When cancer spread into her lungs, doctors told Audrey Toguchi she had six months to live, at best, and suggested chemotherapy as the only option.
Toguchi, however, turned to another source—a Catholic missionary who died more than a century ago.
"I'm going to Molokai to pray to Father Damien," Toguchi calmly told Dr. Walter Y.M. Chang after hearing her death sentence.
"Mrs. Toguchi, prayers are nice and it's probably very helpful, but you still need chemotherapy," replied Chang, who earlier had removed a fist-size tumor from Toguchi's left buttock that was the source of the cancer in her lungs.
Defying Chang and the pleas of her husband and two sons, Toguchi caught a flight from Honolulu to the remote peninsula of Kalaupapa on the island of Molokai to pray at the grave of the priest who had ministered to people with leprosy until he, too, caught it and died in 1889.
"Dear Lord, you're the one who created my body, so I know you can fix it," Toguchi prayed. "I put my whole faith in you. ... Father Damien, please pray for me, too, because I need your help."
On a doctor's visit on Oct. 2, 1998, a month after cancer was first detected in her lungs, doctors expected the tumors to have grown. Instead, they had shrunk, and by May 1999 tests confirmed that they had disappeared without treatment.
Chang and a half-dozen other doctors, including a cardiologist, oncologist, pathologist and radiologist, couldn't explain it. Chang, who does not belong to any religion, urged Toguchi to report it to the Catholic church.
The Vatican conducted an extensive review and concluded Toguchi's recovery defied medical explanation.
On July 3, Pope Benedict XVI agreed and approved the case as Damien's second miracle, opening the way for the Belgian priest to be declared a saint.
The Vatican requires confirmation of two miracles attributed to a candidate's intercession before canonization, or sainthood.
Church authorities approved Damien's first miracle in 1992. In that case, Sister Simplicia Hue of France, who was dying of a gastrointestinal illness, recovered overnight in 1895 after she began a novena, or nine days of prayer, to Damien.
Toguchi's story, and identity, were kept secret for years while the church investigated her case. Today, the 80-year-old retired schoolteacher talks openly of her experience.
She and her husband of 50 years, Yukio, live in the hills above Pearl Harbor, just up the road from Aiea High School, where she taught social studies.
Toguchi is a deeply religious and kind woman who is generous with hugs and smiles to everyone she meets. As a teacher, she often told students how special they were and earned the nickname "Ma" for her nurturing ways. Since retiring in 1995, much of her time now goes to her garden.
Toguchi doesn't care for the title "miracle woman," as some have called her.
"I'm just a regular Joe Blow. You can tell," she said. "I still don't know why this happened to me."
Chang says Toguchi's chances of survival at the time of his diagnosis were zero, even if she had agreed to chemotherapy.
"It may have delayed her eventual demise, probably slow (the cancer) down, but eventually, she would have succumbed to this vicious cancer," said Chang, who retired in 2004.
Toguchi had been diagnosed in December 1997 with liposarcoma, an uncommon tumor that arises in deep fat tissue—in this case, her buttock. She had several operations followed by radiation. A month later, doctors found and removed an unrelated cancer in her thyroid gland.
In September 1998, an X-ray showed three growths in her lungs. A needle biopsy of one showed it was consistent with the liposarcoma found in her left buttock. Follow-up X-rays showed the growths were shrinking on their own.
Dr. Richard Schilsky, a University of Chicago cancer specialist who is president of the American Society of Clinical Oncology, said it's "highly likely" that the lung had already been seeded with liposarcoma cells when her original tumor was found.
Schilsky said it isn't clear that all three lung growths were cancer, since only one was biopsied. And there are several reasons people get small inflammatory nodules in the lungs that might resolve spontaneously.
"The point here is that the primary tumor was treated," and that could have helped her immune system control any remaining cancer in her body, said Schilsky, who did not treat Toguchi. He based his comments on Chang's case report in the October 2000 edition of the Hawaii Medical Journal.
Rare cases of spontaneous remission, or regression, are reported, mostly involving melanoma skin cancer, kidney cancer or lymphoma—hardly ever solid tumors like breast, prostate or colon cancers, Schilsky said.
"The bottom line is, it probably does happen. Obviously, it happens very rarely because it is the nature of cancer to grow, not to regress," he said.
Chang agrees that "no one truly knows" why some cancers disappear.
"For the true believer or faithful, this is a miracle. For the true skeptic, this is a random or very unusual coincidence. For the doctor and scientist, we call it complete spontaneous regression of cancer."
Toguchi believes it was Damien and looks forward to the day when the priest is canonized, which is expected early next year. She plans to go to Rome for the ceremony.
Damien, born Joseph de Veuster, arrived in the islands in 1864. Nine years later he began ministering to leprosy patients on Molokai, where some thousands had been banished amid an epidemic in Hawaii in the 1850s. After contracting the disease, also known as Hansen's disease, he died on April 15, 1889, at 49.
His remains were moved to Belgium in 1936. A relic of his right hand was returned to his original grave on Molokai after he was beatified by Pope John Paul II in 1995.
His life and work have inspired many, from Mother Teresa, who lobbied for Damien's sainthood, to Mahatma Gandhi.
Toguchi returned to Damien's grave after the cancer disappeared. This time, she took her husband, Yukio, who comes from a Buddhist family and attended Methodist church growing up on the sugar plantations of Maui.
"I'm not the praying type but I just wanted to say 'Thank you,'" he said. Every day is a blessing to him now, he said.
Audrey Toguchi still prays often to Damien, asking him to help others.