Cancer forces amputation, but Franklin woman perseveres

Childhood summer outdoors were spent in rural Maryland, picking tomatoes and playing games with her twin sister.

As a child in the 1930s and 1940s, Jane Mahan almost always wore shorts and sunscreen wasn’t widely used.

Sixty years later, the Franklin resident was diagnosed with squamous skin cell cancer on both of her shins.

A bout of radiation did nothing. Surgery was able to remove the cancer in one leg. But just over a year after being diagnosed, she lost her right leg to the disease. Doctors just couldn’t save the leg that had 21 spots of skin cancer.

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Sun exposure is what caused the disease, and she believes her childhood summers, when people didn’t realize the sun could be dangerous, was the root cause. She also went to tanning beds as an adult, which she also believes could have caused her cancer.

“We always played outside in the summers and worked out in the fields,” she said. “I was really inviting the sun, wearing shorts. That was my undoing, I just didn’t know it at the time.”

Around April 2007, Mahan noticed a spot about the size of a dime on each of her legs. The spots weren’t terribly alarming. She thought they looked like scaly, hard pimples.

Her dermatologist did a biopsy on each of the spots and told her she had cancer.

“I was scared to death, never thinking that it would get to this point,” she said.

She was referred to an oncologist and doctors recommended 21 weeks of radiation. For five months she went in and laid on a table while the machine zapped radiation at each of the spots on her legs. The treatment did nothing for the cancer.

And the spot on her right leg kept growing, making it impossible to walk. A surgeon used a special technique, called Mohs surgery, on her left leg, scooping out the cancer layer by layer until that leg was cancer free.

The left leg was harder to treat. The cancer had grown to take up almost half of her shin, and there were 21 total spots of cancer. Mohs surgery wouldn’t work on a cancer so large, she said.

Amputation was the only option.

But Mahan was ready. She had already been using a wheelchair for three months because of the pain in her right leg.

“They give you a pain scale of one to 10. It was 10. Ten-plus,” she said.

The pain was so intense she didn’t feel like eating. In a few months, she dropped 20 pounds from her 100-pound frame. The only thing she could bear to eat was vanilla milkshakes.

Cooking was out, so was getting in and out of the bathtub and dressing on her own. Her husband, William “Guy” handled most of her care.

“I know my mom and how determined she is and how she wouldn’t let something like losing a leg slow her down.” —Bill Mahan

Complaining or even showing pain is not Jane Mahan’s way, her son, Bill Mahan said.

Bill would watch her at picnics and other family functions and see her face scrunch up in pain. That was the only indication that she was hurting, Bill said.

Jane doesn’t complain and would never want to turn a family gathering into something that was about her, he said.

And so she endured it. Stoically.

“It was very obvious she was in pain, that is just tough to see,” he said.

Still, she always made time for her family, Bill Mahan said. She would get down on the floor and play with her great granddaughter, Adeline, who knows her as “Gigi.”

Other times the pain was so great, Bill Mahan didn’t know how she was making it through, he said.

He visited her one day and sat on the edge of her bed, where she was curled up in the fetal position because of the pain, he said.

That day, he wasn’t convinced that his mom even knew that he was there, he said.

So, when doctors told her it was time to amputate, she knew it was the right decision.

The pain was stopping her daily activities, and she and Guy had already discussed the possibility that the leg would have to go. And the cancer had continued to grow, she said.

“My husband and I knew before the doctors said that I would lose my leg,” she said. “We just realized that it wasn’t going to get better.”

On her 75th birthday, 14 months after her diagnosis, she became an amputee.

“No one in the family looked at, what a horrible thing that is,” Bill Mahan said. “It was like, she lost part of her leg, great, this is what she is doing about it.”

And then her next battle started.

A month after her surgery, she was fitted with a prosthesis for her right leg.

She spent a week in occupational therapy after her surgery getting ready for her leg. They tested her balance by sitting her on a rubber exercise ball and asked her to avoid the balloons they threw at her. She did weight-lifting in an attempt to strengthen both her arms and legs.

Doctors were preparing her for a new normal. She would have to relearn how to walk and how to drive.

Each day after she got out of occupational therapy, she had more work to do to prepare for her prosthesis.

What was left of her leg after the amputation was sensitive to touch, so the first part of preparing for her prosthesis was making it less sensitive. So everyday, she would gently pat on her leg until she could stand for it to be touched. She had to wrap it multiple times daily and watch for any signs of infection, using a magnified mirror to search for any sign of infection.

“You want to toughen the skin, so it will tolerate the prosthesis,” she said.

Finally, it was time to get her new leg.

She had to learn to walk with a leg fashioned from pieces of plastic and metal that screws into a cast that she wears. And it was a slow process.

At first, she would just take a few steps. Each day she would take a few more. After a few weeks, she was able to walk across the living room.

A few times, she was sidelined by blisters. Walking was put off for a few days to a week to make sure that the blisters healed before she attempted to wear her prosthesis again.

“With practice, you just learn to do it,” she said.

Relearning to drive took time, too.

An instructor taught her how to use hand controls for the vehicle’s gas and brake pedals.

Guy drove Jane for the most part before her surgery, but it was a source of pride that she would still be able to drive as an amputee.

And that is so Jane, Bill Mahan said.

“She always said she was going to walk and was actually looking at driving,” he said. “I know my mom and how determined she is and how she wouldn’t let something like losing a leg slow her down.”

Luckily, paying for her treatment did not financially cripple the couple, Jane Mahan said.

Medicare covered most of the costs related to the diagnosis and treatment of her cancer, including the radiation, surgery and amputation and countless surgeries on a radiation sore on her leg — essentially an open wound that needs to be covered, she said. Veins in her legs have been closed and rerouted to try and combat the sore. Bone marrow has been transplanted. But the sore is still there, and she is still fighting it, she said.

Radiation never helped the cancer that Mahan had, but she has spent about seven years — and her insurance company almost half a million dollars — fighting a side effect of a treatment that didn’t work, Mahan said.

“It has been a long, drawn out process,” she said. “(Radiation) works for some people, but, not for me,” she said.

She is just glad to have escaped with her life, she said.

Now that she is comfortable with her new leg, life has almost returned to normal.

Jane and Guy moved out of their Indianapolis home to the Franklin United Methodist Community to be near Bill and his family in Greenwood. She has made friends and joined activities in the retirement home, playing dominoes with her friends and going on retirement home planned “joy rides.”

“I don’t have to plan a menu, go grocery shopping or cook,” she said. “That is a nice change.”

Her cancer story is a warning to use protection when in the sun, she said.

Doctors know more now about the dangers of the sun than they did in the late 1930s when Jane Mahan was a young girl. And now, she actively avoids the sun. On nice days when she wants to sit outside, she always seeks shade.

“I’ve been there, done that,” she said.

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Name: Jane Mahan

Diagnosis: Squamous cell skin cancer on both legs.

Age of diagnosis: 76

Treatment: Radiation on both legs; surgery on one leg; amputation of the other leg.

What cancer taught me:

How very valuable life was to me, because when they told me it was my leg or my life, I didn’t have much choice. To me, it made life much more valuable. It was easier to accept losing my leg. Knowing that I was going to have to make the adjustment, I knew I would because life was very valuable for me.

How did cancer change me?

Each day of life is a blessing. God answered my prayers. It has given me the opportunity to inform others about skin cancer and need for protection from the sun.

What I would say to someone just diagnosed with cancer:

To find those relatives and friends that would give you the love and support you would need to meet the situation and also to do some research to find the best oncologist, the one that has had experience with good results and the type of treatment you would have to receive and the treatment and care you would get.

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