Pam Laurie is a breast cancer survivor and currently works as the Risk Manager for Bay Area Hospital in Oregon. She speaks to groups on the importance of using humor in coping with cancer.

Sometime after Christmas four years ago I noticed a lump in my right breast. I thought I would wait for my annual mammogram in February, and when I had it, they wanted to take more pictures, which caused me some concern. The doctor wanted to do an ultrasound also. I used to lecture on breast cancer and teach the importance of self-exam, and I knew what cancer looked like. I could see it on the ultrasound and I knew what I had. Since I work at a hospital, everyone here was concerned and the ultrasound technician sent me to the radiologist, and he told me to get in touch with a surgeon. I knew what I was dealing with and just wanted to get on with it.

I called the surgeon that I wanted to see, and I arranged the person I wanted for anesthesia and the nurses I wanted also. I knew all the people involved, which took away a lot of fear of the unknown many people have. The doctor saw me, and he told me about all the risks involved. I had the biopsy, and of course it came back positive. The hardest decision for me to make was whether to have a lumpectomy or a mastectomy. The only time I really got upset was when I couldn't make up my mind. I decided to have a lumpectomy originally. I took a friend with me to the doctor's office when we discussed all of this, and I think it's very helpful for people to do this because it's impossible to hear everything the doctor has to say. My friend is also a nurse, and she understood all the important facts. Because there was some chance that the cancer could recur, I felt like I had to make my decision all over again, and I decided to have the mastectomy. I didn't want to always wonder if there was anything still there.

My friend tells me she said a lot of supportive things to me during this time. I have naturally curly hair and all I remember her saying was "if you have chemotherapy and your hair falls out and comes back straight, you're going to be very angry." This made me laugh, and was so off the wall and typical of our relationship, it really made me feel better. I knew I would still be the person I was. One of my biggest fears was that I'd become knows as Pam Laurie the breast cancer patient. I didn't want that. Another good friend here said to look at it as just a blip on the screen. We laughed about that, because it became a pretty big blip with some of the complications I had during treatment!

I had the mastectomy and it was a piece of cake. I had no problems, and I knew what I needed to do because I had taught patients before. I knew I needed to move my arm; that I needed to use it. I didn't have a lot of pain, and I didn't have body image problems. Another friend recommended a special t-shirt that you can fill with poly stuffing because it would be uncomfortable to wear a bra for a while. It was $65 for that t-shirt and I only wore it once! It wasn't that uncomfortable to wear a bra, and I tried several strategies: I made a pouch and filled if with rice and wore that for a while, then I tried safety-pinning washers to the bottom of my bra to keep it in place. Then I bought a prosthesis, and that has worked well. My grandson was three at that time, and he found my prosthesis in the bedroom and wore it around on his head. When I speak at oncology conferences, I tell people that when you come home at night and throw your bra on the chair, you need to be prepared for your prosthesis bouncing onto the floor.

I had chemotherapy, and they were going to put in a pic line. The nurse I saw had a lot of trouble getting it in, and I remember being really angry. Not at her, but at the need to have yet another procedure. When you go through this, you feel like you're always dealing with the doctor, and doing all kinds of tests, and I didn't want this to interfere totally with my life. When I left the doctor's office that day, I told my son to take me to Fred Meyer. I needed some retail therapy. I bought a TV, a Nintendo, and some clothes for my son. I spent $500 and I came out to the car and I felt great. I couldn't control all the aspects of my treatment, but I had control there at the store. People often have an aversion to the place where they get chemotherapy if they have a lot of negative side effects. I told my doctor that it was very important that I not have any nausea since I work where I'm going for my chemo. I never had morning sickness with my pregnancies, and one of the nurses told me that they see a trend that women who don't have morning sickness don't have as much nausea with chemo. I took a pill every time I went for chemo which may have helped also. I didn't have any nausea, and I didn't lose my hair, but it did get thinner.

As I went through chemo, I decided I needed a wardrobe to fit the occasion. I was in a battle. I made a Viking helmet out of gold lame, glued jewels all over it and made brown felt horns, and I wore that every single time I had chemo. I envisioned a buxom Nordic goddess coursing through my veins, striking out at cancer cells with her sword. This helmet has almost become like a sacred totem. I've loaned it to several friends who have cancer, and it seems to help them. A colleague took it to a manager's meeting, and one of the men there put it on, as a joke, and she got very upset that he would treat the helmet with disrespect. This hat has become very important to many people. My daughter, who never does any kind of arts or crafts, created a figure for me out of clay. It's a fat naked woman with one breast that is wearing a Viking helmet, and it was very funny and very meaningful to me.

After the chemo I had radiation, and I was very lucky because I didn't get a lot of burning until the last week and a half. I was able to manage it; I didn't miss much work. I did get very tired, and although the radiation therapy building is within walking distance of my office, some days I drove there. My side effects were very minimal. My treatment lasted about 7 ½ months. I had six courses of chemotherapy and six weeks of radiation. I felt like I was totally cured. I really felt my cancer was gone, and I've felt very good since then. I see my doctor regularly and I've had good health reports.

That's my story. I think it's one of the things in life you just brace yourself for and get through. I did attend a cancer support group here for a couple of sessions. I had so much support here at work and from my family; I didn't really feel I needed it. I could talk to anyone here because no one was afraid of the subject of cancer. If people don't have those kinds of support systems in place, it would be much more difficult. I could always share how I was feeling. In the support group, we all told our stories, but I just didn't feel like I needed it. I just needed to move forward and concentrate on the other aspects of my life. I had taught patients before about breast self exam, and felt like I had a lot of knowledge going into treatment.

While I was going through treatment, my son lived in town. He was a rock for me. When I felt very sick, he would come spend the night so I wasn't alone. He took me to appointments and was just always there for me. I have a friend who went through treatment recently, and her family is far away. She did have difficulty with chemo and had some nausea and vomiting, but she really liked my homemade chicken soup. I put it in zip lock bags in small portions so she could freeze it and just eat what she wanted. I got her frozen lemonade sticks also, which are very refreshing and helped her with the nausea. I wanted to be the person she could call on. I was lucky to have such a strong support system in place for myself. If I worked in an office with only men, it wouldn't have been the same. I could tell my women friends here when I was having a "down" day and they were very understanding.

I never felt like getting a cancer diagnosis was a death sentence. I feel very positive about my treatment, and I'm now considering breast reconstruction, just because I can.

I spoke at an oncology conference last summer and I spoke as a cancer survivor. They asked me for my CV, and I told them that for this type of talk, the fact that I was alive was my CV. I told them not to be afraid to treat their patients with appropriate humor. Going through a cancer diagnosis and treatment can be very frightening and to have someone use some levity, or smile, or just be themselves, really helps. I've had lots of funny things happen to me in my "medical adventure". When I went in for my biopsy, I was on the stereotactic table. I was up in the high position like a car on a lift, and the machine blew a fuse or something, and the table couldn't be lowered. I leaned over, thinking that if I wasn't too high, I could jump down. Since I'm the one who's always concerned about patients falling and other risks, the staff was worried that I might fall. They wanted to call Engineering to bring a ladder. As I had no shirt on I said at least give me back my blouse! So I waited for the ladder and when it was brought, I climbed down. Another time, when I went for a mammogram they had a brand new machine. I joked with the technician that it would be funny if the power went out when I was in there, and just as the last "picture" was being taken, it did go out! A car hit a power pole outside and all the power in the area went out. We laughed until we were hysterical. People came in and wanted to know what we were doing that was so funny.

Humor has always been a part of who I am. I've joked with my patients when it seemed like the right thing to do, and know that humor really does help. I've learned through my own experience that you deal with crises in you life like you deal with everything else. It can be so much easier to cope when you can see the humor in the situation.