Today, on the first day of Breast Cancer Awareness Month, traffic will be routed around Allen Parkway as pink-bedecked runners race for the cure. The rest of October will bring pink doughnuts, pink-lit buildings, pinked-out NFL players and cheerleaders. The Katy High School color guard will host Spin for a Cure, a six-hour “spin-a-thon” in which the winner is the last performer standing. At Volcano Room in Seabrook, there’ll be “Tiki Time to Save the Ta-Tas!”
In a month when pink ribbons feel inescapable, it’s hard to imagine why anyone ever felt a need to raise breast-cancer awareness.
Ellen Cohen remembers why.
Today Cohen is a Houston city council member and mayor pro tem. But in 1969, in her late 20s, Cohen was in a different place, at a very different time. She was living in Montreal, a married mother of two small children.
One day in the shower, after an especially good golf game, she rested her hand on what felt like a pea-sized lump in her breast.
“I almost ignored it,” Cohen said. “I didn’t know.”
Instead, that Monday she went to see her internist, who asked if she had a family history of breast cancer.
She said no.
“He smiled paternally at me and said, ‘I’m sure it’s nothing,'” Cohen said.
The doctor decided to draw fluid from the lump – probably just an engorged gland, he said – with a needle.
When she looked up, she could tell he was surprised. They would have to do a biopsy, he said. The word sent Cohen’s mental wellbeing spinning down fast.
She was admitted to a hospital, but the hospital didn’t have the sophisticated equipment needed to analyze the biopsy. While her cells made their way to Boston, she waited in the hospital. And waited.
Thursday at noon, Cohen was standing in the doorway of her hospital room when she saw her husband, Lyon, coming down the hall. She thought: If it’s good news, what is he doing here?
“I’m sorry,” the doctor said. “The tumor is malignant.”
She sized up the windows in the room, considering jumping. “It was the third floor,” she said. “I’d break my legs, and I’d still have breast cancer.”
Limited medical choices
In 1969, nobody said “breast,” and absolutely nobody said “cancer.” Cohen had never known anyone who had the disease. Not in Montreal, not in her hometown of Cleveland, Ohio: no one.
At least the medical choices were simple. She could have a nearly century-old surgery called radical mastectomy, losing the breast, some muscle and lymph nodes; or a super-radical mastectomy, in which even more tissue was removed.
“I was thinking, how can my husband raise two children?” said Cohen, whose daughter and son were 6 and 3.
Breast cancer was dealt with very differently in 1969, said Dr. Aman Buzdar, a breast medical oncologist at MD Anderson Cancer Center and vice president of clinical research administration.
“This is one disease where the therapy has evolved dramatically,” he said. “The outlook is much brighter than it was in 1969.”
At that time, radiation and chemotherapy were rudimentary. Mammography was unheard-of.
“In most patients, we didn’t catch it until much later,” Buzdar said. Finding the cancer late meant more complications and subtracted from the chances of a cure.
Certainly, saving the breast was impossible. A few surgeons, notably Dr. George Crile Jr. at the Cleveland Clinic and Dr. Geoffrey Keynes in London, had good results with less invasive surgery, but they were a minority.
In a sense, Cohen was lucky. She at least knew she had cancer. In many cases at the time, women went into surgery expecting a biopsy and emerged without a breast.
Cohen chose the radical mastectomy. “They lopped it off and wished me good luck,” she said.
She had no physical therapy and certainly no emotional support outside her family. Lyon Cohen, however, did offer support. “My husband was amazing,” Cohen said. “He made me feel beautiful.”
Were too ashamed
About nine months after surgery, Cohen heard about a support program in New York City for breast cancer survivors called Reach for Recovery. It trained survivors to visit and aid women who had just had mastectomies. She went to New York and got the training.
Eager to bring the concept to Montreal, Cohen met with the Quebec Cancer Society. We don’t want any program that started in the United States, they told her.
So she met with the surgeons – all men. We don’t want any do-gooder women in our hospital, they told her.
Besides, one of them said, losing a breast is no big deal.
She almost gave up. Almost.
Then one night the Cohens had dinner with one of Lyon’s cousins, a newspaper reporter who wanted to tell Cohen’s story.
She was reluctant and certainly didn’t want her face in the paper. Then she realized that was why she didn’t know any other breast cancer survivors: They were too ashamed.
Cohen told her story. In response, she received more than 400 letters.
When she called a meeting, 150 women showed up. From those, she gleaned 50 volunteers.
Cohen also found an ally. A surgeon at Jewish General Hospital in Montreal had trained at the New York hospital. “I know it works,” he said.
She was the first support volunteer in Montreal, sometimes arriving at the hospital on her motor scooter.
Squeeze a rubber ball to get your strength back, she would tell the women. Pin a prosthesis inside your nightgown so visitors won’t stare.
The program was off and running, and the idea that women needed and deserved support took root.
Now it’s impossible to imagine any other perspective.
But Cohen still remembers the day, months after her surgery, when she looked outside and saw a robin, and realized she had made it to spring.