When you hear the verdict for the first time a strange phenomenon takes place. Of course there is shock, horror, disbelief (are you sure these are my test results, doc? Maybe they got mixed with someone else’s?) and a feeling that something heavy and hard has landed on your chest. But beyond all that is a strange sense of dissociation, of a boundary dissolving, an invisible, impenetrable wall appearing. You stand on one side of this glass wall, one of the walking dead now ( how much time do I have, please tell me the truth now doc?) and on the other side, just a breath away, are the living, going about their cheerful, indifferent, long lives with the specter of dying buried in some distant, irrelevant future. How you long to be there beside them, to be on the other side of that sympathetic look and softened voice being directed towards you, to bounce out of the room as lightly as the nurse who took your blood pressure, blithely oblivious to the fact that the grim finger of fate has touched you and cut your time on earth down to a few---years? Months? Weeks? How much time do I have left?
My doctor didn’t say, stop being a drama queen, but she came very close. She took one look at my face and said, “I’d better call your husband." When he came, she sat us both down and said firmly, “This is not a death sentence. Cancer treatment has changed dramatically over the years. We treat it as a chronic condition, people learn to manage it and still have a good quality of life. And breast cancer, the kind you have, is like bread and butter medicine.”
I didn’t believe her at first of course; as usual I had to run her words past Dr. Google to confirm that this graduate of a top American medical school was telling the truth.
In the course of my journey on the other side of the wall I talked to oncologists, radiation specialists, friends and fellow breast cancer survivors. I was shocked at how many cancer survivors there were around me (It was a bit like the feeling one has when one is pregnant and suddenly pregnant women pop up all around you).
Cancer is no longer the monster we grew up with, the one that stalked its victims invisibly, revealing its cruel face at the last possible minute, when there was no possibility of survival. Early detection and some very innovative new technologies and medicines have turned it into, “bread and butter medicine,” the kind doctors help patients to manage for the rest of their lives, with occasional flare ups. Of course that’s not to belittle its awful potency---it still kills, but in far fewer numbers, and much more slowly.
The breast cancer I have was detected in a mammogram. I can’t stress the importance of these, and of breast self exams enough. After 40, a mammogram every year or couple of years is essential for early detection. If you have any close relative with breast cancer (mother, sister, aunt, etc, it’s absolutely vital). Since I had no family history, breast cancer was the last on my list of potential hypochondriac worries that made me avoid going to the doctor. But only 5-10% of breast cancers are because of the BRCA1 or BRCA2 genes for breast cancer, which are passed down from mothers or grandmothers.
The rest are all spontaneous, of unknown origin.
And the key to recovery is early detection. Once the cancer reaches lymph nodes or organs, it’s much harder to treat. I used to put off going to the doctor because I had a general dread of what might be discovered, but that is a surefire way to allow the disease to take over your body, and eventually, your life.
Most cancers today, an oncologist friend informed me, are treatable, even curable in the first couple of stages. New therapies which manipulate the genes and use the body’s own immune system (Immunotherapy) have made tremendous inroads in the past 10 years, and have even given Stage 4 patients several extra years. Just to give you an idea of the most current survival rates (measured as those who are still alive and have had no recurrence for five years) Stage 1, where the cancer has not spread to the lymph nodes and the tumor is relatively small, has a 5-year survival rate of almost 100%. Stage 2 has a slightly lower 5 year survival rate of 93%, but by Stage 4, where the cancer has spread to other organs by the time it is detected, 5-year survival is 22%.
I wrote this article because I felt I had to share this jolting, life altering experience in the hope that others like myself, who’ve managed to coast through life with an active policy of avoiding any medical intervention except in the case of raging fevers or throw ups, will begin to understand the importance of the yearly physical, which includes, for women, a mammogram (or a breast exam). In fact, I went for my first ever mammogram because I had read a fact sheet of what women should look for if they are examining their breasts for abnormalities. That, and the fact that my internist gave me a prescription for a mammogram every year, finally made me pay attention. I noticed a change in the shape of my left breast, and began to wonder---was it time for that mammogram?
I got lucky---it was time, in fact almost overtime, but my cancer had not spread to the nodes yet and was still at Stage 2.
So, if you’re pushing 40, or even if you’re not, but still notice significant changes in your breast, look for the following signs when you examine them:
- A lump or thickening which didn’t exist before when you do your breast self exam. These are easy to do --- you could look up websites which would guide you through the process like the Susan G Komen foundation for the Cure, or the American Cancer society’s home page.
- A puckering or dimpling of the skin anywhere on your breast---particularly if it looks pitted, like an orange.
- A change in the shape or size of the breasts, particularly if one becomes asymmetrical.
This is important---in many cases (like mine) there are no discrete lumps. But changes in the shape and size of a breast often occur.
- Red, flaking skin around the nipple or on the breast. Any redness or rash needs to be examined by a doctor because some may be a sign of cancer.
- An inverted nipple or any change in the shape of the nipple.
And remember, when you do go for your mammogram, make sure you ask for the latest technology and get a 3-D image, since that has the highest percentage of detection (yes, even a mammogram can sometimes miss the cancer).
My story hasn’t ended yet. While treatment is mostly over, I still have the sinister shadow- of- cancer dangling- over- my –neck- by- a –thread feeling, and will continue to for the next five years. I’m grateful it was caught early, grateful for the fabulous team of doctors I encountered, and extremely grateful for all the support from family and friends.
I do want to add that nine times out of ten, your symptoms will be innocuous, something that’s not cancer. But don’t risk your life on that assumption.
What I know now, after having been through the tunnel and found light at the end, is the kind of information which could save a life. I dearly hope it does.