It was a Saturday in early January when Joy, a 45-year-old Northampton resident, found a lump in her right breast.

She shared her story to help readers understand the importance of the Relay for Life and the American Cancer Society programs it funds.

The following Monday, Joy, a single mother of two boys ages 13 and 16, saw her doctor. A mammogram and ultrasound revealed an abnormally shaped lump in her right breast and a suspicious node on her right side.

Further tests were done and, during an appointment that Friday, Joy learned she had cancer. Joy then participated in a Multiple Disciplinary Conference, where a team of doctors reviews the patient's case and presents the recommendations together.

The team met with Joy a week later and recommended a mastectomy of the right breast and node removal. The surgery would be followed by four biweekly cycles of chemotherapy drugs called Adriamycin and Cytoxan, 12 weekly cycles of another chemotherapy drug called Taxol and seven weeks of daily radiation. Joy would also need to continue to take another drug, Tamoxifen, for five years.

Next Joy had to decide whether to have a single mastectomy or a bilateral one in which both breasts are removed. She opted for the bilateral mastectomy so she would not have to worry about going through this again.

Her next decision would be whether to have reconstruction or implants. After researching her options, Joy chose reconstruction. The surgeon would remove abdominal fat and tissue to reconstruct the breasts. The surgery would also include a power port because chemotherapy infusions are hard on blood vessels.

Once Joy had a treatment plan, she explained everything to her children. It was important to her to be honest with them so that they knew what to expect and not be scared.

Joy had the surgery mid-March and remained in the hospital for four days. She was sore and had limitations on lifting and moving her upper arms. Sitting up was difficult and getting out of bed was a chore. She was extremely tired.

A friend from the West Coast spent two weeks at the house to help, as did her boys. During the remainder of her six-week recovery period, coworkers and friends brought meals and did the cleaning. Joy learned that she had to ask for and accept help during this process.

Joy also took advantage of the American Cancer Society's Look Good Feel Better program through which patients learn about skin care and make-up application. Chemotherapy can cause dry skin as well as the loss of hair including eyebrows and eyelashes. In a classroom setting, participants receive make-up kits that include items donated from well-known cosmetic companies. The instructor actually takes the class through the application process and provides time for discussion and questions.

To avoid being overwhelmed with treatment, Joy looked at each component as a phase. In April, she started what she calls "chemotherapy phase 1." The three- to four-hour treatments took place every two weeks in a room with 19 others. Patients can close a curtain around them or keep it open to talk to fellow cancer patients. Each patient also has a TV to pass the time and friends are allowed to accompany patients.

The American Cancer Society will also arrange to have a volunteer drive a patient who does not have transportation to treatments.

For each of these first four cycles, Joy would take an antinausea medication and a steroid. Additional medications were also available if necessary. A visiting nurse would stop by weekly to make sure she was not dehydrated or exhibiting symptoms requiring additional care.

Because this chemotherapy infusion attacks the white blood cells, Joy would also go in for a shot the Saturday following her treatment. The shots boost the bone marrow and help support the white blood cell generation.

Chemotherapy also affects the immune system. For about five days after treatment, Joy would be unable to eat fresh fruits or vegetables because the natural bacteria they contain can be harmful. Except for substituting frozen or canned fruits and vegetables, she is able to eat normally. She makes sure to drink plenty of water and an occasional unsweetened iced tea.

After the first treatment, Joy ended up in the hospital with a fever. She was diagnosed with neutropenia, caused by a low white blood cell count. Hospitalized for two nights, she received antibiotics and anyone who came into her room needed to wear a mask.

Coworkers and friends continued to provide meals when Joy dealt with fatigue and other side effects.

For Joy, the biggest low point was when clumps of hair fell out in her hands as she was shampooing. As a result, Joy has had her head shaved. She wears a head covering in the sun because chemotherapy makes her more susceptible to sunburn. She also wears one in air conditioning because her head gets cold.

In June, Joy began receiving weekly Taxol and Herceptin infusions. Taxol is a chemotherapy drug and Herceptin is a drug being tested in a clinical study.

These treatments, part of what she calls phase II of chemotherapy, will continue into mid September.

Once the Taxol treatments are complete, she will undergo daily radiation for seven weeks. The radiation takes about five minutes each day. Joy has been told that the biggest side effect of this is the fatigue and potential sunburn in the targeted area.

Once this is done, Joy will begin taking Tamoxifen. This drug reduces the risk of new breast cancer and can delay the return of breast cancer and control its spread.

The best advice that Joy has for cancer patients, caregivers, friends and family is to be open and talk about it. Ask questions. Call the American Cancer Society's 24 hour hotline at 1-800-227.2345.