Utrena Woodard rests during a stay at York Hosptial in October.  Woodard, who has stage four metastatic breast cancer, has to receive chemotherapy for the
Utrena Woodard rests during a stay at York Hosptial in October. Woodard, who has stage four metastatic breast cancer, has to receive chemotherapy for the rest of her life. In October, she was hospitalized for an infection that started in the port on her breast. She has grown to accept that sometimes her illness will slow her down. However, she hasn't allowed it to stop her from living her life. (Jason Plotkin — Daily Record/Sunday News)

A couple of hours before her weekly chemotherapy appointment, Utrena Woodard ran errands.

She stopped at her bank and a grocery store to request donations for the Dorcas M. Lehman Wings From Heaven Breast Cancer Foundation. The donations would be used to help people with breast cancer and raise awareness of the disease.

The store manager explained he would need the request printed on official letterhead.

Because of her schedule, Woodard knew she wouldn't be able to return until the following week.

Woodard, 38, of York lives on a condensed schedule. Each week, treating her cancer vaporizes time she'd love to spend doing anything else. Staying busy keeps her mind off her illness. Yet treatment extends her life.

Woodard has battled stage four metastatic breast cancer for 11 years. To keep her cancer at bay, she has to receive chemotherapy for the rest of her life.

The treatments, which she receives most Fridays, make her tired and nauseous. By Monday night, she feels better. By Tuesday, she's up and moving.

Her life is a revolving door of treatments and rest.

• • •

Woodard was 26 years old when she learned she had a disease that would most likely kill her.

In August 2002, she felt a stone-like lump in her left breast. By October, the single mom of three -- ages 5, 7 and 11 -- received her diagnosis.

The cancer had spread to her liver. She had a mastectomy and had a large part of her liver, her gallbladder, ovaries and some glands under her arm removed. She received hormonal therapy then aggressive chemotherapy.

"It was really scary," she said. "At the same time, I didn't have any other choice."

• • •

Utrena Woodard, left, holds her niece Sa’miah DeShields, 3 months, in November at her home in York. Woodard’s weekly chemotherapy treatment
Utrena Woodard, left, holds her niece Sa'miah DeShields, 3 months, in November at her home in York. Woodard's weekly chemotherapy treatment often leaves her feeling ill for several days. When she starts feeling better, she enjoys cooking, spending time with family and friends, and helping others. (Paul Kuehnel — Daily Record/Sunday News)

Woodard said the first few years after her diagnosis were the hardest. Shortly before, she had gotten a divorce. Although she moved to York because her ex-husband was from here, she decided to stay so her kids could grow up near their father. Her family lived in Oklahoma, Texas and Arkansas.

During a time when she was still figuring out life, Woodard felt robbed of her freedom. Having cancer made her more serious about life.

Woodard felt anxious and depressed. In the beginning, she cried a lot whenever she was alone -- in the shower or after she put her kids to bed. She worried about her children living a life without her.

The staff at the York Cancer Center -- her "dream team" -- helped her understand her feelings were normal and that she had to give herself time to feel. After a while, she got tired of crying.

In 2006, she enrolled in Harrisburg Area Community College with the goal of becoming a nurse. She scheduled her classes for Fridays so she could do her homework while in bed recovering from chemotherapy over the weekend. In 2008, she was accepted into HACC's nursing program. In April 2009, after she started clinical work, she learned her cancer had progressed. She had to withdraw. Woodard said that was the only time cancer stopped her from accomplishing her goal. Pursuing a nursing degree was too rigorous considering her health challenges. She felt defeated.

She gave herself two weeks to feel depressed. By that December, she started working on a history degree at Millersville University.

• • •

Dr. Amir Tabatabai said average life expectancy for metastatic breast cancer that spreads to the liver is two years.

He said Woodard's success in fighting cancer has more to do with her luck than his treatment.

When treating metastatic breast cancer, he said, the goal is to prevent the cancer from spreading while preserving the patient's quality of life. Over time, a patient might stop responding to a certain chemotherapy drug.

Utrena Woodard, left, with her nephew Jai’on DeShields, 3 years old, in November at her home in York. Earlier that day, Woodard cooked a dinner for
Utrena Woodard, left, with her nephew Jai'on DeShields, 3 years old, in November at her home in York. Earlier that day, Woodard cooked a dinner for her family. Cooking helps Woodard keep her mind off cancer. (Paul Kuehnel — Daily Record/Sunday News)

Woodard said she has had to change treatments six times. She most recently switched treatment in July after tests showed new spots on her liver, where her cancer is contained.

Tabatabai said Woodard has been a fighter from the start.

"Even in the face of bad news, she's always maintained her faith, positive attitude and hope," Tabatabai said.

• • •

When Woodard isn't feeling ill, she's busy doing thing things that make her feel even better. She loves to cook and to help others.

On a fall day at her apartment, the aroma of barbecue filled her kitchen and steam gathered above a pot of boiling macaroni on her stove. It was her oldest son Tyrique Jones' 22nd birthday, and she offered to make his birthday dinner. He requested ribs and macaroni and cheese.

For dessert, she decided to try her hand at baking, which she said isn't her strong suit. She made a fruit pizza -- a sugar cookie topped with a cream cheese-and-sugar mixture, strawberries, mandarin oranges, raspberries and blueberries.

"For me, this is fun," Woodard said.

When she's sick, she often thinks about new recipes to try. When she cooks, she often invites family and friends over.

She also enjoys helping her friends run errands and volunteering. A couple of years ago, she volunteered for the York Cancer Center taking other patients to their appointments. Last year, she raised money for the Dorcas M. Lehman Wings From Heaven Breast Cancer Foundation. A few years ago, the organization contacted her around Christmas and asked what she and her family needed. She received new tires for her car and gifts for her kids.

Woodard said she has always focused on making other people happy.

"I always try to put myself in someone else's shoes," she said. "I just want them to know that somebody else is thinking about you."

• • •

Jones said he sometimes forgets his mom has cancer because she's so active. When she's sick, he tries to do what he can to help out, such as cleaning the house and driving his sister where she needs to go.

He said his mom doesn't talk much about her illness, and she always focuses on the positive. He described Woodard as selfless, a hard worker and a great mother who encourages him to keep pushing toward his goals.

Jones said it's difficult to see his mom when she's sick from chemotherapy or in the hospital with an infection.

That's when it hits him.

• • •

Having lived with cancer for more than a decade, Woodard said her perspective on her illness has changed.

She has learned that it isn't helpful to be negative and obsess about the what-ifs.

"I can treat it like a death sentence or treat it as a matter of circumstance and move on," Woodard said.

She tries to focus on the positive aspects of her life. For example, in 2013, her daughter Brandy Woodard turned 16, her son Trajan Woodard started college, and Jones graduated from technical school.

Now that her kids are older, she's thinking about pursuing a master's degree in emergency management and hopes to find a job that can work around her treatments.

Although she has grown so much through her battle with cancer, she said, one thing has remained the same.

She still can't imagine not being here for her children.

• • •

Woodard also has learned to listen to her body. In the beginning, she ignored symptoms from chemotherapy and tried to push through. Now that she's more seasoned, she knows there will be times when she has to slow down and rest.

Recently, the port on her right breast became infected. At first, her breast was pink. The following day, when she was out fundraising, it stared to hurt and it turned red. Then redness spread to half of her breast. She went to see her doctor, and he told her it was a good thing she caught it early. She needed to be treated in the hospital.

Woodard thought about everything she had wanted to do. She wanted to go out to dinner that night with Brandy, Jones and her aunt Marcia DeShields.

But her plans changed. She ran to the grocery store to pick up a few things for her kids and dropped off an umbrella for her daughter at school. Then she went to York Hospital.

The following afternoon, she lay in bed. Her big hazel eyes framed by short lashes half watched the TV. DeShields sat by her side. She thought about a new recipe she wanted to make: shrimp and crab sauce over rice. She was going to do it yesterday.

In the past, she said, she might not have dealt with being hospitalized as well as she does today. She might have viewed it as a setback. Today, it's more of an inconvenience -- a bump in her road.

She said she knows she's going to have roadblocks. How she handles them is what matters.

Metastatic breast cancer

Metastasis refers to the spread of cancer to different parts of the body, typically the bones, liver, lungs and brain. About 155,000 Americans are living with metastatic breast cancer, and 40,000 Americans die from the disease each year.

Treatment for metastatic breast cancer is lifelong and focuses on controlling the disease and preserving quality of life.

About 6 percent to 10 percent of people who have the disease were diagnosed at stage four.

Twenty to 30 percent of people diagnosed with breast cancer will develop metastatic breast cancer.

-- Metastatic Breast Cancer Network

Meet Woodard

Name: Utrena Woodard

Age: 38

Lives in: York

Family: Sons Tyrique Jones and Trajan Woodard, daughter Brandy Woodard

Education: Bachelor's degree in history

Hobbies: Cooking, volunteering, helping others

On cancer: "I can treat it like a death sentence or treat it as a matter of circumstance and move on."