the body by catching bacteria, infections and other foreign invaders, and so provide clues to what's going on inside us.
Dr. Douglas Marchant, head of the Breast Health Center at Women & Infants Hospital, who is part of a team of doctors treating Wolf, said: "I don't think it's a disastrous situation by any means. I think she's going to be okay."
Indeed, according to Dr. Helena Chang, Wolf's surgical oncologist, there is plenty of good news:
*An examination of the removed right breast revealed that Wolf's tumor was quite small, slightly bigger than half an inch; that it resembled the rest of her breast tissue, which signals a less aggressive cancer; and that the surgery got it all.
*A biopsy of calcified tissue in her left breast showed no malignancy (but it must be watched carefully).
*Wolf's estrogen receptor - a protein found on some cells to which estrogen molecules will attach - is positive, meaning the tumor is less aggressive than some, and that she will have more options for treatment.
*No tumors were present in the blood vessels or lymphatic channels of the removed breast, another sign of a less aggressive cancer.
"Essentially, her prognosis is not bad at all," said Chang.
She and a team of physicians, known as the "Tumor Board," a body that meets weekly at Women & Infants to consider cancer cases, will meet next Thursday to weigh treatment options.
Chang predicts that, given Wolf's age and level of lymph node involvement, she will undergo six cycles of intravenous chemotherapy, lasting from four to six months, depending on how she tolerates it, followed by a regimen of Tamoxifen, a hormonal treatment.
At yesterday's news conference in the dark-paneled dining room of the 19th-century Bishop's House, Wolf was able to joke about one of the side effects of chemotherapy - hair loss.
She'd always considered her hair to be too thick, anyway, she said, so losing some will be one of the "bright lights" of her ordeal. Also, she said, smiling under portraits of two glowering, male predecessors, though she may be the first Episcopal bishop with breast cancer, "there certainly have been a lot of baldies."
Wolf remains philosophical about what's happening to her - "I don't say, 'Why me?' I say, 'Now that it is me, what am I going to do with it?' "
Recently, she said, an acquaintance asked her when she expects to get back to being the bishop. She said: "This is being a bishop."
She confessed, however, to a bit of guilt about "starting a new position and getting sick after having had a very healthy life."
But, she said, "priests in my diocese say, 'Forget it, you know, just get well. We want you here.' "
Wolf, who found the lump in her breast during a self-examination and acted quickly on it, takes comfort that, "as sad as I am, there is nothing I could do any better. I did the best I could. And I still will."
She is reading Dr. Susan Love's Breast Book, a well-known reference book; it lay open to a chapter on "Fears and Feelings."
Always, she said, her relationship with God - which she likened to that of "an old married couple, married for 45, 50 years" - sustains her.
"Just because something like this has happened doesn't mean the relationship has changed. Something comes up . . . it's devastating, but we wouldn't say, 'So how's your marriage?' The marriage becomes a source for the strength.
"If anything, it becomes all that is positive about sharing a life."