Since the world is observing October as Breast Cancer Awareness month, Arab News corresponded with Carol via e-mail to know how the life of a breast cancer patient is. Her story is that of courage, love and hope.
Carol is a 51-year-old ex-US diplomat (for 20 years) and widow of Saudi diplomat, Abdullah Othman Al-Ajroush.
Due to the extensive family history of cancer of all types in both her maternal and paternal sides, Carol was aware of cancers, particularly, breast cancer.
“By the time I reached my 40s, however, I guess I naively considered myself safe,” she said, given that she is the youngest of four daughters of whom none were diagnosed.
Carol was diligent in performing a monthly self-exam. In fact, that is how she found the initial lump in June 2008, which led her to perform a mammogram. With the diagnosis, she admitted there was an initial reaction of shock and fear.
“My grandmother, aunts and cousin died of breast cancer. My cousin was only 31 years old and she had two young children! These thoughts ran through my mind when I learned of my diagnosis.”
To further complicate matters, she was diagnosed in Saudi Arabia with only her husband’s family around her. However, she said she has been blessed with amazing support from her extended family in the Kingdom and her immediate family back home.
She immediately underwent operation at the National Guard Health Affairs Hospital in Riyadh at the age of 48. On July 1, she underwent a mastectomy followed by immediate reconstruction surgery. Since her lymph nodes were unaffected by the cancer, she did not undergo either chemotherapy or radiation, but was rather placed on the drug, Tamoxifen. “Other than periodic blood tests and checkups, I was advised to put my cancer behind me and resume life, which I did,” she said.
However, problems arose in October 2008 when her husband, Abdullah, was diagnosed with aggressive leukemia. He was initially treated at King Faisal Cancer Center in Riyadh. However, they were later informed that his only chance of survival was a stem cell transplant. As a result, they elected to travel in March 2009 to MD Anderson Cancer Center in Houston, Texas in the US — the world’s most renowned for such a procedure.
Abdullah received his transplant in May 2009. While he had his ups and downs, he responded very well to the transplant. By mid-September they were told that they would soon be able to return to Riyadh.
Consequently, after taking permission from Abdullah’s doctor, Carol took a trip from Houston to North Carolina to visit her son (from her previous marriage) and his family in early October before she would return to Saudi Arabia. Shortly after arriving, however, she wasn’t feeling well so her son took her to a doctor. “That was when I learned my cancer had relapsed,” she recollected.
She found out that she was at Stage 3C, the inoperable stage. The cancer had gone into the supraclavicular lymph nodes. She phoned Abdullah to let him know, but when he answered the phone, she immediately sensed that something was not right from the tone of his voice. It turned out that Abdullah’s leukemia had returned as was revealed in his bone marrow analysis.
They both decided it was more practical to stay where they were to get treatment. “Those were such difficult months with both of us in treatment at the same time and in different locations, but we stayed in touch via Skype.”
Due to the advanced diagnosis, Carol had to undergo six rounds of chemotherapy (a treatment every three weeks) and eight weeks of daily radiation treatment.
Unfortunately, Abdullah did not respond well to treatments and his condition continued to decline. By mid-January 2010, the team of doctors told them that they had to make some decisions. Abdullah could remain at MD Anderson where he would be made comfortable or if he wished to return to the Kingdom to die, those arrangements should be made as soon as possible.
Abdullah opted to return to his land where he could bid final goodbye to his mother and other loved ones. He would travel via a medevac flight to die in his homeland. The saddest part was that Carol could not travel to meet Abdullah before his final departure as she had just completed her second chemo treatment.
“I begged my doctor to allow me to travel to Houston so I could see him that one last time to hold him, touch him, smell him, kiss the top of his head and let him know how much I loved and cherished him. I was having a difficult time with the chemo and my doctor gave me blood transfusions and platelet transfusions toward making my aching body travel ready,” she mourned.
Unfortunately, her condition didn’t allow her to travel, even with a private pilot. Consequently, Abdullah’s medevac flight arrived in Houston to transport him back to Riyadh. He left on Feb. 4 and arrived in Riyadh two days later. He developed a high fever during the flight and on arrival in Riyadh was taken by ambulance to the King Faisal Cancer Center. He got to see his mother for the last time before he passed away on Feb. 8, 2010.
Carol was devastated, but knew she had to keep fighting. She continued with her treatments, which ended last July. “I had various scans performed in August, and I learned that the aggressive treatment I underwent did not stop the cancer. My cancer continued to grow and spread. I am now at stage 4, inoperable, incurable cancer, which has metastasized to my bones, lungs and abdomen,” she unfolded.
Regarding her chances of recovery, she said that the cancer will always be a part of her life. “Although my cancer cannot be cured or operated upon, it can be treated with the goal to slow down its growth and spread… I am presently administered a drug called Avastin via bi-weekly infusions. This is a hormonal treatment and works toward starving the cancer thereby slowing down both the growth and spread. Under such conditions my doctor predicts I have five years,” she explained.
Since then, Carol has become a passionate activist on breast cancer awareness. After her initial diagnosis, she spoke out on her journey and experiences on Saudi Arabian Television and Radio. In the United States, she participated in local “Relay for Life” events sponsored by the American Cancer Society toward raising research funds and awareness. Furthermore, she has been interviewed twice by international newspapers on breast cancer. Recently, she participated in three public service campaigns, which can be viewed on Youtube. She was also the key-speaker at Presbyterian Hospital in Huntersville, North Carolina during its Family Cancer Awareness Day and is an active member of the Lake Norman Breast Cancer Support Group.
She is effectively using her blog () for breast cancer awareness. “With my own journey with breast cancer starting in the Kingdom, I experienced firsthand the distinctions between how cancer is approached and treated there as compared to the US. Hoping that my words can help inform or support anyone whose life has been impacted by cancer, whether as a patient, a caregiver or friend, I began sharing my own journey and experiences with cancer through my blog too. I encourage my blog readers to share their experiences, views and suggestions toward spreading greater awareness in the Kingdom and the world.”
She sees a huge difference in people’s attitude between the Kingdom and the US. “I disagree with professionals from the medical sector advising ‘NOT’ to acquire information and additional knowledge. Knowledge is empowerment and allows a patient to be informed and make decisions. I think breast cancer patients may feel more isolated in the Kingdom because support groups are difficult to find and there is a cultural reticence to speak up about the disease and its challenges,” she wrote.
Carol wants readers to know that breast cancer is not “just a woman’s disease,” but a disease that impacts many. “In addition to the woman fighting breast cancer, it impacts her husband, her children, her extended family and friends. Every person has his/her own fears and feelings. They need to reach out and support one another,” she appealed.
She rates the Kingdom’s awareness level at seven out of 10 because there are still many people who keep cancer behind closed doors. “I believe more education and innovative initiatives and awareness campaigns will help break down barriers.”
In most cases, if a cancer is detected at an early stage, the chances of recovery are very high. That is why self-exams and mammograms are so important. Carol’s case proved to be an exception. She was initially diagnosed at a stage 0 and her surgeon in the Kingdom was confident that she was finished with the cancer. Its relapse not more than a year later at stage 3C is concerning.
She reflected, “My breast cancer comes with a poor prognosis which is a ‘major’ understatement. Given that it is incurable, I have a lot of concerns on my mind… I have to face the fact that I may not be around to see my two-year-old grandson enter the first grade. I know that my family and friends are worried and scared… I find myself wanting to protect and shield them. I want to be strong for them.”
What is really uplifting is Carol’s courage and faith. Even though cancer has affected her life and her late husband’s, she doesn’t see it as the end of the world.
“I could easily just sit and allow myself to fall into a deep depression but I’m not going to. Thankfully, my cancer has given me some great opportunities. To begin with, each one of us is here on this earth is on a round trip ticket from God. No one but God above knows when this return trip ticket to Him will be punched. Therefore, I have made sure to ‘not sweat the small stuff,’ but mend any fences that need mending and appreciate and rejoice each and every day to the fullest.”