While dating her teenage sweetheart, Amy Ward observed his character. As a youth at St. Luke United Methodist Church, Rob Ward was gentle with children and always attentive to her needs.
So when Ward, 49, was diagnosed with breast cancer in 2010, she knew her husband of 27 years would be by her side. He was there for her through the shock of diagnosis, hair loss and a lumpectomy. She said he made her feel beautiful, even as she endured all the changes.
"He has known me for a long, long time and has always been a very gentle and kind soul toward me, the true picture of unconditional love," Ward said.
Breast cancer is a disease that can turn a woman's life upside down and strip her of all sense of security and sexual identity. While it ravages the body, it can also take a toll on marital relationships, leaving couples stranded in uncharted waters.
Fighting the life-threatening disease requires navigating the medical system and finding the right course of action. Women must endure harsh treatments that rob them of energy and vitality and surgeries that could dramatically alter physiology.
Martha Dodson, a licensed clinical social worker at the Pastoral Institute, is a cancer survivor who had a mastectomy in January. She said the thought of possibly losing one's life, or one or both breasts, can be a very traumatic experience. But most couples find a way to survive.
"Of course there are the same challenges on a couple as with any other stressful situation, but I think with breast cancer there's an additional one, which is the way it affects a woman's sense of self, and perhaps you call it her vanity, her sense of being feminine, attractive, desirable," she said. "I think that,
that is mostly imaginary on the part of women, that we tend to put more emphasis on that than we need to. Our partners are adults and love us for ourselves. So I think that it turns out not to be as big an issue, I think, as we anticipate it being."
She said some couples may have difficulty with physical intimacy because of all the stress, but it should not stop them from being affectionate. Chemotherapy and other treatments also affect a woman's energy level, brain function and ability to do basic chores, and it takes patience.
"You need help with just normal things, opening a window, opening a jar, making your bed," she said. "And so a woman who is particularly independent is going to have a lot more trouble with it because she's got to keep asking for help. And it would be nice if the man was just ready to give it without her having to ask for it.'"
Twilla Booker hosts an Internet talk show called "Talk Straight about Your Sexual Health" and recently conducted a sexuality workshop at the John B. Amos Cancer Center. She said many younger women, such as actress Angelina Jolie, are opting to have double mastectomies, even before they have breast cancer.
She said today women have the advantage of reconstructive surgery, which can work wonders. Once they discover they have the BRCA gene, they want both breasts removed.
A few years ago, she received a call from a couple concerned about how a double mastectomy would affect their relationship. She suggested they have a symbolic funeral.
"Why don't you just get a box and just really lay the breast and the whole issue to rest," she said. "Kiss them, tell them all the things you loved about them, how you really hated to see them go, but you know that it's for the best?"
To her surprise, the couple took her advice and called her back six months later. The woman underwent reconstructive surgery, and they both were happy.
"It was just the symbolization of 'we buried the breasts and we moved on,'" she said. "People don't realize it then, but time does really heal all wounds."
Still, couples can expect to have some problems along the way.
Dealing with stress
Oz and V.J. Roberts, both 53, said they faced many challenges when V.J. was diagnosed with breast cancer in spring 2010. The two became friends while attending the University of Georgia and married 15 years ago.
Oz is director of corporate photography for Aflac and V.J. is a technical trainer specialist at TSYS. They have a 10-year-old daughter, Jessica, who recently performed in "A Midsummer Nights Dream" along with V.J.
V.J. said she found a lump in one of her breasts in 2005 and went to The Medical Center to get it checked out. She was told her ducts were extended, but not cancerous. Since her breasts were small and fibrocystic, a technician told her she was an unlikely candidate for cancer. Annual mammograms all turned out negative.
But in April 2010, V.J. had her annual health assessment at TSYS. Her blood work raised concerns, so she went for an ultrasound and biopsy. That's when she got her diagnosis.
Oz travels a lot for his job. One day, he was driving back from the Atlanta airport. His wife broke the news over the phone. She was in her car with their daughter, who was 6 years old at the time.
"I have invasive ductal carcinoma," V.J. told him.
"What's that?" Oz asked.
Then he heard their daughter say, "Mommy, do you have breast cancer?" It's something V.J. had explained when the girl wanted to know why she couldn't lift her up anymore. She had told her she was being tested for the disease.
Oz said the word "cancer" had such a negative connotation.
"In my head, I did not know what to expect. I was a basket case," he said. "I was trying to be strong for her, but in my head she was gone, that's all that I could see."
The couple prayed about what to do next and talked to friends. After consulting with doctors, V.J. decided to have a mastectomy. But when it came to deciding where to have surgery, the couple had a little disagreement. V.J. wanted to go to a specialist in Atlanta, and Oz wanted her to stay in Columbus.
"My husband thought it was a little much to leave the family and go there," she said.
But in May 2010, she went to Emory for the surgery. She stayed with college friends while getting the mastectomy and breast reconstruction. She had hoped she wouldn't have to have chemotherapy and radiation, but later had to have the treatment.
That set off early menopause and mood swings.
V.J. said her husband was always supportive but in his own way. Oz said he wanted to be there for her, but he didn't always know what to do.
"I understand that I might have been a little bit on the edge," she said. "At one point, (Oz) said something and I said, 'Don't be laughing about that,' and he said, 'V.J., I'm not going be able to live if I can't laugh about things and have fun. You just can't take it all so seriously.' So we've gotten back to where we laugh and we share a lot of things."
Through the entire experience, V.J. said she wasn't so concerned about keeping her breast or her hair falling out. She just wanted to survive and get the whole ordeal over with.
A year later, doctors found a cyst in her second breast, and she had to have a lumpectomy. She said she has also considered removing that breast so she won't have to deal with cancer again.
Oz said he realizes that some women worry about how their husband will react to breast cancer, but he's just concerned about his wife's health.
"That was never an issue for me because I married her for her inner beauty and for who she was," he said. "She's such a great spirit, just a wonderful person. Her energy is infectious. For anybody that sees her, she just puts a big smile on their face."
Surviving the storm
Amy Ward is a homemaker and Internet blogger. He husband is senior director of corporate communications at TSYS. They are the parents of two sons, ages 22 and 24. Their oldest son, Robert, is married and about to be a father. Their second son, David, is a senior at Auburn University.
The couple's battle with breast cancer began in February 2010. Amy was at UGA tending to Robert, who had a stomach virus. While taking a shower, she discovered something that felt like a small cell phone lodged in her left breast. She tried not to panic, but it was unnerving.
"It kind of caught me by surprise, and took my breath," she said. "I just said, 'Lord, I don't know what this is. But I'm really not at peace with it.' "
The next morning she immediately called her doctor and made an appointment. Driving back to Columbus, she came up with a strategy to break the news to her husband. He was at work when she got home. Later, when he walked through the door, he immediately knew something was wrong.
"I told him and I watched his face as that Adam's apple on his throat took a big old swallow," Amy said.
The next day, the couple went to her gynecologist who thought it was a cyst. But he ordered a mammogram anyway. A couple of days later, Amy had a mammogram and an ultrasound, and the radiologist suggested she get a biopsy.
A couple of weeks later, the biopsy revealed that Amy had cancer, and the couple had to decide what kind of treatment to pursue.
"I could not fathom having a mastectomy at that point," she said. "I really couldn't wrap my mind around it. I was just going through life, day by day, and just hearing God say take the next step."
When Rob learned it was cancer, he couldn't believe it. "You don't plan for these things," he said. "Cancer is such a scary word. Until you've had it, or are married to somebody who has it, you don't think about all the what ifs."
They met with Amy's surgeon and oncologist at the John B. Amos Cancer Center and chose a protocol that involved chemotherapy, followed by a lumpectomy, then radiation. Amy had triple negative breast cancer, which is neither fed by estrogen or progesterone receptors, nor a protein called Her2. The doctors told her the protocol would be just as effective as a mastectomy with that type of cancer. She also tested for the breast cancer gene, which came back negative. Doctors believed her chances for survival were good, so she opted for a lumpectomy.
Rob said their lowest moment occurred two weeks after the diagnosis.
"It's devastating obviously at the beginning, but so much of the energy is thrown into learning about it, understanding what's happened, trying to figure out just what to expect and what's coming," he said. "And then there comes a point where it's just the two of you, and you're kind of sitting there one night and you just kind of look at each other and you say, 'I just cannot believe this is happening.' And then you're crying. That was the first time I saw my wife look like she was really despairing over this issue. For me, it broke my heart to see her that concerned."
Amy had so much she still wanted to experience. That year, her youngest son was a high school senior at Brookstone and her oldest son was getting married in May.
"Amy was wondering, 'Am I going to be there for his wedding," Rob recalled. "She told me one night, 'I don't want you to be with my grandchildren without me.' And, you know, to hear that and know that that's a real possibility, it's heartbreaking."
In March, Amy started six months of chemotherapy, and Rob insisted on being there for every treatment.
"I became very jealous of that time," he said. "If she needed a blanket, if she needed a drink or whatever, I wanted to be the one to get it for her. I was a little selfish that way."
Amy said the worse part was losing her hair and she remembers saying to her husband saying, "I'm going to be a freak."
"I didn't want to go without my hat even at home unless I was by myself." she said. "I was very self-conscious about somebody seeing me without my hair. And although I think my sons could have handled it very well, I just didn't want that picture ingrained in their minds."
So Amy wore a wig she called "Delilah" and hats her sister designed. She had the lumpectomy in September and started radiation at the end of October. It required 33 treatments, five days a week, until December.
After chemotherapy, Amy said the doctors declared her cancer free. She made it to her son's wedding, and she can't wait to see her first grandchild.
Amy now volunteers at the John B. Amos Cancer Center to encourage other patients. She said the trial strengthened her faith and marriage, and she wouldn't trade the experience for anything in the world. But Rob Ward wouldn't go quite that far.
"I still wish she never had to go through what she experienced," he said. "But I do agree that for us, as a couple, there's just a bond that is there."