We never would have guessed that a group interview with breast cancer survivors would be as hilarious as it was poignant. But as breast cancer survivors Bibeth Orteza Siguion-Reyna, Kara Magsanoc Alikpala, Melissa de Leon and Maritoni Fernandez revealed during this animated discussion—it was to promote Silver Linings, the educational forum and homecoming for breast cancer survivors staged by the ICanServe Foundation, on Sept. 17 at Grand Regal Hotel in Davao City—a sense of humor, among other strengths, can help carry you through.
“Akala ng ibang tao na kapag may cancer ka, iyakan kayo ng iyakan,” said Siguion-Reyna. “When we’re together, tawanan kami ng tawanan, at kain nang kain.”
Bibeth Orteza Siguion-Reyna (Bibeth): I was diagnosed November 2004, I was stage 3C. Naramdaman ko that my right breast was heavier than the rest of my body. Hindi siya nakita sa mga mammography, but I prayed on the way to the hospital, ’di ako mapalagay. The mammo didn’t say it, but I knew there was something wrong. On the way to the car, I called up a friend, si Kitchie Benedicto. I said, “Kitch, I think something’s wrong with me.”
I used to be a smoker. In August of that year I got relatively healthy, so I got fat. I went into boxing kasi ang taba ko. I was thinking that if I didn’t quit smoking, baka hindi ko na-realize na there was something wrong.
Did you suspect it was cancer?
Bibeth: I knew there was something wrong. On the way to Makati Med, Kitchie said, “My nephew-in-law will be your medical manager.” Miggy Fores is married to Kitchie’s niece. “Lord, give me signs that all will be well,” I prayed. Pagdating ko doon, sabi ni Dr. Fores, “I have a surgeon with me, she works for Erap, the family of Erap, Tita Armida. Your oncologist used to be Carlitos’ classmate in college.”
There were things like these all the way, so you’d feel better. The private nurse assigned to me said, “Waray ho ako, maingay ho kami talaga, baka you might not want me to be your nurse,” and that was the last sign, dahil ang nanay ko Waray, and I know they’re really, really noisy. (Laughs)
I knew when I’d be recovering from the operation, the nurse would be with me. What better sign do I need? On the record, though, I’m one of those few patients operated on at Makati Med who didn’t require sleeping pills after the operation. I just slept.
As writers, we have such wild imagination that when you imagine seeing God, you think it will be in a “Sound of Music” setting with a mountain. Ang sa akin, banyo ng Makati Med. Sabi sa akin ng nurse after naoperahan na ako at confirmed na, “isha-shampoo ko kayo.” Sabi ko, “Tatayo ako kapag nahilo ako, saluhin mo ako pero habang nakatayo alalayan mo na lang ako.”
The position was this (demonstrates), the lababo was there, you see the bedpan here and there was a stillness and everything was white. There was just this feeling, this voice, it just hit me—all will be well.
You weren’t on painkillers so ’di ka nagha-hallucinate?
Bibeth: No drugs. Ang disappointment ko lang, nasaan ang view! (Laughter) Nasaan ang vista, wala! The last thing I remember was the bedpan! After that I was very, very calm na.
Did you cry?
Bibeth: No. There’s a verse in the Bible that speaks about peace that encompasses all understanding, hindi mo talaga maintindihan kung saan galing. Sabi ng doctors ko, kapag mayroon kayong pasyente na cancer ang diagnosis, you take a moment outside the door, what to say to make the patient better. Ako lang ‘yung patient na pagpasok nila may stand-up comedian sa loob.
When I had that bathroom experience—ang pangit pakinggan ’no? (laughter)—when I had that bathroom experience with the Lord, sabi ko “Lord, take over.”
My second opinion was done for me at Sloan Kettering in New York. Ang hirap kumuha ng appointment, magpa-Pasko, pero priority ang sister-in-law ko. Hindi niya tinigilan si Lita Brown, hanap sila ng mga doctor.
The head of the center was Roberto Moya. In my first meeting with him I asked, “Lord give me a sign.” We were waiting for the guy, so that I could get an appointment with my doctor. He entered and said, “O Bibeth, sabi ko na nga ba ikaw yung pasyente e, Roberto Moya po, pamangkin po ako ng asawa ni Chichay. Noong nasa Maynila po ako, nagtrabaho po ako dun sa JAKA ni Senator Enrile.” Si Hercules Moya ang asawa ni Chichay.
When I sit down and talk to my sisters, we would listen and review all the signs; we were given signs. Ayan naiiyak na naman ako. (Voice breaks) Itong bata na ito (points to Melissa de Leon), bukod sa kapatid ni Christopher de Leon…
Melissa de Leon (Melissa): Bata? Thank you ha!
Bibeth: Bata ka kasi I am ancient.
Melissa: I grew up seeing you.
Bibeth: We took her out for lunch and ayaw niyang maniwala na all was going to be well. Sabi ko same time this year, you look back to this day at tatawa ka na. Ako, natakot rin ako. Ang kailangan lang makinig ka. There are signs.
There are signs, but you were also ready to part with this world, kasi cancer siya?
Bibeth: Ay oo. Kasi nga cancer, alam mong it’s touch and go. In 2007, we were in a rally protesting the electoral code. Rene Saguisag approached Carlitos and said, “I hope to see the day when your wife’s doctors tell you she’s home free.” The thing is, if it’s not cancer, we really go through that door. Huwag ka na lang kasing magmukmok, and find ways to be useful.
Siyempre pag product ka ng UP, mayroon ka palaging position, for against or whatever. For a while I’ve always been a sympathizer, sawsaw dito, sawsaw doon. I went into full swing because of two reasons—the cancer and because I moved to Forbes. It’s easy to pretend that all is well, but things are never well for most everybody, so you really have to do your part. For me, it was going to the hospital to do my checkup. I stay a little longer in my OB-gyne’s clinic. Four out of five times, you’ll hear a woman crying because she got her diagnosis. Siyempre uupo ka doon, siyempre kilala niya ako, so you have to see her.
Minsan sa ospital umiikot ako sa mga nagpapa-chemo. I’m just very glad I have an earthy kind of humor, which helps. May isang babae vaginal ang cancer. Ang treatment niya parang battery na may radiation, pinapasok, nilalagyan sya ng lubricant. I went there and said nakakainggit naman kayo. (Laughter) Tawa siya ng tawa pero sakit na sakit siya. They take it from me. You can put the Santol girl in Forbes, but you can’t get Santol out of the girl.
Bibeth: Santol Street, we lived there for two years.
Is that a thing for survivors, you have to go out and help?
Bibeth: You become more sensitive.
Melissa: When I was diagnosed, I got in touch with Kara (Magsanoc-Alikpala), and when I saw her in a wake we were crying. Hindi ko pa siya kilala, hindi pa kami na-introduce. It’s a natural thing. It means she understood what I was going through. It was a bond. No words, we just embraced.
What’s your history?
Melissa: Bibeth is very much involved in mine.
Bibeth: I called her brother Christopher de Leon who was filming a show. He went to an extra room and he cried. Sa kanila kasi, two sisters e, also Toni Abad.
Melissa: She was ahead.
Did she survive it?
Maritoni Fernandez (Maritoni): Kami ni Toni ang ganoon. I never met her the first time I saw her, and we were crying.
Melissa: When I was diagnosed I already had three kids.
What are the symptoms?
Melissa: I have yearly checkups, and that particular one in 2006, sabi may calcification. The year before that, I had an operation, which they took out and they said it’s benign. So the next year sabi ko, peklat lang iyan, scar lang iyan. Sabi ng doctor, i-observe natin, so biniopsy. Siyempre, ako naman observe lang dahil madaming ginagawa.
Maraming ginagawa o ayaw mong malaman ang katotohanan?
Melissa: Maraming ginagawa at ayaw, tamad. Kasi ang biopsy mahabang needle itutusok sa iyo. I-inject ka rin ng anesthesia so ganoon pa rin. After four months, my doctor called me on Friday night, 7 p.m. I was on the way to dinner with my children to meet my husband: “Melissa, I have bad news for you. Stage 2B.”
Sinabi sa iyo sa phone?
Melissa: Sa phone! (Laughs) Napaka-unromantic!
Maritoni: Unethical! You’re not allowed to do that!
Barkada mo ba ’yon?
Melissa: Hindi. Feeling niya close kami. (Laughter)
Maritoni: I was so irritated!
Does it matter how you are told?
Bibeth: It matters. Parang sinabi na namatay na yung kapatid mo . . .
What’s the best way to be told?
Bibeth: With your family around, your husband around.
Maritoni: I was alone. I was told with my mom sitting beside me. I felt like, “How can I deal with my own emotions, when I am worried about my mom passing out?”
Bibeth: Ikaw naman, you were in a different situation, ipapa-check up yung nanay, ikaw pala ang meron.
What were your symptoms?
Maritoni: I had a lump on my right breast since I gave birth to my kid when I was 26. By 27, I asked my OB-gyne and she said, “Bata ka pa, you have nothing to worry about.” I’m now 42.
Years later, my mom was very sick, she was in Makati Med. She was diagnosed with pulmonary embolism, and being the eldest in the family, I was the one who was told to watch over her. Rudy Fernandez was running for office then. He was my uncle, and my stepdad was his campaign manager, so he was busy with the campaign.
They wanted to operate, remove a part of her lung. We all decided to get a second opinion. I have an uncle who is a doctor in west Virginia, so I took my mom to the US and we found out she was misdiagnosed. She has walking pneumonia, which is causing all the pain in her chest. It had nothing to do with her lungs. It was just an abrasion. The lubrication between her lungs disappears so masakit when she breathes. They gave her an anti-inflammatory.
She was in Makati Med for a month. I did the rounds when I was there. I was thinking, what am I going to do while I’m here? I got mammogram. I’ve never had a mammogram. It was really by chance.
Nag-shopping ka ng services?
Maritoni: Basically, I was bored. I was making friends with all the doctors and nurses. When she checked in, I just grabbed my results, tucked them in my bayong and in one week we were in the States. Dala ko iyong results; I didn’t even change my bag. When my mom was cleared, my uncle sat with us over dinner. I was saying, “Thank you, we are leaving West Virginia because I hate this place.” Puro bundok, there was nothing there, just oil fields, coal mines. I knew I had a lump; I was thinking if I should mention it or not. If I mention it, hassle pa, tomorrow we would be in LA, shopping. (Laughs) Nanalo pa rin si Lord, kasi the Holy Spirit pressured me to say something.
I said: “Tito, I have a lump, I had it checked by doctors in Manila and they said it’s nothing.” It’s there and it hasn’t grown or gotten smaller, its not a cyst because it’s soft. It’s matigas like holen and it doesn’t move. Cysts are soft and they come and go and there’s pain. This one had no pain. I felt it every time I put on a bra and the wire hit it.
He asked if I had anything done. I said yes, got the results and looked at it for the first time. It said I have a palpable mass, calcification; the report said I should have a checkup in six months. My uncle asked if I could postpone the Wednesday flight to Saturday so that we can have a week to do tests. He said, “Let’s do a needle biopsy.”
I was very blessed. He’s Filipino. There’s was a team of 10 doctors, all Pinoy friends of my uncle. He came from the OR and said, “Positive, I’m sorry we have to remove the lump, but they still can’t tell you yet if it’s cancer.” They did a biopsy and found out it was positive for malignancy. They removed 40 percent of my right breast because they insisted that a lumpectomy is as effective as mastectomy.
What’s the difference?
Maritoni: Lumpectomy is to take off the lump and certain tissues within the margins. Mastectomy is to take off the whole breast.
Bibeth: Ako mastectomy.
Maritoni: Ako lump lang. In the US, they are more conservative. Why take off the whole breast when you could save part of it. It’s a controversial issue. Some doctors believe they can remove the whole breast tissue. Some doctors don’t believe that, because the breast tissue spreads all the way up to your armpits and blends into your ribs. So if you remove the breast, you can’t take out all the best tissues, so why remove the breast? The difference is if you remove the whole breast, you don’t need to radiate.
Bibeth: Ako nag-radiate.
Bibeth: Because mine is an advanced cancer. Chemo first then radiation. I was in bed, and you have to moisturize. Ang Pilipino kapag nag-moisturize affected area lang, hindi katulad ng mga puti, talagang head to toe.
I’m a triple D. (Laughter) I was in bed and I turned. Dry iyong skin dito sa chest, so paglipat kong ganyan, the weight of the breast tore the skin! Akala ko it was a heart attack! I really screamed. Carlitos jumped into the bed. He saw a stream of blood kasi napunit talaga iyong skin. He said, “Mama, mama, it’s surface, it’s surface!” Ako naman, “Iyong mga bata, pag-aralin mo!” (Laughter) Siya natatawa.
Imagine, iyong balat masusunog kasi they radiate you. Nilagyan ako ng tattoo to set the parameters. (She and Maritoni show dot tattoos.) Ang sakit. Noong nakita si Aiza Seguerra, sabi ko, “Gaga ka, ako nga apat na dots lang masakit na, iyong sa iyo may design at kulay pa!” (Laughter)
Maritoni: I wanted to get a pink ribbon as a statement to myself. Ito pa lang hindi ko na makaya.
Melissa: Ako rin gusto ko pa-tattoo over the scar. (Shows scar)
Bibeth: Sabi niya (Melissa) before the operation, “How would I feel to see myself deformed?” Pagpasok niya sa bathroom—ang asawa niya maganda ang sense of humor—naglagay ng cutout ng human breast. All she had to do while naked is stand in front of it. (Laughter) Kanya-kanyang way of coping.
Melissa: I was saying, “Honey, I look like a freak!”
Going through chemo and radiation, may nagsabi na “mag-natural ka na lang, those will kill all your good cells.” Sabi ko, nakita ko sila (Bibeth and Maritoni), they sat down with me over lunch, together with Kara. We were crying and laughing. They all went through what I was going through. Sabi ko magka-tumbling-tumbling na, I’ll make sure I’m going to be alive.
Maritoni: I was walking in the mall with my mom after my first chemo and she said, “Anak, buy anything you want.” Normally, with my character, I’d be hmmm, what could I buy? I burst out crying and said I just want to be alive. (Cries)
Did you buy anything? (Laughter)
Maritoni: Looking back now, I should have! (Laughs)
Melissa: When it’s time to tell the children, sabi ng anak ko, “Mommy, are you going to be in pain? Naipit ang aking mga… (touches throat) I said, “Mommy’s going to be in pain. The Lord will carry mommy through this.”
Bibeth: The family will be there for you, you have to show them also that you’re strong. Pagdating namin sa New York noon, maglabas ka lang ng baso, may kamay ng magbibigay ng tubig. May silya agad.
Maritoni: I told her, “Melissa, this is your time to be spoiled.” Most of my co-survivors who I am close to are sobrang maalagang mga babae. Hindi mo pa naiisip, naayos na namin, with our kids, our partners. Pag-gising nila sa umaga, kulang na lang may toothpaste na ang toothbrush. I told her it’s not the end of your life. It’s God’s way of putting a yellow light in front of you. It’s his way of saying, “Slow down, anak, take this as your time, pahinga ka muna. (voice cracks)
How does a single woman manage this?
Bibeth: Mahirap, that’s why we’re here. Kara doesn’t want to talk about it, but she was alone when she had her journey.
Kara Magsanoc-Alikpala (Kara): I was engaged.
Bibeth: I went out of the hospital to buy my breast form kasi nga malaki suso ng lola mo. (Laughter)
What’s a breast form?
Bibeth: Prosthesis, iyong sa akin hindi permanent. Hindi ko pina-reconstruct.
Maritoni: I waited 10 years for reconstructive surgery. I called Kara, sabi ko, “Ten years, graduate na ’ko when I turned 40.” I was diagnosed when I was 30. Feeling ko it was time to buy myself a gift. Sabi ko, bibili ako ng bagong boob.
Nagkita kami ni Dr. [Vicki] Belo, she has a very good doctor, si Dr. Caparas. When Vicki and I saw each other, I showed her my boobs, and she said “ang dali-dali niyan.” In a sentence, she put my fears to rest. I have this fear na baka bumalik yung cancer, baka maging complicated. It would—but only if the implant were put under the muscle, because if this is your breast and they put the implant above your breast, it masks the breast tissue.
It is an augmentation. If this is your breast, they make tastas your muscle, they put the implant inside your muscle, it pushes the breast tissue out so it’s easier to spot any recurrence. That’s what they did.
Have you ever felt yourself ripped in exercise? Normally sa legs, sa loob masakit. They do that in your breast. I remember waking up from my surgery thinking, “Big mistake.” (Laughs)
Bibeth: I decided not to get one, kasi I’m big and they were giving me “tramroll.” They will get the fat from the belly then roll it up and put it in. I asked, “How many stitches?” 160!
Pagkatapos hindi pa papantay, mas malaki pa rin ito (other breast). Pumunta ako sa asawa ko, sabi ko: “Ikaw ba, may balak pang palitan ako?” (Laughter) He said, “I guess I’m stuck with you.” Hindi na ako nagpagawa.
When you get your prosthesis, you make sure it could shake like the other one (stands up and walks to demonstrate). When you walk, it has to have the juggle. The problem is, I don’t want to stay in places with strong air-conditioning because I only have one nipple to show. (Laughter) I’m allergic to false nipples.
Rudy Fernandez said ang gustong-gusto raw niyang feeling e iyong may magsasabi na “Ipinagdarasal kita.” Sabi niya iyan ang lamang natin sa ibang taong hindi katulad natin.
Iyon na siguro ang pinakamalapit na pakiramdam sa hinipo ng Diyos sa pisngi.
Melissa: I was diagnosed and was told, “Huwag mo nang sabihin sa press para hindi ka kakaawaan ng tao.” For me, if people find out, they will pray for me and I need their prayers. I walk in the mall, I do the grocery and people say “pinagdarasal kita.” People we don’t know, and my, I love it.
Maritoni: It reminds you to pause, that life can get so hectic. For me, it’s been 11 years and people still come up to me in the supermarket, and say, “Maritoni, kasi yung mommy ko…” They know I’m a survivor. Sometimes I’m in a rush but I’m standing there, listening to their story and something clicks all the time. It never fails. It’s the Holy Spirit saying “Huwag mong kalilimutan.” (Cries)
Bibeth: Paglipas ng panahon, your sense of humor really surfaces. Akala ng ibang tao na kapag may cancer ka, iyakan kayo ng iyakan. When we’re together, tawanan kami ng tawanan, at kain ng kain. The organization is called ICanServe, but we do an “ICanEat.”
In my house we have a long table really groaning with food. Ang lagi naming joke, sa lagay na iyan, may cancer tayo pero ang lalakas nating kumain.
Maritoni: Hiwalay pa ang dessert table.
Bibeth: Iyong mga asawa gustong sumali. Carlitos has long been threatening to put up an organization called Asosasyon ng mga Lalaking Inaapi ng Asawang may Cancer. Ang acronym ALIPIN. Iyong T-shirt daw kulay gray and iyong letter A, pink ribbon.
Maritoni: You know how hard it is to go through chemo? Para kang nagka-flu ng 20 times.
Bibeth: You feel every cell in your body, pinapatay.
Maritoni: Pagsama-samahin mo ang trangkaso, iyong masakit ang katawan hanggang buto, at hindi ka makabangon. Combine it with the worst hangover of your life, at paglilihi. Tapos i-multiply mo times 100.
Kapag hangover, isuka mo lang, okay na mamaya. Ito kahit makasampung suka ka di nawawala.
Bibeth: Kailangan mo talagang iungol. One cycle is around 21 days. The first three, easy pa iyan, tapos hell na after that.
I went to Hard Rock, kalbo na ko noon. Paalis na ako tapos sina Bert de leon and Cash Manalang said, “We would like to do this song for you.” They sang “The Way You Look Tonight.” Nakatayo ako doon, tumutulo ang luha ko. Naisip ko, ba’t di ako kinantahan ng ganoon ni Cash Manalang noong crush ko pa siya sa UP. Kailangang magka-cancer pa ko. (Laughter) John Lesaca was playing the guitar.
How did you deal with chemo?
Bibeth: Acupuncture helps, it relaxes you. I go to Ed Concepcion, he plots it out on your body.
Maritoni: Sorry, for me it was pot, I had a card. (Laughter)
Subsidized din, government’s money?
Maritoni: Of course, you pay them $1 every time you got it. It worked.
Melissa: Sabi ko noong una kaya ko. First session ang yabang ko pa, sabi ko, “Thank you, Lord, I can do this. I’ll hold on to you.” The second one, sabi ko, “Lord, hold on to me.” (Laughter) Hindi ko na kaya. Kapag nanonood ka ng TV hindi mo na maintindihan.
You also had a mastectomy?
Nagpa-reconstruct ka na?
Melissa: Hindi pa, I’m going on my fifth year this November, not soon. The important thing is, you don’t do it for the man you’re with, you do it for yourself.
Is it true that the lump doesn’t hurt?
Maritoni: If it hurts, it’s less dangerous. If it doesn’t, if there’s no pain, that’s what you have to worry about.
Do you have any dietary restrictions after surviving cancer? Do you still eat canned goods?
Maritoni: No. We eat everything but in moderation.
Even junk food?
Maritoni: Yes, Cheetos.
Does it somehow make it easier that you guys can afford treatment?
Bibeth: Yes, because they allowed septin to be used for treatment. Binabaan nila ng konti ang cost kasi trial, nagsisimula pa lang dito. The 17-18 treatment ngayon would cost about P2 million.
Maritoni: My treatment would have cost P5 million at the time. I’m really blessed because they told me there’s a certain quota for foreign patients to get medical aid if they are diagnosed in their area. Mine was free. I went there and I didn’t know, but if you go there knowing you’re sick, you’re not qualified. I happened to be in their country. They were my guardians while I was in their land. It also helped that I was in West Virginia. Hindi nafi-fill ang quota.
Bibeth: That’s why ICanServe always pushes for early detection. The costs are minimal.
Maritoni: Maski hindi kami makatulong money-wise, there’s support. It’s half your battle.
How about government hospitals?
Kara: Free chemotherapy, pero first come, first served. Only four government hospitals do this.
Bibeth: Sana maisabatas na ang chemotherapy leave. You have maternity leave. Ang problem sa chemo maraming namamatay not of the cancer but of infection. Baka pwedeng may immunity, or paperwork na lang at the comfort of your home. Dapat ma-push na.
Is someone pushing for that? Who filed the bill?
Bibeth: Si Serge (Osmeña) dati meron. This is the greater obscenity. This deserves legislation instead of calling a priest and a National Artist to a session to decide what is a sin or what is not. We can’t even have something like a chemo leave. Sana mapag-aralan.
How about insurance, do they cover breast cancer?
Bibeth: Depende sa insurance mo.
Melissa: Kapag kukuha ka ng insurance after ka ma-diagnose, denied ka, but before diagnosis, may coverage pero depende sa policy.
Maritoni: Kaya ICanServe is trying to educate people to catch the disease before it’s malala na.
But in your case, hindi ninyo nakita. How can other women do that?
Bibeth: Mammogram and sonogram.
Maritoni: Ayaw ng iba magpa-mammogram kasi daw masakit. We tell women how important that we all know about breast self-examination. We have outreach programs in barangays. Since we’re in show-biz, we come up on TV. We say there is no cure, so prevention is the best way. Just get a mammogram.
How often and how early?
Maritoni: If you have family history, early 20s pa lang, check yourself na. If you don’t have family history, the minute you hit 30, a gyne should be checking you yearly.
Family history includes the entire clan, not just the immediate ones?
Maritoni: Everybody, tito, tita.
Bibeth: Men get breast cancer, too.
May member ang ICanServe na lalaki?
How prevalent is breast cancer in the Philippines?
Kara: We have the highest incidence in Southeast Asia. No. 9 worldwide.
Is the stem-cell treatment applicable to breast cancer?
Kara: It’s controversial. It’s not proven.
Maritoni: It’s not breast cancer per se, but there are certain kinds of cancer that can be treated through stem cell.
Ako nag-anak after may cancer. Ayaw ng doktor ko, but I’m pretty crazy.
Kara is ER negative, which means her cancer doesn’t feed on estrogen.
Melissa: There are different types. Hindi basta breast cancer, iyon na ’yon. Ako, if I have a pregnancy and I have a sudden surge of estrogen, the cancer can recur, it can trigger it. Kaya alam ko na I’m okay na because the only way to check if there are dormant cells in my system is to really bombard my system with estrogen, and the pregnancy does that for me.
There’s a new treatment in Japan called cryo technology which targets and burns only the cancer cells. It’s very young, very controversial, but once it becomes mainstream, it would be a blessing to patients.