Lexington breast cancer survivor vows to pay it forward

Breast cancer survivor Ines Fusco of Lexington stands with her oncologist Dr. Neela Natarajan in the Sophia Gordon Cancer Center at Lahey Clinic in Burlington on the day of her six-year check-up.

Lexington — It’s been an eventful week for Ines Fusco. She celebrated her son’s 13th birthday, ran a 10K race in Boston, and made her annual visit to the Sophia Gordon Cancer Center at Lahey Clinic in Burlington where she marked another milestone — six years cancer-free.

The Lexington resident, now 49, was diagnosed with breast cancer in 2005, but she almost wasn’t. She recalled how many health organizations urge women to “be their own advocate” and took that advice to heart after she discovered a lump in her left breast.

A mammogram and an ultrasound both came back negative for cancer, but Fusco was not convinced. She took advantage of an opportunity to get scanned using the Dilon 6800 Gamma Camera, a unique piece of equipment being tested at Lahey that uses radioactive imaging as a means of detection. The machine confirmed her suspicions — the tumor was malignant. Three separate surgeries and a series of radiation treatment ultimately saved her life.

Following six and a half weeks of radiation treatment, Fusco was put on the oral pill Tamoxifen. Her uncle, an obstetrician/gynecologist in Puerto Rico, was wary of the potential side effects, which include uterine cancer, and recommended she have an ultrasound as a point of reference before starting the medication. Six months into taking Tamoxifen, an exam revealed Fusco’s uterus had grown 6 centimeters and her left ovary 7 centimeters. She immediately had a full hysterectomy to remove the pre-cancerous growth.

“If you’re going in for treatment, you just do what my uncle told me to do. You should do the ultrasound of your body because you just don’t know,” she said.

Dr. Rebecca Eisenberg, an oncologist and director of the Hallmark Health Hematology and Oncology Center in Stoneham, said many patients have severe reactions to Tamoxifen, but it is unfortunately the only option for pre-menopausal women diagnosed with breast cancer.

“[The chance of developing cancer] is small (about 5 percent) but it is definitely statistically significant,” Eisenberg said, noting the drug is scientifically proven and FDA-approved for the treatment and prevention of breast cancer. “It is a risk, but the risk reduction of cancer is 50 percent, so on that end, Tamoxifen is still a worthwhile drug for many people, but it does require ongoing monitoring.”

In a long bright and sunny corridor at the Sophia Gordon Cancer Center, several women with brightly colored scarves wrapped around their shaved heads sat awaiting their appointments. Nearby, Fusco met with her oncologist, Dr. Neela Natarajan, who gave her the good news about her health.

Although she is now cancer-free, Fusco said she is reminded every day of her struggle with the disease. A dot tattooed on her left breast is the lasting imprint of where the radiation equipment aligned with her body five times a week during treatment. Following months of excruciating radiation treatment that resulted in second-degree burns on her chest, Fusco said the emotional scars are what hurt the most.

“I still get worried. I still think about it,” she said, noting her recent headaches have her concerned enough to visit the neurologist, just to be sure. “Once you have cancer, it is hard to believe it will never come back.”

With a 13-year-old son and a 15-year-old daughter, Fusco hopes the message is out there for her children, as well those in the community at large, to fight for their health.

“[The fear] kind of just doesn’t go away,” she said. “When I found the lump, I was beside myself. You need to be your own advocate.”

Since her recovery, Fusco has devoted herself to several new passions, including making her own jewelry, running, and actively participating in several charitable organizations.

This January, she is organizing the third annual Resolution Run to Kick Cancer, a 5K road race through Lexington she started with two friends in 2009. Today, the co-founders work with a committee of women to host the event.

According to Fusco, participation in the run grew from 190 participants in 2010 to 545 in 2011, and last year’s event raised approximately $20,000 before expenses. Fusco said money raised through the $25 registration fee is donated to a cancer research institute of her committee’s choosing. Proceeds from the 2012 run will go to The Leukemia and Lymphoma Society and other cancer-related organizations.

“This may be hard for people to understand but I don’t believe there will ever be a cure for cancer. … I think it’s a disease we will always be with us,” Fusco said. “I raise money for patient programs to help further the science. If you can find it faster, and get at it faster, then you prolong your life.”

With the future in mind, Fusco said she keeps a three-ring binder of her medical history so her children will have a point of reference if they are ever concerned about their own health. Many cancer institutions encourage people to be well versed in their family history.

“Cancer was kind of a wake-up call for me. I was working a lot. I had to leave work and I would bring work home a lot,” she said, reflecting on her longtime job as a marketing manager for a medical company. “It was kind of like a wake-up call that I needed to spend more time with my family. That was more important.”

“I am just so grateful for my community. When I had my hysterectomy, I was in bed for two-and-a-half months,” Fusco said, adding friends and family came out every night to fill her fridge with food for the household. “I am so grateful for all the gifts that I received. I am so grateful to be able to celebrate another birthday. I just want to give back and pay it forward.”

Following a discussion of Ines Fusco’s interactions with the breast cancer drug Tamoxifen, Dr. Rebecca Eisenberg, medical director of the Hematology and Oncology Center at Hallmark Health in Stoneham, said it troubles her to say, in the oncology field, Tamoxifen is the only option for pre-menopausal who have been diagnosed with breast cancer.

“I like to have choices for people. There are side effects, and unfortunately, recently, I had patients who needed to stop [taking] it,” Eisenberg said.

Despite side effects that can include blood clotting, uterine cancer and cataracts, research still shows the use of the medication for reducing breast cancer outweighs the potential risk.

According to the National Cancer Institute, Tamoxifen has been used for more than 30 years treat breast cancer in men and women. Tamoxifen, taken orally as a tablet, interferes with the activity of estrogen, which can promote the development of cancer in the breast. The drug is used to treat patients with early-stage breast cancer, as well as those with metastatic breast cancer (cancer that has spread to other parts of the body).

“A mammogram is great but it’s not perfect. It is unsettling to think of the number of women that found breast cancer not through a mammogram,” she said.

Eisenberg noted there are other options for women who sense a palpable lump and have concerns; a patient could have an MRI or even a biopsy.

“It’s important to know that’s not the end of it,” she said. “I have seen bad things happen in women that skip their mammograms or are not familiar with heir own breasts. I’m a big advocate for doing self-breast exams. There’s not a lot of information that says it’s helpful but it doesn’t hurt.”

“I think it’s really hard in all of medicine. People are scared and they don’t want to think it could be something bad,” Eisenberg said. “If you get a mammogram and you think it’s [not] fine … If you know your own body and you know when something’s different, it’s important to stay on top of it. And make sure, when you get an answer, it makes sense to you.”