Cancer Lesson #20: Leave Your Modesty at the Door

Cancer Lesson #20: Leave your modesty at the door.

By the time I met my plastic surgeon (and, yes, it still feels weird to be able to use that phrase), I’d realized a lot (and I mean a lot) of people would be looking at (and probably touching) my boobs in the next year or so.

Thus, when Dr. K2 asked if he could take photos to document his work, I unhesitatingly took off my shirt, stood in front of a blue cloth and allowed my breasts to be photographed for posterity. (A little over a year later, we repeated the process for the “after” shots.)

And that was just the beginning. When I was in the hospital after my surgery, it sometimes felt like I was hosting a parade of interns, each of them interested in one thing – my newly reconstructed right breast.

I’m not exaggerating. My breast surgeon had at least two interns checking in on me, and my plastic surgeon had four or five, all making the daily rounds. Plus there were regular checks (hourly at first) by the nursing staff.

So, if you’re beginning breast cancer treatment and possess even a shred of modesty, I’d suggest you leave it at the door.

More recently, my oncologist has mentioned several times how a TRAM reconstruction tends to age more naturally (read: Your TRAM boob will sag just like your non-TRAM one). He mentioned seeing pictures at conferences that demonstrate this.

It crossed my mind that photos of my breasts have probably been displayed at plastic surgery conferences.

I find this kind of funny. Who would have thought I’d be a pinup girl after all these years? And after all my breasts have been through, they deserve a little extra attention, especially if it helps plastic surgeons do an equally good job on someone else in the future.

Lyndon Johnson shows his surgery scars. Photo from Briscoe Center for American History (if you can’t read the overlay!)

Cancer Lesson #6: All Shall Be Well and All Shall Be Well. All Manner of Things Shall Be Well

Cancer Lesson #6: “All shall be well and all shall be well. All manner of things shall be well.” — Julian of Norwich

Also, John Lennon: “Everything will be okay in the end. If it’s not okay, it’s not the end.”

I believed it then and still do. One way or another.

Cancer Lesson #5: Everyone Reacts Differently

Cancer Lesson #5: Everyone reacts differently.

The doctor’s office called early on Friday, March 18 2011. She wanted to see me as soon as possible, early that morning if I could manage it.

Better to face bad news sooner rather than later, I thought, and agreed I’d come as soon as I got dressed. From the timing of the call and the urgency in the secretary’s voice, I knew my diagnosis was cancer. The only surprise was one of my lumps — sorry, masses — was nothing. The one I’d found was cancerous, and the third was an engaged lymph node (not good news).

I didn’t cry — not then and not much later — focusing instead on what would happen next.

It’s so weird to find out you have cancer, to learn that your body is harboring something that, if left unchecked, will kill you, especially when, like me, you have no symptoms. You feel as if you’ve slipped into an alternate reality, kind of like the suspension of disbelief you experience when watching a movie or reading a book.

I’ve thought about this a lot, and the analogy I keep coming back to is that of a train. You’re on this train, following the same track day after day, when click, you’re switched to a completely different route. All the other trains continue on the main line while you take a detour over some rough but scenic rails. Perhaps you’ll rejoin the fast track again, perhaps not. Nobody knows, but for now at least, this new track is your only way forward.

Everyone reacts differently, not only emotionally but physically too — this is a lesson I’ve learned again and again. The range of possible emotions is so wide — everything from anger to fear to outright disbelief. There is no one right way to feel.

I remember driving home thinking, “I should be crying. Why am I not crying?” but all I could think of was how I would have to ask someone else to captain my soccer team and where and when I could tell my family. I decided to tell my husband that night, but not my daughter. She’d just gotten her driver’s license the night before. That’s such a milestone. I couldn’t ruin it for her so quickly.

It was thoughts of her that brought the only tears to my eyes that day, when Dr. S suggested I be tested for BRCA1 and BRCA2. She recommended this course of action because I was “young” and one of my aunts also got breast cancer early, and then got it again thirty years later.

The idea that I might have passed on such a gene to my only child scared me more than anything else I might have to face.

Cancer Lesson #82: Everything Gives You Cancer

Cancer Lesson #82: Everything gives you cancer.

One of the (many) weird things about having survived breast cancer is that no one really knows why I got it. As you can imagine, this makes it hard to figure out how to avoid a recurrence.

That doesn’t mean there’s a shortage of opinions on the subject, in fact, quite the opposite. There are a plethora of behaviors, foods and environmental factors that have been linked to cancer.

Next time you’re bored (or even now), try typing  ___________ and “cancer” into your favorite search engine. Fill in the blank with whatever you like. I’d lay money your results will say that thing either causes or prevents cancer.

For example, “tea and cancer” (since I’m drinking a cup right now) rewards us with “Among their many biological activities, the predominant polyphenols in green tea―EGCG, EGC, ECG, and EC―and the theaflavins and thearubigins in black teas have antioxidant activity (12). These chemicals, especially EGCG and ECG, have substantial free radicalscavenging activity and may protect cells from DNA damage caused by reactive oxygen species.” from Cancer.gov. Excellent! I’ll go pour another cuppa.

“Reading and cancer”  brought up “A new study released Monday by the Centers for Disease Control has found a direct link between a particularly aggressive strain of ocular cancer and reading text on a computer screen …” Good thing I noticed “The Onion” heading at the top of the page, or I’d have been worried.

The Mayo Clinic says a glass of red wine is good for your heart, so let’s try “alcohol and cancer.”

From Breastcancer.org: “Research consistently shows that drinking alcoholic beverages — beer, wine, and liquor — increases a woman’s risk of hormone-receptor-positive breast cancer. Alcohol can increase levels of estrogen and other hormones associated with hormone-receptor-positive breast cancer. Alcohol also may increase breast cancer risk by damaging DNA in cells.”  But according to a  CNN health blog, drinking alcohol may improve breast cancer survival.

Which is it?  I know which outcome I favor.

Because there’s a lot of talk about pregnancy’s effect on the risk of breast cancer, I searched “pregnancy and cancer.” Here’s what the Susan G. Komen site said: “Although a first pregnancy may increase the short-term risk of breast cancer, it lowers the long-term risk. Pregnancy’s effects depend on your age when you first give birth.”

Confused yet?

“Exercise and cancer,” “soda and cancer,” “lemon juice and cancer,” even “vinegar and cancer” — according to someone somewhere they’re all connected to cancer.

I finally searched “things that give you cancer” and got several lists, including one from the UK’s Daily Mail. It tops out at 116 items and includes wood dust, outdoor air pollution, and oral contraceptives, along with at least 100 chemicals I can’t pronounce but have no doubt come into contact with.

I’ve concluded I must do what seems logical to me. So here are my personal anti-cancer strategies:

• Eat more vegetables (grown organically and/or locally when feasible) and less chemical-laden processed food (although I still can’t bring myself to eat kale).
• Exercise regularly. For me, this is at least three times a week and should be more.
• Know what’s important and what’s not worth worrying about.
• Take a multi-vitamin, calcium, and my hormone inhibitor.
• Enjoy time doing the things I love, with family and friends and sometimes by myself.
• Keep my sense of humor.

Will it work? No one knows.

As the American Cancer Society says ” … even if you do everything just right, the cancer still might come back.”  Later in the same article, they continue, ” … with our current understanding of how it develops and grows, cancer is still a mystery in many ways.”

There are no guarantees.
There never has been.

Still, to help with the keeping your sense of humor strategy, here is a link to  Joe Jackson’s  jazzy thoughts on the subject.
Click through. I think you’ll enjoy his song.

 

 

Cancer Lesson #81: I Am Hope.

Cancer Lesson #81: I am hope.

When I did the American Cancer Society’s Relay for Life a few weeks ago, I didn’t introduce myself with the rest of the survivors. This year, it felt a little too self-congratulatory, celebrating a result over which I had minimal control.

My mind began to shift, however, when the “Honorary Survivors” spoke. The “Junior Honorary Survivor,” who was about fourteen, talked about how she understands there are some things you can change and some you can’t. She said how important it was to focus on what we can do, instead of worrying about what we can’t, which I thought was very wise for one so young.

The adult spokesperson was a theirteen-year survivor of pancreatic cancer. This is almost a miracle, and that fact alone made me begin to think a little differently. (The Hirshberg Foundation for Pancreatic Cancer Research quotes the American Cancer Society as giving an average five-year survival rate of about 6%.)

My perspective began to change that day, but the lightbulb moment came when I was folding a load of laundry earlier this week.

I am hope. I am hope. I am hope. 
On t-shirt after t-shirt, the message stared up at me. 

I am hope.

Not because I did anything special.  And certainly not because I deserve it more than those who are gone. But just as my friends’ deaths were beyond my control,  I also don’t want to change the fact that I’m still here.

It’s time to focus on what I can control , to consider what I can try to be for others.

Hope.
A beam of light to those who are beginning treatment.
A voice of — if not reason — then at least perspective on what the future might look like.

I am the hope, that five years after surgery and chemo, you can still ride a bike, play soccer as badly as you did before, enjoy your family and loved ones.

I am the hope that, like me, you might take a little extra time to appreciate the beauty of our world — the green of the trees, the glimmer of sun on water, and yes, even the raucous cacophony of cicadas.

I am the hope that you will survive to become hope too.

And I am the hope that we will always remember those who didn’t.

Namaste, Pat, Dale, Maribeth, and everyone else who is no longer with us.
The light within me salutes the light within you, the light that lingers on in those you loved.

 

Cancer Lesson #76: We are not in control.

 

For most of my life, I’ve deluded myself into believing I am somehow in control.

Getting cancer swept that illusion away, but the lesson proved astoundingly easy to forget once I started feeling better.

Today, though, I was reminded once again just how helpless we all are.

We fool ourselves into thinking there’s always something we can do to make things better, whether it’s for ourselves or for those we love.

And sometimes there just isn’t.

Still, I find it hard to give in, to surrender this illusion of control, though I know it is only an illusion. It’s just so damned hard to realize there are some situations you can’t fix.

Maybe that’s why we find it difficult to deal with terminal or serious illness.

What do we do when nothing we do will help?

I don’t know the answer to that question. Maybe all we can do is admit we don’t know what to do and ask if there’s something we haven’t thought of.

And when we have the opportunity to do anything – however small – that will make someone’s life a tiny bit better, we should act.

Because there will be times when there’s nothing we can do.

Cancer Lesson #75: Tittoo Defined

Cancer Lesson #75: Tittoo Defined
Warning: This post may be a little TMI for some readers.
Tittoo: [ti-too]  verb, –tooed, -tooing, noun, plural -toos
verb: 
to color a reconstructed nipple by puncturing the skin and infusing dyes.
noun
: 1. procedure used to color the nipple on a reconstructed breast,
2. reconstructed nipple that has been colored by puncturing the skin and infusing dyes.

Sample Sentences
Verb: Part of the physician’s assistant’s job was to tittoo the breast cancer patients who had undergone reconstructive surgery.
Noun: Wow! My tittoo didn’t hurt at all — not like the tramp stamp I got in Vegas when I turned twenty-one.

Cancer Lesson #74: Happy to Be Here. Happy to Have Hair.

Cancer Lesson #74: Happy to be here. Happy to have Hair.

I find it hard to believe it’s been three and a half years since my last chemo. How could I have had surgery and treatment for cancer, and managed to emerge with a normal life once more?

It boggles my mind.

It’s a new kind of normal, of course. Though they’ve faded, I have scars to rival Frankenstein’s, and — like others who have gone through a bodily trauma — aches and pains I never had before.

For nearly a year, my chemo curls rowdily rioted around my face like the aftermath of a bad perm.

But I’m back to playing soccer, and last year I did a bike tour. I’ve also been known to attempt a cartwheel, usually in an ill-conceived fit of whimsy. The last one ended with me plopped on my bottom, but never mind.

Clearly neither my tumbling nor my soccer skills will ever win me a place on an Olympic team. And there are granddads (plenty of them) who zoom past me whenever I ride my bike.

The point is no one know if I’d ever be able to do any of these activities again, and I can.

That’s worth a cartwheel.

Having survived cancer, I know everything else is gravy. The icing on the cake. The cherry on the – well, you get the idea.

Being alive is a miracle, and I developed a mantra to remind me of that fact.

“Happy to be here. Happy to have hair.” I say it whenever I start to stress over something stupid. Sure, it’s not the most sophisticated phrasing, and maybe I sound a little silly.

I say it anyway because I know I’m one of the lucky ones.

I’m still here.

“Happy to be here. Happy to have hair.” I say it in memory of those who are not.

Take a moment to think of them. And take some time to enjoy the life’s extras too – the gravy, the icing, and the cherry on that sundae.

I do. Especially the sundaes.

Cancer Lesson #73: Being Treated for Breast Cancer Expands Your Undergarment Wardrobe.

Cancer Lesson #73: Being treated for breast cancer expands your undergarment wardrobe.

Sorry, guys. I’m not talking Victoria’s Secret. Think Bridget Jones’s granny panties.

You see, while having tissue relocated from stomach to chest leaves a flatter stomach (Yay!), it also weakens the abdominal muscles (Boo!)

Hence, the temporary need for support knickers, aka “granny panties.”

For several weeks – or was it months? – these lovely undies were accessorized by a cotton contrivance of a brassiere with thick straps and Velcro closures. Sexy, this bra was not.

For a long time, even wearing a sports bra was painful because of my scars so I resorted to camisoles, and not the alluring lacy ones the word calls to mind. Mine were more like tank tops with lycra. Not bad, but definitely not the come-hither attire of a siren.

Then I had my “reconstruction revision procedure.” How’s that for a medical euphemism? (See Cancer Lesson #43 “A Glossary” for more and #57 “Sets Don’t Have to Match” to add to your breast vocabulary.)

Happily, the anesthesiologist knocked me out for the procedure. Unhappily, I work up wearing yet another surgical bra.

Sigh. I put on my big girl panties and got on with it.

Addendum: I would be remiss if I closed without sharing a link to “Otto Titsling” sung by Bette Midler. If you’ve never heard this paean to the subject of female support, click through and enjoy.

Cancer Lesson #72: Don’t Ignore the Lump.

Cancer Lesson #72: Don’t ignore the lump.

Each year when I go for my annual mammogram, I get a little nervous. Some breast cancer survivors find follow-up tests very distressing, but I always feel better after being checked. Ignoring a problem rarely makes it go away, especially when that problem is cancer.

If you’ve had breast cancer, you know people like to share their own close calls.

“I had a lump once,” they’ll say. “I was really worried, but it turned out to be nothing.”

Those are the good stories.

We also hear the other, not good stories. At least one person has told me “If I’d gone to the doctor when I first found my lump, my cancer wouldn’t have been so advanced by the time it was treated.”

The most heartbreaking of all was the man who said, “If my wife had gone to the doctor right away, she’d probably still be alive.”

You may be thinking I made that last one up.

I wish you were right.

So, here’s Cancer Lesson #72, repeated because it’s so important: Don’t ignore the lump, no matter where it is or how small.

If I’d ignored mine, I’d still have cancer, just more widespread and, oh yeah, more likely to kill me.

Thanks. I’ll take that mammogram.