Meg Lowry and Michelle Simmons are wives, mothers, teachers and friends, spending the past 13 years together as teachers at Odenville Elementary School in Alabama. Both are in their mid-30s. After a challenging 13 months, both are survivors of breast cancer, a disease that will affect more than 307,000 women in the United States this year.
“Breast cancer is not as scary as you immediately think it is when you first hear, ‘You have cancer,’” Lowry said. “It’s not your grandmother’s story anymore. It might not always be an easy road, but it’s treatable.”
“This experience has brought Meg and me closer to each other and also closer to our community here in Odenville, because our faculty, our students, their families and the people of this community have done so much to support us,” Simmons said. “And we have learned what a tremendous resource we have in Birmingham with UAB, because the care we have received has just been amazing.”
Both Lowry and Simmons have undergone treatment through the University of Alabama at Birmingham’s Comprehensive Cancer Center, one of the nation’s leading cancer research and treatment centers. The center is the only National Cancer Institute-designated comprehensive cancer center in the six-state area of Alabama, Arkansas, Georgia, Louisiana, Mississippi and South Carolina.
As is standard for any UAB breast cancer patient, both Lowry and Simmons met with a team of oncology physicians and caregivers in the UAB Breast Health Center to develop a plan of attack specific to their types of breast cancers.
“They did all of my major tests in one day – a mammogram, ultrasound and a needle biopsy,” Lowry said. “I knew to a great extent what I was facing the moment I walked out of that meeting.”
“UAB really looks at your individual need,” Simmons said. “I’ve heard that, at other places, when they know it’s cancer, they automatically do chemotherapy and radiation. UAB’s doctors were thorough, caring and so knowledgeable. I felt like they were ahead of the game in treating this disease. I trusted them with my care.”
This is the story of Lowry’s and Simmons’ journeys through breast cancer to the other side.
‘It’s just terrifying’
Meg Lowry knew she had a potential problem the moment she felt the lump on her left breast in spring 2015. She immediately scheduled an appointment with her primary care physician.
While the lump was concerning to Lowry, there was always the thought that it might, in fact, be nothing. She has no family history of breast cancer.
“I had lots of knotty, dense tissue, so my doctor didn’t have any reason to believe it was anything other than that,” Lowry said.
Lowry was 34 at the time of her appointment, and her insurance would not cover a mammogram until she turned 35 a few months later. So, she waited, assuming it was nothing.
When she did have the mammogram, it showed something different. Two days after her mammogram, she got a call and was told to go to another diagnostic center for more in-depth images. Two days after those tests came the confirmation phone call.
“When you hear you have cancer, you’re terrified,” Lowry said. “You don’t know how far along it is. You don’t know where all it may be in your body. I have a husband and two young boys. … It’s just terrifying.”
Lowry wanted to know as much as possible about what she was facing, and a family member told her to make an appointment with the UAB Breast Health Center, where she quickly learned she had HER2 negative lobular cancer. HER2 negative cancer, or hormone receptor-negative, tends to grow more quickly than hormone receptor-positive cancers and is more common in women who have not yet gone through menopause. Lowry’s cancer had already spread to her lymph nodes.
UAB physicians ordered a genomic test known as a MammaPrint, which analyzes the activity of certain genes in early-stage breast cancer to help physicians gauge which treatment might initially work best.
The MammaPrint suggested that hormone therapy was the best initial treatment option. So Lowry began a six-month hormone therapy regimen with the hope that it would completely kill the cancer. If so, she would have her mastectomy afterward followed by radiation treatments and then breast reconstruction surgery to follow.
“I learned a lot about cancer in a hurry,” Lowry said.
The staff at Odenville Elementary School rallied around Lowry immediately after her diagnosis in September 2015.
Simmons vividly remembers coming to school one morning only to be met by a large number of teachers who were going outside to pray.
“I asked them where they were all going, and they said, ‘We’re going to pray,’” Michelle said. “I said, ‘Well, all right. Let’s go.’ And then I asked what we were going to pray about. Meg had sent an email telling us she had been diagnosed with stage 2 breast cancer, and I hadn’t seen it yet.
“I just remember that I couldn’t even cry because I was just in so much shock.”
The school hosted a Pink Party for Lowry, giving gifts of necessity and support. It was support that poured out in many ways throughout the fall and into the winter. Kids came to school wearing “Megafight” T-shirts, and T-shirts were sold to help raise money for her fight. Parents came up to Lowry to tell her how much they were praying for her.
“That outpouring of support really gives you that first initial big jump of power that lets you know you can fight this,” Lowry said.
‘I just thought I would ask’
In January of this year, Simmons called to schedule her annual checkup with her primary care physician. She was turning 35, and she had heard of other women getting a mammogram when they turned 35.
Her own family’s history with breast cancer, and even Lowry’s situation, didn’t prompt her to ask whether she should get a mammogram.
“My mom’s mom had breast cancer and my great-grandmother on my dad’s side had it; but that’s really not why I asked, because I hadn’t even thought about it,” Simmons said. “Both my grandmothers had it later in life. I just thought I would ask.”
The decision on when to start mammograms depends on the patient’s risk factors, says Helen Krontiras, M.D., co-director of the UAB Breast Health Center. Krontiras encourages women to know as much about their family cancer history as possible and to let their doctor know about any changes to their family history at yearly checkups.
“Women with a strong family history of breast cancer on either side of the family may want to start screening earlier than the American Cancer Society guideline of women ages 40 to 69 years,” Krontiras said. “That guideline is intended for average-risk women, and women with a history of breast cancer in their family are at an increased risk.”
Simmons’ mammogram showed a suspicious spot, “and that’s when I started thinking about family history,” she said. Simmons immediately went to Lowry after she got that first mammogram result.
“Meg said, ‘We’re going to pray it’s nothing; but if it is, I want you to use my doctors at UAB,’” Simmons said. “She immediately became an incredible resource for me.”
Simmons came to UAB’s Breast Health Clinic and was given the news that she did indeed have breast cancer – ductal carcinoma in situ – the most common type of noninvasive cancer where abnormal cells have been found in the lining of the breast milk duct. The good news was that the cells had not spread outside of the ducts into the surrounding breast tissue.
Krontiras delivered the news to Simmons and her husband, Barry, who were both understandably stunned.
“When we finished getting the news and absorbing what I had and what was to come, Dr. Krontiras hugged me and reassured me that I was going to be OK,” Simmons said. “And when she did that, I knew I wasn’t just a name. I was a person that she truly showed concern for, and it gave me relief and comfort knowing I was a special person to her. You would have thought the way she acted toward me that I was her only patient.”
Because Simmons’ cancer was confined in one location, she did not have to undergo any chemotherapy or radiation treatments. However, she was going to have to have a mastectomy.
Doctors gave her the choice to have only the affected left breast or both breasts removed. Her right breast did have a spot of concern that tested benign, so if she opted to have just the left breast removed, she would have to go for MRIs every six months and have more biopsies.
Andres Forero, M.D., director of UAB’s Breast Cancer Program, and Richard Fix, M.D., a breast reconstruction surgeon in UAB’s Department of Surgery within the School of Medicine, gave Simmons guidance on her decision. What were the risks of keeping the right breast? How would she look afterward if they only removed and reconstructed the left breast? The questions were numerous.
Simmons appreciated that the doctors were taking her emotions into account as well. They laid out all of the options for her, but said it was going to be her decision on how she wanted to proceed. Simmons opted to have both breasts removed and have new breasts reconstructed by Fix.
“I’m young, and I do care about how I look, and there was no guarantee they could make a single reconstructed breast look the same as my natural breast,” Simmons said. “A part of me was kind of sad because these were my God-given breasts. But keeping my one unaffected breast would have meant more mammograms, more biopsies and increased risk. … You don’t want to deal with the possibility of cancer.”
‘I wouldn’t change any of it’
Simmons and Lowry were actually in UAB Hospital together in April 2016, undergoing mastectomies two days apart.
Just a few days before Simmons’ surgery, Lowry organized a Pink Party at Odenville Elementary School for Simmons. She received button-down shirts, gift cards, house shoes and other accessories she would need after her surgery, as the school lived up to her “Fightin’ 4 Michelle” slogan.
Simmons had her mastectomy and reconstruction at the same time. She opted for the most invasive surgical reconstruction, known as the DIEP flap. A DIEP flap is a type of reconstruction in which blood vessels called deep inferior epigastric perforators – and the skin and fat connected to them – are removed from the lower abdomen and transferred to the chest to reconstruct the breasts after mastectomy without the sacrifice of any of the abdominal muscles. In total, Simmons was in the operating room for almost 14 hours.
“My whole experience from diagnosis to surgery was really kind of a blur because I was diagnosed Feb. 11 and had surgery April 6,” Michelle said. “It was a difficult recovery, but I’m absolutely pleased. I’m now five months out from surgery, and I wouldn’t change any of it.”
Lowry had her mastectomy April 8, during which it was found that additional treatment was needed to completely eradicate the cancer. Lowry had four rounds of chemotherapy and 28 days of radiation from May to September, finishing her last radiation treatment on Sept. 28. Now she must wait three months to heal from the radiation treatments before she can undergo her reconstruction.
In the midst of all of this, Lowry’s husband, Blayne, was diagnosed with colon cancer this past April at the age of 33. Genetic testing conducted in UAB’s Department of Genetics Medical Genomics Laboratory uncovered that both the Lowrys carry the CHEK2 gene, which increases the risk of breast, ovarian, colon, prostate and other cancers.
“What has made our story kind of crazy is that I had this gene, and then we found out my husband carries it, too,” Lowry said. “They told us that it’s very strange that both of us would have it. Uncovering the genetics aspect of all of this has been great, though. It’s given us a roadmap for what to do with our children and our family.”
Because both the Lowrys carry the CHEK2 gene, their two children have a 50 percent chance of carrying one copy of the gene, a 25 percent chance of carrying both copies, and a 25 percent chance of carrying neither. They can be tested at age 18 to see if they have it.
Other family members also will be or have been tested for the gene. Tests have shown Lowry’s mother and one of her sisters have the gene. Another sister and her brother will be tested soon. If Lowry’s brother is found to carry the gene, his daughter will be tested at 18. And if she tests as a carrier, she will be able to have her first mammogram – covered by insurance – at age 23.
‘Our team has been phenomenal’
Through this battle, Simmons and Lowry have been there for each other and grown closer.
“We have a bond now that you don’t really understand until you meet someone else going through it,” Lowry said. “We’ve shared other heartaches together in the past; we both struggled with infertility and were able to share those troubles together. Now, we’re sharing this together. I think it helps both of us that we have each other to lean on.”
“I tell Meg all the time that she was my rock through this,” Simmons said. “When she was first diagnosed, yes, I was extremely concerned and worried about her because she is a co-worker and a friend. But I had never experienced cancer, and I didn’t understand everything from her perspective. I didn’t ask her a bunch of questions because I didn’t want to overstep my bounds. When I was diagnosed, however, I immediately went to her because I knew she was going to know exactly what I needed to do, and she has been there to guide me in every way. She’s been amazing.”
Along with the encouragement they have provided to each other, both Lowry and Simmons say the community support has been more than they could ever have imagined.
Odenville Elementary School Principal Christa Urban says Lowry and Simmons are special people who were loved by the community long before their public fights with cancer. The outpouring of support they have received, she says, is a reflection of the people they have always been.
“Meg and Michelle are both innovative leaders at OES,” Urban said. “We are a close-knit family at our school. Since both of these Godly women endured such a tragedy, our community, school, faculty, staff and students continue to rally as a support group for these courageous, faith-driven women. We are so proud of their fight against this disease and the work ethic at OES they have shown through these tiring months of their fight. We will continue to battle through this disease alongside our determined co-workers and precious friends.”
Pink shirts, T-shirt sales, balloons, cards, signs, gift cards, meals, prayers – the Odenville community has covered Lowry and Simmons and their families in love.
“I always say that cancer is a team effort because it’s not just one person fighting cancer,” Lowry said. “Your husband and kids fight it, your family fights it, your friends fight it, you fight it. It’s a team effort. And everyone needs a team when they are diagnosed. Our team has been phenomenal.”
“I’ve been teaching here 13 years, and two years ago, we moved our family to this area,” Simmons said. “As soon as we found out the news, the very next morning, the faculty had prayer with me just like we did with Meg. And they told me how supportive they were of me, and that Meg wasn’t going to be alone in her journey, and I wasn’t going to be alone in mine.
“And parents, students, teachers — everyone has just been amazing. People I don’t even know have befriended me on Facebook, and they’ve come to me asking how I’m doing and telling me how much they’ve prayed for me. It’s been the most amazing experience,” she said.
Lowry’s and Simmons’ next steps together and with their community of supporters will come Saturday, Oct. 15, when they plan to participate in the Komen Race for the Cure event in Birmingham.
UAB Cancer Center physicians offer patients access to state-of-the-art treatments and clinical trials through a nurturing team approach, and their services are routinely recognized as being among the nation’s best. More than 330 physicians and researchers in the center treat an estimated 5,000 new patients each year. To receive an initial or second-opinion appointment, please call the UAB Breast Health Center at 205-801-8266 to speak with a nurse coordinator. To learn more about breast cancer, visit www.uabmedicine.org/breastcancer.