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Breast cancer follows fight with Hodgkin’s


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Mary Hauswald has survived bouts with breast cancer and Hodgkin's lymphoma.
PHOTO BY JOSHUA MARSHALL
Mary Hauswald has survived bouts with breast cancer and Hodgkin's lymphoma. PHOTO BY JOSHUA MARSHALL


The news that she had cancer again was as alarming to her as a diagnosis of pneumonia: serious but treatable, and nothing to be afraid of.

Mary Hauswald knew the malignancy in her left breast would need to be treated quickly with surgery. She also suspected that the radiation treatments she’d received decades earlier when she’d been diagnosed with Hodgkin’s lymphoma had led to her breast cancer.

But more importantly, the radiation had kept her alive for 39 years. That had been enough time to continue raising sons Greg and then Jeff, whom she was pregnant with when she was diagnosed with Hodgkin’s in 1959.

Surviving Hodgkin’s had given her and husband Ronald the chance to have a daughter, Carol Wietholter, and for Hauswald to help raise all three kids until they graduated high school.

Mary Hauswald

Age

77

Residence

Franklin

Breast cancer diagnosis

Stage 1 in spring 2000

Treatment

Mastectomy of the left breast.

Date of Hodgkin’s lymphoma diagnosis

1959

Treatment

Radiation, a shot of nitrogen mustard

What cancer has taught me

How to deal with things that you don’t ask for. How to take one day at a time. How to appreciate what you have. You learn what’s important and what isn’t important.

How has cancer changed me

Live in the moment. Spend less time planning the future.

What I would tell someone who was just diagnosed

Think positively. Pay attention to the doctors. Talk with people.

Because she’d beaten Hodgkin’s and lived long enough to see her kids grown, breast cancer didn’t scare her.

“I know people don’t believe me, but that’s really the way I felt. The traumatic experience was back then,” she said.

In 1959, Mary and Ron Hauswald were living in New Albany with 1-year-old Greg. The family was taking a trip to Ohio when Hauswald, who was pregnant with Jeff, felt a lump in her neck.

A week later she saw a doctor, who told her she had Hodgkin’s. The prognosis, the doctor told her, was better than if she had leukemia, which was considered a death sentence, she said.

Hauswald asked about the cancer, what it was and about treatment. She didn’t ask about the survival rate because she didn’t want to know.

“He would have given me the odds, and the odds at the time weren’t good. And it’s better to think positively than negatively,” she said.

Hodgkin’s is and has been one of the most curable forms of cancer, and in 1959 the cure rate was about 60 percent, compared with 90 percent today, medical oncologist Pablo Bedano said. Bedano is a physician at Johnson Memorial Hospital and did not treat Hauswald.

Hauswald was sent to see a radiologist and was treated with five days of radiation per week for six weeks. During the treatments, a lead apron covered her belly to protect her unborn son from the radiation.

“They felt like this would be OK, and I just had to take their word for it,” she said.

Today, when a patient receives radiation treatments, doctors use CT scans and 3-D modeling so they can focus several concentrated beams on the tumor, instead of having one unfocused beam that could hit regular tissue, Bedano said.

Because the older radiation treatments were less precise, that’s put Hodgkin’s survivors at a greater risk for other cancers, Bedano said.

“In cancers in which we’re good at curing people, we see what the effect of the cure is,” he said.

At the end of Hauswald’s sixth week of radiation, the Hodgkin’s was gone, but she was worried that it would return. Her biggest concern was being around for her two boys until they graduated from high school.

If she was with them long enough to get them to graduation, that would be enough time to prepare them for adulthood, she said.

Two years later, the lump in her neck returned.

Hauswald was sent for more radiation treatments, this time three days a week for six weeks. She also was given a shot of nitrogen mustard.

Nitrogen mustard was one of the earliest forms of chemotherapy. It was derived from mustard gas that was used during World War I and that had been stockpiled during World War II, Bedano said.

Doctors studying soldiers who had been exposed to mustard gas noticed they had low white blood cell counts. Cancer patients typically have high white blood cell counts, so doctors started using it to treat the disease in the 1940s. Nitrogen mustard was discontinued about 30 years later because it increased a patient’s risk of leukemia, Bedano said.

Hauswald’s arm was sore for two or three days after the shot, but that was the worst side effect she suffered.

This time the Hodgkin’s stayed away for good. Hauswald received annual checkups but was cancer-free for 39 years. The fear she felt after her first diagnosis took about five years to fade, and after that she forgot about it unless someone else brought it up.

In the spring of 2000, Hauswald had a routine mammogram that found something suspicious. That led to a second mammogram and then a biopsy which revealed she had Stage 1 breast cancer.

Hauswald believes and Bedano said it’s likely that the radiation treatments she received when she had Hodgkin’s ultimately caused the cancer. But she didn’t feel any anger about that.

“Because of that radiation, I’d had those 40 years of life. So how can you get disturbed at something that’s given you 40 wonderful years,” she said.

Hauswald’s left breast was removed a month after the breast cancer diagnosis, but she never had reconstruction. She would have undergone surgery if she were younger, but loss of her flesh didn’t change her or the way her husband looked at her. And if the cancer returns, she’ll be able to feel it more quickly, she said.

She still thinks about the cancer coming back from time to time, but it’s not something she worries about.

“Something is going to crop up sometime. I am 77,” she said.

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