VALDOSTA – It was Feb. 28, 2003, three days following a routine checkup.
Her husband beside her, 38-year-old Derenda Sizemore sat in a private room at her physician’s office awaiting the results of an examination.
“The doctor came in and I heard him say, ‘Derenda, you have been diagnosed with colorectal cancer,’” she said.
Her mind emptied. She entered a zombie-like state, she said.
She was Stage Three.
She didn’t feel sick.
She didn’t feel bad at all.
She was a wife and a mother to two sons.
Her mother battled lung cancer.
Her cousin, Denise Goodman, was diagnosed with colorectal cancer six months prior. They were like sisters.
There are thousands of people, like Sizemore, who brave the battle against cancer.
The Pearlman Cancer Center at South Georgia Medical Center reports it serviced a total of 4,509 cases from 2013-18. That’s an average of 900 cases per year.
Of the 4,509 cases, 2,674 of them were Lowndes County patients.
Nearly 70 percent of cases seen in Lowndes – about 1,800 patients – reach the five-year survival mark, Pearlman reports.
Though she was fearful, Sizemore wanted to reach her five-year mark.
She was in denial when she first received her diagnosis, but just because she wanted to believe she didn't have cancer didn't make the cancer any less real.
It was very much alive in her body, and on that day of disbelief in February 2003, she began her fight to survive.
Double the Heartache
The Sizemore family was devastated to learn two loved ones developed colorectal cancer six months apart.
Like herself, Goodman was diagnosed at 38 years old and was married. She had two daughters.
“I remember one of the things she said to me was, ‘Derenda, I’m not scared of dying. I just don’t want my girls to grow up without a mother. I want to see them turn 16.’ She said, ‘I want to see them go to a prom. I want to see them get married. I want to see them have kids,’” Sizemore said tearfully.
Goodman eventually succumbed to cancer and died, Sizemore said.
Sizemore learned the cancer in her family could have been genetic.
She faced a tough question when telling her 6-year-old son about the diagnosis.
“His first words to me, he looked up at me and said, ‘Mama, can I get cancer, too?’” Sizemore said. “A 6-year-old looking up at you with sky-blue eyes and asking you that question, I cannot to the day remember the words that came out of my mouth.”
Following her diagnosis, Sizemore met with a colorectal surgeon where she was told a grapefruit-sized tumor near her colon line and rectum would be removed.
She was told she would have to wear a colostomy bag. She refused.
“I said no. She said excuse me. And I said, no, I won’t wear a bag,” Sizemore said in a low-tone, almost quietly. “She said, that’s not a question. You will be having to wear a bag.”
The surgeon hoped Sizemore wouldn’t have to wear the bag for the rest of her life.
Almost three months later, it was withdrawn.
She recalls sitting in an Atlanta hospital seven or eight days after her procedure. The surgeon walked in, sat on the foot of her bed and told Sizemore she was cancer-free.
Unlike Goodman, she never had to undergo chemotherapy or radiation treatment.
By 2008, Sizemore was considered a survivor.
“I try not to think about it because sometimes you wonder why you were picked,” she said. “How come one stays and one goes? I know that’s a weird way to put it. You can’t help to think why.”
She said she still feels survivor’s guilt.
Number of Cases vs. Deaths
Cancer threatens thousands of Americans daily.
The Center for Disease Control and the National Cancer Institute reports, from 2012-16, there was an age-adjusted incidence rate of 466.4 for all cancer sites. That’s slightly more than the national rate of 448.
The incidence rates are cases per 100,000 population annually, according to CDC and NCI documents.
Breast, prostate, lung and bronchus and colorectal cancer top the state list with the highest rates in Georgia.
Dr. John Devine, Pearlman director of radiation oncology, agreed patients believe they’re facing a death sentence when they are diagnosed with cancer.
“Absolutely not. Look at the numbers. We have the majority of patients who are surviving five years later; all sites, all stages, all put together,” Devine said.
“Being bluntly honest as far as what you can do and what you can’t do, if you’re incurable, then we’re going to say that, but we’re also going to tell them if their odds are very treatable and treatment can improve their quality of life and prolong their survivability.”
Dr. Samuel Ofori, Pearlman medical director, echoed Devine.
“Regardless of the cancer, the cancer you are diagnosed, you are much more likely to be cured than to die from it,” he said.
Early stage detection is key to a cure, Ofori said.
So is patient management.
He said circumstances have gotten better now than in the past.
“For the past 20 years, we’ve seen the cure rate go up, mortality rate go down,” he said. “The reason why we are doing way better now, I think, is in large part due to one, the decline in tobacco smoking … and two, because we’ve gotten better in detecting cancers very, very early.”
Ofori said the most deadly forms of cancer are pancreatic, liver, gall bladder and lung, he said.
Lung cancer is difficult to treat and is the common cause of cancer deaths generally speaking.
“The reason why the mortality rate for lung cancer is very low is because we do not have an effective way of detecting the cancer before it develops full-blown,” Ofori said. “Usually, by the time patients present with their symptoms, the cancer is already very well advanced.”
The American Cancer Society surmises 142,670 deaths will be caused by lung and bronchus cancer in 2019.
Of the hundreds of thousands of new cases expected in 2019, less than half are estimated to result in deaths, according to ACS data.
For most cancers, death rates range anywhere from 1,000 to about 50,000 for men and women, according to the ACS.
The giant – breast cancer – is expected to reach nearly 300,000 new cases this year, the ACS reports. A little more than 42,000 deaths are projected to occur.
In an unrelated interview, Janna Luke, director of Pearlman, said breast cancer patients represent 20 percent of the center’s case load.
From 2013-18, Pearlman treated 844 breast cancer cases for patients in Lowndes and surrounding counties. Of this total, 89 percent reached their five-year survival point.
Devine credits the center’s survival rates to appropriate guidelines, equipment, chemotherapy drugs and physicians’ skills.
“Some patients are going to do better than others. Lung cancer is a very bad cancer,” he said. “... The majority of our breast (cancer) patients, prostate, colon, are going to be cured.”
Making It Through
Hoping to be in that majority is Whitney Robinson, a current Pearlman patient who was diagnosed with ER/PR-positive, HER-2 negative breast cancer in February.
She faced a long road.
Though her grandmother developed breast cancer, Robinson had previously tested negative for the cancer gene.
The 43-year-old teacher was at home the day she discovered a lump in her right breast. She was getting undressed and said she could feel it.
“It was a God thing,” she said. “I found it, and in my heart, I knew right away it was cancer.”
The following day, Robinson made a visit to her OB/GYN’s office where she had a mammogram and an ultrasound.
“They could tell from the mammogram and the ultrasound right away that they didn’t like what they saw,” she said. “I have seen God in this from the beginning.”
She had a tumor that was two-and-a-half centimeters in her right breast. Her cancer was at stage 2B for prognostic and stage 3A for anatomic.
Robinson is a mother to two children – a daughter in high school and a son in the fifth-grade.
“For me, my biggest fear was not being here for them. The thought of them growing up without a mom was my biggest fear,” Robinson said, crying. “The fear was not the treatment … It’s something that doesn’t ever go away.”
She is concerned about not seeing retirement.
“Because of my faith, I can turn it over and trust but it’s also something that you take back daily," she said. "You have to turn back over to Jesus because without (Him), I couldn’t put one foot in front of the other.
“It, at times, can be debilitating, just the fear. But that’s not how we’re called to walk through this, and I just have to trust."
After a double mastectomy that left her with air expanders for breasts, Robinson began treatment at Pearlman in April.
She wrapped up four chemotherapy rounds of Adriamycin/Cytoxan, which she said staff calls the “Red Devil,” and four rounds of Taxol in July.
Ofori, who administered her chemo, said it was given for four months biweekly.
Unplanned, Robinson and her husband spent their 20th wedding anniversary at Pearlman as she went through chemo. A valet employee purchased a card and balloons for the couple.
The next step after chemo was to exchange her expanders for implants and then undergo six weeks of radiation, she said.
Ofori said radiation completion typically takes two months.
After radiation, Robinson must take pills for the next 10 years.
“Breast cancer can be very aggressive,” Ofori said. “It is the most common cancer in a woman. Actually, it is the second leading cause of cancer deaths in a woman.”
Though the odds were against her, Pearlman staff deemed Robinson’s cancer type the most treatable form.
The measures are preventative to hinder Robinson’s cancer from returning. She’s currently in remission.
“Our goal in treating her is to try to cure her, make sure the cancer goes away and never comes back,” Ofori said explaining why Robinson must endure the treatment. “The total added together will contribute to her surviving her cancer.”
Generally, nationwide, the survival rate for breast cancer with all stages combined is at 90 percent.
As she continues her road to recovery, Robinson battles emotional ups and downs.
“The only way you can get through the emotional roller coaster is other people going through the same thing,” she said.
Robinson found inspiration through her OB/GYN who is a breast cancer survivor, she said.
She said God has seen her through an imperfect journey and now she desires to be a light of motivation for other people.
“Without question, I can say that my ministry is to help the next person go through this,” she said.
Having a Foundation
Experts who work with cancer patients say support is a good foundation for them.
Luke added mindset is also important.
“If you have that support, I think that helps prolong the recovery immensely, or at least it will make it that much better,” she said.
Ellen Woodard, Pearlman oncology social worker, said the center offers a support group named Best Buddies for its patients.
The center has yoga for survivors, a dietician and chaplains. Woodard said Pearlman staff does stress tests with patients to assist with emotions.
A decision must be made once treatment has started, Robinson said.
“I made the decision that I didn’t want to be the girl with cancer,” she said. “I just wanted to be Whitney. I wanted to keep living my life. I wanted to keep it as normal as I could for my kids and myself.”
She has strong support, Luke said, explaining the staff labeled people attending Robinson’s treatment with her as her “posse.”
Aside from its Hope Lodges – which offer free meals, emotional support and lodging – the ACS offers an initiative known as the Road to Recovery.
Through this program, community volunteers partner with patients who need transportation from homes to cancer treatment centers, said Demetria Redding, ACS community development manager.
As patients undergo treatment, they face mixed emotions, she said.
“It’s the unknown of what’s ahead whether it be because of the treatment or because of the cancer itself,” Redding said. “It’s the will I be able to get to the point where I’m able to go back to my normal state of life. It’s just a number of emotions. Nervousness. Fear of the unknown.”
Some patients experience treatment with a good support system while others don’t.
“Your emotional well-being has an impact on your overall physical, so if your spirits are down, and you don’t have some sort of support, then I do believe that there is a correlation between the two,” Redding said.
The ACS has established a phone line, (800) 227-2345, for patients or caregivers to call for assistance. More information is also at cancer.org.
Other ACS supportive efforts include its Relay For Life program.
Team members are asked to alternate walking laps during the 12-hour relay in memory of people who have lost their fight with cancer and for those who have survived, according to national organizers.
The event raises thousands of dollars locally.
Proceeds benefit research for a cancer cure, as well as, improving care for patients, according to previous interviews with organizers.
Having been a staple in her life for nearly 15 years, Derenda Sizemore is Lowndes’ survivor chair.
When she was invited to a Relay For Life in North Carolina prior to her death, Denise Goodman welcomed Sizemore to join.
“I remember going out to Franklin High School, sitting on that hill with my youngest son, he was 5 at the time,” Sizemore said.
“Survivors were on the field, and at the first light, they were letting kids go. I was in awe at all the children who were survivors of cancer. I had no clue there were that many kids.”
She got involved eventually becoming the survivor chair for Newport Beach, Calif., and again for Lowndes, during two relocations.
She is also the team captain for a family team named Remembering Angels and a church team for Gateway Baptist.
She works closely with survivors through her leadership role.
“I’m right there to hear their stories, and then in turn, tell them about me, too,” Sizemore said.
One story she knows all too well is the one of 13-year-old Madeline “Maddie” Pitts and 83-year-old Nina King.
The two were the 2018 honorary survivor chairs. Months following, they walked the Relay For Life track together during the Survivor Lap.
Months later, within 24 hours of one another, they both died. It was King’s birthday.
King had survived cancer five times. She was given the ACS Lifetime Achievement Award. The first time the award was presented during a Lowndes County Relay For Life.
Through her many years of participating in Relay For Life, King raised more than $250,000 for the ACS.
The Pitts family also lost Maddie’s sister, Elizabeth Pitts, to leukemia and a brain tumor when she was 10 years old. These were the same two cancers that claimed the life of Maddie.
Maddie was not being treated for leukemia at the time of her passing.
Melanie Pitts, Maddie’s mother, established Hugs of Hope to aid children with cancer.
Sizemore is a board member for the organization.
“I know that one day there is going to be a cure, and yesterday sure can’t be too soon,” she said.
Cure vs. Remission
Cure means there are no traces of cancer after treatment and the cancer will not come back.
Remission means the signs and symptoms of cancer are reduced. Remission can be partial or complete. In a complete remission, all signs and symptoms of cancer have disappeared.
If a person remains in complete remission for five years or more, some doctors may say they are cured. Still, some cancer cells can remain in a body for many years after treatment. These cells may cause the cancer to come back one day.
For cancers that return, most do so within the first five years after treatment. But there is a chance the cancer will come back later. For this reason, doctors cannot say for sure a patient is cured. The most they can say is there are no signs of cancer at this time.
Because of the chance that cancer can come back, a doctor will monitor a patient for many years and do tests to look for signs of cancer’s return. They will also look for signs of late side effects from cancer treatments.
This information is provided by the National Cancer Institute, cancer.gov/about-cancer/diagnosis-staging/prognosis.