Tuesday, July 10, 2007

My Cancer: Executive Summary

At first, I found it weirdly exhilarating to tell people about my cancer. When someone asked, "so, what's new?", I now could share a stirring narrative. This doesn't mean I was happy about getting cancer, just that it was dramatic, and god knows I love drama and attention. Then, it began to sink in: this isn't happening to someone else--it's my cancer. After about a dozen emotionally draining conversations with different people, I realized that I was going to go nuts if I had to answer the same questions over and over. Thus, I hope this summary will help all of us deal with something that scares the hell out of me, and causes a lot of anxiety among those who care about me.

What kind of cancer is it?

I have breast cancer. The primary lesion is in my right breast, with additional malignancy detected in at least one of my axillary (armpit) lymph nodes.

At least you caught it early

I wish it had been caught sooner. I have had history of benign lumps, and must admit that I became pretty cavalier about having things checked on a regular basis. My OB/Gyn recommended an ultrasound in August of 2006, and I neglected to follow up. The lump had been previously examined and appeared to be cluster of benign cysts. I hope my experience will be instructive to others and get a few of you in for a screening. The final diagnosis was confirmed by biopsy two weeks ago.

What finally made you go in for a screening?

The lesion started to feel and look different than benign breast lumps. Benign breast tumors are often (but not always) tender or painful. This produced very little pain. Also, it started to pull my skin inwards, producing a visible dimpling on the outside of my breast. Skin dimpling is often an indicator of malignancy.

Are you getting a mastectomy?

Research has shown that survival after mastectomy is not significantly better than after a lumpectomy, a procedure which removes only the lesion and a ring of tissue surrounding it. My problem is that I have small breasts, actually smaller than an "A" bra cup, and a lumpectomy would be the same as taking off half of my breast. Because of the poor cosmetic outcome, and more importantly because of the spread to my lymph nodes, the surgeon and oncologist both recommended that I receive chemotherapy before surgery. Chemotherapy may shrink the primary lesion, allowing a lumpectomy, and also address the spread of the cancer. Of course, there are no guarantees when combating this disease, but it seems like my best option.

After chemotherapy and surgery, I most likely will have to undergo an additional series of radiation treatments, and then take the drug tamoxofen for five years.

Yes, this is serious stuff.

Will the chemotherapy make you nauseous and lose your hair?

I will lose my hair. The oncologist will give me a prescription for a cranial prosthesis, in other words, a wig. I plan on having my hair cut short to minimize the mess and emotional trauma. He reassured me that the nausea medications available now have eliminated the loss of appetite and vomiting previously associated with chemotherapy. That means I will probably have to decline one friend's kind offer of some "herbal" remedy, alas.

Chemotherapy has other undesirable side effects, including "chemo brain," or cognitive effects such as memory loss and slower information processing. This varies depending on the age of the patient and the level of treatment, and can be minimized with proper nutrition, exercise and adequate sleep. Chemotherapy usually causes menstruation to cease during treatment, and in women of my age, premature menopause. The next person who tries to comfort me by telling me that I was close anyway, will get slapped.

Will you stop working, exercising, going out to live music, traveling, eating sushi, drinking alcohol...?

I have been asked all of the above. No, I won't stop any of those activities, but I will make adjustments based on my physicians' recommendations and on how I feel. Aside from some intermittent fatigue, and interruptions to my schedule from medical appointments, I should be able to do all of the above. But, my work/life balance will tip toward life, and the things which give me pleasure and reduce stress. Do invite me to social events or out for the evening. If I'm feeling up to it, I and my bald head would be delighted to attend.

Is there anything I can do to help?

Please be understanding of my mood swings during this time. It's nothing personal. I've experienced flashes of anger at myself, and most irrationally, at people who are simply not sick. I'll get over it, but I'd like to apologize in advance if I act like a jerk now and then. There are a number of things to not say to a person with cancer, and I'll include some of them in a subsequent post. If you simply tell me that you're thinking about me...you can't imagine how much that means to me. Heck, you can even pray for me. I'm an atheist, but feel free to cover all bases. If you want a unique prayer assignment, I don't believe anyone has spoken to Ganesha on my behalf, yet.

On a more practical note, I may need rides from chemotherapy. I don't have my schedule of treatment at this time, but it will probably start next week. If you're available during the day, let me know and I'll pencil you in on the cancer calendar.

Love to all,


boyd said...

Hey little sister--Keep your big brother informed as I have inherited the family propensity to worry - in spades. If I happen to utter something insensitive--well, just consider the source. If you become annoyed with me--well it won't be the first time.

Do stay in touch
love you

The Fifty Foot Blogger said...

Bro..it would do me good to become more tolerant of annoying people. After all, I have done so much to annoy others. :)
love, e

Mom said...

Hello, Daughter,
Re: Boyd's blog. It's genetic. Moms worry big time. I echo his sentiments: if I say something insensitive - or just dumb - please excuse it. Remember I love you. I, too, like the hair. It's about as much as you had when you were born - Kathleen and Boyd had peach fuzz. Keep us informed (I know you will)- Love, Mom