Scott Webb (Host): Today in a very special episode of the Health Works Here podcast, I'm joined by Dr. Liza Coyne and cancer survivor, in her words, cancer beater, Kay Burke. And they're going to have a candid conversation about surviving breast cancer. Also Kay's love of skydiving and her desire to live, to be 104, at least. This is the Health Works Here podcast from Emerson Hospital. I'm Scott Webb.

So it's really great to have you both on today. I can't wait to hear more about Kay's story. I know that she was a medical professional, but she's on today in her, let's say capacity as a patient. So Dr. Coyne, I'm going to turn it over to you.

Liza Ragulin Coyne, MD (Guest): Thank you. Hi, Kay. Thank you so much for joining me today, for this discussion and I was hoping to do is just ask you a few questions about your journey as a, you know, breast cancer patient and about what things are like to you, for you. The question that I wanted to start with is, how did you feel when you got your abnormal mammogram and if you can talk a little bit about it, then your emotions and what your experience was like initially.

Kay Burke (Guest): I went in for the mammogram and all my mammograms have always come back that I've had dense tissue and I've had an ultrasound following it up, but, obviously this is the first time the radiologist told me that the mammogram and the ultrasound were abnormal and he didn't give me a diagnosis, but he said to me, you need to be referred to an oncologist.

And I thought to myself, I could have cancer could, but rather than panic, and get myself upset, why don't I just sit back and look at it? I do much better having all the information, having a potential diagnosis that will be determined in the not too distant future by a biopsy. Fine, but I need to have my ducks in all for control.

And even I thought to myself, if this comes back bad, what are you going to do about it? You can cry. You can be angry and that's all good. You have a doctor, you're going to have input from this doctor as to what needs to be done to address your diagnosis. And you have to take all that information, make a decision and do it.

It's as simple as that. My biggest fear was that my diagnosis would be cancer and it would require that I receive chemotherapy. People in my family and friends who have received chemotherapy and as a woman, and I'm seeing the effects of chemotherapy, it was not something that I was hoping, would ever be part of the routine, but if it was, I'd deal with it.

So I wasn't panicking. Then when I met Dr. Coyne, we did the biopsy and she told me it was stage one. There was some precancerous cells, but they weren't on the edge of the tissue sample. I was relieved obviously, but when I told my family, my children, I did not tell my children until after I got the diagnosis with the biopsy.

But in talking to people who, women, I knew that had cancer and sometimes had it come back, I felt like I just had a touch a cancer and I couldn't say I really had cancer, which sounds kind of stupid to say, I mean, stage one, but I just felt okay.

This is simple. Biopsy, they put in something to ensure that when Dr. Coyne went in to take it out, she could find it. The people that I met during this whole process were professional, but there was something about them that made it different than dealing with other health professionals that this sort of kind of a comrade that comes with being part of a group of people who have been diagnosed with cancer. That's what I found. And I'm like, I'm only stage one. I don't deserve this, whatever it was, the warm fuzzies that they give. So I wasn't panicked. I was going to deal with it. Obviously, I didn't want to deal with anything bad and I certainly didn't want chemotherapy and right upfront, Dr. Coyne told me that I wouldn't need chemotherapy, so that wasn't difficult. If anything, after I had the lumpectomy, I just had a touch of cancer. And for friends that had real bouts with cancer, they were thrilled, absolutely thrilled that I only had stage one, but I didn't want to tell people.

Dr. Coyne: Yeah, I think every journey is so different and, you know, I think we're certainly very lucky and very fortunate that your case was early. And I think that's where it was so important to get the screening and come in and get checked out. And, you know, I and I still remember meeting you and I remember how worried you about talking to your children and you decided to just send them all a text all at once to, to kind of call you later.

And I remember your phone started dinging right away. Because you were worried about, should you tell them or should you not?

Kay: Their father died of cancer when they were all little children. My oldest daughter's a nursing professor. I didn't want to say to them I had an abnormal mammogram, what are they going to do with that information? And then when you told me it was stage one, somebody in your staff, I should remember her name helped me put by five children's emails or whatever we did, phone numbers, texts to them, and then I put them on and then I said all is well that ends well, and just sent it to them. And you're right before I left your office, my phone was ringing, and they understood that. They understood that because what are they going to do with the information and had it been different information, I would have done a Zoom call and just said to them, mom has to tell you something.

Dr. Coyne: But I think, you know,

Kay: But early diagnosis. I almost didn't have that mammogram. I had gone for my annual checkup with my primary care. And he said to me, you didn't have your mammogram. I usually get it in the spring. And I said, yes, I did. He said, no, you didn't. And I looked at the information I got and it was 2018. This all happened in 2019 and have no idea why I forgot to get it, but I can say that in all my years of being a woman, I don't think I had ever done any breast self exams. I always was sort of negligent in that. So to women, do it, examine your breasts and certainly when 40 or older, or if you have a history, get a mammogram and do it every year. Cause that's why I got an early diagnosis.

Dr. Coyne: And you know, Kay, I think you touched on the important comment about rallying up your troops, rallying up your village and, you know, letting the kids know and having the support network and, sometimes it's really hard to keep being all that inside. And sometimes, you want to wait for the final plan to let everybody know, but, you know, I think it takes a village to get through a journey like that.

So, what's your experience, you know, personally and with your village while you were going through surgery and the other treatments.

Kay: Oh, I had obviously wonderful support from my children. I want to start off, there's a sign in the parking lot of Emerson Hospital. It says Mass General Cancer Center, and I'd see it. This is, see it travelling down route two all the time. And I would look at it and go, ooh. Oh, okay.

Now I look at that sign and I think it's okay. 've been part of the cancer center and it's been a journey filled with people from radiology, to the doctors, nurses, yourself, obviously included that give you information you can discuss with them. But the bottom line is you make decisions based on good information obtained from healthcare professionals, but there were other people, the radiology. Just going through radiology and four weeks, I got what's called a boob pillow.

Somebody makes the pillows, cuts them out in heart shape, hand sows them, stuffs them. And sews them up. It was so when your breasts were sore from the radiation, you could comfort it. Stores give acupuncture, massages, beautiful stuff. I mean, there were people that you don't see that sort of envelop you the same with the staff of radiology and a couple of events, the puzzle, sitting in radiology, you have your time slot. There's a puzzle and it's got teeny pieces in it, and the picture on the puzzle is extremely intricate. So, I would look at the puzzle and I'd come in the next day and it would be filled in a lot. So, I just assumed that people in other time slots after mine, mine was early noontime, that they filled it in.

But I got to be curious about it because none of us in radiology talk to each other. So, one day an older woman came in, very elegant, sat down and proceeded to put pieces onto the puzzle. And she had her back to me just the way the room was set up. So I walked around so I could sit and look at her because for some reason I was fascinated with this puzzle, the woman next to me, she and I started talking.

She was stage one and we started talking about how we felt, you know, like we just sorta kind of had a touch of it and she was really upset. Her sister had been diagnosed with stage three and her sister was thrilled about her diagnosis. So we talked to the lady with the puzzle, all of a sudden people in the room started talking and the puzzle and how to learn to put a puzzle together.

And at the end of radiology, when you finished your course, you rang a bell when you left, but I can't explain the moments. They were really warm moments being there. So, when I look at the sign in the parking lot, I had a nice time there, which sounds strange, but I did, I never would have met the people I've met, never would have experienced sort of a warm feeling all the time.

The nurses are appropriately funny. They really are funny, but if I were to have had a different diagnosis, I hope my attitude would have been the same. I would have been totally pissed at the cancer and I would have said, okay, you're out. All right, Dr. Coyne, what do I need to do to kill this?

But I also know from friends who have had cancer, you have your downtime. You have your sad time. You had your scared time, but I really didn't have that because I kept the stage one, I am now 83 years of age. But my journey within Mass General Cancer Center, I can't say if I had to do it over again, I would do it, but I certainly had a journey with surgery, with the nurses, with Dr. Coyne, with decision-making. With people that I would never have met that certainly changed my life. Does that make sense?

Dr. Coyne: Yeah. You know, I think coming in and seeing patients go through exactly what you described, you know, the acceptance, the anger, the frustration, and just raising up to the occasion fighting, that hardest fight of their life to get to the other side. And, you know, I know you feel that you had a touch of cancer, but you went through a lot and you know, you did it with such strength and power. I always, am amazed by my patients and how they, you know, go through this with grace and resilience and grit.

What I will want to hear from patients in, especially hoping that it will help other patients to kind of dig down deep in their belly to figure out how can they get that strength. So, you know, how did you cope? What helped you through the process? What are your words of wisdom from your long nursing career and your experience, your journey for the patients of what did you do and how did you take care of yourself?

Kay: I know within every individual born, there's a core strength. It just comes with being human and being born. Some people, that core of strength, it's covered up by abuse, by put downs, by failures. So when something horrific happens in their life, cancer, they don't realize they had it, but I think you do have it. You do have dignity. You do have worth, you do have the ability to take information, because the doctors know what they're talking about. They will give you information based on solid knowledge that you can take that information internally. And for me, my strength comes from my belief that I'm a woman. I have dignity, and I have just got this in me that, and I need to have a certain control.

So I'll take the information in and what do I do? I want to survive. I want to live, even if I didn't have a family, even if I didn't have anybody in my life, I have dignity and worth to the world, but I do. I have a family. I have people I love, I have friends and I want to survive on my own and for myself, but I also want to survive for them.

So just, reaching inside. You can cry, you can scream, you can do whatever you want. And then when you're through you say, okay, okay, I'm going to let that out of my body. And I'm going to just relax. You can fight the cancer, but I think my strength comes from a belief that there's somebody more powerful than me in my life.

Dr. Coyne: I think there's so many different belief systems, but ultimately it comes down to exactly that is that, you know that strengthen the inside, the support in the outside in it's really being emotionally, trying to be emotionally in a good place through this.

And there'll certainly be, you know, ups and downs, and it's a bit of a roller coaster for a few months. But it really trying to focus on the kind of the light at the end of the tunnel and really taking it day by day because there's good days, but really to appreciate good days, you have to have bad days because it's all perspective really in life.

Kay: It life doesn't guarantee good days every day and life actually, can change in a heartbeat. A cancer diagnosis changes your life in a heartbeat, but life can change in many ways in a heartbeat.

Dr. Coyne: And how did it change you? How did it change you now, you know, a couple of years out, do you feel different?

Kay: Yeah, I always took things seriously. I don't control people cause I did that enough, said to my kids is mom controlling, you know, am I like that? And I go, it's difficult mom to take care of you. It's difficult for you to accept anybody taking care of you, you have this thing in your head that it's you and they're right.

I have this sense of that I have to control that all that happens to me, but can't be that way. I can be human. I don't have to be mom that walks on water. I don't have to be a friend that has all the answers because I don't. But I can be a lot more accepting of people who want to help me where before I sort of was kind of stand offish.

Dr. Coyne: And I think, you know, that's what I hear from patients is that, you know, there's nothing like a cancer diagnosis to, you know, figure out who are the people in your life who are there to stay versus more casual, who rise to the occasion or who just come where you don't realize they were really there. And all of a sudden they become a big, important part of your life. And you know, it's those little things that really make you experience. And I think, grow you and grow your community and the other question I want you to ask you is, you know, now looking back a couple of years, looking at everything and your experience is and thinking about a patient who is just at the beginning at the diagnosis, you know, what is your advice to the patients who are just starting their cancer journey and you know, words of wisdom.

Kay: Okay. Obviously, that depends on what you're going to say to them about their cancer, but get an early diagnosis. Have your mammograms, do your breasts monthly checkups. But you get an early diagnosis. When the doctor gives you the news, there has to be somebody you can turn to, but get all the information, go home, cry, be angry, because your world has just been turned upside down and it's a grief process. I mean, denial, anger, all of these things will hit you. If you have friends in your life that you can tell them and they are reliable friends, wonderful. If you don't, I'm certainly sure that people in the world of cancer and people who have beaten cancer will certainly come to your aid. There's no question. There's a lot of people out there who are survivors and I hate the word survivors, they beat cancer.

They didn't survive. They beat cancer. That would come to the aid of these people. Get them in your life, find out what needs to be done. And do it, but take the information and use it as a weapon against the cancer, whether it's chemotherapy, radiation, medication, use it as a weapon and begin a battle against it.

But you are going to have bad days. You are going gonna have days and if you're going through chemotherapy where you're going to be very sick. Bring people into your life. People who are positive, certainly people who made it through it, they beat cancer, bring them into your life because they're positive entities and on bad days, and there are bad days, they're in your life, you're not alone, but in reality, when the middle of the night and you're scared and you are alone you have to be open to people because nobody can get into you.

Can't get into you and make you all better. It would be nice. Parents of children with cancer would gladly take the cancer away. You can love somebody, but you can't take the cancer away because that's that person's journey. And it may sound weird, but it's a journey and it's a journey that you need support on, but it's the journey where you can fight a hell of a battle.

Dr. Coyne: No. Absolutely, it is a journey and it's sometimes a lonely battle, even though there are people around you, but they are around you and they will lift you and support you. You just have to focus on that goal and just you know, take it day by day. And, I'm so glad that we are two years out having this conversation and you know, you're continuing to do well and hopefully continue to do all the fun things that you do outside. I still remember.

Kay: Skydiving, I'm going skydiving again.

Dr. Coyne: Yeah, I know. I still remember a bit of a shock when you asked me during the post-op visits, when you can go skydiving. And, I had to double check that I heard you correctly before saying, well, let's wait a little longer, but I know you went and ...

Kay: I did, but you know what? All my life I always wanted to do that. There is no guarantee how long anybody's is going to live. I but I get up every day assuming I'm going to get up tomorrow and the next day and the next day, but I've always wanted to go skydiving, but I could come up with a million million reasons why it would be unsafe. And then one day I just said to myself, this is stupid. This is stupid. Do it. You want to do it? Do it. I mean, I had a doctor that once said to me, you're your own worst enemy. I've decision trees of what could go wrong. I made life a decision tree. This could happen. This could happen. Finally, I said to myself, do it. I loved it. I loved it.

Dr. Coyne: That's amazing.

Kay: Yeah, but I mean, it's like, I think having the diagnosis, it's strange because it's opened my eyes to things my kids said, right. Nobody can help you. Nobody can reach you when you're upset. They were right, and now it's like I'm not going to be that way anymore.

Dr. Coyne: I think that's important, you're right, you kind of look inside, look outside and sometimes reevaluate the priorities, you know, reassess what's important. And sometimes you just kind of reaffirm that everything is okay and, you know, I'll just keep doing everything I'm doing.

But I think sometimes it does make us pause and really say, look, you know, can I live every day or every year like it's the last year and then you have no regrets. I think that's the way to do it and every time I talk to you and every interaction I had with you, I always get that feeling that you really, really do live by that motto. And it, you know, it inspires me every time.

Kay: I do, because I think in nursing, there've been patients in my personal life, my husband's diagnosis was stage three metastatic. That changed my whole world, I volunteer at a hospital. I've seen patients in the hospital fighting cancer and the most incredible people I've met. You could listen to them. They tell you what's happening to them, but they have this strength. And I have said to patients, can I hug you? Can I just hug you? So I get some of this, there's something strong about this person. There are people like that. And you would think that all that they've gone through, they would be beaten down. They're not, they're standing tall and they're fighting a battle. And so a lot of people in my life have taught me a lot of good things. So I'm blessed with that.

Dr. Coyne: Yeah. So you're very lucky to have people like that around you.

Kay: But my husband is ill. So a lot of things I can't do now, but I'd like to get involved with whoever made that I call it my boob pillow. Whoever made that pillow, made it by hand. It was obviously made with love. The scarf is beautiful. I mean, those are the things I keep and I keep the pillow on my bed, not as like, oh my God. i had cancer. I keep that pillow on my bed because somebody made it for me by hand. And, it's a precious gift.

Dr. Coyne: It is a wonderful gift and certainly extremely well thought of. Kay, do you have any other thoughts you wanted to share?

Kay: Actually, there were a number of people when I did tell them, cause they were close friends. They were like, you still have mammograms? And I go, what do you mean? Do I still have mammograms? They're in their fifties and I'm like, you should be having mammograms. What are you doing? Oh my God. Oh my God. I'm going to have a mammogram, you do things that are in the best interest of you and your health. You do them, you see a doctor, you get checkups, you do breast exams but just take care of yourself. Women have a dignity that belongs only to womanhood. We are dignity. Know that you're precious. Know, that you're special. Know that you're strong, but you have to take care of yourself. You have to look to see what you need. Go get checkups, get mammograms, do all the things that need to be done to keep you well, it's not that simple, but I mean, that's what you have to do and know that you are really special.

Dr. Coyne: Well, this is such a wonderful message. I think for everybody, men and women, on different levels and

Kay: I men have breast cancer and it must be hard for them hard for them in this world.

Dr. Coyne: Yeah, but I think, I so appreciate you taking the time to share your thoughts.

Kay: Well, I appreciate your care.

Dr. Coyne: Oh, my pleasure.

Kay: I will see you every year until you say goodbye to me. I, I can't live my life waiting for the cancer to come back. It's gone. It's gone. If I were maybe four different stage of cancer, that might be a different, I'm sure. But there was a beginning and an end to the treatment, it's done. I'm not going to relive it. I'm glad I'm here. I've got a new appreciation. I'm more open to people caring about me, life, just live it, just live it.

Dr. Coyne: Yes, it's very precious to live in. You know, don't waste a second. I think that's very important, and I'm always happy to see you, but hopefully we'll continue to have it as a casual social visits, but, you know, should we to do anything, we'll we'll certainly take care of you.

Kay: We'll cross the bridge when we come to it, if we come to it.

Dr. Coyne: Absolutely.

Host: You know, this conversation has been such a gift for me. Kay, just hearing your whole journey and knowing that you're a cancer survivor and also you jumped out of airplanes. And you want to do it again, and you want to live to at least 103.

Kay: No 104.

Host: Oh 104.

Kay: I have a granddaughter who's on the autism spectrum. And during COVID, when she finally got to see me, she started crying and I said, what's wrong? And she said, I don't want you to die. And she was really upset. I said, grandma's gonna live to be 104 and her older brother went grandma. And I went well, at least if I'm not drooling or sitting in a wet diaper I'm game for 104. But I'm going to live to be a 104 at least.

Host: After hearing this story today, Kay, I wouldn't put it past you. Dr. Coyne, your expertise, your compassion. Kay, your amazing story. Really inspirational. Thank you both.

Dr. Coyne: Thank you.

Kay: You're welcome.

Scott Webb (Host): That's Dr. Elisabeta Raglan coin and K Burke. And we thank them for their time. Visit Emerson hospital.org/breast health. For information about Emerson's comprehensive breast health program. And thanks for listening to Emerson's health works here, podcast I'm Scott Webb and make sure to catch the next episode by subscribing to the health works here, podcast on apple, Google, Spotify, or wherever podcasts can be heard.