The breast cancer sisterhood

The first time she walked into the gym with a scarf on her head, it felt like a declaration.

"It was like okay, here I am: Cancer," said Nicole Manan. She was a regular there, and knew that striding in with her former long hair replaced with a scarf would draw attention, and it did-- but not all of it was what she expected. A woman approached her to ask about her chemotherapy, and then talked about her own battle with cancer. Later, another woman approached her at the mall-- another survivor.

"What I find amazing was that just random people out there talk to me and ask me (about treatment)," said Manan, a breast cancer patient at Madigan Army Medical Center at Joint Base Lewis-McChord, Wash. "It's like a little sisterhood."

That concept of a sisterhood was months away for Manan, though, when she was first diagnosed in August 2013. At first, it was just her husband and her, when she found the small lump near her sternum, found a larger mass after a mammography and ultrasound, and then got the dreaded result from the Breast Pathway Clinic's clinical coordinator: positive.

"The day when she told me, that was the worst day of that whole time, not the day after surgery, or chemo; it was just that day because that day was just suddenly the world ends," said Manan, who said that the coordinator, Genevieve Fuller, made the whole process easier, though, by really caring about her well-being.

What followed was months of treatment: a double mastectomy and two follow-up surgeries, and weeks of chemotherapy afterwards. While Manan's family supported her greatly, her parents even flying in from Germany for extended stays, she still felt the need to keep some of her worries from them.

"I always tried to be strong in front of everybody," she said, only really crying in front of them when she was diagnosed.

She started thinking earlier this year about forming a breast cancer support group, where "you can just be what you feel like being and everyone understands."

The timing was uncanny; it turned out that a social worker in Madigan's oncology department, along with a nurse case manager, came up with the idea of reviving the hospital's breast cancer support group at the same time; the group now meets once a month for breast cancer patients and survivors. It's a place where Manan and other women can meet in an intimate gathering to share their experiences and to give each other hope.

"I think that's the best thing they ever did for women, 'cause it helps your mind. You get around these people and you see how long they've been around," said Kathryn Roddy, another breast cancer survivor who joins in the group.

When Roddy was diagnosed in July 2011, "I felt like I was hit by a bus; it was just devastating. And then finding out it was stage four…,"she said. "I couldn't understand it; I was in denial."

Roddy found out that she had a unique type of cancer that is estrogen-fed, along with bone cancer in her sternum; she got radiation for her bone cancer and she takes an arsenal of drugs for her breast cancer that act as estrogen blockers.

Unlike chemo-- "the scarf tells," as Manan put it-- Roddy's treatment didn't leave her with an outward symptom of her illness to draw survivors to her. Instead, she sought out her own sisterhood of survivors just by sharing her story. She talked to a friend's mom, who Roddy started calling "Coach," and she met other women who also lived through cancer, including her good friend who survived stage three cancer and a double mastectomy.

"She means a lot to me as a survivor, being around that," said Roddy. The "C" word doesn't usually come up. Instead, they just spend time together; they support each other; they laugh.

"Basically, it's all about hope. It's about hope," said Roddy-- being around other survivors changes her perspective.

It's that hope that Manan would like to bring to other women fighting breast cancer. She points to the experience of one woman who came to the support group the day after she was diagnosed, very upset still. She told Manan later that "It helped her so much to think that she could make it too because we didn't all look like death walking around, and everybody coped with it, and we were laughing."

Although Manan is now past treatment herself, she plans to keep going to the group to be there for other women.

"It's so nice to help other people get through it," she said.

Roddy echoes the importance of survivors helping survivors. "We have to stick together."