Remembering Pioneering TV Journalist Cokie Roberts, Who Bravely Fought Breast Cancer– Her Campaign For Mammogram Awareness

Roberts once told The Washington Post, “I am very religious about annual mammograms and annual visits to the gynecologist, and I was furious during the period when people were being told that under age 50, they did not need to have mammograms. They do save lives.”

Roberts broke into the news industry, focusing on politics during the 1970s. After working for National Public Radio (NPR), she moved into television and joined ABC News in the 1980s. Her parents served in Congress, so her ties to Washington politics became deeply entrenched at a young age.

“Cokie Roberts was a trailblazer who forever transformed the role of women in the newsroom and in our history books. Over five decades of celebrated journalism, Cokie shone a powerful light on the unsung women who built our nation but whose stories had long gone untold,” Speaker Emerita Nancy Pelosi previously told The Associated Press.

Roberts’ ‘Surprising’ Cancer Diagnosis

Roberts’ cancer diagnosis came as “a surprise.”

As a staunch advocate of breast cancer awareness and early detection, she admitted that she felt “the irony of the situation” after her diagnosis at 58 years of age.

Her diagnosis came after her doctor detected a suspicious lump, and a follow-up mammogram revealed she had a small tumor in her left breast.

For treatment, Roberts underwent a lumpectomy for initial treatment.

A lumpectomy is surgery to remove cancer or abnormal tissue from the breast. It’s also known as breast-conserving surgery because, unlike mastectomy, only the tumor and some surrounding tissues are removed.

WATCH: Should I Have a Lumpectomy or Mastectomy?

A lumpectomy usually lasts about an hour. Since it’s an outpatient procedure, patients go home the same day.

“Really, all you remember from the surgery is just going to sleep after the IV goes in,” said Dr. Sarah Cate, Chief of Breast Surgery at Stamford Hospital.

“As the breast surgeon, I then make a cut in the breast and remove the cancer, and then I will do certain plastic surgery techniques to rearrange the tissue just in that area to make it look nice. A lot of the time, the stitches are underneath the skin, and I use a skin glue…a plastic surgery technique for the best possible appearance of the scar,” Dr. Cate continued.

WATCH: Recovering from a lumpectomy.

After surgery, Roberts underwent six months of chemotherapy.

At the time of her diagnosis in 2002, Roberts said her doctors told her, “There are different effects for different people.”

“I am likely to feel crummy for a day or so after every treatment,” Roberts added.

Managing Chemotherapy and Its Side Effects

Chemotherapy is an effective tool for oncologists to help treat cancer by stopping cancerous cells from growing, dividing, and spreading to other organs. Chemo works by traveling through the bloodstream, killing cancerous cells. However, the process also impacts healthy cells, leading to side effects.

Patients almost universally experience fatigue, often alongside gastrointestinal side effects, such as nausea and hair loss. Doctors have many effective medications to combat chemo-induced nausea. “But mitigating that fatigue often depends on the patient,” Dr. Urban said.

“Neuropathy is probably one of the most challenging side effects,” Dr. Urban continued.

Neuropathy results from damage to the peripheral nerves. It usually resolves after chemotherapy treatment, but sometimes symptoms can persist. While it’s typically characterized by numbness or a pins-and-needles sensation in the hands and feet, neuropathy can have several different symptoms, including:

• Weakness in the hands or feet
• Stabbing or burning pain in the hands or feet
• Difficulty gripping, such as when holding a fork
• Difficulty with fine motor skills, such as writing or buttoning a shirt

Nausea and vomiting are common side effects of chemotherapy. When chemotherapy affects the rapidly dividing cells in the stomach lining, the resulting cellular havoc in the gastrointestinal tract can lead to side effects such as nausea and vomiting. However, doctors can help patients mitigate the hit with various medications before, during, and after treatment.

“Part of the chemotherapy prescription includes a set regimen of anti-nausea medications…We also ensure patients have medications at home that they can use should they develop nausea after treatment,” Dr. Urban added.

Hair loss can be an emotional stage of anyone’s cancer journey. SurvivorNet has tips and resources for anyone facing this side effect and struggling to manage it.

“For cancer patients, losing one’s hair can be unbelievably stressful. To start with, the dread of losing one’s hair can lead to some sleepless nights and feelings of anxiety,” Dr. Samantha Boardman, a New York-based psychiatrist and author, told SurvivorNet.

Chemotherapy can cause hair loss. It usually begins about three to four weeks after starting chemotherapy and continues throughout treatment.

WATCH: Hair loss during chemo.

It happens because this treatment targets quickly dividing cells throughout the body. That includes cancer cells but also hair cells.

Radiation is another treatment that can lead to hair loss if the hair is in the path of the tumor being treated. Radiation for a brain tumor, for example, may cause hair loss on the head.

“If you do lose hair, it will regrow several weeks or months after treatment,” radiation oncologist at GensisCare Dr. James Taylor told SurvivorNet.

“Fortunately, for most patients, hair loss is not a concern when having radiation therapy,” Dr. Taylor added.

Most patients can expect regrowth four to six weeks after treatment. However, it is possible that when your hair grows back, you may notice changes in its color and texture.

If losing your hair is a concern for you before cancer treatment, know you have options like wigs, hats, wraps, and scarves, among other things.

As for Roberts, she resorted to wigs because while undergoing treatment, she chose to keep working and reporting the news.

“I felt, first going on the air in a wig, that I looked really goofy. And election night 2002, it was my best wig. It was the human hair wig, not the synthetic wig. I thought it just looked awful. So, I don’t know. It’s hard,” Roberts told ABC News.

In 2016, Roberts’ cancer returned after a long stretch in remission.

Eagle-eyed news viewers noticed Roberts’ weight loss. She later acknowledged her change in appearance when she said on an episode of “This Week,” “I have had some health issues which required treatment that caused weight loss. I am doing fine.”

In September 2017, Roberts died because of “complications from breast cancer,” her family said in a statement to NPR.

In the wake of her passing, many people came forward to shower the late journalist with praise.

Former President Barack Obama and former First Lady Michelle Obama called Roberts a “constant over forty years of a shifting media landscape and changing world, informing voters about the issues of our time and mentoring young journalists every step of the way” in a statement.

Improving Survival Rates

Efforts made by people like Roberts – and others – to educate more women to screen for cancer appear to be paying off, according to a study published this year in the medical journal JAMA. Researchers say improvements in screening and treatment are associated with a “58% reduction in breast cancer mortality” for breast cancer.

“In 2019, the combination of screening, stage 1 to 3 treatment, and metastatic treatment was associated with a 58% reduction in breast cancer mortality. Of this reduction, 29% was associated with treatment of metastatic breast cancer, 47% with treatment of stage 1 to 3 breast cancer, and 25% with mammography screening,” the study says.

Breast cancer mortality varied depending on whether the cancer was estrogen-fueled (ER-positive or negative, HER2 positive or negative).

According to the Centers for Disease Control and Prevention (CDC), the overall 5-year survival rate for breast cancer is 90%. When the cancer remains localized, the survival rate is 98%. When breast cancer is regionalized within the body, the survival rate is 86%. When the cancer has spread to distant parts of the body – metastatic cancer – the survival rate is much lower at only 32%.

The CDC adds that survival is higher when breast cancer is detected in its early stages when it is easier to treat. “Among females diagnosed with breast cancer from 2015 to 2019, 1,097,918 were still alive on January 1, 2020.”

How to Decide the Right Course of Treatment?

Dr. Elisa Port is the Chief of Breast Surgery at Mount Sinai Health System. She explains that many factors determine what type of treatment a patient will receive and in what order.

“Breast cancer has multiple different subtypes. These different subtypes can behave extremely differently, almost like different diseases,” Dr. Port said.

WATCH: Deciding if surgery or chemo is needed first.

HER2-positive breast cancer or triple-negative breast cancer are subtype examples that sometimes benefit from having treatment first and then surgery. However, the majority of other types of breast cancer undergo surgery first, and then doctors use the information they learn during surgery to determine what additional treatment is needed.

“We know that there’s no one size fits all, and we customize and tailor treatment, both the treatments that people get and the order in which they get them, based on the subtypes of cancer and a variety of different factors,” she added.

Ongoing Progress for Breast Cancer Patients

If you are diagnosed with late-stage breast cancer, you should know you still have many treatment options to improve your quality of life. For metastatic breast cancer patients, the drug Trodelvy (drug name sacituzumab govitecan`) is showing promise. Metastatic or stage 4 cancer means the cancer has spread to distant parts of the body.

Trodelvy is a type of drug called an antibody-drug conjugate, which is an antibody and drug combined. It works because the anti-cancer drug is attached to an antibody that recognizes cancer cells. When the drug enters the bloodstream, the antibodies deliver the anti-cancer drug directly to the cancer cells by IV infusion. Since the drug goes straight to cancer cells, it has minimal effects on healthy cells.

WATCH: How Trodelvy Offers Hope

Traditional chemotherapy, on the other hand, doesn’t target cancer cells as strictly. It can damage healthy cells, too. That’s what causes the side effects for which chemo is well known.

That doesn’t mean that Trodelvy is without side effects. Roughly one in ten people who take the drug have severe diarrhea, and roughly half hit very low levels of the type of white blood cell (neutrophils) that help fight bacterial infections.

Results from a trial show that Gilead’s drug, Trodelvy, demonstrated exciting results for breast cancer patients with hormone-sensitive tumors who tested negative for a receptor called HER2 and who had stopped responding to at least two earlier courses of therapy. The phase III TROPiCS-02 study, presented at the European Society for Medical Oncology (ESMO) Congress 2022, showed that Gilead’s drug had a positive effect on patients with hormone-sensitive tumors that tested negative for a receptor called HER2 and who had stopped responding to at least two earlier courses of therapy.

Hormone-positive (HR+) and HER2-negative (HER2-) breast cancer is the most common type of breast cancer, accounting for about 70% of new cases worldwide per year. HER2 stands for human epidermal growth factor receptor 2. It’s a protein that helps breast cancer cells grow quickly. The presence of HER2 has been divided into two groups, either positive or negative, leaving about 50 percent of patients somewhere in the middle. These groupings are based on how the tumors appear under a microscope when graded by the pathologist or with additional testing a pathologist may perform.

Patients with HER2-positive tumors have tumors that show HER2 over-expression, while patients with HER2-negative tumors show minimal or no expression.

Phase III trials represent one of the highest levels of scientific evidence available in medicine.

The study presented at the ESMO’s annual meeting in Paris compared Trodelvy to chemotherapy in 543 patients. Trodelvy extended by 3.2 months the survival of patients with advanced stages of a common type of breast cancer. Put another way, the Gilead drug reduced the risk of death by 21%.

“This is very encouraging data for women whose cancers are hormone receptor-positive. So yes, it’s very, very exciting. I don’t think we can actually start using the drug in the clinic until we have approval. That may be forthcoming, we hope it is,” Dr. Ruth Oratz, a medical oncologist at NYU Langone Perlmutter Cancer Center in New York City, told SurvivorNet.

Last year, the U.S. Food and Drug Administration (FDA) approved alpelisib (also known by its brand name, Piqray), a drug that could help metastatic breast cancer patients.

“Now our patients will have one more non-chemo option,” Dr. Jame Abraham, Director of Breast Oncology at Cleveland Clinic, told SurvivorNet. “Most importantly, it is a first-in-class drug, which showed significant improvement in progression-free survival.”

As a “first-in-class drug,” Piqray is the first PI3K inhibitor to enter the market for breast cancer treatment. A PI3K inhibitor works by blocking the PI3K (phosphoinositide 3-kinase) enzyme, which is essential for allowing cells, including cancer cells, to grow.

For breast cancer patients diagnosed with triple-negative breast cancer – an aggressive form of the disease – Trodelvy (sacituzumab govitecan) significantly prolonged life and progression-free survival. It’s called triple-negative because it does not have any of the main drivers of breast cancer, the estrogen receptor, the progesterone receptor, and the HER2 receptor, and doesn’t respond to the currently available treatments that target them. However, experts tell SurvivorNet that the disease often responds well to chemotherapy.

WATCH: Understanding triple-negative breast cancer.

The FDA approved Trodelvy for the treatment of metastatic triple-negative breast cancer in women who had already received two previous types of treatment. Trodelvy works by attaching the anti-cancer drug to an antibody that recognizes cancer cells and then kills it directly with minimal effects on healthy cells, reducing side effects.

The new data released last week, based on 468 patients, show that women who take Trodelvy survive a median of 12.1 months compared to those who survive a median of 6.7 months on chemotherapy. The drug halted disease progression for a median of 5.6 months, compared to 1.7 months on chemotherapy.

Questions for Your Doctor

If you have a breast cancer screening coming up or recently had one, you may have questions you want answered. SurvivorNet suggests the following questions to kickstart your conversation with your doctor.

• Do my mammogram results indicate I have breast cancer, or am I at higher risk?
• If I’m at higher risk, what are my treatment options?
• What side effects should I expect related to my treatment?
• How much will this diagnosis prevent me from working or fulfilling my daily activities?
• Will insurance cover my breast cancer screening, or are there other financial resources available?

Learn more about SurvivorNet's rigorous medical review process.

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