Cancer runs in John Foulston’s family.
His mother, maternal grandmother and a 28-year-old first cousin on his mother’s side all died from breast cancer.
And 20 years ago, John underwent a radical prostatectomy after having been diagnosed with an aggressive form of prostate cancer.
So when the 74-year-old retired lawyer and former judge-turned-Butler County emergency medical technician and educator stepped out of the shower and noticed that his left nipple was retracted, it caught his attention.
He asked his wife, Peggy, to check it.
"That's a lump," she told him.
On Friday, April 2, went to see his primary care physician, Norman Koehn, MD, an internal medicine specialist at Ascension Medical Group Via Christi on Murdock, who scheduled him for a mammogram Monday morning.
"My results were inconclusive, so they did the biopsy then and there," says John.
The bad news ...
On Tuesday evening, he got a call from Dr. Koehn, who said, "It's not good. There's a malignancy."
He was referred to breast care specialist Patty Tenofsky, MD, who along with her nurse navigator, Terri Leschuk, RN, sat down with John and Peggy and developed a plan of treatment.
John was scheduled for surgery on April 22 at Ascension Via Christi St. Francis. On the day before surgery, he was injected with a radioactive solution in the skin surrounding his left nipple to help identify the first or sentinel, lymph node. Using a hand-held gamma counter to locate the sentinel node, she removed it and sent it for biopsy to see if it contained cancer cells--an indication that it may have spread to other lymph nodes.
Fortunately, the lymph nodes were negative.
A plan for the future
Dr. Tenofsky next removed the tumor, which was less than 2 centimeters, and sent it for OnctoType testing to determine the best course of treatment.
The results showed that his was a relatively aggressive type of cancer. So after finishing four rounds of chemotherapy with Phu Truong, MD, an oncologist at Cancer Center of Kansas, he began taking a selective-estrogen-receptor-modulator, or SERM, medication and will do so for the next four to five years.
Additionally, given his extensive family history of breast cancer, he underwent testing to determine whether he had a BRCA gene mutation that indicates an increased lifetime risk for breast and other types of cancers.
To his surprise — and that of Dr. Tenofsky, who serves as co-medical director for Via Christi’s Cancer Outreach and Risk Assessment program — he tested negative.
“I’m guessing you may have a mutation that has not yet been discovered,” Dr. Tenofsky told him, adding that “we will need to watch for that carefully in the future.”
In the meantime, John continues to enjoy his active life on their acreage in rural Whitewater.
"Each day is a gift," he says.