Three months after Lori McGonigal ran her first marathon, she found the lump.
"I knew this was something that needed to be checked out, but before I could do that my husband and I had to make sure we had health insurance coverage," she says.
Ethen McGonigal and Lori are both teachers at West Point Christian Academy, where he is also principal and serves the church as children's pastor.
Lori, 45, doesn't fit the profile of a person likely to develop a life-threatening illness.
Trim and energetic, she is a health enthusiast who, at least four times a week, begins her day with a four-mile run along a straight, flat stretch of highway near her rural Doniphan home. The rest of her time is largely spent being active with her 5-year-old students or participating in some other youth event. She does not smoke or drink.
Her only risk factor is having two aunts on her father's side of the family who had breast cancer.
A woman of strong faith, Lori says prayer got her through the three months of uncertainty while she and Ethen waited for her insurance coverage to take effect. She also did a lot of research into what types of activities or habits might cause lumps to form in the breast, and she was encouraged by what she read.
"I learned that running can actually cause lumps, because of the jarring and pressure it places on a woman's breast tissue. Ethen and I really hoped we would find out my lump was caused from running," says Lori.
She made an appointment with a nurse practitioner in May and was scheduled for her first mammogram. The test revealed a 2-centimeter lump, and Lori was diagnosed with Stage III breast cancer.
This means the cancer had extended beyond the tumor and possibly to lymph nodes and muscles, but not to an organ. Prognosis for survival for this type of cancer is about 75%. The McGonigals wanted a second opinion, so Lori sought advice from Rebecca Johnson, a friend in the ministry who'd had breast cancer.
"Rebecca was so encouraging. She told me having cancer changes people, many times in a good way. She said, for one thing, it causes you to see the suffering of others in a different light. It makes you more compassionate with others. I have found that to be true," Lori says.
Johnson recommended her oncologist, Dr. Laura Gills. Dr. Gills was getting ready to go on vacation but delayed it to keep the appointment with the McGonigals. She confirmed Lori's diagnosis and referred her to a surgeon.
Lori braced herself, accepting that surgery would be the next step. However, the surgeon recommended chemotherapy first, to possibly shrink the mass before surgery.
"I was resigned to losing a breast, but not to having chemo. I didn't want to lose my hair," says Lori.
She admits at that point the consult became "an extremely emotional moment."
Pentecostals believe a woman's uncut hair is a "glory" to her, a spiritual covering blessed by God with spiritual implications. For Lori, keeping her hair intact was a sign of respect for God, a very important part of her covenant of obedience and submission to Him. Therefore, reconciling herself to the idea of losing her hair was an agonizing, soul-searching process which had nothing to do with feminine vanity.
A big concern for Lori and Ethen was how to break the news to their children, Konner, 16, and Makenzie 14. The McGonigals had a family meeting at the dinner table to talk about the diagnosis and what it would likely mean to all of them.
More than two years have passed, and the teens still do not like to talk about their mother's ordeal, stating only, "We are just glad it's behind us."
Lori's chemotherapy lasted four months, followed by her surgery and then six weeks of radiation.
"I got really sick during chemo, but my family was awesome throughout the whole thing. They did all the housecleaning and most of the cooking," she says.
"We also had great support from the church family. The ladies (West Point Church) provided meals, as well," adds Ethen.
"I had my treatments on Thursdays so that I could have the next four days to recover because the school is closed on Mondays. Every time I had a treatment, someone brought food," Lori remembers.
Although the treatment was brutal, the outcome was, "worth it," says Lori.
"After chemo and radiation, the mass was so little, they couldn't find it. Only the marker was there, and that's the part that had to be removed," she explains, giving thanks to God for answering prayer.
Lori was able to endure to the end, even the hair loss. Not having her own long, naturally curly locks, she preferred to wear hats rather than a wig as a covering. She'd had misgivings about how to explain her illness to her class, not wanting to cause any fear or worry for them.
However, it seems they were more intrigued by the hats.
She smiles, "And, of course they wanted to see that I didn't have any hair underneath."
Today, Lori is cancer-free.
She has to go back every three months for lab work and ultrasounds, appointments she always dreads.
"It is difficult not to give in to fear and worry the cancer will come back, and every tiny ache or pain makes me a little uneasy. You just have to trust God that the tests will continue to come back negative," she says.
In the meantime, she continues to run ... and hope that she's outrun cancer for good.