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Breast Cancer Victim Succumbs After Marathon Effort to Live

October 6, 1991

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DENVER (AP) _ We cannot pick our time.

Jan Modeland was not ready to die. But after years of hope and struggle to overcome breast cancer, she succumbed to pneumocystic pneumonia Saturday at a Denver hospital.

Hundreds of people who had raised more than $100,000 in two states to pay for her bone marrow transplant were devastated by her death in the intensive care unit at Rose Medical Center.

Her struggle was not unique but it is symbolic of every woman’s battle against breast cancer.

Ms. Modeland, who was the subject of a months-long series by The Associated Press on the diagnosis and treatment of breast cancer, had been recovering from the transplant and looking forward to what many, including her physician, believed would be a healthy, extended life.

But three weeks ago she developed gastritis from steroid medication she was taking as a result of the transplant. Once launched, the biological chain reaction just got worse: gastritis led to diarrhea and mouth sores, which meant she couldn’t eat and her weight plummeted, which weakened her and led to the pneumocystic pneumonia. That is the same killer that claims so many AIDS patients because their immune systems are destroyed by their disease.

In Ms. Modeland’s case, her immune system was inoperative because she had been so blasted by the chemotherapy needed for her bone marrow transplant.

″We were caught between a rock and a hard place,″ said Dr. Scot Sedlacek, her primary physician for the past three years. ″In four hours she went from feeling fine to being on a ventilator that breathed for her. Her lungs just gave out. It’s a tough, tough loss. She was not only my patient, she was my friend, I had become very close to her and her family. I am very, very sad.″

At her bedside when she died, along with her family and friends, Sedlacek broke down and wept with the others as Ms. Modeland slipped away in a coma.

″He told us that up until then we had been prolonging her life, and now we were prolonging her death,″ said Darcy Spomer, Ms. Modeland’s best friend. ″Her quality of life was gone. But she fought so hard, she wanted so much to live.″

In the end, that no longer mattered. Her fate was not shaped by wants or wishes, but by the body’s ability to respond. Jan Modeland’s body was worn out from five years of cancer and, more recently, a toxic bombardment of chemotherapy drugs that left her immune system completely dysfunctional. Her heart was willing, but her other vital parts simply did not work.

″We are doing an autopsy to find out if the transplant was successful,″ Sedlacek said. ″It will be harder to accept her death if she died without disease, if the transplant worked but the procedure killed her.″

Ms. Modeland was Sedlacek’s first bone marrow transplant patient in the new transplant unit at the University of Colorado Health Sciences Center in Denver.

″My other patients are going to be discouraged because they had come to know and like Jan,″ said Sedlacek. ″Naturally, they will probably ask me how this affects them. But Jan was sicker and had more complications than any patient I’ve had. They must have hope that what happened to her won’t happen to them.″

However, Jan had already beaten the odds because about one out of every three women who are even accepted for a bone marrow transplant in the late stages of breast cancer survive the procedure.

It is a grueling six to eight weeks of chemotherapy and recovery in an isolation ward. Because the body’s defenses have been disarmed, most of the women who don’t make it through the procedure die of infections their body can’t fight off.

At the time of her death, at the age of 38, Ms. Modeland left thousands of dollars in hospital debts. Her insurance ran out last year, and she was unable to work as a self-employed surveyor.

Because of her dire financial predicament and her need for the transplant if she was to have any hope of staying alive, her friends in her hometown of Estes Park launched a fund-raising drive to help her. Friends in Alva, Okla., where her parents Betty and Owen Modeland live, got involved in the campaign.

Over the past year, more than $100,000 had been raised through bingo nights, bake sales, art auctions, and dances. In Estes Park, there were ″Help Jan Modeland″ fruit jars on business counters in nearly every store in the town of 5,000. The response was overwhelming, surprising even the fund drive’s organizers. Some of them were with Ms. Modeland when she died.

″We thought, once she’d made it through the transplant, that we’d won,″ said Tammy Rumley, who organized the effort that began last January with a flyer in mailboxes announcing, ″This week marks the start of our campaign to save a life.″

″But at least she got a few extra months, she got to come home for the summer, and she got to have hope that her life would go on, would get better, and that she might even get well. And we all learned a lot from this,″ said Ms. Rumley.

″We learned that each of us can make a difference if we decide to get involved, and we also learned that this could happen to any of us at any time.″

One in nine American women will be stricken with breast cancer during their lifetime, and of those afflicted, one in four eventually will die of the disease. This year alone, 45,000 American women will be killed by breast cancer.

Sadly, after a nearly miraculous battle to stay alive, Jan Modeland is now one of them.

But to everyone who knew her, who gave a dollar here or $10 there, she was a valiant woman who never gave up. She fought the good fight as her friends and family kept the faith. And from the beginning, they all knew that we cannot pick our time.

Funeral services will be held this week at Our Lady of the Mountains Roman Catholic Church in Estes Park. A date has not yet been determined.

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