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16 years fighting breast cancer takes its toll, but Gainesville couple perseveres
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Richard and Jorene Pilcher sit in a waiting room at the Northeast Georgia Medical Center Thursday, Sept. 5, 2019, for her echo cardiogram appointment. - photo by Scott Rogers
When the end of life came up in conversation between Richard and Jorene Pilcher, the tone was matter-of-fact, not emotional.
Richard asked his wife for suggestions in planning a trip as part of the Longstreet Society — an organization that strives to preserve the legacy of Confederate Lt. Gen. James Longstreet. It’s a group the Gainesville couple have both enjoyed and one that Richard had led for years.
She looked at her husband and said, “But Richard, I won’t be alive next year.”
In a recent interview discussing her cancer, Richard paused for a moment as he recalled the chat. “We don’t like to talk about that or even think about it,” he said.
Jorene’s breast cancer, diagnosed 16 years ago and occupying nearly a third of the couple’s 54-year marriage, is something ever present — not just an elephant in the room, but an elephant that refuses to leave.

“It isn’t terrifying,” Richard said. “It’s just that constant grind of knowing what you’re dealing with. And it’s harder knowing what she’s dealing with.”

Celebrating perseverance

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The battle became more of a drain when Jorene’s latest oncologist — her last one died about three years ago — told the couple her cancer was terminal.
“No one had said that yet,” Richard said.
Still, the doctor went on to encourage more treatments, and that maybe there’d be a cure.
Richard, 78, is keeping the hope, but he’s also watching his 76-year-old wife’s health.
“She’s getting weaker, and she’s short of breath,” he said. “I wonder sometimes if maybe that cancer is not somewhere else.”
The cancer has caused open wounds, which can be covered with bandages, but Jorene worries about bleeding through them.
“One of the worst things about cancer is (patients) worry all the time,” Richard said. “And when she worries, I worry. It’s just not been a fun thing, and I’m not a very good nurse. I have to keep in mind that when she’s in ill humor — that it’s not me, it’s the cancer.”
The disease showed its first signs with a lump in her breast 16 years ago. She didn’t tell Richard about the lump until she had visited an oncologist — not wanting to scare him without reason.
When the cancer diagnosis eventually came, “it was scary,” he said. “It’s really a frightening thing, especially if you’ve had cancer in your family before.”
Adjusting to the life change also was hard, “but I was pretty eager to do what I could do,” Richard said.

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Richard and Jorene Pilcher get signed in at the Northeast Georgia Medical Center Thursday, Sept. 5, 2019,for Jorene's echo cardiogram. - photo by Scott Rogers
At first, he wasn’t that involved.
“She was pretty strong, healthy and still working,” Richard said.
“Until she went into remission, she drove herself to appointments,” he said. “The only thing I went to was (appointments) when she had surgeries and the occasional conference with doctors.”
Overall, “we got into a routine and I was like, ‘This is no big thing,’” Richard said.
There were some early insurance issues, however.
Shortly after Jorene had a port implanted for chemotherapy, a change in medical insurers was made at his workplace. The new insurance company was going out of network with Northeast Georgia Health System.
“We lost the use of her oncologist,” he said.
The doctor referred the Pilchers to a doctor at Northside Hospital Forsyth, where his new insurance was accepted. They started making the long trips.
Eventually, Richard’s insurance was accepted at NGHS, but by that time, Jorene “liked the new doctor, facility and the attitude there,” he said. “She got accustomed to it and … developed a level of trust.”
Richard added: “We didn’t know then that it was going to be 10 years of driving back and forth to Cumming — no telling how many thousands of miles we put on the car.”
She was treated for five years before going into remission for six years.
The first sign of cancer’s return was weakness in her right arm. Soon she found “she couldn’t push the button to release the parking brake on the car,” Richard said.
A doctor’s visit revealed cancer in a nerve bundle in her right shoulder.
Jorene gradually lost complete use of her right arm. She stopped driving 4-5 years ago and turned in her driver’s license about a year ago.
“She can’t move it, but she can certainly feel the pain, and it’s constant, severe pain,” Richard said. “She’s on a pain program now that’s helped a little bit, not a lot.”
Jorene had taken a quarterly injection in her shoulder to help the pain, but it only got worse.
“So, she quit that (regimen),” Richard said. “Now, she’s using an opioid patch she changes once a week, and that’s helped.”
Another issue has been that one of her cancer drugs came with a lot of warnings about heart problems, and Jorene fell victim — as if the cancer wasn’t enough.
“I suffered heart failure and a mild heart attack” in 2013, she said in a 2017 interview.
She began a cardio-oncology program at Northeast Georgia Medical Center, as the Pilchers’ insurance was in network, at that point.
“We combine state-of-the-art cardiac imaging with best practices for early diagnosis, prevention and treatment of heart problems associated with cancer therapy to improve the quality of life for cancer survivors,” said Jorene’s cardiologist, Dr. Abhishek Gaur, in 2017.
Recently, she went to the hospital’s Ronnie Green Heart Center for an echocardiogram, accompanied by Richard.
Jorene said she would be in a nursing home without his help.
“I can’t live by myself,” she said before the Heart Center visit. “I do what I can, but (Richard) does almost everything.”
Otherwise, “I have my good days and my bad days.”
It was another appointment in a string of doctor visits, and it’s been an emotional rollercoaster.
About the time of her previous oncologist’s death, Jorene had decided enough was enough, Richard said.
“She was going to stop doing chemo, which made her sick all the time, and going to doctors. She decided she’d rather not be nauseated, which was just about 24 hours a day, enjoy life for a little while and go ahead and die,” he said.
“She was ready to go.”
At one point, the cancer spread to her brain, but a gamma knife treatment — a type of radiation that attacks cancer with extreme precision — “worked like a charm,” Richard said. 
“It got rid of the cancer, but it has to be checked quarterly,” he said.
The ordeal has left Richard with at least two strong pieces of advice to pass on to others.
“Don’t try to do Medicare without getting supplemental insurance,” he said.
Because of the fuller coverage, cancer care has “not been a financial burden, particularly.”

Also, “if you’ve got a suspicion (about cancer), take off and go — don’t wait,” he said. “The oncologist will work you in. They don’t want you to wait either.”

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