It wasn't a big deal," insists George Sotsky '58S of Republic Industries, a company that typically works with machinery weighing 50 tons or more.

But to several breast cancer survivors in Louisville, it was an act of great kindness.

The women were to wear human-sized butterfly wings-the butterfly representing hope-as they marched alongside a float sponsored by the Kentucky Cancer Program (KCP) in this year's Pegasus Parade. The heavy, rigid wings, however, turned out to be uncomfortable for those who had undergone breast surgery.

Enter Sotsky. He led an all-night engineering session to redesign the costumes, creating a new and better version within 24 hours-and says he was delighted to do so.

With 13 regional offices, the KCP is administered jointly by U of L and the University of Kentucky. Its mission is to reduce the burden of cancer on Kentuckians through education, research and service programs. According to director Connie Sorrell, KCP serves as a model nationwide.

At U of L the program is part of the James Graham Brown Cancer Center. Dedicated to clinical care, research, education and outreach, the center is world-renowned.

Breast cancer is just one type of cancer treated there, but aside from malignancies of the skin it is the most common cancer affecting women. It is also the second-leading cancer killer of women, topped only by lung cancer.

One in every eight women will contract breast cancer at some time in her life. More than 2,700 in Kentucky are diagnosed with the disease each year; 600 are expected to die.

But new research and treatments are offering fresh hope to patients and their families. U of L is right in the midst of the fight against this disease; for many university staff and associates, it's a very personal war.

Marching for Hope

Jo Spencer, a long-time student affairs employee, is a breast cancer survivor and activist. Marching with the KCP float was an invigorating experience, she says, because it allowed her to be among a very special group of peers-other survivors.

That's far different from how she felt when she was first diagnosed 10 years ago at the age of 51.

The bad news hit at what was already a low point in Spencer's life. She had just lost her mother to lung cancer when a routine mammogram led to the discovery of her own disease. Treatment included a radical mastectomy in which the breast tissue, underlying muscles and adjacent lymph nodes were removed.

After a slow and painful recovery, Spencer now enjoys good health. But she hasn't forgotten that bleak era a decade ago. When she discovered she had cancer, Spencer visited a psychologist to learn how to cope.

He asked her, "What was the first thing you did after the diagnosis?"

She replied, "You dig your grave, you clean your closets and then you are free to live."

Alumni Association executive vice president Tara Singer '83A, '87G, '93G is Spencer's daughter. She remembers the ordeal vividly.

"How did I feel?" she responds when asked what it was like to learn her mother had cancer. "Saddened and scared. But it's important to know that today there are so many treatment options.

"I also know all about the hereditary factors that affect me because of Mom's involvement with the survivors' movement," Singer adds. "I have sons, but one day I might have granddaughters. My awareness of what this means has increased because of Mom."

Singer is proud of her mother's efforts to help others. Her voice catches as she says, "Mom has taken something that could be very sad and directed it into a source of hope and knowledge for others.

"It's her gift to the world."

Early Detection Saves

Helen Wessel Feige '91A is another survivor. Ironically, she saw the colorful butterfly marchers gathering in the parking lot of the Brown Cancer Center on the day she underwent her first course of chemotherapy there.

At 34, Feige was younger than most breast cancer patients when she was diagnosed last April. Research shows that about 82 percent of breast cancers occur in women 50 and older, with the risk especially high for those over 60. With no history of breast cancer in her family, Feige's diagnosis came out of the blue.

"When I first found the lump, I was told it was probably benign," Feige recalls. In fact, most lumps are.

"Then I got the diagnosis. I cried for 72 hours straight."

Luckily, she benefited from early detection and prompt treatment. After consulting with physicians at the Brown Cancer Center, Feige opted for a lumpectomy and chemotherapy.

"It's tiring and I have some nausea," she says," but in six days I'm back to normal and even forget I'm on chemo."

Feige's road to recovery has been made easier because of her confidence in her medical team, she says. Along with the Brown center's staff, she also credits her 4-year-old daughter, Emma Louise, and husband, Karl Henry Feige '89A, for helping her along.

They've made it easier to endure-and sometimes even laugh at-what's happened. For example, knowing that hair loss is a common side effect of chemotherapy and was likely to happen to Helen, Karl shaved his own head in the family backyard as she, Emma Louise and the neighbors looked on and cheered.

Lifesaving Pictures

Breast cancer doesn't always manifest itself physically, nor does it cause pain in many during the early stages. That's why regular self-exams and professional checkups are vital.

An annual mammogram might also need to be part of a woman's health regimen. Experts disagree about just how soon women should start having them, but studies have shown that at least for those aged 50 and over regular mammograms can be lifesavers.

Joyce Hack '85E, an administrative assistant in Speed Scientific School, is a true believer. A 67-year-old widow who earned her degree while her own children were in college, she credits a routine mammogram last March with saving her life.

"I can't stress enough how important it is to get annual mammograms," she says. "The doctor hadn't felt the lump; it was undetectable."

Hack's initial mammogram was followed by an ultrasound, which uses high-frequency sound waves to discern structures in the body. As sometimes occurs, Hack's lump did not appear on the ultrasound. It did, however, show up on a second mammogram.

A biopsy confirmed that she had invasive ductal carcinoma, which means that her cancer began in a breast duct and spread to the surrounding tissue.

Hack chose a mastectomy over a lumpectomy, opting to have the breast removed and reconstructive surgery done in a single operation, followed by a round of chemotherapy.

It was tough, she remembers. Not only did she suffer some unpleasant side effects-"I had sores in my mouth and nausea," she explains-but she also lost a close sister-in-law during that period. Like so many other survivors, however, Hack focuses on the future.

After all, she says, if you want to survive, "You must stay up emotionally."

At Risk

Like Feige, Hack had no family predisposition toward breast cancer. Some women, however, have an ominous cloud hanging over them: They know they are at risk.

Pat Woods, a staff senator and historical researcher in the university's development office, is a case in point.

At the age of 30, she survived a pre-cancerous condition of the cervix; 13 years later her brother died of colon cancer. Then in 1995 her sister, Dorothy Ann Duffy-the grandmother of former Cardinals basketball star Dwayne Morton-succumbed to breast cancer. "When Dorothy Ann was diagnosed, our doctor advised all of us to have mammograms," Woods recalls. "Even my 93-year-old mother went in."

Both her mother and another sister had benign cysts. Woods wasn't so lucky. The day after Dorothy Ann died, she had a malignant lump removed from her breast.

"I hate the feeling that my sister might have died in vain," Woods says. "But she didn't. She saved me."

Women like Woods who have had a first-degree relative-that is, a mother, sister or daughter-with breast cancer stand a greater chance of getting the disease. Along with that and age, factors that seem to increase the risk of breast cancer are early onset of menstrual periods, never giving birth or having the first child after age 30, high alcohol consumption (two or more drinks per day) and a diet high in fat.

Doctors say that lifestyle improvements may offer some protection against breast cancer. At the least, they add, leading a healthier life can decrease your chance for other life-threatening conditions.

From Caregiver to Patient

Mary Karen Powers, director of the U of L Women's Center, has a unique perspective on cancer. She spent 11 years as a hospice chaplain in Massachusetts prior to assuming her current post.

Then the day came when she herself was diagnosed.

Her sister, a physician, made the discovery when the two were in Louisville a dozen years ago to watch their 74-year-old mother graduate from U of L.

Powers' dealings with cancer patients left her with what she calls "an odd double-awareness" of the disease.

"I knew that while it could kill me," she explains, "early detection could make my prognosis quite good."

Powers suffered from melanoma (which attacks the skin's pigment-producing cells) rather than breast cancer, but her own brush with death has given her a real empathy for those who suffer from the disease.

"Caring for hospice patients made me understand that terminal illness is a naturally occurring part of life, and that death is simply a part of being human. Being a cancer patient myself gave me a better sense of compassion and a deeper sense of connection with my patients," she says.

Following the graduation Powers returned home to Boston where she underwent treatment at Massachu-setts General Hospital. When she saw the words "ambulatory oncology" chiseled in stone as she went in for the first time, she thought, "This can't be happening to me. I take care of oncology patients. I don't want to be one."

She literally had to stop for a moment and convince herself to walk on into the hospital, she says. Powers no longer thinks about her brush with cancer every day. But she has turned her empathy for its victims into action. Much of her effort is spent educating women about breast cancer, a disease that almost exclusively attacks females. Men aren't immune, but they represent only a fraction of the cases. This year, for example, 1,400 males in the United States are expected to be diagnosed with breast cancer compared to nearly 183,000 females.

Powers fights the disease through the Hospice and Palliative Care of Louisville's speaker's bureau and by ensuring that the Women's Center promotes early diagnosis.

She says, "I learned from experience that early detection and treatment can make a significant difference in the prognosis. That is why I support self-exams and mammograms."

Bright Horizons

Education is proving a forceful ally in the fight against cancer.

As women become better informed about the disease and are more proactive in guarding their health, the result is earlier diagnosis of breast cancer overall. Combined with new treatment advances, a patient's prognosis has improved significantly. The five-year survival rate has jumped from 72 percent in the 1940s to 97 percent today. That's great news for the medical community-and even better for the patients and their loved ones.

Jo Spencer knows all about how important it is to spread the word.

"Take charge of your life," she urges. "Many women consider themselves caregivers and frequently 'self' comes last. So be aware of yourself as an individual."

And if the worst does happen?

"Remember," Spencer advises. "There is life after cancer."

She's living proof.

For more information about breast cancer talk to your doctor. The Web also offers valuable data. To get you started, we recommend the Brown Cancer Center site at www.bcc.louisville.edu; the ACS site at www2.cancer.org/bcn; and www.nbcam.org, sponsored by the organizers of National Breast Cancer Awareness Month. Nancy Gall-Clayton '80L is a Louisville-based freelance writer, playwright and attorney.