Amoena Life readers face breast cancer the second time around with grace and determination. Every battle is a courageous one. Every story matters. These four women have ridden the waves of cancer's storm more than once, and their experience sheds light on what it's like to have a recurrence, and what it's like to stare it down.

Better and better - Betsy Kulick, Age 57, Diagnosis 1995, Recurrence 2006

Although each annual mammogram since her first bout with breast cancer was scary, Betsy Kulick dutifully got them – and her recurrence was discovered at one of those regular appointments. “Sure enough in 2006, I heard the dreaded words, ‘The radiologist would like to see you, Ma’am.’ I knew then I was facing the beast again.”

But she says the second time was not as terrifying. “The first time, I could hardly read anything about breast cancer because I was literally terrified. I was simply on automatic pilot, following instructions from my very capable medical team. The second time, at least I knew the drill,” she explains. “I could read the pamphlets about diagnosis, pathology, treatment options, and question them, explore them, and select among them.” She was able to approach her journey with “a quieter kind of calm” the second time around.

As for knowing where to go for support, she says, “Because they can’t do radiation again on the same side, a lumpectomy/radiation was not an option. That meant mastectomy and the decision about reconstruction or not. So that set me on a 3-week fact-finding tour, talking to various people about breast form options, and the pros and cons of reconstruction. I was lucky to find a terrific outreach program where a wonderful two-time survivor… gave me great hope and courage to face the new challenge.”

And Betsy realized that it is almost a “new” disease. “Even in the eleven years since my first diagnosis, the gains that have been made in terms of surgery and treatment are amazing. It is NOT the same disease that struck terror into millions of people’s hearts even five years ago. Each day, advances are made in diagnosis and treatment, including gains against aggressive types of cancer.”

She says she’s very happy with her decision not to have reconstruction, and now Betsy’s taking Armidex. She has fought back by participating in nearly 16 different awareness walks with both Avon and the Komen Race for the Cure programs – and she takes joy in the fight. “I think I’ve raised more than $20,000 and that’s been very gratifying.” Both organizations fund solid research into diagnosis and treatment options, as well as community outreach activities benefitting all those who are touched by breast cancer.  Her newest race “uniform,” pictured here, has been years in the making. It gives her something to laugh about. Humor is key to fighting the fear and keeping the strength, Betsy says. The other component is “the knowledge that regardless of what I have to face, I’ll have the support of a wealth of ever-expanding knowledge. Advances are being made so quickly. Plus, on a more personal level, I have been blessed with an incredibly loving family, fabulously supportive friends, and a lot of luck! There is so much positive, so much to hope for, now more than ever.”

Life is good - Sheila Rawlins, Age 57, Diagnosis 2002, Recurrence 2003

Just when she thought she was moving on – the day of her last fill-up for a tissue expander on her left side – nurse Sheila Rawlins felt a lump in her neck. “I must be having a reaction to the tissue expander,” she thought. “I’ll show the doctor when I get there. I wasn’t worried, I felt great, and was about to get the ‘new old me’ back.”

For her, the news that the cancer had metastasized to her lymph nodes was just as upsetting as the first diagnosis had been, a year earlier. “How can this be happening to me… again? Am I going to die?” she wondered. It was October – Breast Cancer Awareness month. “Everything was a sea of pink, and I was drowning in it,” she remembers. Oftentimes, patients in their second diagnosis can feel left out of all the “surviving and thriving” excitement of October activities.

Her doctors started her on Herceptin immediately, which was still fairly new in 2003. Sheila was grateful because, unlike chemo, Herceptin doesn’t cause nausea or hair loss – she hated the thought of losing her knee-length hair. She says, “Actually other than the time it takes to be administered and a runny nose and eyes, it’s a walk in the park… but my life was so different, starting then. I would need constant treatments and medication the rest of my life. Before, life revolved around fun and work and children and grandchildren, and now the focus is survival.”

But survive she has, with the decision to focus on what she has gained, not what she has lost. “I have gained many friends, women who are fighting this every day. I have gained knowledge and power over this disease… I have gained a new appreciation for things that I would have never known, I have gained strength to be positive on this journey, and to help others who may be on this road.” Finally, another spread to her supraclavicular nodes required chemotherapy in 2006: Xeloda, and when that didn’t work, Taxol and Avastin. “I have been blessed with the most amazing chemo nurse – anyone who can make you smile through chemo is an angel. And I have gotten used to not having much hair.”

Each year for the last three, Sheila has traveled to San Antonio, Texas, for the Breast Cancer Symposium – a gathering of top oncologists from all over the world. Her own medical background fuels this desire for information. “I gain knowledge there about the trials and new treatments, and I am then able to use this knowledge in my own care, and help others in my support groups to empower themselves all they can.”

“As with any disease, I still worry about every ache and pain, the ifs and whys. But in the end, the most important thing I have gained is acceptance. Recent CTs showed some tumor shrinkage in the chest nodes. This is great! I am getting hair! And eyebrows! This is the new me, and I am a survivor!”

Living Strong - Angie Suttles, Age 42, Diagnosis 1998, Recurrence 2003 and 2008

Angie’s recurrence came five years after her first cancer was, she thought, mostly over. The five-year mark is a big one, so it was especially cruel that Angie found a lump in her left underarm that year. “My oncologist sent me for a mammogram, but due to my age and the density of the breast, the mammogram was clear.” They did not ultrasound the breast. In fact, for a second time, Angie was incorrectly told that she had an “infection,” and was put on antibiotics – the same had happened before she was originally diagnosed.

A month later, after several more lumps had appeared, she underwent surgery to remove the lymph nodes and the tumors – one of which was five centimeters -- from her left breast.

“I remember waking up from surgery in the recovery room, and asking my surgeon, ‘Was it cancer?’ He asked me to wait until I returned to my family for an answer. At that very second, I reminded myself that I had been through cancer before and I would come through it again.” Nine lymph nodes and the tumors tested positive, and she then had a mastectomy.

“It was not until later down the road that I realized I carried great bitterness toward the doctors who had been caring for me since the first cancer, and the doctor who did not ultrasound the breast. While under their care I developed stage 4 breast cancer! But with the help of my pastor, I had to let that go. Humans fail us and at times, so do our bodies, but…. anger toward all the doctors who got it wrong was not helping me with the weight of such a heavy burden.”

What did help? Activism. During chemo when she was very sick, Angie’s oncologist gave her a yellow wristband with the word “LiveSTRONG” written on it. “That word clearly defined where I was in my life,” she says. “I had to pull myself back up out of this painful vortex. Once I put the wristband on, I found myself unable to take it off and I couldn’t get it out of my head.” Of course the yellow wristband is now well known now as the symbol of the Lance Armstrong Foundation (LAF). Angie was chosen to represent them in Washington, D.C., sharing her unique story with legislators -- and she’s been with the organization ever since, at local and national levels. “LAF’s message is we keep picking a fight with cancer and never stop… but I say it’s time to stop picking a fight and wage a war.” She founded one of the first LAF “Armies,” and has just begun a Dragon Boat racing program in her area.

It’s evident that nothing stops Angie. She even had a temporary dragon tattooed on her bald head during her most recent bout of chemotherapy! Angie shrugs, “I guess it was just part of turning the tides. I decided to enjoy my bald head this time, and create some laughter. We can find some humor in the aches and pains of life. I considered getting a tattoo over the scar on my chest, but it is already a ‘tattoo’ that makes a big, bold statement. I am strong and awesome and cancer has lost.”

Of course she wouldn’t have chosen what happened to her. But Angie believes that these battles with cancer have positioned her life for its true purpose. “I have to be that voice that speaks out against this disease. I have to be the hand that holds the one getting that diagnosis today. I have to show the world that there really is life during and after cancer.”

Great faith, great change - Sue Snizek, Age 60, Diagnosis 1993, Recurrence 2008

There’s a note of sarcasm in Sue Snizek’s tone when she talks about her breast cancer, and that of her friends. She hails from Long Island, NY, where in 1993 Congress ordered an in-depth study because breast cancer death rates and rates of new breast cancer cases were higher than national averages, based on National Cancer Institute (NCI) reports.

Those studies have effectively concluded that environmental factors on Long Island are not to blame, but the controversy lingers in Sue’s mind. “I don’t drink, I never have smoked, I watch my weight. I had the breast cancer gene screening, and I do not have it! So what is to blame for this?”

Her first diagnosis came the same year the study began, and after surgery and treatment, she went on with her life as a survivor. Fifteen years later during a regular mammogram, cancer was detected again. “The first thing I thought? Not again! How could this happen after 15 years? I have so much to do!”

But she approached the recurrence more confidently. “First off, I had tickets for two Broadway shows with my grandchildren,” she says with a grin. “I was not about to give those up. My friend’s 60th birthday was next, and I was not missing that. I told my doctor that surgery would have to wait until I took care of those things.” That unbeatable attitude buoyed her up. “I was not afraid. I have great faith. The Lord sustains me through all of life’s little tricks.”

The love and support of family and friends helped, too. This 2nd time, Sue was divorced, and she admits living alone was scary. She was relieved and grateful when her daughter, Jeanette, moved back home from Manhattan. Her co-workers pitched in: “I work full-time and wasn’t sure how I was going to get time off for treatment. We have a ‘cancer pool’ at work, where people donate their vacation time for those who get cancer. (What does that tell you about Long Island?) I got enough time so I lost no pay.” The chemo took its toll. “I was 16 years older and it really got me! Flat on my back.” So the gift of those days – four and a half months to heal and recuperate – was welcome.

Environmental factors, if they are at fault, are beyond Sue’s control. However, she’s realized there are other things that she can control to improve her risk. “At first I felt that nothing I do will change this. But right now I am really trying hard to change my diet. What you eat really is so much a part of cancer, I am learning, as well as stress. I am buying organic, and I hardly ever have soda… even though that ice-cold Coke calls me every now and then! I am looking into a raw food diet, and I walk every day,” she adds.

Gardening, old movies, her diet, her 8 kids and 16 grandkids motivate her now. “My garden has always been my sanity garden. A vase full of my own flowers or a great ripe tomato from my vegetable garden – I love it. My grandchildren are my real gift. They can be a handful… but ‘Mema’ is my name, babysitting is my game! Some of them help me in the garden!” Surrounding her home environment with such beauty, Sue is treasuring each moment of life on Long Island.

Check out the photo gallery for more photos of our survivor-contributors!