STORY BY SARAH MONDELLO
It was March 2014. Karla Kash was in her sixth year as Associate Professor of Theater at Drake University. She received tenure and was head of the B.F.A. Musical Theater Program. She divvied up her time between instructing Drake students and freelancing at theaters in the Des Moines community.
She directed and choreographed musicals at Drake in addition to teaching performance-based classes. From directing, choreographing and even acting in community productions to providing instruction on acting, auditioning, directing, movement and musical theater history, her plate was full of fun things she loved to do.
Then one weekend at the end of the month, Kash was in the shower when she discovered a lump in her breast. She contacted her doctor that Monday, went in for an appointment on Wednesday, received a biopsy by Friday and had results the following Monday.
Kash, 40, was diagnosed with breast cancer. She hadn’t even qualified for mammograms yet. They typically begin at age 50, or age 40 for women of high risk.
Kash was terrified due to her family’s history of life-threatening illnesses. Her mother had breast cancer and died in August 2010 when it metastasized into her liver. One of her sisters has a rare skin disease, though it has been in remission for most of her life.
That Wednesday, her sisters visited from Arizona. On the same day, Kash received a call from the provost informing her that she had won the Mentor of the Year Award to be presented at graduation.
Kash was thrilled to receive such a positive message amidst the solemnity of her newfound situation. When it became time to discuss treatment options, Kash opted for the most aggressive route.
She chose to have a double mastectomy (which removes all breast tissue) followed by breast reconstruction, as opposed to lumpectomy (which only removes the tumor from the breast).
Lumpectomies also involve radiation and have a higher recurrence rate, both of which swayed Kash’s decision.
The mastectomy surgery took place at the end of April. Kash says it was very easy to recover from, and she was back to work a week later. She also was placed on a chemotherapy regimen with six rounds of chemotherapy, with one round every three weeks. She began a second round of chemotherapy every three weeks for a year, which will conclude this month.
“This type of chemo is a really new, innovative type of chemo, and it knows to only attack the bad cells, so that’s why you don’t get sick — that’s why your hair grows back,” Kash said, sporting a cropped hairstyle in contrast to the bangs and shoulder-length locks she had possessed prior to treatment.
According to Kash, steroids are given to patients who go through chemotherapy in order to combat the possibility of an allergic reaction to the cancer treatment. Kash soon discovered that she was having a rare reaction to the steroids when she was unable to sleep for 10 days. She was taken to the hospital and sedated. She slept for three days until her brain resumed healthy functioning.
Recovery took a full week.
“I actually was hallucinating,” Kash said. “It’s the scariest thing I think I’ve ever gone through in my life. It was way more terrifying than the cancer itself just because I thought I was losing my mind, which is what happens when you don’t sleep.”
After the sleep deprivation incident, Kash was terrified for her second round of chemotherapy, which hospital staff administered without the steroid.
They kept a close watch on her for allergic reactions. She is thankful that none occurred.
In spite of the scary struggle with sleep, her biggest battle was yet to come.
Kash opted for reconstruction surgery to complement the double mastectomy. She chose the newer type over the traditional route, which fills implants in order to expand the chest. The newer type of reconstruction was innovative in that specialists took tissue from her abdomen and created breasts from it. The nine-hour procedure followed by three days in the hospital was Oct. 29, 2014. Kash still taught one theater class that fall, which was originally scheduled for one day a week. She doubled-up on Saturdays to ensure that the class would end before her breast reconstruction surgery.
Kash recalls that it was a very intense surgery. Afterward, she was in a lot of pain. She could barely move. She soon developed blood clots in her chest and leg — which left her hospitalized for another five days.
“The whole month of November was a really hard month – spent most of it on the couch or in a hospital bed,” Kash said.
More complications arose in December when she needed retouch for the reconstruction surgery. Thankfully, recovery was not as intense as the actual act of reconstruction.
Kash has come back to Drake full time this semester and has recently started working out again, though not as intensely as she used to.
“My life didn’t really change that much until I had the surgery,” Kash said, “but up until that point my life was pretty steady, the way it normally would be.”
She had no major reaction to the first chemotherapy set other than feeling a little lethargic for a day or two following each of the six rounds. Overall, she remained very active during treatment and even directed and choreographed two plays during that time. Her second set of chemotherapy continues today and will conclude this month.
However, Kash will remain on Tamoxifen, a hormone blocker pill, for the next 10 years.
She was diagnosed with triple positive estrogen-driven breast cancer, making Tamoxifen necessary to block the estrogen.
Though she has no children and never intended to, taking this pill until her early 50s means that she no longer do so.
“It’s basically like putting me in menopause before I go through menopause,” Kash said. “To know that it’s no longer an option is a little sad. It’s a weird dichotomy.”
Dane Van Brocklin, a senior musical theater major from the Des Moines area, has known Kash since before he enrolled at Drake. They met at the Des Moines Playhouse where Kash directed “Joseph and the Amazing Technicolor Dreamcoat.” She has subsequently directed him in productions in and outside Drake.
Van Brocklin was in Acting III with her at the time she announced her diagnosis. Kash recalled that he was very upset at the news.
“I’m pretty sure I got kind of teary-eyed and I freaked out a little bit,” Van Brocklin said, “I also thought to myself if anybody could take this on, I knew Karla had the guts to. I was concerned, but I also wanted to be strong.”
Van Brocklin continued to work closely with Kash over the summer in the production of “Avenue Q,” which she was directing while receiving treatment.
“She handled it fairly well,” Van Brocklin said. “While she was going through treatment she still seemed like her usual, perky self, but you could tell that she was a little fatigued.”
He says she seemed more stressed than usual during this time, but notes that it was most likely a combination of the treatment and her stressful lifestyle.
“Karla is someone who likes to bite off more than she can chew sometimes and presents herself with a lot of challenges,” Van Brocklin said. “She’s a determined individual.”
He felt relieved upon hearing the news that Kash is on the road to recovery.
“Knowing that I’d leave Drake and not really see Karla much anymore after that,” Van Brocklin said, “I felt a lot better about it knowing that she is through the worst of it and that she’ll be fine at this point. I know she’ll be okay because she’s a fighter.”
Kash says she stays strong through a positive mindset modeled to her through both her mother and sister.
“My mother’s motto was always to live life,” Kash said. “She was completely positive up until the day she died. (My sister) could have easily been a lot sicker than she is, and I think part of the reason she’s been so healthy is because of her positive attitude. Those have been two incredible role models for me with dealing with a life-threatening illness.”
Van Brocklin values his time spent working with Kash.
“Karla Kash is a very strong personality with just as strong a heart,” Van Brocklin said. “I think that she has the best intentions for everyone, especially her students.”
Van Brocklin is currently enrolled in Kash’s American Musical Theater History class.
“I’m going to keep up with her, let her know what jobs I’m getting, ask her how she’s doing, ask her how Drake is,” Van Brocklin said. “And if I’m back in Iowa I’ll totally ask for dinner or coffee or something.”
For women currently battling with breast cancer, Kash offers her words of wisdom as a survivor.
“Surround yourself with positive people as much as you can,” Kash said. “I also think it’s important to stay as active as you can. Know your limits. Know what you can’t handle and can handle. Be okay with trying to downsize your life, but also keep some things in your life as much as you can.”