Norberto and Ana Costa – A true give and take

We hear how married couple, Norberto and Ana Costa, faced three cancer diagnoses without medical aid, with their love and sense of humour carrying them through.

You can listen to this article below, or by using your favourite podcast player at pod.link/oncologybuddies

Norberto (65) and Ana Costa (59) live in Edenvale, Gauteng. They have two sons and one grandson. They have been married for 41 years.

When Norberto and Ana moved to South Africa in 1994, they were on a medical aid. However due to the medical aid refusing to pay for Ana’s tubal ligation (fallopian tubes are cut to permanently prevent pregnancy), stating it was a cosmetic surgery due to her age (33) and then also refusing to pay for her son’s tonsils to be removed, Norberto decided to stop the medical aid as they were paying cash anyway for all their needed procedures. If they can afford the cost of private doctor appointments, they pay but then get referred to public hospitals for any surgeries and procedures.

Breast cancer

Ana was diagnosed with breast cancer, in 2012, at the age of 48. Norberto, being a loving husband wanted to go fetch the results after the biopsy so Ana wouldn’t have to but unfortunately, they had already phoned her and told her the diagnosis. “I was crying; to hear that news over the phone from a stranger while alone at work was terrible,” she says. 

“When I came home and told Norberto, we cried together but he reassured me that I was strong, and we would get through everything together.”

Ana’s GP referred her to a breast specialist: when the breast specialist heard she didn’t have medical aid, Ana was referred to Helen Joseph Hospital Breast Care Clinic. At first Norberto was against it but once they were showed around the unit, they were happy. 

Due to Ana not having a lump, she had calcifications (carcinoma in situ) all over the left breast, the breast specialist explained a lumpectomy couldn’t be done and a mastectomy was needed. Ana was given the option of having both breasts removed with immediate reconstruction, or only having the left breast removed but there was a chance that calcifications could appear in the right breast and then chemotherapy would be needed.  

Supportive husband

Ana spoke to Norberto about it and he expressed that it was her choice entirely as it was her body and he would support her either way. “I had already made my decision and I opted for both to be removed and reconstruction,” Ana says. 

The surgery took place in May 2012. Ana found the management of the drains the most difficult but thankfully Norberto took charge, measuring the fluid coming out, writing it down, then empting them and changing plasters. He jokes saying, “I did it because I knew I didn’t have the money to pay if anything went wrong.” 

Ana has since become a volunteer for Breast Health Foundation and their support group Bosom Buddies.

Removal of thyroid

Ana was also diagnosed with rheumatoid arthritis (RA) in 2011; her GP informed her that somehow RA is connected to thyroid problems. 

In 2014, her thyroid was removed as she had a goitre and one of the eight nodes was cancerous. She currently is on thyroid medication. 

Colon cancer

In March 2022, Norberto consulted with an ENT regarding polyps in his nose that were causing headaches and a runny nose. An operation was suggested and so he was referred to a public hospital to have the surgery. The operation was a success.

Since Norberto had also experienced stomach pains for the past four years, he mentioned this and was referred to a gastroenterologist. In June 2022, he had an endoscopy (camera through mouth), and a colonoscopy (camera through anus) and a biopsy and Stage 3B colorectal cancer was detected 40cm from the rectum. A CT scan was booked to prepare for surgery.

The 65-year-old said he felt nothing when he heard the news and drove back home to tell Ana and their son. “I was crying, and my son was worried, so we were more anxious than him,” Ana says. 

Treatment

Ana says Norberto was worried about whether he would need a colostomy bag (an opening in the large intestine to collect faeces). However, the doctor explained that would only be decided during the operation when they see how much of the colon needed to be removed; three surgical options were proposed.

Thankfully, the surgery was a success and they could remove the cancer and re-join the colon, so no colostomy bag was needed. “If I needed it, I needed it but it’s not nice to have so I was happy I didn’t need one,” Norberto explains. 

Eight cycles of chemotherapy started in December 2022 which has recently been completed.

Side effects

Norberto says he battles with nausea the first few days after chemotherapy, but he can handle it. However, the fatigue is taking a toll on him. “But what I want other men to know is that they will lose their sex drive while on chemotherapy; it’s not the same,” Norberto says. Ana laughs at this comment and says, “The main focus here is for him to get well.”

Doing much better than expected

Ana admits that she never expected Norberto to do so well during chemotherapy. “I was preparing him for the worst, but he has done so well. He drives himself to the hospital and drives back after every session,” Ana says. 

“I went with him twice but since I can’t sit with him in the chemotherapy unit, he told me that it was no use for me sitting for hours, waiting for him. And he doesn’t sleep or stay in bed during the day, he always keeps moving around.”

Both Norberto and Ana see age as just a number and feel they both done well in treatment, irrespective of their ages. “Both of my parents lived till their mid-nineties, so I hope to follow them,” Norberto concludes.  

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