Karen Lander doesn't care whether doctors prescribe prayer along with chemotherapy. And not even the most devastating test result could convince her that the prayers said on her behalf haven't been heard. Though she's battling a cancer that refuses to retreat, this 39-year-old mother is a staunch believer in the healing power of prayer.

In July 1996, when the youngest of her three children was not yet five months old, the Brewster, New York, woman learned she had an uncommon but aggressive form of breast cancer. In the 4 1/2 years since, she has undergone a mastectomy, chemotherapy, drug trials, surgery for a tumor that spread to her brain, and radiation for tumors that spread to her chest. She had an unsuccessful stem-cell transplant and, based on the latest troubling test results, will undergo treatment for another brain tumor soon.

But all is not CAT scans and ORs for Karen Lander thanks--in her view--to her own prayers and those of family and friends. She recently earned her emergency medical technician license and works 12 hours a month at the profession, which, she says, keeps her mind off her troubles. She routinely stops the car to admire a deer or a bird with her children. And she--always one to hold a grudge--doesn't anymore.

The richness of her life, she believes, is proof that prayer works. "God did not give me the tumors or the disease, but God's helping me cope with what's happening in my life. He's giving me the strength to deal with what I have to deal with."

And, she said, God's response to intercessory prayer on her behalf allowed her far more time than she was supposed to have. Typically, patients with her diagnosis could expect to live 16-18 months.

Lander said it has been communal prayer with fellow church members that has strengthened her most. When their friend's treatment appeared to be failing, some of Lander's fellow parishioners at St. Andrew's Episcopal Church in Brewster sought out then-pastor Susan Richmond, who assembled a prayer group.

"A lot of people thought she was dying. They weren't sure of what role they should play, or what they should be praying for," said Richmond. Her intuition, she said, was "to pray for what Karen wants...to ask her `what is it you need from us?'"

The priest, who has since moved to the Boston area, said Lander tended to request prayers for her family, for healing, for strength and courage, and to be able to know God's will. With those requests in mind, the six women she assembled, who ranged in age from early 30s to 84, meet at Lander's home at least monthly for readings, poems, healing prayers, and the laying on of hands. They end with a celebration of the Eucharist.

Typically, each woman offers her own individual prayer for Lander, often in very characteristic styles. Some are open-ended in the results they request. Others are extremely specific, praying for removal of a particular tumor, for example. After the service, the talk turns to temporal needs as the women make sure meals, chauffeur duties, and other household details are covered.

Yet despite the group's prayers and tangible efforts to support Lander, the cancer continues to advance. Does this mean, as some researchers conclude, that prayer doesn't work?

Said Lander's former pastor, "I believe what Karen tells me--that she wouldn't be alive if it weren't for the prayers that surround her. She's lived far longer than expected, and she's lived well. And there's certainly been emotional healing and spiritual healing."

Lander said the group, especially, has given her strength. "It's very calming, very reassuring. There's almost a peacefulness," she said, a sense that "you're not alone--not one person out there sick by yourself having to figure out what to do with your life."

Lander has left some meetings feeling stronger immediately. "They're exhausted and I have all this new energy," she said. She recalled one memorable "laying on of hands" in which those praying place hands on the person being prayed for. "Before they began, I was crying. Afterward, they were crying and I was fine. They transferred their prayer and their strength into me, and I felt it." Richmond recalled that Lander "started laughing about it. The group was full of laughter. Even during the liturgy," she added. "The laughter was about equal to the tears."

Lander attributes such healing to the Holy Spirit and said it has happened repeatedly. Fortified by prayers as she headed into the operating room to remove her brain tumor, she said she felt "this calming warmth come over me, as if the Holy Spirit said, `You made the right choice and everything is going to be fine.' I've never seen a miracle, but I've felt one [that day]."

Richmond said that while the focus of the St. Andrews prayer group has always been Karen Lander's well-being, she believes each of the women has been changed by what she called "God's almost tangible presence" in the group. They have developed a deeper understanding of God and of their own trials, she said, and several have taken up ministries of their own at the church.

In Paoli, Pennsylvania, a suburb of Philadelphia, Lander's older sister, Alison Ross, also prays fervently and faithfully despite more than four years of ever-worsening news. But Ross said the prayer for healing she remembers most was said on her own behalf, not her sister's.

About a year ago, learning that her sister faced yet another uncertain treatment, Ross was raw, numb, exhausted, and angry at God. A fellow parishioner saw Ross as she dropped her daughter off at dance class that day, and, according to Ross, asked, "What's wrong?"

"I said, `Everything's fine.' She said, 'No, it's not.' She began to pray for me, and I could finally let go of that dam that was blocking me," Ross recalled.

Scientific studies won't change the minds of many believers who are convinced they have already tasted the fruits of prayer, regardless of whether the "answer" is yes or no, sickness or health. Says Richmond, "I am one of those people willing to chalk it up to the mystery of the Lord."

As for Karen Lander? She testifies to prayer's power simply by stating, "I'm still walking, I'm still breathing, I'm still driving."