NORFOLK, Neb. — In a sunlit hospital room the size of a school classroom, a handful of people sat quietly in tan recliners, covered with blankets and hooked up to IV bags.
The drugs coursing into their veins are powerful cancer killers.
They save lives, but they make food taste like a bitter penny, cause hair to fall out in handfuls and render some women unable to naturally bear children.
As Mike Flood walked into that room in January with his wife, Mandi, for her first chemotherapy treatment at their hometown hospital, their tears began to flow and reality took hold.
He looked around. His 36-year-old wife was a good 40 years younger than anyone else there. Suddenly it struck him: She's really sick.
"How did we get in this place?” he wondered.
The shock and fear triggered by a first visit to the chemotherapy suite is not unusual for those facing cancer treatment.
But Mandi Flood's case is an unusually public one. Her husband, a popular speaker of the Nebraska Legislature, had launched his campaign to run as a Republican candidate for governor the month before her diagnosis.
Mandi Flood introduced him at his November announcement, enthusiastically grabbing a microphone and telling an overflow crowd that her husband was a good man who deserved their votes.
Now Mike Flood was out of the race, abandoning it quickly after learning his wife's diagnosis. Instead of a political battle, the couple were standing at the threshold of a life-altering fight with cancer.
“There was this unknown. What's this going to be like?” Mandi Flood said. “You know you have to get started. But it's hard.”
The part-time schoolteacher and mother of two spirited boys was diagnosed in December with a fast-growing form of breast cancer.
She wasn't, of course, the first to face the daunting diagnosis. It is estimated that one out of eight women nationally will get breast cancer, and 180,000 new cases are diagnosed each year. The rate of breast cancer is even higher in Nebraska, which ranks among the top 10 states in the incidence of breast cancer.
Mandi Flood's very public case has prompted an outpouring of support for the couple and their sons, Brenden, 6, and Blake, 3.
While breast cancer typically attacks older women, cases are increasing among women younger than 40.
To open a window into how a young couple deals with cancer, The World-Herald asked the Floods to share their story. It's a story of tears, hope, support from a legion of friends and strangers, and the forging of bonds through a shared struggle.
The Floods are far from alone.
To illustrate, Dr. Ken Cowan, head of the Eppley Cancer Institute at the University of Nebraska Medical Center, performs a drill annually at the Cattlemen's Ball, a fundraiser for the cancer center held in a big-top tent on the pastures of a host ranch.
He asks those in the crowd who have had cancer to stand up. Then those who have had a spouse or child with cancer. Then those who have been touched in any way. By then, everyone is standing — all 4,000.
“Cancer touches everyone,” Cowan said. “One out of two Americans will be diagnosed with cancer in their lifetimes. There's no family who hasn't been touched by this.”
But only 5 percent of new breast cancer cases occur in women younger than 40, according to the American Cancer Society. It's a number so low that yearly mammograms are not recommended.
Breast cancer rates for younger women are rising, though, while numbers have remained steady among other age groups.
It's a puzzling trend, said Cowan, who has treated patients as young as 21. Breast cancer is harder to detect and spreads more rapidly in younger women, making it more dangerous.
Younger families also face different challenges: They aren't as established in life, may have young kids to raise and may not be as financially secure.
“All of a sudden, things get complicated. You have this big blip on the future,” said Peggy Jarrell, a certified oncology social worker at Omaha Methodist Hospital's Estabrook Cancer Center. “Your mortality hits you in the face. ... When you're 20 or 30 or 40, it's something that maybe you've never thought of.”
Mike and Mandi Flood were living their dreams last fall.
Mike, who owns two radio stations in Norfolk and had served eight years in the Legislature, had thrown himself “1,000 percent” into his run for governor. He was traveling 300 miles a week, visiting communities across the state, asking for votes, telling people what he would do if elected.
“People were responding to him,” Mandi said. “He was at the top of his game. He's good at it.”
Mandi had also realized a longtime dream: a new house. The couple, married for nine years, had just moved in. The brick home sits atop a tall bluff and has a commanding view of Norfolk, a northeast Nebraska community of 24,000 that's fueled by farming and a huge steel mill.
The Floods are widely known: he as a community leader, she as a local teacher.
Mandi found her cancer fairly early. In October, she felt a small lump in her breast but didn't think much about it. Then, a day after her husband's campaign announcement, she felt it again. A pea-size lump. Strange.
Mike Flood admits to being something of a hypochondriac. As a child, he had seen his mother survive two bouts with breast cancer. He remembers her violent illness after treatments and the days when she couldn't get out of bed.
So he immediately called a friend who is a doctor. Eight out of 10 times, the doctor told them, such lumps are harmless fibroid cysts. Two weeks later, on Nov. 30, the lump was surgically removed.
“I really thought we were done,” Mike Flood said. “The surgeon even said, 'It looks like a cyst.'”
For a breast cancer patient, the three most trying days are when you are diagnosed, when you first see the chemotherapy suite and when you lose your hair.
Mike Flood remembers that first hurdle well. He was driving back from the state capital and was already north of Seward, on Highway 15. He called Mandi's surgeon.
“Hey, is my patient going to live?” Flood joked.
“She's going to live,” the doctor replied, “but it's cancer.”
Tears flowed that night in the house on the bluff. Mandi held her boys tightly. It was “the worst of the worst,” Mike Flood said.
He knew Mandi couldn't do this alone. She had stage 2B breast cancer, and it had spread to one lymph node, which was enlarged. Not the worst, at stage 4, but not the best.
After announcing the end of Mike's run for governor, the family took a hastily arranged trip to Disney World. The Floods hadn't had a family vacation in a long time, and the need to get away was strong.
As they walked through the airport terminal to board their flight to Orlando, Fla., Mike Flood glanced at the front-page World-Herald story about his exodus from the race. The article noted that the five-year survival rate for women like his wife — diagnosed with breast cancer before age 40 — was 84 percent.
"Eighty-four percent,” he thought soberly. “That seems low.”
The trip was a blur. Mandi couldn't stop thinking about the lump.
A week earlier she was taking spinning classes at the YMCA and could wrangle two rambunctious boys and an ambitious husband; now she was bracing for weeks of chemo, more surgery, maybe radiation.
While Mandi napped with the boys at Disney World, Mike sneaked phone calls to friends who had experienced cancer. What's ahead? What can I expect?
After they returned home, they consulted with Dr. Cowan, who had been recommended by a friend and whom they'd met at a Cattlemen's Ball. His specialty is breast cancer.
He told them that treatments for breast cancer have improved, and so have survival rates. There are 12 million cancer survivors in America. Because Mandi is young, the cancer is more aggressive, but it can be beat.
Mandi said she could see the doctor's lips moving but didn't hear the words.
Said Cowan: “It's kind of like stepping into a roller coaster for the first time and not knowing what you're in for.”
Mandi decided to undergo chemotherapy before having surgery. She would receive the treatments in Norfolk, at the Carson Cancer Center, funded by Johnny Carson, the late talk show host who grew up in Norfolk.
She decided to start chemo after Christmas and take treatments every other week, so she would have more time when she was feeling well, for her boys.
She's at the chemo ward for half-day stays every other Wednesday. Two days later, she's hit hard. The treatments, she said, leave her feeling drained and also achy, as if she has the flu.
By the following Monday or Tuesday, she's OK again.
“Your whole world revolves around chemo and non-chemo weeks,” Mandi said. “But I'm not clinging to the toilet. It's not so bad.”
Donations of meals and pizza gift cards arrived from friends, neighbors, fellow teachers and “the Legislative Ladies,” a group of legislators' spouses. State Sens. Chris Langemeier and Beau McCoy delivered a bigger freezer to store all the food.
Cards, letters, emails and texts poured in from people they knew and didn't know.
The Floods devised a routine to deal with the chemo treatments, which will stretch into April.
Mike's parents take the boys for a couple of days after the treatments.
Brenden gets more visits with friends. Mandi's parents also help. And Mike, who used to juggle two or three jobs at a time (radio station owner, lawyer, state senator, political candidate), got more involved at home.
The boys now sometimes ask for him in the middle of the night instead of mommy. He's driving them to dance class and wrestling practices. When Mandi needs to lie down and rest, he and the boys head out.
“We go bowling,” he said. “A lot.”
Mike said he hit bottom when he had to cut off his wife's hair.
Mandi knew she was going to lose her brown hair because of the chemotherapy and had bought a wig early on, during a shopping trip to Omaha with girlfriends.
The plan was to have her sister cut off her hair when the time came. But after she emerged from the shower in early January, her hair filled a comb.
They decided they couldn't wait. Mike used scissors, then a three-blade razor, then a two-blade razor, then a single-blade razor.
“It is bad,” Mandi Flood said. “But it's a relief. It's another step.”
They told the boys that mommy was going to “take some medicine” and lose her hair but that it would “kill the cancer.”
Six-year-old Brenden smiled when he first saw his bald mommy. Toddler Blake said she looked like Brenden, who has a crew cut.
Mandi said that her older son has some understanding of what she's going through. Blake, at 3, not as much.
“Brenden had a stomachache the other day and threw up,” she said.
He told her: “Mommy, now I know what it's like to have cancer.”
A tremendous bond forms when you go through chemotherapy.
The Floods said friends, family, nurses, doctors and strangers have helped them through their battle with cancer.
Mandi Flood, who didn't have much history of cancer in her family, said she was shocked at how many people have dealt with the disease. One friend, a teacher, just had her first chemo treatment. Another just had her last.
Friends have come to sit with Mandi and Mike during her treatments.
Now Mandi is making those trips, helping others through the anxious hours.
She took two bottles of sparkling grape juice to the chemo ward one day to “toast” the end of treatments for a former teaching colleague, Lorri Porn of Norfolk.
Mandi shot a video of her friend ringing a bell at the cancer center, signaling she'd just had her last dose of chemo.
“You are almost in a sisterhood,” said Porn. “You just have so many of the same shared feelings and questions, knowing what a person is going to experience.”
Porn said she barely knew Mandi before they met at the cancer center. Now they get together on Mandi's chemo weeks, on the day after Mandi's treatments, when the kids are gone.
They go out to eat and they talk about everything: what foods might taste good despite the women's metallic taste buds; how many treatments are left.
Mandi Flood said several of her friends have undergone breast cancer tests because of her case. If something good is coming of her illness, that's it, she said.
The Floods said they have been overwhelmed by the emails, texts and Facebook messages of encouragement.
“You don't know how strong you can be until your only choice is to be strong,” one says.
“Praying for you,” says another.
Mandi says it's now her turn. She is sending the same messages to others undergoing treatment.
She's counseling and consoling new cancer patients. Telling them about the hot flashes — a side effect. Sharing her story.
“There are so many people who have gone through this,” she said, wiping away tears. “You just feel a need to help them through it, to pass it on.”
The Floods received good news two weeks ago: The first four chemo treatments were working. The enlarged lymph node had shrunk and was back to normal.
“I'm through five of eight,” Mandi said of her chemo treatments.
She's looking forward to ringing that bell at the cancer center.
She has decided to have a double mastectomy May 2, after the chemo treatments end.
She could have chosen less radical surgery.
“I want to do everything I can so I don't have to do this again,” Mandi said.
After the surgery, a biopsy will tell the Floods if the chemo and surgery got all the cancer.
The good news has lit up the political rumor mill with conjecture that Flood will get back into the 2014 governor's race.
“I don't even want to go there,” the 38-year-old said last week.
Time will tell, Mandi said.
“Maybe there is a little hope, and we can start again,” she said. “Everything happens for a reason.”
But on this afternoon there are other things to focus on. Blake is fussy and won't take a nap.
“It's Blake one and mommy zero,” said Mandi, who was looking forward to some quiet time to catch up with Facebook messages.
The boys, she said, bring her back to reality. There's this horrible disease to fight, but life moves on, and you just have to keep going.
She's already marking down the landmarks.
Last chemo treatment: April 12.
Surgery: May 2.
Two weeks to recover.
Four to five months before her hair grows back.
What will her first meal be when her taste buds return? Lobster.
“It's morning again in America,” said Mike Flood, quoting one of his political heroes, Ronald Reagan.
There's no guarantee the cancer won't come back.
But the doctors tell the Floods that Mandi should live into her 90s.
“In my mind, I've done everything,” she said. “By June, we'd like to look back and say 'It was bad, but it's over.'”
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