By Mike Wise
Washington Post Staff Writer
Saturday, June 6, 2009
When the chemotherapy treatments began last summer, and her coffee-brown locks began to bunch around the shower drain, Nancy Cooley drove to her eldest son's home and walked downstairs to the utility room. Chris already had a stool, newspaper on the floor and an electric razor waiting.
"I knew she was worried sick, so I tried to make it as humorous as possible," said Chris, the Pro Bowl tight end of the Washington Redskins. "I tried to goof around a lot. To be honest, a little comedy was the only way I could handle something that stressful."
A week before Chris's wedding in May 2008, Nancy Cooley was told she had a three-inch, aggressive tumor inside her right breast, medically known as an invasive ductile carcinoma. Stage 3 breast cancer.
She was no longer just the independent woman who raised her two sons alone in Logan, Utah, so she could finish college and earn her master's degree in business education. Or merely the mother of a famous NFL player. Nancy was also among those who have breast cancer, thousands of whom will likely take part in the Susan G. Komen Foundation Global Race for the Cure this morning on the Mall, the 5-kilometer event that drew more than 45,000 participants a year ago and raised $4.9 million toward breast-cancer research and awareness.
"When you hear, the first thought is everybody's first thought, 'I've got cancer, am I going to die?' " said Nancy, who turned 50 this year. "And then you go through the treatments and surgeries and appointments. And you start to come out on the other side and realize: 'What if I didn't have insurance? What if my son hadn't called the Redskins' team doctor to get the quickest appointment with the best doctor?' That's where I am now."
Over the past 11 months, Nancy confided about her fight against the disease in a series of conversations and e-mails. Her only request was that a story not be published until she had breast reconstruction surgery, which she successfully underwent April 17.
In that time, a woman who had trouble asking others for help began to rely on a support network that reached far beyond her sons, Chris and his younger brother Tanner, to people Nancy had never met before walking into their medical offices.
Stephanie Akbari, the surgeon who performed Nancy's bilateral mastectomy on Oct. 7, first met Nancy in May 2008 at the Virginia Hospital Center in Arlington, where Akbari is the director of the hospital's Center for Breast Health.
"She was scared, like everybody else," Akbari said. "Here she is, her son's getting married in four or five days, she's got breast cancer and she had just had to be feeling, 'Wait, things aren't supposed to happen this way.' "
Looking back, Nancy's meeting with Akbari just three days after the cancer was initially diagnosed had set her on perhaps the fastest possible track toward being cancer-free. It also made her an aberration in a world where being seen by the most prominent medical specialists can often take weeks and sometimes months.
Nancy never liked being introduced as "Chris Cooley's mother," feeling the label took away some of her own identity. But, for once, she embraced her son's celebrity.
The first phone call Chris, 26, made after his mother told him the news was to Redskins team physician Anthony Casolaro, the vice president of medical staff at Virginia Hospital Center. Casolaro immediately lined up an appointment with Akbari, formerly the chief resident at Harvard Medical School's Beth Israel Deaconess Medical Center, who had also treated Tanya Snyder, the wife of Redskins owner Daniel M. Snyder.
"I know now that's why I got such fast appointments," Nancy said, referring to her son's Redskins ties. "If I would have had to just wait two weeks from the Friday I found out till my first appointment, it would have been awful."
In one day, Akbari's staff arranged appointments with a breast oncologist, a breast surgeon, a breast imager, a plastic surgeon and a radiation oncologist.
Akbari acknowledged she had never heard of Chris Cooley and knew nothing of the tight end's Pro Bowl fame before she treated his mother, adding, "Any [new patient] with a cancer diagnosis who I see has a slot to see me within two or three days."
Steven P. Davison knew who Chris Cooley was. He has held 50-yard-line, club-level seats for the Redskins for four years. He used to volunteer as a physician at FedEx Field, "just so I could go to games."
Davison said it was a little different when Nancy walked into his plastic surgery practice in the District a year ago. "The general feeling is it's a little more stressful to work on famous people or the family of famous people, especially if you're a fan," Davison said. "But because [Nancy] is so down to earth, it really makes you realize you need to treat everybody the same."
After Akbari performed the bilateral mastectomy in October, Davison inserted expanders in Nancy's chest cavity, a process that involves making diamond-shaped surgical cuts near the breasts. In mid-April, he performed what is known as DIEP (deep inferior epigastric perforator) flap surgery. The breasts are essentially reconstructed by borrowing living fatty tissue and skin from the abdomen -- almost the same procedure used for cosmetic tummy tucks. Tiny blood vessels are then matched to blood vessels from the mastectomy site and reattached under a microscope. "The procedure rebuilds the patient with their own tissue," Davison said.
"Basically they cut you open from hip to hip and move that stuff up to make new ones," Nancy said. "It's not pleasant. Cancer is no fun, trust me."
She has grown numb to pain the past year, having lived with two-inch scars in her chest between May 2008 to October, lost her hair and eyebrows to chemotherapy and both her breasts and 20 lymph nodes to the disease. Twenty-eight radiation treatments later, she still recalls the tubes of her own secretions and fluids building up in the surgically inserted drains, which her niece, Brooke Brandt, emptied.
"I just had to keep remembering, 'Hurt make you better, hurt make you better,' " Nancy said.
On one of her first visits to Davison she said she was told she would look "100 times better."
"You know, six-pack stomach, 26-year-old boobs," she said, laughing. "I'm like, 'All right, if you say so.' "
Next month, Nancy will enter the final phase of reconstruction -- having her breasts reshaped, including the twisting of the skin to create new nipples. Finally, she will have areolas tattooed on to match her skin color.
"When you hear the term, breast cancer, you never think of all that," she said. "You just hope they get rid of the cancer and you don't become any sicker. But now I know more about this disease than I ever wanted to. I hate it so much."
Over the past year, Nancy's uneasy feeling about going public with her condition changed. The caretaking woman who always fixed everything for her boys, who didn't want anyone outside of her family to know she had breast cancer a year ago because she did not like someone thinking, "Oh, poor thing, you have cancer," became a fundraiser and advocate.
In the second week of April, 10 of Chris Cooley's teammates gathered at The Original Steakhouse in Ashburn for a $50-a-plate dinner for the American Cancer Society's Relay for Life on behalf of Nancy. Clinton Portis, Jason Campbell and Colt Brennan played auctioneers for their own items. The event raised nearly $30,000. Many of the business-law students at Briar Woods High School, where Nancy has taught for four years, competed in the relay event, raising an additional $7,000.
Nancy found out that Emend, the nausea medication she was taking for her chemotherapy, would have cost an uninsured woman $700. For three pills. The four series of eight injections she had to give herself to help her white-blood cell count -- 32 shots in all -- would have totaled $4,800.
When the day came for a special accreditation to be given to the Center for Breast Health in April, two days before her reconstruction, Nancy sat with Akbari and Tanner at a news conference in Arlington and told her story. "What I've learned is how fortunate I am the moment I got this disease," she began, "and how many others aren't."
Nancy missed just one of Chris's home games last season, the one scheduled five days after she had both breasts removed. She took six weeks off work, returning the week of Thanksgiving to her other kids, some of whom took part in the school's "Pink Out" last fall at a football game, where the crowd wore pink in support of breast cancer awareness.
In November, after her mastectomy, she wrote in an e-mail: "Seven weeks of radiation and another huge surgery to try to rebuild my body, which feels like a war zone. Hopefully all of the pain will be worth it, and I will be like my grandparents and live to be 90+."
She added: "When I decide to feel sorry for myself, I don't have to look too far and can find someone in a much worse situation. I can't imagine a child going through this. No one deserves to have to go through this."
At her home in Ashburn on Wednesday night, still a month away from her final surgery, she said she is cancer-free and hopes to be for at least five years, at which point she can genuinely call herself in remission.
"It's still hard for me to have someone care for me," Nancy said. "I'm still not good at that. But I also realized asking for help doesn't make me feel weak, either. In fact, it makes me feel strong."