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Her bald head exposed, Becky Smothers sits fiddling with her bandanna while the doctor talks to her.


Dr. Susan Williford cautions the High Point mayor not to let her busy schedule push back the need to deal with the emotional aspects of her breast cancer recovery.


Smothers has rarely cried over her diagnosis. She's faced the disease in her matter-of-fact way, focusing on her physical recovery, her family and her job as mayor.


This time, though, she wipes away tears.


In this moment, she's not High Point's mayor. She's a girl going through some stuff.


"She feels like she has to be very stoic because she's a public figure," Williford says. "I tell her she's just a girl."


'Am I going to die?'


She never felt a lump. It was a spot on a mammogram that got her doctor's attention.


There were follow-ups and two biopsies to determine just what that spot was. It was suspicious, but her doctor told her not to be too alarmed.


So when Smothers, who is 68, went to her doctor's office to get the results in March, all she worried about was making it to her hair appointment on time.


"I cannot believe this," the doctor told her. "This thing is malignant."
Smothers quickly got to the point: "Am I going to die?"


No, he told her. The cancer, called metaplastic spindle cell carcinoma , was uncommon and aggressive. But the tumor was small and treatable, and the mammogram caught it early.


She went home — after first going to that hair appointment — and broke the news to her husband and their three adult children. She didn't get emotional or dwell on it. That's not her style.


But that night, she couldn't sleep. She got up and started writing her obituary. She jotted down who would get her jewelry.


"But after that, I didn't do it again," she said.


Cancer, she decided, would not dominate her life.


She attacked it pragmatically like other issues she's faced. She made doctors' appointments and sought second opinions. She read up on the cancer. She told her doctors at High Point Regional Hospital's Hayworth Cancer Center to tell her the truth and not paint her a rosy picture.


Smothers focused on the fight.


"With the big things, it's 'Let's strap on the helmet and get rid of this,'" her husband, Ed Smothers, said.


And she used her job as mayor as a distraction.


"Becky has not missed a beat," High Point city manager Strib Boynton said. "I've worked with others where the world just stops. The world hasn't stopped."


Going public


At first Smothers tried to keep the diagnosis quiet. She didn't want sympathy.


But when rumors started going around that she had three months to live, she decided to be open about her illness.


She wrote a letter, published in the High Point Enterprise, telling residents she had cancer and encouraging them to take care of their own health.


"I felt they deserved to know that there was going to be a period of time that I would not be available, and that there was a very serious health issue but one that I was able to cope with," she said.


After the biopsy confirmed cancer, she had surgery to remove the cancer, surrounding tissue and some lymph nodes as a precaution. In late May , she began chemotherapy.


When her daughter-in-law, Debbie Smothers , arrived to take Smothers to her first chemo session, she asked how she was doing.


Smothers said she was scared. Really scared.


It's a feeling she rarely expresses.


"She's dealt with a lot of stuff with the City Council, but has any of it scared her?" Debbie Smothers said. "I doubt it."


Smothers didn't want the cancer to dominate her life, but she found the treatment did. Chemotherapy left her exhausted. She felt like she'd been hit by a truck.


"It sure will make your fanny drag," she said, with her characteristic blend of humor and honesty.


Her hair started coming out in clumps, so she decided to shear it off, wearing wigs and bandannas instead.


She had four chemo treatments, each three weeks apart. She tolerated it better than some, but had to get fluids in the days after each treatment to prevent dehydration.


The treatments made her white blood cell counts drop. As a result, she had to avoid contact with people and cut back on meetings and events in the days following treatments. It was frustrating.


That was her toughest time, her daughter, Beth Smothers Jones, recalled. "She wasn't able to do her thing. It took away her normalcy."


Setting an example


After chemo ended in mid-July and her blood counts stabilized, Smothers was able to do her thing again.


The first of 33 radiation treatments began in late August.


Now, she lies on a table five days a week to have vast amounts of energy aimed at marks tattooed on her left breast to kill the cancer. It takes only a few minutes.


Over the course of the treatments, she's become fatigued and developed an itchy red rash on her chest.


Her openness about her cancer has meant that she has been constantly talking to people about her illness.


At one doctor's appointment, another patient spoke with Smothers. The woman, Judy Smith , is a breast cancer survivor.


"I wanted to tell you for encouragement," Smith said, "it's been six years."


As they chatted, Smothers asked how long it took for her hair to grow back.


"I'm in a real funk over my eyebrows," Smothers said. Without eyebrows and eyelashes, your face disappears.


During visits to her doctors, she has sometimes reverted to mayor mode, working the rooms of patients and medical staff with jokes and greetings.


In chemotherapy, she befriended a young woman who was getting treatment at the same time, bringing her a bandanna.


"She knows everybody's name," her son, Rick Smothers , said. "My mother's incredible about that. That's the way she's always been."


Williford, Smothers' primary oncologist, said she sets an example for other patients.


"You've done a lot of positive things in this office," the doctor told her. "It's not because you're a mayor."


Back on the job


As a mayor, Smothers is known for speaking her mind, for her sense of humor and for her resolve.


She first ran for public office — a seat on the High Point City Council — 30 years ago, when the powers that be thought one woman on the council would suffice. That attitude didn't stop her then, and she's determined the cancer won't stop her now.


"I've been so proud how quickly she returned to her job as mayor," friend Mary Lyon said. "I really feel it was therapy."


These days, Smothers' doctor's appointments are mingled in with city business.


Content to wear bandannas since she lost her hair, Smothers breaks out her "Barbie wig" for official meetings.


Her first council meeting back after chemotherapy, she joked that she can never have a bad hair day. But she hates the wig because it itches, and she constantly adjusts it.


At meetings, she's still asking questions, cracking jokes and not hesitating to show impatience when she's irritated.


"Even though she's down and out, she's been engaged in what we're doing," Boynton said.


And she has remained quick to take up for High Point.


At a recent meeting, she scolded a businessman who mistakenly referred to his High Point company as being in Greensboro.


"I was going to give you one slip," she said.


In those moments, talking about transportation projects and the Randleman dam, the cancer seemed far away.


But it was never that far.


"You look great, by the way," Archdale Mayor Bert Stone told her at the end of the meeting. "You doing OK?"


"Doing fine," she said and moved the conversation back to government business.


Being mayor has kept her busy and focused. And support from the community has been a source of comfort.


After news of her cancer got out, Smothers was inundated with get-well wishes, so much so that city officials had to ask people to stop calling.
"If anyone can beat this, you can," one card read.


"This cancer does not know who it's messing with," said another.


Yet another reminded her that even though she has cancer, she's still mayor. "You're in my thoughts and prayers," the sender wrote, and then reminded her to vote against a zoning change.


Smothers said she reads those cards when she's down.


"It makes you realize that you are not alone in any dark time," she said. "I think it's relieved my family to some degree not to have to be my only support."


Dealing with it


Smothers hasn't been afraid to ask for help when she needed it. But she has tried to be self-sufficient.


"She's always been an independent person, but she's willing to let others help," Debbie Smothers said. "She didn't close us out."


A family member was almost always with her during chemotherapy, but she goes alone to radiation. In the end, Smothers said, you have to deal with it.


"I knew that I had to handle the realities of the cancer and all those things that go with it myself," she said.


Smothers likes to cook and her family raves about her food. But this summer, she relinquished some of the cooking on an annual family beach trip to her daughter and daughters-in-law. At least a little bit.


"If she wasn't doing it, she was directing it," Ed Smothers recalled.
There have been other things she's needed help with. She couldn't go out in the heat, and her husband had to water the flowers on their deck.

Her grandchildren walked the dog.


But there have been no pity parties.


"Her general attitude has not changed or wavered one little bit," son Rick Smothers said. "(My parents) look forward, and they are not going to pity themselves or each other."


That's just the way she — and the Smothers family — deals with things, friends say.


Smothers worried most about how the diagnosis would affect her youngest grandchildren, Becca, 9, and Ashley, 4. She baby-sits them often, and they are her frequent companions at City Hall and as she runs errands.


This summer, though, Becca "baby-sat" her grandmother as she recovered from chemo.


"It's nice to have life around when you feel like 'Yuck!'" Smothers said.
The cancer has made her and members of her family question mortality.


"I don't want you to die," Becca told her grandmother as they walked the dog.


"Oh, Becca. I'm not going to die," Smothers told her. "I'm going to live to be an old, old woman and tell stories at your wedding."


Different kind of 'normal'


Smothers looks forward to when cancer will be a distant memory. The eyebrows and eyelashes have grown back. Her hair is coming in. It's erasing the reminder she got when she looked in the mirror.


She'll complete radiation this month. Her doctors have said she's done everything in her power to beat cancer.


"She should be cured," Williford said. "She's got a really good chance."
Insurance covered most of her care. The biggest concern is a reccurrence. Because she has a rare form of breast cancer, she has higher risk than other breast cancer patients. She'll be monitored regularly.


There are still scary moments. Every ache and pain makes Smothers worry that the cancer has spread. She's anxious about future check-ups.

That's a normal fear.


No matter what, her life has changed. Her "normal" is going to be different. Her appreciation for life's little joys and for the people in her life is greater.


A friend recently commented that she would be doing less for Christmas this year.


"I'm not," Smothers told her.


Next summer, a year after Smothers started treatment, she'll have to decide if she wants to run for office again.


If you enjoy your job and your health is good, a bout with cancer shouldn't stop you, she said. But she'll make her decision next year.


"I know one thing's for sure," Rick Smothers said. "She's not going to sit in the house."



Contact Amy Dominello at 373-7091 or adominello@news-record.com

About the cancer
Becky Smothers has metaplastic spindle cell carcinoma, a rare form of cancer that is not hereditary.

Although her tumor was small — about the size of a fingernail — she does have an aggressive form of cancer.

The biggest concern is that it would recur and spread to her lungs.

The reoccurrence rate for Smothers is about 20 percent, while most breast cancer patients with the same size tumor have about a 10 percent reoccurrence rate, according to Dr. Susan Williford, Smothers' primary oncologist.

Mammograms
The N.C. Central Cancer Registry predicts 310 women in Guilford County and 6,155 women in North Carolina will be diagnosed with breast cancer in 2007.

Many will survive thanks to early diagnosis by mammograms. The following are guidelines for getting mammograms:

- Women 40 and older should have a yearly mammogram and a clinical breast exam.

- Women between the ages of 20 and 39 should have a clinical breast exam every three years.

- Monthly self-exams should begin for women in their 20s.

Source: N.C. Central Cancer Registry

Reducing the risk
- Control your weight and exercise.

- Know your family history of breast cancer.

- Limit the amount of alcohol you drink.

- Get screened for breast cancer regularly.

Free screening
The Guilford County Department of Public Health provides free screening and follow-up examinations for breast cancer to eligible women who are 50 and older.

Call 641-3233 for more information.