San José, Costa Rica, since 1956

Expat ‘Beats the Crap out of Breast Cancer’

Lisa DeFuso smiles when she tells the story of how the thieves of Costa Rica saved her life.

The New York City native has been living in the western San José suburb of Escazú with her husband, Tom Humes, for the past 10 years. In 2007, a string of violent robberies in her neighborhood had DeFuso worried. The bandits, she explains, were breaking into homes and holding the owners at knifepoint, forcing them to open their safes and then making off with the contents.

The strong-willed DeFuso was determined not to become a victim. She redistributed her valuables among various hiding spots, leaving behind only important documents she wanted to keep safe from fire. Among the tax returns and insurance policies, she found medical records that reminded her she had neglected to get a mammogram since 2002.

She scheduled an appointment at once.

After several tests and a subsequent lumpectomy, doctors discovered DeFuso had Stage 1 breast cancer that had spread to one lymph node. Although the cancer wasn’t as serious as it could have been – as if a 1.2-centimeter, cancerous tumor can be called anything but serious – two years of chemotherapy, a catheter and radiation treatment aren’t anything to laugh at. But that is exactly what she did.

DeFuso refuses to see her sickness as anything other than an “adventure.” Sure, there were terrifying times of uncertainty, she says, and she had a few well-deserved meltdowns here and there, but she made a serious effort to stay as positive as possible.

Every month of her adventure, she sent out a personal newsletter to her friends. She called it “Lisa Beats the Crap out of Breast Cancer,” and her buoyant attitude shone through in self-deprecating jokes about hair loss and Spanish-language mishaps.

More than anything, she wanted to provide the women she knew with practical information about breast cancer and to warn them to stay up to date with their mammograms.

“You shouldn’t have to go through this,” DeFuso says. “This is one of those cancers where early detection is what it’s all about.”

Breast cancer does not discriminate by age or lifestyle. Any woman can be a victim, regardless of whether her family has a history of the disease. No one in DeFuso’s family has ever had cancer, and she had no way to see it coming.

“What I learned is that I didn’t do anything wrong. I didn’t do anything to cause it. I take no blame for it. It’s really a crap shoot,” she says.

Last year in Costa Rica, more than 380 women died from breast cancer. DeFuso insists there’s no reason not to get a mammogram. Friends have explained to her that they don’t want to go because they are afraid of what the mammogram might reveal.

“I know it’s a scary proposition, but if you nip something in the bud, it’s a lot easier on you in the long run,” she says.

Cost should be no impediment either, DeFuso says. Even without insurance, Clínica California in eastern San José’s Barrio La California offers mammograms and ultrasounds for ₡50,000 (about $100) – a small price to pay for the health and peace of mind the simple procedure can bring.

In fact, all treatments and medications are much less expensive in Costa Rica than they are in the United States. For example, radiation treatment costs about $16,000 dollars here, compared to $60,000 in the U.S., DeFuso says.

DeFuso considers herself fortunate to have discovered her breast cancer while living in Costa Rica.

“If this had happened to me in New York, I would have been wiped out. There just would have been no way to pay for this,” she says. “So if you think about it, I was really lucky.”

Although she acknowledges she still feels a little tired sometimes, DeFuso is back to her everyday life. She exercises, plays with her dog, Jhadi, and teaches a middle-school drama class. She considers her stint with breast cancer to be no more than a “hiccup” in her life, and now she’s back with a renewed resolve.

While she’s always had a profound appreciation for life, DeFuso says her perspective has changed. Instead of getting upset by little setbacks, she repeats what has become her mantra: “I didn’t beat breast cancer to be taken down by this.”

October is Breast Cancer Awareness Month. Movimiento Rosa, a Costa Rican organization promoted by Auto Mercado supermarkets, is working to educate women about breast cancer and to raise money for medical equipment to treat women afflicted with the illness in Costa Rica.

Those wishing to support Movimiento Rosa can purchase promotional items like umbrellas, bracelets and pins at any Auto Mercado store. From Oct. 15 to 30, supporters can also make donations at the supermarkets’ cash registers.

For more information on Movimiento Rosa, visit its Facebook page. For information on breast cancer and Breast Cancer Awareness Month, see

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