When Elvira Escamilla heard a voice telling her to go to the doctor, she ignored it, as would many busy mothers.

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Yet the nagging persisted, gnawing and growing into a sense that whatever was wrong had to do with the left side of her body.

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How important is early detection?Women with breast cancer diagnosed at the earliest stage (Stage 1), before the cancer has spread to lymph nodes or other locations outside the breast, have a 99 percent chance of surviving at least five years. Women who are diagnosed with breast cancer after the cancer has spread to nearby lymph nodes (Stages 2 and 3), have an 84 percent chance of surviving at least 5 years.Once breast cancer has spread to distant lymph nodes or organs throughout the body (Stage 4), the five-year survival rate falls to 23 percent. S.C. Department of Health and Environmental Control

It made no sense. At 37, she felt perfectly healthy. Plus, the Goose Creek mom was busy working and raising a family. She also lacked health insurance, so going to the doctor meant paying out of pocket at a time when making ends meet was hard enough.

But what if God was speaking to her?

Escamilla is a woman of faith, so when God speaks, she listens. She went to the doctor, if nothing else to obey the voice and then move on.

While she was at the appointment, her doctor performed a breast exam. He felt two or three possible tumors, all on her left breast. She told him about the voice.

“How long have you heard this?” Dr. Richard Rhodes asked.

“Two months.”

“Why did you wait so long?”

“I was afraid people would think I was crazy!” she said.

He immediately sent her for a mammogram.

“I prayed, no cancer, no cancer,” Escamilla recalls.

Right after the mammogram, she underwent a breast ultrasound. Even with no training, she clearly saw several seashell-shaped splotches — two smaller ones, one bigger — on the black-and-white screen above her head.

The radiologist sent her for a biopsy.

Finally, a doctor told her: “I’m sorry, you have cancer. It’s a very, very bad cancer.”

It was an aggressive, fast-growing form that already had spread to her lymph nodes. To survive, if she survived, it would take a bilateral mastectomy, chemotherapy, radiation and reconstructive surgery.

Her 6-year-old son, Daniel, was in the room when she met with her doctor. Afterward, Daniel looked at his mom.

“Mommy, I will pray for you. God is strong.”

It was February 2011.

No way to pay

Escamilla also prayed as hard as she could. “I would tell God, ‘Please, I need help,’ ” she recalls.

She imagined herself like the legend of an eagle that pulls out its feathers and claws, only for them to grow back again. “I tell my God to please give me a chance to fly on top of this storm.”

Adding to her fears, Escamilla had no health insurance. The Mexico native prepared and sold meals to construction workers. Her husband worked in construction. They paid the bills, but neither one had health insurance from work.

It would cost $95,000 for one surgery alone.

In stepped Penny Fanning, a breast care nurse navigator with the Trident Breast Care Center. Fanning applied on Escamilla’s behalf for Medicaid’s breast cancer coverage. Escamilla was accepted, removing one giant hurdle from her quest to survive the disease.

“I was so scared. It changed my life. I prayed to please give me power. I know that cancer is terrible. But God is more strong,” says Escamilla, a native Spanish speaker who at times turns to her close friend, Evelyn Fuerte, when she needs help with English words.

Escamilla believes God led her to Dr. Douglas Michaelsen, a medical oncologist who happened to speak Spanish. With no language barrier, she could speak the words most comfortable to her, whose nuances and inflections she knew well. This was a time for clarity.

She would undergo six months of chemotherapy, a mastectomy, then six weeks of radiation.

It sounded terrible. But Escamilla had reason to fight, two reasons really: her two children. She was especially close to her daughter, Miriam, who was finishing high school. And Daniel was only 6.

‘She is my voice’

Escamilla also had Fuerte. The two had been casual friends before, but one day Fuerte had a feeling that she should call Escamilla. It was right after Escamilla’s diagnosis. The two became inseparable.

Since that phone call, Fuerte has accompanied her friend to surgery, doctor’s appointments and chemotherapy, along with helping with Spanish-to-English translation.

“She is my voice,” Escamilla grins at her friend, who is from Costa Rica.

For Fuerte, it was a welcome chance to help someone else in need. She knew the darkness of loss and fear. Fuerte’s own 32-year-old daughter had died several years earlier after a heart transplant. Today, Fuerte is raising her daughter’s two young children while coping with the unimaginable pain of losing a child.

Together, the two women navigated their respective journeys.

‘You have my life’

After surgery and chemotherapy, Escamilla found herself sick, bald and without breasts. In some ways, losing her hair was the worst because it was a big part of what people saw when they looked at her. Fuerte recalls often admiring her friend’s long, dark hair, which cascaded down her back “like a princess.”

Plus, after her mastectomy, Escamilla had to wait for reconstructive surgery. Sometimes she wondered if she would ever feel like a sensual woman again.

It was hard for her husband as well. He could not protect his wife from this disease or from the possibility of her death from it. Escamilla watched him turn inward, as if he was afraid even to touch her.

But she was still a woman. One day, she brought his hand to her chest and implored: “Look at me. You have me. You have my life.”

Fear in the dark

Escamilla felt she had to be strong for her entire family.

Nights were the worst. Silence let in the fear.

Escamilla would go to her car at night while her family was asleep. Sometimes, she would sit and think and watch the stars and moon and wonder how much longer she would be around to see them.

Other times, alone, she could collapse. She would cry and pray until she could return to the house, strong again.

One night, she awoke in the middle of the night to find Daniel lying on the floor beside her bed. In the darkness, he was watching her.

“What are you doing?” she asked.

“I’m taking care of you,” he replied.

He always was a prayerful boy. He had spoken at their church before. And like his mother, he prayed often.

She remembers the first time he cried about her cancer. It was when he first saw her without hair.

“Why?” he asked God in prayer. “Why this for my mom?”

She, too, turned increasingly to her faith for comfort, praying often and reading her Bible.

“She was very strong and took chemo very well,” Fuerte says. “It has a lot to do with her faith and the way she took care of her body.”

One day at a time

Escamilla loves to cook and is a huge proponent of using fresh, organic foods and drinking juices made from greens and fruits. She credits them with easing chemotherapy’s side effects and with keeping her strong.

And then there’s her personal support system.

Escamilla is very close to her daughter, Miriam, who recently left for Air Force boot camp. She has good friends. And she has huge support at her Seventh-day Adventist church.

Today, at 38, she appears to be cancer-free.

“It’s wonderful,” says Fanning, the nurse navigator. “She has such a sweet and beautiful spirit.”

But her journey isn’t over. Escamilla underwent her first reconstructive surgery in March. She faces perhaps two more reconstructive surgeries and will take hormone therapy for five years.

Whether from the stress or from chemotherapy, Fuerte’s friend is more forgetful than before. She helps her to keep track of appointments along with life’s other details that can get lost in a sea of to-do lists for even the healthiest mothers.

Escamilla compares the ordeal to the marks on Christ’s hands after his suffering and crucifixion. She, too, bears the scars of suffering on her body.

“I am living one day at a time, and they are good days,” Escamilla says. “The devil took one little piece of my body. But he won’t have all of me.”

Reach Jennifer Berry Hawes at 937-5563 or follow her at www.facebook.com/jennifer.b.hawes.