Dorothy: [00:00:00] Not only is Maria Boyce a Crackerjack attorney and board member of The Rose, but she’s also a breast cancer survivor. And one of the things that Maria taught me as I was first interviewing her was that how we respond to diagnosis is very, very important. Maria had triple negative breast cancer, one of the toughest breast cancers to beat, and beat she did. And you’ll hear more about her story and why she has turned adversity into advocacy and all the wonderful things that she is doing to help us serve our uninsured.
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Maria: So Dorothy, I think that one of the things that is so important in having cancer is receiving the support of your friends. And I wanted to just read an excerpt from a book by Margaret Renkl. The book is called “Graceland, at Last,” and I think this articulates better than anything I’ve ever seen, what it means to be a friend supporting someone with cancer.
And the context of this is, she is writing about a time when tornadoes struck her, north of her [00:02:00] hometown, uh, in Tennessee. And this is what Margaret Renkl writes. The day after the tornadoes, I was texting with a friend who moved to Middle Tennessee from Bay St. Louis, Mississippi. Her family had made it through Hurricane Katrina, a calamity that happened on a far larger scale, but making comparisons wasn’t what was on her mind.
Lewis and I now talk about the private Katrina our friends might have. Cancer, death of a child, you name it. One day the sun is shining and all is intact. The next day, everything is broken. And the rest of the world goes on. You’re trapped in your own crazy snow globe that’s been shaken so hard all the pieces fly loose.
This is a truth we all instinctively recognize. [00:03:00] That random funnel cloud of death and destruction could have happened anywhere. It could have come for any of us at any time, and while we understand that we have not been singled out by God for survival, we also understand that we can be God’s hands here in the rubble, helping our neighbors dig out.
She articulates, I think, what it’s like to have cancer and what it is like to receive the love of friends.
Dorothy: Oh, Marie, that’s beautiful, beautiful, to dig out.
Maria: Yeah.
Dorothy: Yeah.
Maria: And the hands of God.
Dorothy: Yeah.
Maria: Our friends wear the hands of God.
Dorothy: I once heard someone saying after the death of her husband, she was just resting in God’s hands. And I thought, what else can you do, you know, someone she loves so much.
Maria: Absolutely. Absolutely. And to be surrounded by that [00:04:00] love.
Dorothy: Right.
Maria: In very tangible ways.
Dorothy: Right. Absolutely. So Marie, you had quite a scare with your cancer. This was not, and I know there is no ordinary cancer, but triple negative is a pretty serious type of cancer, and I want you to tell us in lay people’s terms what exactly that means.
Maria: So triple negative cancer is named for what it is not. Most cancers are really fed by the hormones estrogen or progesterone or the protein HER2, and in triple negative, those are not the drivers of the cancer. It is a much more aggressive cancer.
It is unusual, only about 10 percent of breast cancers are triple negative. And in my case, it’s even more unusual because triple negative [00:05:00] usually affects people who are under 40 or women of color. And often, people who have, are positive for the BRCA gene, and I’m none of those, Dorothy. So, I was 58 at the time of my diagnosis. Um, I am a Caucasian woman, and so it was a very unexpected and unusual diagnosis. Um, because it is so aggressive, it is treated very aggressively. Uh, because when triple negative metastasizes, um, the life expectancy is relatively short. So we needed to do everything we could to prevent that from happening.
Dorothy: Right. And yours was found on routine mammograms.
Maria: It was. We were very fortunate. Um, and I feel very fortunate to have had access to annual mammograms and, um, it was seen on a [00:06:00] mammogram, um, as something that was suspicious. Triple negative is only diagnosed by a biopsy, um, and ultimately, uh, we went to MD Anderson, uh, and the biopsy results reveal the diagnosis.
Dorothy: I know that when I, the very first time I had a chance to really meet and visit with you, uh, you had told me your diagnosis and I went, oh. And, and you said, yeah, that’s the response I got from almost everybody. I felt so bad, and it never occurred to me, I mean, in the breast cancer world, we know that’s a tough cancer, we know, but how the patient might feel, it’s like, oh my gosh, what a lesson you gave me that day.
And, the other part that I remember is, you do so [00:07:00] much about it. I mean, I thought this is someone who really educated herself about the type of cancer, what to expect. And I know you, then you attribute it to the wonderful physicians you had, but I think that’s a little bit of Maria too. I mean, I think you’re going to explore and, and find out for yourself what’s going on. Did you, was that a little bit of the truth there?
Maria: I actually did a lot of research after, um, we knew that, that, uh, I had no evidence of cancer after the, after the chemotherapy and the surgery. Um, After I was diagnosed, my dear husband Bill did a little bit of research and he said, you know, I don’t think you really need to read up on this too much.
Um, and I took his word for it. It was actually good advice. Um, you know, Dorothy, yeah, I think I’d never heard of triple [00:08:00] negative. I’d had several friends. And in fact, my mother had a hormone based, um, breast cancer. And, and frankly, There was every reason to think that’s what I would have had, um, until we found out what the diagnosis was and, um, I, I now realize obviously that, that, that it was very serious and we knew that based on the treatment regimen.
You know, just by way of context, the, the initial tumor that was found was less than a centimeter, like the size of a pea. it was actually never felt. It could only be seen on a mammogram. And so the fact that we then turned around to go into intensive chemotherapy gave me a pretty good clue that this was serious.
And Dorothy, the reality is, is that of women with triple negative who go through chemotherapy like I [00:09:00] did, Only 50 percent end up with an immediate, um, what’s called a pathologic complete response or a PCR, which, which reveals no evidence of cancer. It had not spread to my lymph nodes, so, um, sort of knowing the treatment, that regimen that we went to immediately, and knowing the odds of it working indicated it was pretty serious.
And, and since then I have read a lot more, a lot more of the science articles. Um, It, it is a, a fair characterization to say that I’m somebody who does a lot of research. I did that for my job as a trial lawyer. I love reading, um, articles about science. I actually tried a lot of cases in courtrooms all over the United States involving science and pharmaceutical products and engineering concepts. I love learning and [00:10:00] reading and figuring things out. Complicated concepts that then I can figure out and hopefully explain to a jury on behalf of my client.
Dorothy: I want you to take off your lawyer’s hat.
Maria: Okay.
Dorothy: Did you find yourself ever asking or being upset with your body for betraying you?
Maria: Um, not really. I, I just sort of wondered, this is interesting that this has happened. Um, I also, um, I never said, why me? I, I never, and I still don’t. I, I never did. I, I, I really think, Dorothy, why not me? Um, why not have this happen to somebody who has incredible access to healthcare, who, who can be treated at MD Anderson, by the best doctors in the world who has very good [00:11:00] underlying health? And, and that really helped me get through the rigors of chemotherapy, who has an incredible loving family around her and friends.
And I had every advantage going into this to fight this thing. And so I was ready and I just gutted it up and just we got through it. And so I’ve never said, you know, why did this happen to me? Um, better it happened to me than to somebody who didn’t have the advantages or, or for whom it was caught later.
Um, I also think Dorothy, that it is a blessing because it has given me my path forward. Uh, I know that what God has in mind for me now is instead of, um, advocating for my [00:12:00] clients in the courtroom, it is to advocate for women who didn’t have the advantages that I did. It is to work with you and the wonderful people at The Rose to do everything we can to get underserved and uninsured women a mammogram so that if they have breast cancer, we can find it early. It is to advocate for women who can’t get access to health care. It is to advocate on behalf of getting the funding we need to figure out this disease. And thank God that I have been fortunate to find this path forward. And I, I feel absolutely certain that this is what I should be doing next.
Dorothy: My gosh, you’ve covered a lot of areas there. I want to go all the way back for just a minute to [00:13:00] describe to our listeners, to me, what does gutted up mean?
Maria: I think back on, I have to tell a story about my mom, my mom who we lost in 2005 and she was so influential from heaven in my journey, um, in many ways. But what it’s important to know about my mom is that when she was 30 years old, this would have been in the early seventies, she was diagnosed with multiple sclerosis. Um, MS is a tough disease. They can do a lot for it now. Um, but back then they had a hard time even diagnosing it.
Dorothy: Right.
Maria: And so basically for the remaining 35 years of her life, her body was taken away step by step by MS. But she was so gutsy. She never felt sorry [00:14:00] for herself. She never complained. And I thought back on that. I mean, Dorothy, this was the first time I’d ever been sick. I mean, this was the first time. And I thought back on how courageous she was. And how she just moved forward as her, as her ability to walk was taken away, as her ability to, to see was taken away.
And she was always so positive about her life and, and such an influence on me. And I’ll share two other stories, if I may, about her and her influence on me during my cancer journey. Um, so, before I started chemotherapy, I had a minor operation in which they install what’s called a port. And a port is how, you basically get the chemotherapy drugs into you, and it’s, um, installed right below my, uh, [00:15:00] left collarbone.
And the doctor at MD Anderson who installs ports is named Dr. Brown. And Dr. Brown is famous around MD Anderson because he sings during surgery. And, um, when I had my port installed, I was sort of, you know, out of it, but I wasn’t asleep. So I was, I was aware of my surroundings and Dr. Brown’s sang some beautiful songs. And then he started singing a song called Moon River. And it’s a classic sort of late sixties, seventies song. And it was my favorite, my favorite song of my mother’s, my mother’s favorite song.
Dorothy: Oh.
Maria: So I said, so This is me, I’m sure, I’m, my words are garbled, and I said, Dr. Brown, that’s my mom’s favorite song. Can I sing along with you? And he said, sure. And so I sang to the words of Moon River. My mom was there with me. I can [00:16:00] only imagine how horrible I sounded singing. And he was very gracious to let me sing along. And, um. But of all the songs that he would sing, that he was singing my mom’s favorite song was pretty awesome.
The other thing that I, I know my mom was with me was on January 17th, um, 2023, when I had the lumpectomy to remove, uh, the cancer and this was post chemotherapy. Um, that was the anniversary of my mother’s death. And she was with us.
Dorothy: Oh. Oh, how sweet.
Maria: She was with us in that operating room.
Dorothy: Right. Oh. Thanks for sharing that.
Maria: So when I talk about getting it up, I talk about emulating my mom’s courage.
Dorothy: The thing you talked about having that access and and having your mammograms and and [00:17:00] of course the work that The Rose does is to make sure that women who don’t have that access have it, uh, as best we can. Because so many of our uninsured women are not coming to us for a screening mammogram. They’re coming to us with, they already have a problem. Which, as you know, can change options and, uh, make treatments more aggressive. However, by the same token, triple negative has the most aggressive treatment you can get. So, it’s, it’s like the irony of you with these resources. With this ability to understand how important it is to continue your mammograms and have the access, also having to go through the toughest kind of treatment, is just, um, that’s such a dichotomy and yet so reflective of so much of what our women have to deal with. Uh, do [00:18:00] you think there is an answer for the uninsured?
Maria: I do, um, and it’s a, it’s a complicated answer because it’s a societal answer. I think it is a, in many ways, it is a political answer. Dorothy, some of the work that I do and really what led me to The Rose is through an organization called the Episcopal Health Foundation, a wonderful foundation set up by the Episcopal Diocese of Texas that focuses on health equity issues.
And, um, we are so proud to, to, we are so proud to support The Rose and the great work that it does. But one of the recognitions that we have is that in our society, um, there are what are called social determinants of health, also called non medical [00:19:00] drivers of health. And these are factors that directly affect health. They may be, uh, lack of access to good housing, lack of access to healthy foods, to transportation, to education that leads then to, you underemployment that leads to a lack of insurance. We need to be addressing, and the Episcopal Health Foundation is doing a good job of supporting organizations that are addressing the consequences of those social determinants of health and ideally addressing the determinants themselves.
I think we also have to recognize that legislatively, um, we need to use our voice and our vote to support, People in power who support providing care, whether it be Medicaid, whether it be research funding to [00:20:00] help people with breast cancer. And so there are answers, they are complicated answers, and we as a society really need to focus in on answering those questions and lifting up those who need our help, need our support, um, so that if they are diagnosed, they can, they can fight this disease.
Dorothy: Now, you know, Maria, some of the words you’ve just used in the descriptors, our listeners may not have heard. And, uh, I think you took that progression very well, you know, where you live, what you eat, your education level, your ability to earn a living. And your ability to be in a situation that allows those other benefits, resources. All of that adds up. All of that can mean so much, uh, more. And how you can deal with a [00:21:00] health care issue.
Maria: Absolutely. I am. I’m so in awe of the women who you have had on your podcast. I think specifically of Vanessa who was diagnosed. Um, she was living in a shelter with young children. Um, and the courage that she had. Talk about gutting it up, Vanessa. Vanessa is a hero of mine, um, and I, and I think of, um, of other women who, um, for them getting a mammogram is, is a day off of work. It’s a decision perhaps not to be able to feed your family that day, um, to get pay and, and the work that, that you and The Rose are doing to try to bring healthcare to rural areas where our rural hospitals have been, um, decimated. Um, the decisions that [00:22:00] have been made, um, to take, uh, money away from rural hospitals and to provide rural care and the fact that, that The Rose is providing mammograms to women who really wouldn’t have access to it. Dorothy, there’s nothing more important than that, because, again, if we can get breast cancer early, the outcome can be so different, and, and that’s, that’s what you and The Rose are doing— is we’re, we are providing the service to people just who don’t have access to it. And of course, providing that to underinsured and uninsured women. So important.
Dorothy: And so, you know, it’s also that part of getting over those cultural misbeliefs or misconceptions, or beliefs. All the things that might, you might not want to have a mammogram that we’ve had to also address. [00:23:00] Which is no criticism. It’s I mean, I remember going through a time with my husband who had heart surgery, not knowing anything about heart issues. I mean, my goodness, I’ve been in health care 40 years, but I don’t know anything about that? No. And if you don’t, how are you going to deal with it? And how are you going to know this is something important to do?
I think of all the things The Rose does, it’s staying with that woman after she’s been diagnosed. And making sure that she understands you can’t skip this next treatment. You can’t, you’re going to have to find a way to get to it. And doing whatever we can to make sure they do. But there’s still a lot of stigma around breast, around surgeries, around all of those things. That, um, that’s going to take a long time to address, I’m afraid.
Maria: It is, and I think, um, again, [00:24:00] Um, having the ability and providing the ability to get to the treatments, um, my course of radiation was 20 treatments, five days a week. And the transportation alone for some women to get to the radiation center, um, can be daunting.
Dorothy: Oh yes.
Maria: Um, or they don’t have, um, a job like I had where I could make my own hours and make sure that I got to the treatments or that I was able to be healthy enough to, uh, get through some pretty tough chemotherapy because I had underlying good health. So I don’t think we can understate the importance of addressing these social determinants of health so that when a health crisis occurs, um, we have the strength, we have the [00:25:00] support, to make it through. Um, I think one of the most important things my husband did was he came to every appointment that I had, um, and he took notes and he listened and we would leave sometimes and he had heard one thing and I had heard another because it’s so overwhelming and to have a friend who can help you, um, through those appointments, or I think of, of three of my women friends who sat through the chemo sessions with me when Bill was not able to come. To have that support network, I think, is um, is instrumental.
Dorothy: And sometimes hard for us to ask.
Maria: Yes.
Dorothy: And easier when they just show up. So that’s one message I continue to hear from almost everyone. Just show up. And I think the other thing that you’re touching upon, you are a perfect example. Tough cancer. [00:26:00] Caught it early. I mean, you’re done. You know, I mean, you’re, you’re on to your next phase of life. And if there’s anything that we need to really stress, it is that early detection. It is so important. Talk about underlying health. You know, I, I don’t think I’ve ever heard anyone use that expression in context with, this is how I got through. This came up. Just speak to that a little bit.
Maria: Sure. I, um, had been blessed with very good health my entire life. I, um, had the ability to eat healthy food, to get exercise. I have a very incredibly supportive and loving family and loving friends. Um, I have a job that I absolutely loved. I loved being a trial lawyer.
I got to do it for 36 years until I decided to retire to, to really pursue patient advocacy. [00:27:00] Um, all of those factors, um, Led me into this battle, and I, and it is a battle, um, feeling very strong, and I can’t state enough the confidence that we had in being cared for by MD Anderson, by Dr. Litton, and by all of the, um, wonderful people who we met there who were so compassionate. Um, who gave us all the bad news, um, but were with us side by side. And we knew we were in a wonderful place to get treatment for a tough disease. Um, there was a lot of confidence that we had in knowing we were in the right place and we felt very blessed to be able to be treated there.
Dorothy: And one of the number one things we often hear is how much belief that woman has in her doctor, how much confidence she has [00:28:00] in it. It makes all the difference in the world in her recovery. She’s not over questioning, you know, she’s going to follow the plan as it is and understand there could be hiccups along the way.
Maria: Absolutely.
Dorothy: That’s, that’s one thing I think MD Anderson is very good about saying. “If. “And be prepared. Yeah.
Maria: Absolutely. I can, I can share a story when, when, right when I was first diagnosed. And we realized that this was a very small tumor, less than a centimeter. Um, and Dr. Litten had explained the chemotherapy that was um, about to happen, a standard of care chemotherapy. I asked her, is there any other alternative that we have? This tumor is so small. And she said so poignantly, Maria, this is the time I have to cure you. After this, I can only treat you. And I let that [00:29:00] sink in and I realized that, yep, we got to get it now.
Dorothy: Wow.
Maria: We got to get this cancer now. It is serious. And, but I appreciated that. That was exactly what I needed to hear is that you have this pea sized tumor, but we got to get it and we got to get it dead, um, as quickly as we can. And that was, that was, um, that was really, uh, the straightforward advice that I needed. Um, I was advocating for myself and she said, nope, we got to do this. Um, I’ll, I’ll share another story, Dorothy. Um, I had two types of chemotherapy. Uh, the first type was the, was the tougher one. And about halfway through, um, after the, after the first type of chemotherapy wrapped up, they did a, a, a scan to see how, how it was doing.
Um, The initial tumor [00:30:00] had gotten smaller. But there were some new calcifications or new areas of cancer that had appeared. And, um, I remember, um, Bill at an appointment talking to Dr. Litton saying, well, it’s really good that the first tumor’s smaller, isn’t it? Isn’t that a really good sign? And she said, No, we have to wait till the biopsy to see. What’s in there? It doesn’t mean because it’s smaller. It doesn’t mean it’s gone. It doesn’t mean the cancer is dead. I remember a podcast that you had with Dr. Raz?
Dorothy: Uh huh.
Maria: Where he talked about the purpose of neoadjuvant, which is pre-surgery chemotherapy and one of the The benefits of that is it causes cancer cells that aren’t apparent to come to the surface. [00:31:00] So although we saw this second area of cancer was actually larger than the first one, that was exactly what we wanted the neoadjuvant chemotherapy to do. It brought to the surface another area of cancer so that we knew to take it out when the surgery happened.
Dorothy: Oh, good point. Yeah.
Maria: So that, that, I think his explanation of neoadjuvant or pre-surgery chemotherapy and the purpose of it was, was very helpful. I remember when we were telling people about my cancer and we were trying to figure out how to explain it. We said, we got it very early, but we’re gonna have to undergo chemotherapy. And, people would normally assume, well that’s good, it’s to shrink the tumor. And, and actually in my case, it really wasn’t, the tumor was small. The, the purpose of neoadjuvant chemotherapy for [00:32:00] me in triple negative was to try to kill the cancer before it spread and, and we were successful in doing that.
Dorothy: One last question.
Maria: Yeah.
Dorothy: So, for your children.
Maria: Yeah.
Dorothy: Your girls. What’s your wish for them?
Maria: The best day that I had, you would expect it would be when I found out after some pretty arduous treatment that I had no evidence of cancer. That’s what you would think the best day would be. But in fact the best day was when I found out I did not carry the BRCA gene. Because I didn’t want to pass that on to them. We are blessed with two amazing women as daughters, and I was able to see my older daughter get married last October and this past weekend. I was able to see my younger daughter graduate from law school. And so going through this with them seeing the love of their friends surround them and support them [00:33:00] was um, an incredible sight to see and, and I wish for them the strength and the love that they give to my husband and me every day.
Dorothy: For the rest of their lives.
Maria: For the rest of their lives. They are amazing young women and, and.
Dorothy: Well, of course. Look at their parents. Come on. Thank you so much, Maria, for being with us today and for sharing some really different kind of things that we don’t always want to talk about. And for those personal stories. Makes such a difference.
Maria: Well, thank you for the opportunity, and thank you for what you do every day to help women ideally not go through this journey, but if they do, hopefully position them to be able to fight breast cancer. I’m so privileged to be on the board of The Rose and, and so honored to, to be here with you today.
Thank you.
Dorothy: And that’s why we can do these things. [00:34:00] Thanks again.
Maria: Thank you.
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