The Orrs confront cancer challenges with courage and faith, side-by-side

Noreen Hyslop photo Darryl and Diana Orr's experience with cancer began in 2000, but a recurrence over the past year has granted them an even deeper appreciation for family, friends and the medical community at large.

"When the doctors tell you that your wife needs a needle biopsy of an area that looks suspicious," says Darryl Orr, "you start thinking bad thoughts, but you know you can't show fear because your wife is already afraid, and rightfully so. So you walk a tightrope. You can't act too positive or it appears that you don't care, but you can't panic either because fear spreads a lot faster than cancer."

For the Orrs of rural Dexter, their face-to-face confrontation with cancer began in 2000, shortly after Diana retired from a teaching career at Dexter High School.

"I was looking so forward to spending time being a lady of leisure," she remembers. "All of that changed when I found a pea-sized lump in my right breast."

In spite of regular checkups and mammograms, healthy eating habits and an exercise routine, Diana Orr had cancer. It was the most common of breast cancers; invasive ductile, and it was estrogen positive.

The call telling Diana that the tumor was malignant came a few days after her biopsy. She was alone and recalls, "I went to the bedroom and lay down on the bed and prayed a little prayer that I would be strong and not cry, and I didn't, but I was certainly scared."

"When Darryl came in for lunch that day, I told him. He hugged me and has been right by my side from that moment."

"I was given two choices," Diana explains. "I could have a mastectomy and no radiation or a lumpectomy and six weeks of radiation."

Given only a five percent rate of reoccurrence, she opted for the lumpectomy, followed by radiation.

Twelve lymph nodes were taken to biopsy and all were found to be clear. The most trying part of the ordeal, says Diana, was not from the lumpectomy itself, but rather from the drainage tubes that remained intact upon being released.

"You're given exercises to keep the arm mobile and I did them faithfully, but I still developed what doctors refer to as a 'frozen shoulder,' and that is big time pain."

Once she had healed, Diana's Cape Girardeau oncologist began the process of radiation, beginning with marking up her chest with black magic markers to map out the course for the treatment. Other than minimal fatigue and what appeared to be a serious sunburn, she tolerated the radiation well.

It was the middle of October when her youngest son, Greg, planned to be married and Diana was feeling well. Grateful to be in improved health and having beaten the odds, she went shopping for a dress for just the right outfit.

"I found the perfect thing, but when I tried it on, there was a little problem that I hadn't considered. My black magic marker drawings showed, so I had to find an alternate outfit," she says with a smile.

The marks were all that remained as evidence of her diagnosis. She was well on her way to recovery. The next five years included regular mammograms and when she hit that magic number of years cancer-free, she and Darryl celebrated and breathed a sigh of relief.

Cancer is an ugly and unpredictable disease and for those who have gone through a diagnosis and treatment, the threat of reoccurrence is ever-present. Still, it came as a shock, when last summer Diana found yet another lump in the same breast.

"I thought at first that it might be scar tissue from the lumpectomy and I had a mammogram scheduled a few weeks later, so I waited."

"I knew something was wrong, though, when I went for my appointment because I was asked to stay for further tests that included an ultrasound."

Darryl recalls the sequence of events and how that fear struck home once again.

"I was in the waiting room while Diana got her annual mammogram when the nurse came out and called my name. When she told me that Diana wanted me back there, I knew something was wrong. She never needs me in the examining room. They had found a suspicious lump in the same place and about the same size as the initial cancer."

The second time was much worse emotionally for me," Diana confesses. "This time the tears came, not in the doctor's office, but at home."

Upon the advice of her physician, the Orrs elected this time to have the mastectomy with reconstructive surgery to follow. With that decision made, plans went into motion to coordinate a schedule compatible for both the breast surgeon and the plastic surgeon who was to perform the initial steps for the reconstructive surgery. This coordination effort involved some waiting, and anxiety set it. The already diminutive Diana lost her appetite and several pounds awaiting the surgery. She tipped the scales at barely 100 pounds by the time her surgery took place in mid-October of 2007.

During a mastectomy, when the patient has opted for reconstructive surgery, the plastic surgeon is on hand in the operating room to put an expander in place after the breast is removed before the incision is closed. The expander's purpose is to literally stretch a woman's skin over the area where the breast had been. The device resembles a deflated balloon and every two to three weeks, the patient visits the surgeon and he injects a small amount of saline solution into the "balloon."

For most women, this process, although painful, is successful. For Diana Orr, it was anything but a success.

"The whole expanding process was by far the most painful aspect of either cancer experience," she confirms.

Diana's next step was to begin chemo, even while periodically reporting to get the saline injections every few weeks.

"My tumor was sent off to California for some further and innovative testing to determine not only the rate of possible reoccurrence, which in turn helps in determining whether or not chemotherapy is to be recommended. Twenty-one genes taken from the tumor are tested."

"My tests showed that I had a 34 percent chance that the cancer could reoccur within 10 years," Diana states. "For that reason, I was prescribed chemo, along with Herceptin which works to cut those chances in about half."

"My cancer had an HER2 gene, however, and that made it more difficult to predict how the treatment would react with the other cancer cells. So, I was prescribed Herceptin to take every three weeks for one year to combat that HER2gene."

Prior to the start of her chemo, a port was inserted under Diana's collarbone for the chemo to be fed directly through the port and into the bloodstream, insuring no leakage into the tissues.

"The epirubicin (one of the chemo drugs) can destroy tissue if it is allowed out of the vein," she explains.

Chemotherapy treatments required the 100-mile round trip to Cape Girardeau every three weeks for four treatments and the Orrs celebrated each milestone with a special meal or something to ease the fears and the burden of the treatment itself.

"It's important to create some positive memories through cancer treatments," Darryl explains. "Sometimes we'd have a 'One down, three to go' celebration or we'd go out to eat after Diana's treatment."

" It helps that she thinks Steak and Shake is a really fancy restaurant!"

Diana considers herself fortunate to have had no serious side effects. Her long hair went by the wayside and she had soreness in her mouth for a time, but having been prepared for the worst, she calls herself lucky.

"I was very careful not to be around large crowds during treatment because my blood counts were affected and I was susceptible to more infections. I was administered a shot of Nuelasta the day after each chemo treatment to aid in boosting the white cell counts."

Five weeks following her last chemo treatment, the Orrs traveled back to the hospital for Diana's final step in the reconstructive process. The process was completed, but not without some difficulty. Diana's skin had been so compromised by her previous radiation and by her chemotherapy that her skin was extremely thin. The combination resulted in the couple's worst nightmare becoming a reality about five weeks following the surgical procedure.

"I awoke at around 5:30 one morning and the incision had split open and blood and fluid was leaking terribly," she recounts. "We made a mad dash to the hospital and I had emergency surgery to remove the implant."

Doctors then presented Diana with another option toward reconstruction that involved taking muscle and tissue from her back and bringing it around the front to create more skin for another attempted implant.

"I didn't have to think too long about that before deciding that I wanted no part of it."

Diana's port will be removed next year and that, she and Darryl are confident, will put an end to surgical procedures.

The Orrs have come away from their cancer experience with a more sincere appreciation of relatives, a loving Church family and friends and even of each other.

"The support we received was just overwhelming," Diana says. "Not only were we blessed with meals and well wishes and so many prayers and those prayers just sustained us both. I received cards from people I barely knew, and you just can't put into words what that kind of support means."

Darryl Orr says he learned a lot over the past few years.

"I've found out what is important in this life," he says. "Time becomes important. People become very important. Everything else is secondary."

Most importantly, he says, "I love Diana very, very much. She is the toughest and strongest, yet still the sweetest, most loving woman in the world."

"God has given me so much," he concludes, "and the best is Diana."

The Orrs will be attending Stoddard County's Relay for Life on Aug. 1-2 at West City Park.