Horses ordinarily don’t have much wisdom to offer about cancer. But when former Siteman Cancer Center patient Marsha Morlan was facing a double mastectomy for triple-negative breast cancer, she found an unlikely source of inspiration and strength in a beautiful palomino quarter horse who lives on her farm in Mount Vernon, Ill. “Palomino” is a term for a golden-colored horse – Ruger, Morlan’s palomino, brought light into her life when she needed it most.
Morlan resides in the same farmhouse she grew up in. She’s always been passionate about animals, especially horses.
“I’ve been around horses since I was 5 years old. They’re the love of my life,” she said. Today, she owns nine of them. One was a rescue, but she’s raised the others since they were foals. Ruger, the palomino quarter horse, joined the herd a few years ago. Morlan enjoys trail riding with her favorite horse, Rocky, in her spare time.
In April 2017, a routine mammogram detected a tumor in Morlan’s left breast. After further testing, she was diagnosed with triple-negative breast cancer. The diagnosis triggered a deep fear: Morlan’s mother, Mary Elizabeth, had died of the same cancer in 1992, and she worried that her outcome would be the same.
Fortunately, there were a number of treatment options to explore. Triple-negative breast cancer is aggressive, but it also tends to respond well to chemotherapy. Morlan began chemo on June 1, 2017, and underwent 16 rounds of treatment with Guillermo Rodriguez, MD, from Illinois Oncology in Swansea, Ill., now part of Siteman Cancer Center.
“Marsha was interested in knowing as much as she could about her disease process,” Rodriguez said. “From the beginning, she had a very positive attitude about her new diagnosis. She knew that she could potentially be going through difficult times, but always had a smile on her face.”
“The chemotherapy was the hardest part,” Morlan said.
To better ensure that the cancer could never return, Morlan also chose to have a double mastectomy. She wanted to have the procedure at Siteman because of its excellent reputation and opted to see Virginia Herrmann, MD, the same surgeon who had performed her mother’s surgery. Herrmann helped assuage Morlan’s fears.
“I was not in a good frame of mind when I was diagnosed because of my mother,” Morlan said, “but the first thing Dr. Herrmann said was, this is 20 years later and this is not the same case as your mother.” Herrmann helped Morlan realize that breast cancer is not a death sentence anymore.
“A diagnosis of breast cancer is difficult, especially when you have been on this journey with a loved one,” Herrmann said. “But newer treatment options today allow us to target a woman’s cancer and individualize her treatment, with better outcomes.”
At Siteman, Herrmann sought additional advice on Morlan’s case, tapping into the cancer center’s network of experts.
“She put my diagnosis and my information before a tumor board at Barnes and suggested a team of doctors to work on how to handle the situation,” Morlan said. The doctors on her team put her mind at ease. “It was reassuring to talk to the doctors, who were up-to-date and knowledgeable about the disease,” she said. “You have to be comfortable and have faith in the doctors you have.”
In return, Morlan’s doctors admired her grace under pressure.
“Marsha paid close attention to the information we discussed,” Herrmann said. “She was always gracious, attentive, and kind, at a time when most of us would be otherwise. We feel like we are her extended family.”
Herrmann and the other members of Morlan’s team supported her decision to have a double mastectomy, but the reality of the operation – what it would mean for her and her body – was still overwhelming. Feeling weak and ill as she underwent chemotherapy, Morlan was at a particularly low point as she faced the mastectomy. That’s when she realized that Ruger the palomino had an issue with his eye.
“During the chemotherapy treatments, I was upset about my hair loss, and so, so tired. I felt like I hadn’t gone outside to check on my horses as often as I should have. It was in the summer and he was out in the pasture with the other horses,” Morlan said.
When Ruger’s eye failed to improve, despite her best efforts and those of her vet, Morlan’s friend drove her and her horse to the large animal hospital at the University of Illinois, where she got bad news.
“They said that he had already lost most of his sight, and that he was in a lot of pain. So I had to make the decision for them to take his eye out,” Morlan said.
This was a difficult step to take: Morlan initially felt that removing the diseased eye “maimed him – made him not as perfect as he was.” As she grappled with her own illness and upcoming operation, it seemed tragic that the horse, like her, would be disfigured.
But as Morlan watched the horse recover, she began to take courage. Far from being damaged, the horse thrived after his eye was removed, and what was true for him could be true for her, too.
“The horse is the same horse with the same sweet personality. So I can still enjoy him. I just had to adapt to how he sees with the one eye and be safe,” Morlan said. “What happened to my horse made me realize that my breasts were not what made me as a person, so when I had to have them removed, I was able to accept what I looked like after all the surgeries were complete.”
Morlan proceeded with the double mastectomy in November 2017 at Christian Hospital, which had recently become a Siteman satellite location. Starting in January 2018, she began 28 sessions of radiation under the supervision of Brian Baumann, MD, a Washington University Physician at Siteman. Once her treatments were complete and her mastectomy had healed, she was ready for a reconstructive procedure.
“My decision to have reconstruction surgery was solely based on the fact that I enjoy swimming and going to the pool or beach. I just wanted to look normal in a bathing suit,” Morlan said.
Morlan had been vocal about her wishes to have reconstructive surgery even in her initial appointments at Siteman. Her treatment team included a plastic surgeon, Donald Buck, MD, who met with Morlan early on to discuss her options and plan for the procedure. On September 19, 2018, she underwent D.I.E.P. flap surgery, a technique that uses muscle tissue from the abdomen to recreate the breasts.
Some complications arose in recovery when the blood vessels in Morlan’s new right breast initially didn’t take. To stimulate blood vessel growth and promote healing, Morlan’s doctors suggested that she receive hyperbaric oxygen therapy. Morlan had 15 sessions of therapy, which involved lying in a pressurized treatment tank and breathing in pure oxygen. It sounded much scarier than it actually was.
“You’re in this little capsule where you could watch TV. It improved the healing process on my stomach extremely well,” Morlan said. “It aided to save and protect the transplanted material so I wouldn’t have to have another surgery. And the outcome was very good.”
Today, almost two years after her diagnosis, Morlan’s life is returning to normal. Looking back on her experiences, she has a few words for women and fellow breast cancer patients. “Well, first of all, please make sure you have your yearly exams,” she said. “And if you are told you have breast cancer, understand that it’s no longer a death sentence. It’s not a pleasant thing to go through, but it is doable.”
Cancer patients shouldn’t hesitate to make their surroundings as safe as possible, Morlan said.
“Eat right, and do what you need to do to keep your environment healthy,” she said. “This can help you avoid setbacks.”
Morlan also encourages patients to be open with their feelings and accept “help, kindness, and prayers” from others. She finds that many patients try to hide their cancer and, in the process, close themselves off from potential sources of support. “That, to me, is a toxin, and you need to just let that go and let people in and let them help you and talk to you and help you through it,” she said.
“My horses are fine, they made it, I made it, we’re here and alive. I plan to do a lot of catch-up riding this summer,” Morlan said. “I feel like I’m back to my old self.”