The following passages are excerpted from Close to the Heart: A Family's Encounter with Breast Cancer, Copyright 1997, Barry D. Teater. No part of this publication may be reproduced without the written consent of the author.

Friday, September 27, 1988, was a perfect Indian summer day in Raleigh, North Carolina. The air was cool and crisp, and the sky was electric blue. Normally on a sunny Friday afternoon, Gena Lynne Teater would be driving home from her accounting job, singing to the rock music on her car radio, tapping her fingers on the steering wheel, and getting in the mood for a festive weekend with friends. But on this day the car radio was silent and her fingers clung tightly to the wheel. She was overwhelmed by feelings of acute loneliness. She viewed everything and everyone with frightening clarity as if she were seeing them for the very last time.

"In a few months from now will I even be alive," she wondered ominously, fighting back the tears.

Minutes earlier, her doctor had given Gena the shock of her life. He had looked her in the eye, flinched and said, "We've got some bad news. You have breast cancer."

At that terrifying instant, Gena became one of the 180,000-plus women who are diagnosed with breast cancer each year. The line was drawn for an epic personal battle.

Gena approached her mastectomy with steady resolve. She didn't think of the surgery as an amputation of her womanhood, but as a necessary step toward curing a potentially fatal disease. Her breast was her own mortal enemy that had to be destroyed, and she was ready to get rid of it. She literally said good-bye to it a few days before surgery.

Lying on the operating table minutes before the operation, she found an inner peace like none she had ever experienced.

"I was so relaxed," she wrote in her diary. "God was with me."

Her last words to the surgeon before going under anesthesia were, "Do your best work."

I was glad Gena considered the mastectomy in positive terms and had already planned to reconstruct her breast as soon as possible. Yet, I feared the social implications of her temporary disfigurement. It was difficult enough for a divorced woman to meet a suitable partner, let alone if part of her womanhood had been pared by a surgeon's scalpel.

How would she get along in a culture obsessed with breasts? Would men run away when she told them about her misfortune? And if a man could accept her altered appearance, could he make a long-term commitment to a woman with a life-threatening disease? Her prospects didn't seem very bright.

"Many of the men I dated during the next year were friends or friends of friends, all of whom knew about my breast cancer before they called me for a first date. Obviously, they weren't put off by it. I dated a few men who didn't know about my cancer, and I had to decide how soon after the first date to tell them. I arbitrarily decided that the third date was the appropriate time to bring up the subject. I didn't want to scare them off before we even barely knew each other, but I felt like I owed them the honesty before the relationship advanced too far so they wouldn't think I had deceived them.

"I feel like there was only one man who quit calling me simply because of my breast cancer. I decided it was just as well to know early on that he wasn't strong enough to weather tough times and that I was better off finding out before I became emotionally involved. Otherwise, I believe that my other dating relationships ended for the usual reasons and not because of my cancer."

Just when she had fully recovered from a mastectomy and chemotherapy, finished reconstructive surgery and met the ideal companion, Gena was suddenly kicked in the ribs again. Her cancer had apparently metastasized, or spread, to her lungs.

"I really had a deep-seated feeling that after my chemo I would never get cancer again," she recalled. "I couldn't help but ask 'why me' because in my mind my cancer wasn't supposed to recur. I had played by the rules by detecting and surgically removing the cancer before it had spread to the lymph system, and I had taken the added precaution of undergoing chemo. I considered a recurrence to be very unfair.

"Also, at the time I was happier than I'd ever been and therefore had more to lose if I died. I felt like my happiness was well deserved, and now cancer threatened to take it all away. I had already battled this disease with as much courage and spunk as anyone, and it wasn't fair to have to prove myself all over again."

Feeling victimized, Gena searched for answers to the nagging question "why me."

"I came to realize that there are no answers to that question and that I should instead be pondering such constructive questions as how I could best channel my energies and resources to beat cancer. Asking 'why me' is a normal reaction when diagnosed with cancer, but if you dwell on it too long it becomes counter-productive. I decided to exercise as much control over my battle with cancer as possible, empowering me and making me feel less victimized."

In dealing with Gena's cancer, our family had become adept at pushing her situation from our minds at certain times and enjoying the moment. We learned that it was too taxing to live in a constant state of alarm. Maintaining a sense of everyday normalcy was far more productive. There was a time for working, a time for playing and a time for dealing with cancer, and it was best not to mix the three.

High-dose chemotherapy with a bone marrow transplant . . . seemed to be the one treatment that could give her a shot at a remission or even a cure.

Since 1985, doctors at Duke University Medical Center in Durham, North Carolina, had tried this bold approach to treating metastatic breast cancer. Early results of the Duke program and others like it had indicated that high-dose chemo with bone marrow support could produce significant remissions, or periods of no disease, in some patients, and there was cautious optimism that it could perhaps even cure a small percentage of women.

Women were enrolling in bone marrow programs at Duke and around the country in growing numbers. According to the Autologous Blood and Marrow Transplant Registry of North America, more than 4,000 breast cancer patients received this form of therapy in 1994, up from only 522 in 1989. Despite the growing demand for the treatment by desperate patients, however, doctors at Duke and other research hospitals would need to treat and follow more patients over longer periods to determine if the treatment is any more effective than standard chemotherapy.

The treatment is difficult and complex for both the patients and the physicians. It begins with the partial removal of the patient's bone marrow, which produces the blood cells constituting the immune system. With the marrow safely frozen and stored, doctors give the patient chemotherapy in doses three to six times stronger than standard doses. Of course, while these drugs are killing cancer cells they are also destroying the patient's remaining bone marrow. Wiping out the bone marrow with chemotherapy would be fatal to every patient were it not for giving back some of her own healthy marrow that is collected and frozen before the chemo onslaught.

The Duke program carried great risks, Gena's oncologist cautioned. In high doses, chemotherapy is extremely toxic to the body's cells, tissues and organs. Patients are highly vulnerable to infection, bleeding and organ failure. Between 10 and 20 percent of women died from the procedure due to bacterial or fungal infections, internal bleeding, and heart, liver or kidney failure, we were told.

These mortality statistics were frightening, so we tried to invert them to show how encouraging they actually were: eighty to 90 percent of the women survived the treatment, and some of those had significant remissions of advanced breast cancer.

The last patient Gena's oncologist had placed in the program – a woman in her 40s – had died from the procedure, he said. Despite this caution, he strongly recommended the program for Gena if her hormonal therapy failed. He would suggest the same to his own wife, daughter or sister if they were in Gena's predicament, he assured us.

We were simultaneously hopeful and fearful of the Duke program. It was a little like Russian roulette. It held the promise of a remission and the hint of a cure, yet the treatment could kill Gena long before her cancer ever would.

Gena used to require about one and a half hours to prepare herself for work and social outings. Now that she had no hair to wash, dry and style, no leg or underarm hair to shave, and no contact lenses to insert (due to dry eyes), she could be ready in 30 minutes or less – like a Domino's pizza, we quipped.

"Being able to laugh and joke about your hair loss or other changes in your appearance helps put those around you at ease," she said. "Often, people aren't sure whether to comment on your new appearance the first time they see you, so I usually took the lead by patting my wig and asking them how they liked my new 'do.' This cued people that I was open to discussing my new appearance and how my treatment was going."

When Gena was born in April 1959, an article of prophetic importance to her and thousands of other future cancer patients was published in the New England Journal of Medicine. It reported the first experiments by doctors to treat human cancer with bone marrow transplantation. In a last-ditch attempt to save three young children from recurrent leukemia, doctors in Massachusetts gave the children potentially lethal doses of total-body radiation followed by infusions of their own bone marrow that had been harvested during remission and stored.

Two of the children died within days of the treatment. But the third – a plucky 2-year-old girl – gained a remission of her cancer. Three decades later, Gena and thousands of other cancer victims would stake their own lives on the promise of this same type of treatment.

The pungent odor of bone marrow thawing in a preservative filled the hallway of the ninth floor. Reminiscent of rotten eggs or raw oysters, the smell always signaled to the nurses when a patient was getting her marrow back. On her ninth day at Duke it was Gena's turn to receive her marrow, a milestone in her treatment.

Unlike the painful harvest of marrow from her hip bones a few weeks earlier, the re-infusion was simple, quick and painless. It took only 25 minutes to give back the precious substance. From a syringe, the watermelon-colored marrow flowed through Gena's Hickman catheter and into her bloodstream. From there it would eventually migrate back to the bones, re-engraft, and resume its job of churning out blood cells, rebuilding her immune system virtually from scratch.

Our family had not been singled out for medical misfortune; there were plenty of others around us who were waging their own wars. All we had to do was read the newspapers and visit the crowded oncology clinics to see how pervasive cancer was. Sooner or later, the disease engages us all, directly or indirectly. The only questions are how close to the front lines it will draw us and how fiercely we will fight back.