2009, Magazine: The Oprah Magazine

The Proud Survivors

Charlene Yared talks to three strong women who share what they did to overcome breast cancer and how it changed the way they lived their lives, forever.

BATTLING IGNORANCE: Mandithiza Pikoli (29), diagnosed at 26
“I thought I knew who I was before cancer, but in truth, I had no idea. I didn’t realise how much inner strength I had and what I could truly accomplish.”


It was like any other Thursday. Mandithiza Pikoli was watching television at home in Motherwell, Port Elizabeth when a programme about breast cancer and self-examination began. Curious, she went to her room and immediately started inspecting her own breasts. Finding an unusual lump in her left breast, she decided to go to the clinic on the following Monday for a check-up. “I was simply curious, not frightened, to find out what the lump might be, because I thought I was too young to have anything as serious as cancer,” she says.


The hospital biopsy confirmed it: she had breast cancer. Upon removing the cancerous lump, it was discovered that it had spread and a mastectomy was scheduled.


As a young single mother of Iviwe, her three-year old son, Mandithiza had just finished an internship for an automobile company, where she had recently taken up a permanent position. Six days after her first day at work, she was diagnosed with cancer.


Seeking support
“I was completely shocked, because I was too young for cancer and there was no family history of the disease, as far as I knew,” she says. “I knew very little about what it meant to have cancer, because no one in my community had ever mentioned it. As far as I knew, this sort of thing never happened to black people.” Breaking the news to her highly traditional family wasn’t easy. “They didn’t take it very well at all. Since I had just started working permanently and was the only one earning an income for the family, they said that my good fortune had caused some people in the community a great deal of jealousy, which caused the curse of my cancer. They said that therefore I had brought this sickness upon myself.”


Totally against any form of medical treatment, they immediately made plans to take me to a traditional healer for a cure,” she says.


Although, Mandithiza continued paying visits to the hospital, her family persisted and set up an appointment with a healer against her wishes. “I had seen the results of someone who had only gone to the traditional healer for treatment and the doctors confirmed that there was nothing they could do for her. I didn’t want to be like her,” says Mandithiza. “I realised that I needed to live not just for myself, but for my son – and I trusted the medical doctors to help me.” So, a week before her appointment with the traditional healer she took herself to the hospital for the scheduled mastectomy. The mastectomy confirmed that seven of the fourteen lymph nodes under her armpit were malignant. She had tried to avoid the radical operation by asking the doctors to remove more of the lump, but they advised her otherwise, explaining that a mastectomy was the safest way to prevent further spreading. “I called my family just before I went in for the operation and they were furious with me,” she says. “It was difficult to go through everything alone, but I was left with little choice and had to find the strength within me to survive it.”


Armed with the support of her faith, her younger sister Lhose (21 at the time) and a few friends, Mandithiza started her chemotherapy treatments against the wishes of her family. Says Mandithiza, “I needed them to be at my side through the journey I was about to take, but they just weren’t there for me.” Unable to reconcile their traditional beliefs with contemporary medicine, her family brought her elixirs made by the healer after the operation. Swallowing hard, Mandithiza drank the mixture to keep the peace. “It was awful – and combined with the chemotherapy made me feel so sick,” she says.


Higher Education
Limited cancer awareness in her community meant people assumed she was suffering from HIV/AIDS. “I had a lot of people looking at me strangely, thinking I was HIV positive. When I told them I had cancer they would act surprised and some would say that I was going to die, comparing my illness to AIDS. They saw it as a death sentence,” she says.


But Mandithiza found the strength to rise above the narrowmindedness of her community. She believes now that breast cancer gave her a gift that nothing else could. “I thought I knew who I was before cancer, but in truth, I had no idea. I didn’t realise how much inner strength I had and what I could truly accomplish. I was also able to tell my story in the DVD launched by GVI Oncology in August, called Survivor Stories. This documentary will be used to empower others with information about cancer,” she says. “As human beings we realise our greatness only when we are faced with our mortality.”


She and her son are still living at home with her mother and sister. Mandithiza is living a healthy lifestyle, eating wisely, going to the gym often and regularly gives herself breast self-examinations. “I am looking after myself far better than I ever have. I have a positive attitude and dreams for the future, which gives me the strength to wake up and face everyday with gratitude. I beat cancer because I wanted to see myself in ten years time,” she says.


“My family has finally come to terms with my operation and I know that on some level they admire the courage I had, to go ahead with my gut instinct. I helped empower and educate them about cancer, sharing what I learnt with them, so that they also understood. I am now well-equipped for anything that comes my way,” she says. “I will never regret the decision I made – even if I had to do it all over again. If I let anyone else decide what was best for me, I would not be here today.”


What you need to know in your 20s:

  • Family history plays a role. “If there is no family history of breast cancer in your family, the risk of getting breast cancer in your 20’s is 0.6%,” says breast physician, Dr Anne Gudgeon “The impact of the diagnosis is the fear of rejection by partners and infertility after treatment.”
  • Check yourself regularly. “In your 20s, conduct monthly self-examinations in the week after your menstruation and begin going for annual gynaecological and breast examinations for early cancer detection,” says Dr Gudgeon.
  • Look for signs. According to Professor Apffelstaedt, Associate Professor of the University of Stellenbosch and head of the Breast Clinic at Tygerberg Hospital, “Watch out for a painless lump, contour changes, changes in the size of the breast, skin changes such as areas of redness that persist for more than five days, changes of the nipple, nipple discharge, skin dimpling, retraction of the nipple and/or skin and lastly, lumps in the armpits,” he says.
  • Mammograms are not recommended. “Mammograms are not recommended in the 20’s as the breast tissue is too dense,” says Dr Hugo Allison, a surgeon for Vincent Pallotti and a senior specialist for Groote Schuur Hospital.

TAKING RESPONSIBILTY: Sue Maude (39), diagnosed at 36
“As the radiation burnt away any stray cells of cancer that remained, I visualised it also burning away the old me to make way for the new.”

Lying on her stomach in bed one morning, Sue Maude noticed a pain in her left breast. When she touched the breast to investigate, she felt a lump. Cancer was the last thing she had anticipated having to face in her thirties and the thought of it left her cold. She put it out of her mind and continued daily life running her freelance business. However, the breast remained uncomfortable and after two months, she realised that she could not avoid it any longer – she made an appointment at the clinic.

A mammogram and biopsy confirmed the existence of a lump 2 centimetres in diameter that contained oestrogen receptive cancer cells.

Getting Real
“I think I was in denial about the state of my health. It took me so long to go to the clinic. Cancer was such a distant thing, especially at my age, I never considered it happening to me. I convinced myself that the lump I found would be benign,” says Sue. After the biopsy, she was given the choice between having a lumpectomy with intensive radiation therapy, or a mastectomy. After reading and researching every avenue, she decided to have the lump removed. “The thought of having a mastectomy was just too drastic. I could not consider losing an entire breast, a source of my womanhood, for a small lump of just 2 centimetres. Luckily my risk factors were relatively low, so I felt comfortable with my decision to save the breast,” she says.


Healing Herself
After reading books by authors Brandon Bays (The Journey) and Louise Hay (You Can Heal Your Life), Sue realised she needed to take responsibility for her health, as a personal goal.


“Louise Hay and Brandon Bays are both living examples of how one can overcome cancer by dealing with your psychological issues,” says Sue. “I believe in the mind/body link and know that my cancer was partly caused by my low self-esteem and because of my tendency to bottle up my feelings. You need to face up to this kind of baggage, because it tends to manifest itself physically.”


After the lump was removed, Sue returned to hospital to have more of her breast removed. “I then had to go for radiation treatment once a week for six months. As the radiation burnt away any stray cells of cancer that remained, I visualised it also burning away the old me to make way for the new. It helped me grow on so many levels.”


Sue says her lifestyle took a 360 degree turnaround. Now she was focused on improving her health by eating correctly, getting more exercise and making informed decisions about her treatment. Today she only buys organic fruit and vegetables, never fries her food, because heated oil is carcinogenic, and always drinks filtered water. She also notes how she let go of “immature pleasures” such as excessive drinking of alcohol. “All these things I had to start taking into consideration, because my life depended on it,” she says. “Your natural instinct is to put your health and well-being in the hands of doctors around you, when you really should be taking on the responsibility of your own wellness by educating yourself.”


After her treatment was concluded, she focused her energy on building a nest. For years she had felt the need for security and to settle down in one place. Says Sue, “Cancer made me focus on what was important to me – I got my dream house six months later.”


She regularly goes for check-ups and breast examinations and has remained in the clear since 2007. “An ideal life is not one without adversity, because then you learn nothing. You have to know the bitter to know the sweet in life and cancer came along to teach me to value myself,” she says. “I don’t label myself as a breast cancer survivor, because I have moved beyond that point.”


What you need to know in your 30s:

  • Family history plays a role. “If there is no history of breast cancer in your family, the risk of getting breast cancer in your 30s is 4.8%,” says breast physician, Dr Anne Gudgeon. “In your 30s, the main concern women have is dying and leaving their children without a mother and worrying how they will react to your change in appearance.” According to Professor Apffelstaedt, statistics from Western Countries show that 6% of all breast cancer occurs in women under 40 years of age. “This may be quite different in our country with a young population structure and the well documented earlier onset of breast cancer in non-white populations. In our practice about 15% of patients are diagnosed below age 40.”
  • Exercise more regularly. “Some studies suggest that exercise reduces the risk for breast cancer mortality by 40% to 55%, which is as much as standard treatments. These studies vary in their recommendations for exercise — some aimed for 90 minutes a week, others for two to three hours a week, but the Health, Eating, Activity and Lifestyle (HEAL) Study conducted by the American Society of Clinical Oncology in 2008, showed a benefit from any amount of exercise,” says Dr Rika Pienaar, Clinical oncologist of GVI oncology for the Panorama Medi-clinic.
  • Alcohol increases your risk. According to Dr Pienaar, there have been dozens of studies done showing the increase in the risk for breast cancer, even with very low levels of consumption, which indicate an established relationship. “There is strong evidence that even one glass a day can cause a small, but significant increase in the risk of breast cancer,” she says.
  • Have a clinical breast exam every year. “Apart from conducting breast self-examinations, make sure that you go for an annual clinical breast exam,” says Professor Apffelstaedt.
  • Avoid prolonged use of oral contraceptive. “This is especially true into your 30s and early 40s, where alternative measures are available,” says Dr Allison.

CHAMPIONING THE CAUSE: Madhuri Chavda (48), diagnosed at 45
The day the twin towers came crashing down, Madhuri Chavda was flying to America to visit her cousin, Rajee, who was in the final stages of recurring breast cancer. Madhuri didn’t know it then, but the day that changed the world was to be the start of another more personal transformation in her own life. Six months after she left America, her cousin passed away, then four years later, Madhuri started her own battle with cancer. But remembering how much her cousin had suffered, she took drastic steps to make sure it wouldn’t return.


Listening to Her Gut
“If I hadn’t seen the torment Rajee went through, I believe I would not be here today. It’s really a miracle that I went to see her,” says Madhuri.


In April 2005, Madhuri sensed something was wrong. She felt constantly tired and noticed that her one left breast had become considerably larger than the other. Immediately, she went for a mammogram and biopsy, and her worst fears were confirmed. Says Madhuri, “The moment my oncologist put the box of tissues in front of me, I knew it would be bad news. Thank God the cancer was still in its early stages of development.”


After being diagnosed, Madhuri was faced with a range of options which included having a lumpectomy with radiation treatment for each breast and then monitoring the progress closely, but was told that this route would not guarantee that the cancer wouldn’t return. Remembering her cousin, Madhuri opted for the last option; a bilateral mastectomy, which would remove both breasts entirely. “I couldn’t go through what my cousin had experienced,” she says. “It wasn’t a difficult decision to make.”


Deciding not to tell her then 18 and 15-year old daughters until a week before the operation, Madhuri continued with daily life. “My girls Priya and Sandhya were both preparing for their June exams and the eldest, Priya, for her matric dance. I just couldn’t put this on them,” she says. Taking them for coffee with her husband, Dinesh, the following week, Madhuri broke the news to them. “They were so concerned, but I explained to them how important it was for me to see them grow up and enjoy their lives, into my old age.”


Speaking out
After spending some time at home with the loving support from her family and friends, she started on her journey to recovery. “Everything unimportant and petty goes out the window – and this includes vanity. Now I am stronger, more confident and I live life to the fullest,” she says.


Striving to overcome the taboo in her community surrounding breast cancer, Madhuri got involved in fundraising for the CANSA Association. In 2006, she raised R15,000 for the annual event Cuppa-for-Cancer and later in 2007, raised R35,000 for refurbishing the Eikehof Interim Home, situated in Athlone. “It is my way of giving back to the community and for thanking God for my life,” she says. “It is also so important to raise awareness around cancer, especially in communities where nobody wants to even mention the word. It shouldn’t be something that is whispered. It’s time for strong women to speak out loud about cancer!”


Every year, Madhuri arranges an awareness talk in her community on the different forms of cancer. All women attending the talk are given free pap smears and breast examinations, and men are given free prostate screening tests. “You never know what will happen tomorrow, so I use today to its fullest capacity. I know my purpose now is to help people become aware of cancer and to know that it’s not a death sentence – it can be cured.”


The next Cancer Awareness Talk organised by Madhuri to be held in Cape Town this month is on the 31st of October. For more information, email her at madhurichavda@gmail.com or call her on 082-777-1311.

What you need to know in your 40s:

  • Family history plays a role. “If there is no family history of breast cancer in your family, the risk of getting breast cancer in your 40’s is 18.1%,” says Dr Gudgeon. “In your 40s, worries and concerns centre on the early onset of menopause and reduced sexuality, relationship issues and work-related discrimination.”
  • Get physical to stay healthy. Exercise, says Dr Gudgeon can decrease the risk of developing breast cancer by 37% if started before the age of 45 years and continued regularly for at least five years.
  • Have baseline mammograms every two years. According to Professor Apffelstaedt, baseline mammograms should be accompanied by a physical examination and repeated every one or two years in your 40s.
  • Be cautious about using HRTs. “With genetic testing, we can identify an abnormality in genes that govern the estrogen metabolism and expose the body to heightened estrogen levels that are known to significantly increase breast cancer risk, especially in overweight women,” says Professor Apffelstaedt. “Women with this particular gene variation are advised to be cautious about hormonal replacement therapy.”

What – and What Not – to Say:
Remember the old adage, think before you speak? It’s especially important when trying to make a friend with cancer feel better. What you say can really make a difference. Charlene Yared asked some famous survivors of cancer what they heard that was most helpful.


“One of the most practical things said to me about looking beyond illness and treatment was you don’t go back to normal; rather, you move on to a ‘new normal.’ I thought this was a great way of acknowledging what a tremendous ordeal you are going through, that life will never be the same again, and yet, life will go on.” -Kylie Minogue, singer


When you are ill, many people feel that they identify with you and then they make the big mistake to share all their illnesses and suffering with you. I cannot bear listening to people who wallow in their misery. I feel that it is unhealthy. Some words that really pulled me through my ordeal came from my ex-husband who said ‘in a time of crisis, you need to be practical and not emotional.’ Cancer has given me more life than health. I have discovered more joy and more love through it. -Janie du Plessis, SA television presenter


“I had a huge aversion to anyone who whispered the dreaded ‘Are you all right?’ in that tone of voice that says you must be going to die. Or people who said I would never be able to work during treatment. In fact, I kept performing in a show my entire six months of chemo and radiation.” -Lynn Redgrave, actress


“I found that fellow survivors always knew what to say – and sometimes had good advice. However, I found many people to be unsympathetic, because they couldn’t see any physical scarring, especially when I was going for chemotherapy. They would say – ‘you look fine, you’ll be ok.’ If only they knew how I really felt, or what I was going through at the time, but I always stayed positive, regardless.” -Lillian Dube, actress


“I loved how my friends supported me. Sometimes one would just pop in to ask if she could pick the kids up from school or have a cup of tea. Just being there during the ordeal is enough and is more valuable than giving advice on how to cope. Sometimes you just don’t feel like talking about your cancer – all you want is happy company and a good chat.” -Wilma van der Bijl, ex-Miss SA 1987

Author: Charlene Yared-West. Published in The Oprah Magazine, October 2009, Vol. 8, No. 10, p. 70.(Please note that the copy posted above is the unedited version of what was published in the magazine and will differ slightly. To read the edited version of the article, please click on the images for an expanded view.)

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