His Promises Are Sure

When you, or someone close to you, has been diagnosed with cancer -- you may feel a need to reach out beyond yourselves for hope, and reassurance.

For my wife and I, that means reaching toward the Lord for the strength that we need in a time of trial.

Last night, we went to the temple. It was our first visit there since Dawn Ann’s diagnosis of Breast Cancer. As a result, perhaps our feelings and emotions were a little closer to the surface than usual.

During our sealing session, we were called to the altar first. Dawn Ann and I looked at each other across the altar, as we did for the first time at a similar altar nearly 16 years ago. As the ceremony, which binds a couple together for time, and for all eternity, was pronounced, tears came to Dawn Ann’s eyes. Just a few tears at first, then many more later. The officiator who was performing the ordinance handed us a box of Kleenexes so she could wipe her eyes.

As for me, I looked into those eyes, which I have loved for the last 16 years. She always looks so beautiful in white. I am so grateful for her. For the love she has brought to me. The children she has brought into this world. And all she does for us to provide a home for our family.

As I looked at the tears coming from her eyes, I thought I perceived what she might be feeling, and why the tears. Later, I confirmed with her that what I had perceived was correct. As Dawn Ann heard the blessings and promises of eternal marriage pronounced once again, she felt a peace and assurance from the Spirit of the Lord that no matter what happens in this life, the Lord's promises to us are sure. That she and I will be together eternally.

This was what brought tears to her eyes. The witness of the Spirit that despite the challenges we are currently facing, the diagnosis of breast cancer, that she can be assured that all will be well – no matter what happens.

My turn would come a few minutes later, as the ordinance worker gave a few words of counsel to the group of those in attendance.

He counseled that the Lord wants each of us to return and enjoy eternal life with him. He counseled that the Lord will leave no stone unturned to make this happen. He paraphrased this scripture:

“ . . . For I will go before your face. I will be on your right hand and on your left, and my Spirit shall be in your hearts, and mine angels round about you, to bear you up.” (D&C 84:88)

He then counseled that the blessings of eternal life will come through our faithfulness. Then he explained what that means.

He explained that our faithfulness doesn’t mean that we have to be perfect right here, and right now. What it does mean, however, is that we should continually try to become better people little by little. Not in huge spurts, not mile by mile, but inch by inch.

The goal should be to examine ourselves a few months from now, and to be able to see how we have become a little bit better than we were before. We should always be making that comparison with ourselves over a period of time, never in comparing ourselves against others.

There may be other people, great people, whom we admire, and may even try to emulate. We should not be comparing ourselves with them. Normally we only see them when they are at their best. They are human too. We just don’t generally see them in their weak moments.

As the officiator spoke his words of counsel, I found tears coming to my own eyes this time. As he paraphrased the scripture, I felt that we do not have to face this breast cancer alone. That He will go before us, that He will be on our right side, and on our left, and that His angels will be round about us. He will be there for us. He will not desert us.

The words from the fourth verse of “I am a child of God” best describe my feelings:

I am a child of God.
His promises are sure;
Celestial glory shall be mine
If I can but endure.

(I Am A Child of God, Lyrics by Naomi W. Randall)

All will be well. We have placed our trust in him, and I know we can pass through this trial – no matter what.

If you too, find yourself struggling against breast cancer. Remember, that you are not alone. Trust in the Lord. Go to Him. Pray to Him. And find His peace.

For I know -- His Promises are sure.

The MRI Results

We received some really good news today! The results from the MRI that took place last Tuesday came back: The left side is clear of any sign of cancer!!!

The previous diagnosis was confirmed on the right side: DCIS in two places. However, on the bright side there was no other cancer found in the right breast other than what we already knew about. Here is an example of an MRI image of DCIS.

It was a great relief to Dawn Ann. She has been a little tense the last few days, worrying about what these test results might reveal. This is the best possible news that we could have expected to receive. Our prayers have been answered.

We have been considering various reconstruction options. Later this month we will be visiting with two different plastic surgeons to consider what the best approach might be in Dawn Ann's case. She was worried that if she had a double mastectomy, that having dual reconstruction might be too much to deal with all at once. Her inclination was to not do reconstruction right away, if she needed a double mastectomy.

The good news is that only a single mastectomy will be needed. Now Dawn Ann can better face the challenges that reconstruction will bring. This news was a huge relief for her, and she was jumping up and down for joy.

Some ladies from our church were at our home (visiting teachers) at the time the phone call came from the doctor's office. After the phone call, Dawn Ann was happy to announce that she will be getting a new perky one! They all had a good laugh at the newfound prospects.

I was excited to hear the news when she called me at work. I felt that a little celebration was in order. So I stopped on my way home from work, and picked up some Dots candy, and a package of hostess snowballs.

With a little creativity, I came up with this:




After the kids went to bed, I prepared a little treat and brought it to her. When she saw my piece artwork, she had a good laugh. It was good for her to laugh. I hope to keep her in good spirits as much as I can during the next weeks, months, . . . and even years as we go through this process. Little unexpected surprises will be a good way to keep her spirits up, and to keep from dwelling too much on fear, and worries about the future.

All in all, its been a really good day, for the things that matter most.

The Breast MRI Test

As I write this, I am sitting in the radiology waiting room at the hospital. My wife, Dawn Ann is here for a breast MRI.

The whole family is here. Dawn Ann brought the kids here, after
school. I took off early from work to be there for our 4:00 PM appointment. The kids brought our laptop, and are watching the DVD of Pirates of the Caribbean on the computer.

I got here in time to visit with Dawn Ann a few minutes before she went back into the radiology department.

As I arrived, she was filling out the obligatory forms you always have to fill out for an MRI or a CT scan. One of the forms was a cancer questionnaire. That kind of freaked her out a little bit. It was the first time she has filled out such a form since her diagnosis.

She joked, “I guess I will be considered a cancer survivor from now on.” I
put my arm around her and held her close. I told her, “We wouldn't
want it any other way!”

Then she said – “Well then it must be so, because daddy said!”

Today Dawn Ann is receiving an MRI of her breasts. This will be an MRI with contrast. That means that that she will have to be injected with a dye through an IV prior to receiving the MRI.

The objective if this test is mainly to check for any indications of breast cancer in the left breast - the breast that so far is thought to be cancer free. The MRI can detect the presence of DCIS at a much earlier stage than is possible with a traditional mammogram.

One potential drawback of the MRI is that it is so sensitive that it can pick up 'False Positives' - that is it may pick up spots that may not actually be cancer, but would require further analysis. This could potentially could mean biopsies on the left side.

The MRI is also intended to shed further light on the conditions found in right breast, which has already been diagnosed with DCIS in two places. This information may better help inform the surgeon as she prepares for the mastectomy of the right breast.

Ultimately, this MRI will help us determine if we need a single - or a double mastectomy.

UPDATE: The MRI is over now. Dawn Ann said that it was relatively painless. She said that when they injected the contrast dye into her IV, that she started sneezing, and her sinuses filled up. She also had a few moments of nausea, which she was told was normal.

The sneezing was enough that they had to repeat a part of the test. Each time she would sneeze, she would bounce off the roof of the MRI tube. There was a 6 minute span that they had to re-do.


The MRI test had her lying face-down in the MRI tube, on top of a specially built platform for breast MRI’s. Her arms were outstretched in front of her “superman style”. There was a space in the platform that held her head, with a mirror so she could look forward, instead of having to stare at the bottom of the MRI tube.

Dawn Ann said that the staff was really nice, and they made every effort to keep her modest for this procedure.

We were told that we should get results back this Friday, September 7th.

Meet Dr. R -- The Breast Surgeon

After receiving the biopsy report that Dawn Ann was positive for breast cancer, we met with Dr. R, the breast surgeon the next day.

Dawn Ann dropped of the children at grandma’s house, then we drove together to the doctor’s appointment. As I mentioned previously, we were very grateful to get in to see Dr. R. We knew that she would be on vacation the following week, and that it might take 2-3 weeks after that to get an appointment with her. Fortunately there had been a cancellation, and they were able to fit us in the next day after getting the biopsy results. We consider this a great blessing from the Lord, for which we are extremely grateful.

The doctor’s office was extremely busy. Each of the doctors there specialized in cancer treatment of some kind. One of the other doctors specialized in melanoma. As I looked into the faces of the people waiting there, I knew that cancer had touched each one of their lives. You could see the worried looks on their faces.

Virtually no one was there alone. Whether they were there for melanoma, or for breast cancer they had a spouse or someone else with them. This is a very good thing. No one should have to face a this life-threatening disease themselves.

The going was slow in the waiting room. We arrived at 12:45 PM. Our appointment was at 1:00 PM, but we didn’t actually get back into an exam room until close to 2:30.

After we got to the exam room, a nurse came in and asked us if we knew the results of the biopsy. Apparently some patients are sent there with their radiology films and pathology reports, but without being told what the results were. I thought that was a little odd. I’m glad the Women’s Center let us know right away.

After waiting another half hour in the exam room, we finally met Dr. R. She is a slight woman, in her late forties to early fifties. We talked about the results of the biopsy.

The kind of breast cancer Dawn Ann has is called DCIS – or Ductal Carcinoma in Situ. We learned that of all the types of breast cancer one can have – this is the best one to get (as If there is a best kind of cancer to get!) You can see an example of DCIS microcalcifications here.

From the mammography, and the pathology report, it was determined that the cancer was present only in the milk ducts, and appears not to be invasive. That means that it likely has not spread outside the milk ducts into other parts of the breast, or to other parts of her body. If left untreated, this kind of cancer could eventually become an invasive, life threatening type of cancer.

The doctor reassured us that no one dies from DCIS – which was quite a relief. In our case, the pathology report indicated that the aggressiveness of the cancer cells were at a low-to intermediate grade – which is an indication of the risk of the DCIS turning into an invasive form of cancer.

As far as treatment options go – it appears that mastectomy will be required. Since Dawn Ann has DCIS in two different quadrants of the right breast, doing a lumpectomy would not be prudent. Two lumpectomies, on the two different DCIS spots, would remove too much of the breast tissue to save the breast.

During the surgery, a dye will be injected into the breast. The purpose of the dye will be to determine the location of the sentinel lymph node. The sentinel lymph node will be removed and biopsied to determine if any cancer cells have entered the lymphatic system. If no cancer cells are found there, then it will indicate that the cancer has not spread beyond the breast.

The good news is that if the diagnosis is correct, that mastectomy should get all the cancer. Radiation and/or Chemotherapy should not be required.

Of course, the final treatment plan will not be known until after the final pathology report after the mastectomy takes place. If the sentinel lymph node is clear, and if the breast tissue around the margins is free of cancer cells, then we believe that all of the cancer will be removed from her body with the mastectomy.

If cancer cells are found in the margins of the breast tissue, or if cancer cells are found in the sentinel lymph node, then further treatment will be required, such as radiation, or chemo.

I asked the doctor how soon we need to have this surgery performed. The surgeon replied that it doesn’t have to be done within the next few days, but that we have a few weeks to have further diagnostic testing performed, and to consider breast reconstruction options.

The doctor recommended that we get a Breast MRI screening. This will mainly be done to check out the left breast more thoroughly. The mammogram showed no cancer in the left breast, but the MRI can detect DCIS much sooner than is possible with a mammogram. The drawback to the MRI is that it has many more false positive results – meaning that it can pick up non-cancerous calcifications that might require further investigation or biopsies. The MRI may also reveal further information on the right breast, that we know has cancer cells present.

The doctor also recommended that we may want to meet with a genetic counselor to determine if Dawn Ann has the genetic markers that indicate a susceptibility to cancer.

Cancer does run in Dawn Ann’s family. Her mother was diagnosed with breast cancer (IDC) 8 years ago in 1999, at the age of 61. She had a lumpectomy, and both chemo and radiation treatments. So far she is still cancer free.

Both of Dawn Ann’s grandmothers died of cancer – although not from breast cancer. One grandmother died of ovarian cancer, and the other grandmother died of cancer of the throat and tongue.

All of these considerations need to be taken into account as we plan our treatment options. We need to decide if we need to have a single mastectomy, or a double mastectomy. Even if there is no cancer found in the left breast, we still have to consider the possibility of having the left breast removed also as a preventative measure.

The other big decision we need to make is with regard to breast reconstruction. We are studying various reconstruction techniques. We already have scheduled appointments to consult with two plastic surgeons. Dawn Ann wants to get more than one opinion on reconstruction. We have learned that different plastic surgeons go about reconstruction in different ways.

If we decide on reconstruction, then we could have the reconstruction begin at the time the mastectomy is performed. In this scenario, after the mastectomy has been completed by the breast surgeon, Dawn Ann would be turned over to the plastic surgeon to insert a tissue expander for a future implant. The surgeon would also leave some extra skin to accommodate the reconstruction.
Dr. R stated that we don’t have to do reconstruction right away, if we don’t want to. However, it would get the process underway as soon as possible.

There are also some financial implications involved here too. Our health insurance has a maximum out of pocket expense level – which we will surely pass this year. Once the maximum out of pocket amount has been reached, further surgeries and treatments will be covered 100% by insurance, through the end of the plan year – which ends on June 30, 2008. If we start the reconstruction right away, more of the treatments will be covered 100% since we will have surpassed the out of pocket limit. If we wait until future years, we will have to start the out of pocket expense over again.

I don’t want finances to be the driving force of our treatment options, however it is a reality that needs to be considered.

For now, our next steps are the Breast MRI, and consultations with plastic surgeons. We also may meet with a genetic counselor as well. After that we will meet again with the breast surgeon. Our follow-up appointment with the breast surgeon is on October 3rd. At that time we will make the final treatment determinations, and schedule the surgery.


It was so good to visit with Dr. R. She gave us some great information. It was good to know that Dawn Ann’s cancer has been caught at a very early stage. The good news that Dawn Ann’s DCIS as currently diagnosed, is 99.9% curable.

For now, that is our focus, to get the cancer out, and to preserve the life and health of my dear wife, and the mother of our children. We want to keep her around for a very long time to come.