Early Winter 2009
Garden of Hope
Garden of Hope

Trumbull resident Maureen Herrmann won the battle against two cancers—and now has the strength to garden again.

Maureen Herrmann of Trumbull never could have imagined bringing bouquets of flowers cut from her award-winning garden to an oncologist’s office—let alone her oncologist’s office.

But in spring 2007, all that changed when she discovered a lump in her left breast. An ultrasound revealed a large, tadpole-shaped mass.

The next step was a breast biopsy to test the lump and surrounding breast tissue for cancer cells. Maureen was referred to Mary Pronovost, MD, Medical Director of Bridgeport Hospital’s Norma F. Pfriem Breast Care Center. Dr. Pronovost used a special needle to remove a small amount of tissue from Maureen’s breast. Bridgeport Hospital’s pathologists examined the tissue under a microscope and confirmed what the doctor suspected.

“Maureen had metaplastic carcinoma. It is a type of invasive cancer which can grow rapidly within the breast,” says Dr. Pronovost. “We see these in fewer than two percent of breast cancer patients.”

Dr. Pronovost called Maureen at home to gently tell her the devastating news. “I only remember bits and pieces of that conversation, her telling me, ‘I’m so sorry, it’s malignant…it’s a more aggressive cancer,’” says Maureen. “But I can recall how touched I was by her compassion.”

Maureen and her husband, Tim, met with Dr. Pronovost to discuss a course of treatment. A lumpectomy (surgery to remove breast tissue) was recommended as a first step, followed by chemotherapy (medication) and radiation. That’s when Maureen met with medical oncologist Neal Fischbach, MD, to discuss chemotherapy options.

Tim recalls, “The day of the appointment, Maureen walked into the office and started crying. What was I supposed to do with that? And this was just the beginning.”

“The nurse who led me into the examination room gave me just what I needed—a big hug,” says Maureen. “To this day, I can still feel her reassurance and understanding. I can still feel how much she cared about me.”

Soon after that appointment, in May 2007, Maureen underwent her first breast surgery—a lumpectomy. “During surgery, it was evident that the cancer had spread to Maureen’s sentinel lymph node,” says Dr. Pronovost. “If cancer is found in the sentinel lymph node, it is usually a sign that the cancer has spread to other lymph nodes.” Dr. Pronovost removed the tumor, 11 lymph nodes and some surrounding breast tissue. She also inserted a small port through which Maureen’s chemotherapy would be administered later on.

Final pathology results from the surgery revealed that Maureen’s rare cancer had not spread to any other lymph nodes, but there were features that raised concern about residual cancer in the breast.

As is true for every breast cancer patient at Bridgeport Hospital, Maureen’s treatment plan was discussed by members of Bridgeport Hospital’s Breast Cancer Tumor Conference. This multidisciplinary team of breast specialists including pathologists, surgeons, radiologists, radiation oncologists, medical oncologists and plastic surgeons meets regularly to review all newly diagnosed patients and develop a coordinated plan of care. Based on the group’s expertise, Dr. Pronovost recommended removal of Maureen’s left breast (a mastectomy) after completing chemotherapy.

“Chemotherapy after surgery is generally recommended when there is a significant chance of recurrence,” says Dr. Fischbach. “Because Maureen had an aggressive cancer, we discussed the options and thought chemotherapy before surgery was the best next step for her.”

Maureen was working at an elementary school. She timed her chemotherapy to begin in mid-June so her hairwouldn’t fall out until school was in recess for the summer. By July 4, her hair was gone, but her sense of humor and positive outlook were intact.

“Losing your hair can be traumatic, but I chose to have fun with the various hats I wore, and I chose to be grateful that I didn’t have to shave my legs all summer,” she recalls, chuckling.

“Overall, I managed chemotherapy very well by combining conventional medicine with nutrition, lots of prayer and utilizing many of the services offered at The Norma F. Pfriem Breast Care Center,” she says. Maureen attended workshops, counseling and a support group at the Center. “Joining the support group for women undergoing treatment for breast cancer was the best decision I ever made.”

During treatment, Maureen also elected to participate in a clinical trial at Bridgeport Hospital that was investigating potential treatments for mouth sores that can be a side effect of chemotherapy. “For several months, the research nurse visited and called Maureen at home to closely monitor sores in her mouth,” says Bridgeport Hospital Research Coordinator Diane Eannotti, RN, CCRC.

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Mammogram, Ultrasound and Self-Exam

“Every woman 40 and older should have an annual mammogram,” says Gynecologist Robert Deal, MD. “Also, keep in mind that many women under the age of 50 have dense breast tissue. Sometimes dense tissue can camouflage a mass so well that a mammogram can’t detect it.” For these women, ultrasound is a very useful diagnostic tool.

Maureen also emphasizes the value of breast selfexams. “Today I tell my two teenage daughters—and all women I know—that their lives are worth the one minute a day it takes to do an exam so their story doesn’t turn out like mine,” she says.

Dr. Fischbach adds, “Major advances in cancer care are built on the strength and determination of people like Maureen who, while living with cancer, are willing to participate in clinical trials.”

With the summer’s flowers fading into fall, and Maureen’s mastectomy looming, she made a choice that surprised her physicians. “Although my doctors told me that the chances of cancer developing in my other breast were very low, I made the painstaking decision to remove both breasts (bilateral mastectomy),” says Maureen. “I already had this rare cancer and I thought, if it does spread to the other breast at some point, I don’t want to have to go through surgery again. I couldn’t face the emotional roller coaster I would have to get on every morning, wondering, always wondering.”

In October 2007, Maureen triumphed through a bilateral mastectomy with Dr. Pronovost and breast reconstruction with Anke Ott Young, MD, PhD, from the section of the plastic and reconstructive surgery at Bridgeport Hospital.

Maureen thought that was the end of her cancer story. She never guessed she would be hurled onto another roller coaster just nine months later.

In July 2008, Maureen met with Gynecologist Robert Deal, MD, to talk about a heavy menstrual period that had been ongoing for 16 days. “He did a biopsy and an intra-vaginal ultrasound in the office,” she remembers. “The biopsy came back negative, but the ultrasound showed some polyps (small growths) within my uterus. Polyps could have been the reason for my unusual bleeding. We discussed my options for having them removed, and I requested a D&C.”

“Dilation and Curettage—or D&C—is a very common gynecologic surgical procedure. It can help diagnose the reasons behind unexplained vaginal bleeding,” says Dr. Deal. As a standard part of this procedure, the physician takes tissue samples from the uterus for testing.

Maureen chose to have the procedure done at Bridgeport Hospital. “My instincts were telling me not to take any chances and to be thorough in getting to the bottom of this,” she says.

Samples were quickly examined by the hospital pathologists. Maureen got another call. Tests revealed it was cervical cancer.

“I was not prepared for this,” she remembers. “I was actually starting to feel like myself again. I liked my new short curly brown hair and had just returned to gardening. Then everything changed. I was absolutely devastated.”

Because of Maureen’s age and the stage of her cancer, Bridgeport Hospital Chief of Gynecologic Oncology Masoud Azodi, MD, and Dr. Deal recommended a radical hysterectomy (surgery to remove her uterus, cervix, ovaries, fallopian tubes and part of her vagina). They chose to use the da Vinci “S” robot-assisted minimally invasive surgery system.

Compared to traditional open surgery, minimally invasive surgery provides excellent, if not better, access to the tiny areas of that region of the body,” says Dr. Azodi. “Most women who undergo this surgery have less blood loss during surgery, a shorter hospital stay, less scarring, significantly less post-operative pain and a quicker recovery.”

The reality of a cervical cancer diagnosis on the heels of her breast cancer treatment was more than Maureen could bear. “I was physically, emotionally and psychologically at rock bottom, and I realized this was all too much for me to contend with alone,” she says. “Although I knew The Norma F. Pfriem Breast Care Center was for breast patients, it was the only place I thought to run to. They had become like family to me and I knew I could talk to an oncology social worker about how I was feeling.”

In total, Maureen had eight cancer-related surgeries in two years. “As difficult as it was, each time I went to the hospital for treatment or surgery, I was reminded again that there are a lot of people—from the front desk staff to the transporters to the clinical team—who are not simply working there, but who care deeply about patients,” she says. “Every nurse was kind and funny, and seemed to read instinctually what I needed before a surgery, which was usually humor!”

Maureen had her last reconstructive surgery this past summer. While she was waiting in the pre-op area, Donna Twist, PhD, Executive Director of The Norma F. Pfriem Breast Care Center, paid her a surprise visit. “Donna came down for a few minutes before I went in to surgery just to give me a hug and a kiss,” Maureen remembers. “With all that she had going on that day, to take those few minutes was kind and so meaningful to me. It’s the little things like that that makes me toot the horn for Bridgeport Hospital.”

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Celebrating 10 Years

A decade of healing. A decade of hope. For 10 years, The Norma F. Pfriem Breast Care Center, part of The Norma F. Pfriem Cancer Institute, has served thousands of women and their families.

When the Fairfield Center opened, it was the first free-standing breast care center in Connecticut, with a breast surgeon and support services on site.

Today, with one phone call, women can gain access to a full spectrum of services, including screening and diagnostic procedures, breast surgery and reconstruction, chemotherapy and radiation therapy, appointments with physicians, prosthesis/wig fittings, massage therapy, nutrition counseling, one-on-one and group therapy and educational programs.

For information about The Norma F. Pfriem Breast Care Center, with locations at 111 Beach Road, Fairfield, and at Bridgeport Hospital, please call 203-255-5300 or visit www.bridgeporthospital.org/cancer.

Dr. Ott Young performed the final reconstruction and Dr. Pronovost assisted. “For me, to have Anke and Mary in the same room for the final piece of my reconstruction, the very place where I began this journey two years prior, made me so happy,” says Maureen. “I truly felt a sense of closure.”

The best news of all came at the end of September. “I am most happy about the latest PET/CAT scan I had,” says Maureen. “‘Everything looks perfect, just perfect,’ is how Neal put it. That brought me and my family a sense of peace.”

Since then, Maureen has finally felt the strength to garden again. “It was as if I were holding my breath for two years, afraid to enjoy one of my greatest pleasures. Now I can exhale again,” she says. “In getting things ready for winter, I think I’ve done more gardening these last few weeks than I have in the last two years.”

Come next spring and summer, her flowers will grow back and she will arrange them into bouquets again. “I want to revel in how far I’ve come and how I feel,” Maureen says, smiling. “Because of the expertise of my doctors and the team at Bridgeport Hospital, I’m okay—I’m more than okay!”

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