Like many women, Lori Yourell made some big decisions at a young age decisions like getting married and having children. Unlike most women, she made these decisions because she didn't think she'd live to be 30.
Yourell, now 38, was diagnosed with Hodgkin's lymphoma when she was 18, just as she was graduating from high school. Her plan was to start college that September to become a pediatric nurse, but the radiation treatments she received to her chest and abdominal areas just exhausted her.
"The school held my seat for one semester, but I still wasn't ready by the time the second semester started "Thankfully, the Hodgkin's was contained in one node in my neck and one in my lung."
What Yourell didn't understand at the time was that such extensive radiation could cause other types of cancer, in particular breast cancer, which can occur 10 to 20 years later. Her oncologist, Dr. Dennis Slater, remembers Yourell as "a sweet and innocent 18-year-old" who, while scared of her cancer diagnosis, was also rather blissful and naïve.
"Radiation causes chromosomal damage," says Dr. Slater, founder of Eastern Connecticut Hematology & Oncology Associates, and is affiliated with The William W. Backus Hospital in Norwich and Lawrence & Memorial Hospital in New London. "And for young people who receive mantle radiation (which encompasses the neck, chest and upper abdomen) the risk for additional cancers in those areas is substantially higher in the second and third decade after the radiation treatment ends, so we recommend yearly screenings."
Yourell remembers not taking it too seriously at the time.
"When I hit the five-year mark I figured I was pretty much cured, but then Dr. Slater said, 'see you next year,' and I was shocked and angry. I didn't realize that this would be a life-long proposition."
She went on with life, returned to college, and got married when she was 24. She received her bachelor's degree in child development psychology from Eastern Connecticut State University and then her master's in education from Sacred Heart University in 1998. She started teaching fourth grade at Griswold Elementary School in 1999. She was 28.
Just six weeks after starting, she was diagnosed with breast cancer, exactly 10 years after completing her radiation for Hodgkin's. "When I look back on that day now, I am grateful that Dr. Slater knew what he was looking for. He found it immediately and was able to treat it immediately. Together we decided that a mastectomy would be the way to go, based on the mammograms and the bone scans, and I wouldn't need any additional treatment like chemotherapy."
Yourell made another important decision at that point. "I didn't want breast reconstruction because I still hadn't had a child and I knew that the process of reconstruction, which involves cutting stomach muscle, would make it difficult for me to carry and deliver a baby."
So she got pregnant and had her son Cameron a year later.
"When I look back at that time, I realize that I thought my life would be over by the time I turned 30. I wanted it all: a husband, children and a house with a white picket fence. I felt like I didn't have any time."
In the meantime, she knew that Dr. Slater was concerned about her remaining breast and so she continued to get mammograms every six months.
"I can't stress how important it is for women who receive mantle radiation to get annual mammograms and to not smoke," Dr. Slater says. "And the mammograms need to start much sooner than in women who haven't received radiation, around age 25 or 30."
It was just three years later that she received her second breast cancer diagnosis. "By that time I was fully involved with the Survivors In Fashion event that the Backus Foundation puts on every other year," Yourell remembers. "And I used to schedule my mammograms for the day of the show as a symbolic gesture. I'd have my mammo that morning and then do the show that evening.
"After the appointment I went to pick my son up from my parents' house and when I got home there was a message telling me to call my oncologist immediately. I was in tears. And Cam, who was diagnosed with autism when he was two, didn't speak...he never said anything. I hugged him and said that I loved him. And for the first time ever, he said it back to me. He said 'I love you' and at that moment I knew everything would be okay."
And so the day she got her third cancer diagnosis in less than 15 years, she stepped on stage with a smile on her face.
Barbara Chiangi, a two-time breast cancer survivor herself and the Producer/Director of the show, remembers it this way: "Lori showed up before the show and told me that the cancer was back. Just five hours before the show she'd had a 'bad' mammo. But she went out there like a trouper. How many people do you know who would go out on stage for a fashion show, with a smile on their face, five hours after having been diagnosed with breast cancer for the second time? That's Lori!"
Two days later, on the Monday following the fashion show, she had her second mastectomy. "I told Dr. Slater to just take it. I didn't want to go through waiting for it to show up again."
Yourell is pretty positive these days. Because her breast cancer was most likely caused by the radiation and was not genetic or hormonal, her prognosis is excellent.
"I think I'd be lying if I said that when I start to feel sick or run down that I don't think 'oh no, could it be back?' But I also appreciate my life so much more now that I am not worried about doing everything before I die. There are moments when everything catches up with me and I look around and think about all the fear I had, and the decisions I made because of that fear."
Yourell's first marriage ended in divorce four years ago, but she says she realizes the marriage was a mistake, one she made because of her cancer.
"I made that decision at a time when I had no clue about who I was. You have to love and understand yourself first, before you can love someone else in the same way. Even though experiencing cancer at such a young age led me in a direction I'm not sure I would have taken in such a hurry, it ended up being positive because I was able to have my son -- something I thought cancer would rob me of, but didn't."
This year Yourell married for the second time and became a mother again, this time to her new husband Brendan Yourell's two children, Owen and Molly. They live in East Lyme and she still teaches fourth grade at Griswold Elementary School, where she was named Teacher of the Year in 2006.
"I don't look at life as something I have to rush through because I'm going to die. I think about how long and wonderful it will be. I'm actually grateful that I had cancer because it allows me to see the positive in myself. And in turn I gained the strength to reach out and help others."