privilege

I am one of the world’s “privileged”.

Because I have health insurance, and because I live in a country where medical care is readily available, I discovered my cancers early. No expense was spared to properly diagnose and treat me. I have had the best doctors and care that could be given to me, anywhere in the world.

This is not the situation for most of the peoples of the world. I did nothing to “deserve” this privilege, it was merely an accident of my birth.

Had I not had this “privilege”, my cancers would have spread and I would not live to see my 60th birthday.

This thought humbles me. Healthcare should be available to everyone in the world, not just me. Why should I live, while others must die?

healing ... again

It is good for me to be told: no you cannot exercise, no you cannot swim, no you cannot work.

I am free to do nothing. To sit outside with Jubilee and watch the wind in the trees. To be empty, and quiet.

I am healing … again … I think both emotionally and physically … from the trauma of being diagnosed with breast cancer, having my breast removed, and then “reconstructed”. In time, I want to write a little more clearly and decisively about this experience, and in a way that will directly address the way the medical system and the culture responds to breast cancer, and the way that the patient gets sucked into that mindset.

Reconstructive surgery is touted as either “no big deal” or the greatest thing since sliced bread. It is neither. It is both painful and disfiguring, even if you have the best plastic surgeon (and I do).

I know that I will adapt to my new breast, but I also know that I will never be “normal-looking” again. I wonder if I could have had the guts to be a uni-breast, if it had been more encouraged, more accepted.

My cancers were very small (the invasive cancer was detectable only by MRI) and early stage. There must be a way to stop cancers at this stage without resorting to removing the entire breast. I have read somewhere about an infrared (I think) beam that could be directed at the tumor, and kill it from within. However, it needs further testing and research. I would have gladly volunteered to be part of that study.

And I will get photos up here of my new breasts – I’m just still feeling a bit too swollen, wounded and vulnerable. So I return to the backyard – to heal.

recurring cancer

I have been thinking about cancer lately.

Over Xmas, my sister’s brother in law was complaining of a cough, night sweats. They discovered cancer – in his lungs, his bones, his lymph nodes. They don’t know where the primary cancer began, just that over the last few years it had metastasized everywhere without his knowing. He’s undergoing chemotherapy now, but they don’t expect him to live more than 6 months. Verne has always been healthy, he ate right, his father is still alive and 95 years old.

When I was discovering my breast cancer, another friend of my sister was discovering hers. We were both on the same page – 2 cancers in one breast, so a mastectomy was required. She underwent reconstruction during her mastectomy a week before mine; they took tissue from her tummy to make a breast. Her surgery lasted 7 ½ hours. I had an expander put in. Though my initial mastectomy surgery and recovery was easier, I’m now facing another 3 ½ hour surgery next month (in less than 2 weeks, as a matter of fact).

Her cancer was HER2 positive but was not estrogen responsive. Mine was HER2 positive and estrogen responsive. She is undergoing chemotherapy now. I’m taking the estrogen blocker for 5 years.

The big fear is a recurrence of cancer. My cancer was small, only detectable by MRI – but it was invasive. The cancer cells could have gotten into my blood or lymphatic system and spread somewhere else in my body – my bones, my brain.

A recurrent cancer is much more problematic than another primary cancer. A primary cancer can be removed and then treated with chemotherapy. A recurrent cancer means that a cancer has ventured out of its site of origin, and there’s no telling where it will turn up next.

I guess I’ve sobered up some on this issue of cancer. I no longer feel so invincible. I take my Femara every day, even though I blame every ache and pain and sleepless night on it.

the "test"

Tomorrow I should get the results of the "test” (oncotype DX assay).

It’s funny not having a clue as to how it will come out. The way I see it, I have a 50/50 chance of being in the low risk group and will not need chemotherapy. I read over and over my pathology reports. There are favorable signs – the cancers are estrogen and progesterone responsive, the Ki-67 marker is less than 10%, the S-phase is low. Actually, the only unfavorable sign is the HER2 positive result. And the fact that there were 2 separate cancers in my breast worries me.

But the result of this test will determine the next year of my life, at least. And how I know and trust my body.

I feel like I did before I knew the results of the MRI-guided biopsy that determined whether the “something” that they saw was cancer or not. I was so hoping for it to be nothing because I did not want to lose my breast.

For now, I am thinking positive. Yesterday I had my last injection of “new breast”, and Dr. Lickstein says that I can plan on implant surgery in 3-4 weeks. I’m actually looking forward to surgery! My expander now is every bit as big as my native breast, and I am confident that Dr. L will put me back together well.

And, since John has been laid off, we have decided to make lemonade and go on a 1 month road trip to the Southwest. Just forget everything and go away for awhile. There’s something healing about that for us.

2nd thoughts on cancer

If indeed I do have this more serious form of cancer – this genetic predisposition toward producing a protein that feeds cancer cells – then I am not going to worry. I am not going to become mired in self-pity or even pious prayer.

Instead I am going to be me, to live, to rejoice in the gift that I bring to the world and life. I am going to receive and enjoy everything that is given to me.

And I’m not going to do things that I don’t want to do.

(It may be that I need to start planning that trip to the Clairvaux prison in France.)

still in the woods

Just when I thought I was out of the woods, home free, exercising, getting my life back together …

The pathologies from my mastectomy looked pretty good to me. Small tumors, clean nodes, clear margins. Even Dr. Rimmer said that I had come out on the good side of the numbers, with a 9mm tumor which is 1 mm shy of the size at which they would recommend chemo.

It seems that there are other factors. Like HER2/neu.

HER2 is a protein that promotes the growth of cancer cells. One of every four breast cancers over-produce this protein, which means that the cancer is more aggressive. They think that breast cancers that test positive for HER2/neu are more likely to recur.

I had 2 primary cancers in the breast that was removed. Both were relatively small. The DCIS was more extensive (2.5 cm) but showed small places (1mm) where it was getting out of the duct and becoming invasive (micro-invasion). Both cancer sites tested positive for HER2. The invasive site was less positive (rated 2.something), the DCIS site was more positive (rated 9 something). I don’t have a copy of the report.

If it were not for the HER2 distinction of my cancers, I would definitely not benefit from chemotherapy. As it stands now, it’s unclear whether or not I should be given the drug, Herceptin, which, according to Dr. Bertand, my oncologist, is given with (or as) chemo-therapy. (I still don’t really understand cytotoxic therapy, I’ve been avoiding the topic).

But there is this test - the Oncotype DX assay. It can predict the likelihood of breast cancer recurrence in women with newly diagnosed, early stage invasive breast cancer. That’s me. Oncotype DX also assesses the benefit from chemotherapy.

The test is also very expensive. Like thousands of dollars. Evidently it analyzes the genetic makeup of the cells. Dr. Bertrand says that the results are a good guide to whether or not chemotherapy should be prescribed for people like me. She says that it will help us to decide.

I’m not sure if my insurance will cover it. I have told Dr. Bertrand that if my insurance does not cover it, I am not inclined to pay for it myself. I would rather take my chances and NOT have chemo.

Somehow, I still don’t feel like I have cancer! I feel more like a number on a chart. Maybe all of this radical treatment (mastectomy, chemotherapy) would be easier if I had BIG cancer tumors, or if my lymph nodes were infected with cancer cells and I knew I was in trouble.

Anyway, we’ll see. The test takes 10 days. Dr. Bertrand is going to order it. I have another appointment with her in 2 weeks.

oncology

I am dragging my feet on going to see the oncologist. My pathology report came back looking pretty good – clean nodes, clean margins, small tumor. According to Dr. Rimmer, the tumor was 1 mm shy of warranting chemo.

So, I’m assuming that I’m relatively safe, as far as cancer goes. And that I am very lucky. I even feel out of place at the breast cancer support group where most all of the women have had to go through chemo. My own cosmetic concerns seem trivial.

One of the reasons I’m dragging my feet is because I want to heal from the surgery. Everything happened so fast before the surgery, and now I like having the freedom to do things on my own time. The other is that I know that she will want to put me on an estrogen-blocking drug, and I don’t like that idea.

But I know that I need to at least argue my case with her.

vegans to be?

Today John and I took the bike (motorcycle) out the back roads to a U-Pick organic farm. The idea is to eat vegan every other night until we get the hang of it, and then maybe go all the way. Tonight we had navy beans with carrots, swiss chard, spaghetti, and butternut squash. Yum! I'm convinced that the problem is with the hormones that the cows and pigs are fed, and the pesticides that are put on the produce. One in every 8 women are turning up with breast cancer. What else could it be? (something seems to be off on the color cast of my camera ...)

mastectomies, not a thing of the past ...

The thing that bothers and surprises me is how quickly and definitively my own breast cancer was deemed a case that warranted mastectomy. I mean, this is 2007. I thought that advances had been made so that options were available for women with breast cancer that would preserve the breast, and that mastectomies were becoming a thing of the past.

I was talking today with my cousin’s husband, who is a doctor in Arizona and an expert on breast disease. It seems that with MRIs, more and more small, previously undetected, breast cancers are discovered. Twenty years ago, the site of my 2nd site of cancer cells would never have been found. I would have had a lumpectomy and then radiation. Would the radiation have killed the 2nd small site? Who knows? Maybe.

So it seems that now with the super-sensitive diagnostic testing, more 2nd cancer sites are discovered. And the protocol, at this point, is that if 2 primary cancers are detected in the same breast, mastectomy is the answer – no matter how small the cancers are.

Because more 2nd cancers are detected, more mastectomies are being done than before. Is this "progress" saving lives, or just generating more surgical business?

It seems like overkill to me. There must be a way to remove small cancers on the same breast without having to remove the whole breast. If we are going to detect earlier and smaller stage cancers, there must be a way to treat them without surgery. However my cousin's husband said that, in this day, I would have a hard time finding a doctor who would risk it.

And then there are the women in my breast cancer support group who elected to remove their healthy breast, and who had mastectomies when only a lumpectomy was required. Perhaps I don't know enough about cancer.

morning ramblings

It is important that I be as honest as I can when I write about how things are. And though I am not writing these things for anyone – I am writing for myself – it is somehow important that I put these thought out here, if only for an imaginary you. I have a tendency to present to the world an image of who and how I am that may not exactly jive with what is really going on with me. I can hide behind a mask. I can overly judge how you will react to what I say before I determine what it is that I will say, and I end up fudging the real truth of what’s going on with me to the point where I don’t even know anymore what's going on with me. I think this is called co-dependency in some circles.

It’s not that I want to boldly assert my feelings and my thoughts – but sometimes it is only in writing that I can even figure out what I am thinking or feeling. And it seems important for me to, in some way, integrate this with how I am with others. My outer face.

So – that’s the long story of why I need to write here (and already I’m imagining the reactions of “what an over-analyst!” – jeez – maybe it’s just an inner-critic that needs to be met and dealt with!)

I had too much wine last night.

For awhile now I’ve been telling myself that if I can’t have just one glass of wine, I should just forego the whole thing.

And then I read in this morning’s paper that there is a study indicating that even small amounts of alcohol have been shown to increase incidents of breast cancer in women.

So maybe that is another reason.

I don’t want to evade the reality of what is going on. Sometimes it seems that a little wine helps me to get more in touch with what I am feeling – loosen up, relax, slow down. But there comes a point where the wine becomes a drug, and I know that I am using it to run away.

And I think that I can find my way through breast cancer without having to drink my way through.

The other night my vegan friend, Sharon, was telling me that if I went on a vegan diet, I could reverse the cancer. I’m not sure that, at this point, I would want to count on it, but it does sound like an interesting change in lifestyle that might prevent new cancers from forming. But I need for Sharon to move in for a week to teach me how to cook and eat vegan!

beginning thoughts on cancer

It is not easy for me to grasp “cancer” – the concept or the disease. I don’t feel sick, and yet I have cancer. It is only when I read the pathology reports that I begin to get some sense that there is something going on in my body that is alarming.

The cells don’t look right, with nuclei that are high grade, and micropapillary architecture showing frequent central necrosis. At the building block level, something is out of whack. Cancer is like an invader, and yet these are my cells that have begun acting differently and turned into something else.

When I first heard that cancer cells had been detected in my body, I thought that I was sort of like a tree with something else growing up the side of it, and eventually it would kill the tree if it were not cut off. Now I feel a little differently. The cancer feels more like it came from within me. Not that my environment – and all the hormone and pesticide laced food – does not play a part. It’s just that I don’t feel myself separate from my environment.

My environment and I are both the same life (if that makes any sense). I cannot hold myself apart from the world I live in, or protect myself from it. We are one.

Some tips on lifestyle to prevent cancer

Some tips on lifestyle to prevent cancer.

Copied and pasted from a forwarded mail.

Cancer News from John Hopkins.

AFTER YEARS OF TELLING PEOPLE CHEMOTHERAPY IS THE ONLY WAY TO TRY (TRY THE KEY WORD) AND ELIMINATE CANCER, JOHN HOPKINS IS FINALLY STARTING TO TELL YOU THERE IS AN ALTERNATIVE WAY .

Cancer Update from John Hopkins:

1. Every person has cancer cells in the body. These cancer cells do not show up in the standard tests until they have multiplied to a few billion. When doctors tell cancer patients that there are no more cancer cells in their bodies after treatment, it just means the tests are unable to detect the cancer cells because they have not reached the detectable size.

2. Cancer cells occur between 6 to more than 10 times in a person's lifetime.

3. When the person's immune system is strong the cancer cells will be destroyed and prevented from multiplying and forming tumours.

4. When a person has cancer it indicates the person has multiple nutritional deficiencies. These could be due to genetic, environmental, food and lifestyle factors.

5. To overcome the multiple nutritional deficiencies, changing diet and including supplements will strengthen the immune system.

6. Chemotherapy involves poisoning the rapidly-growing cancer cells and also destroys rapidly-growing healthy cells in the bone marrow, gastro-intestinal tract etc, and can cause organ damage, like liver, kidneys, heart, lungs etc.

7. Radiation while destroying cancer cells also burns, scars and damages healthy cells, tissues and organs.

8. Initial treatment with chemotherapy and radiation will often reduce tumor size. However prolonged use of chemotherapy and radiation do not result in more tumor destruction.

9. When the body has too much toxic burden from chemotherapy and radiation the immune system is either compromised or destroyed, hence the person can succumb to various kinds of infections and complications.

10. Chemotherapy and radiation can cause cancer cells to mutate and become resistant and difficult to destroy. Surgery can also cause cancer cells to spread to other sites.

11. An effective way to battle cancer is to starve the cancer cells by not feeding it with the foods it needs to multiply.

CANCER CELLS FEED ON:

a. Sugar is a cancer-feeder. By cutting off sugar it cuts off one important food supply to the cancer cells. Sugar substitutes like NutraSweet, Equal, Spoonful, etc are made with Aspartame and it is harmful. A better natural substitute would be Manuka honey or molasses but only in very small amounts. Table salt has a chemical added to make it white in colour. Better alternative is Bragg's aminos or sea salt.

b. Milk causes the body to produce mucus, especially in the gastro-intestinal tract. Cancer feeds on mucus. By cutting off milk and substituting with unsweetened soya milk cancer cells are being starved.

c. Cancer cells thrive in an acid environment. A meat-based diet is acidic and it is best to eat fish, and a little chicken rather than beef or pork. Meat also contains livestock antibiotics, growth hormones and parasites, which are all harmful, especially to people with cancer.

d. A diet made of 80% fresh vegetables and juice, whole grains, seeds, nuts and a little fruits help put the body into an alkaline environment. About 20% can be from cooked food including beans. Fresh vegetable juices provide live enzymes that are easily absorbed and reach down to cellular levels within 15 minutes to nourish and enhance growth of healthy cells. To obtain live enzymes for building healthy cells try and drink fresh vegetable juice (most vegetables including bean sprouts) and eat some raw vegetables 2 or 3 times a day. Enzymes are destroyed at temperatures of 104 degrees F (40 degrees C).

e. Avoid coffee, tea, and chocolate, which have high caffeine. Green tea is a better alternative and has cancer-fighting properties. Water- best to drink purified water, or filtered, to avoid known toxins and heavy metals in tap water. Distilled water is acidic, avoid it.

12. Meat protein is difficult to digest and requires a lot of digestive enzymes. Undigested meat remaining in the intestines becomes putrified and leads to more toxic buildup.

13. Cancer cell walls have a tough protein covering. By refraining from or eating less meat it frees more enzymes to attack the protein walls of cancer cells and allows the body's killer cells to destroy the cancer cells.

14. Some supplements build up the immune system (IP6, Florssence, Essiac, anti-oxidants, vitamins, minerals, EFAs etc.) to enable the body's own killer cells to destroy cancer cells. Other supplements like vitamin E are known to cause apoptosis, or programmed cell death, the body's normal method of disposing of damaged, unwanted, or unneeded cells.

15. Cancer is a disease of the mind, body, and spirit. A proactive and positive spirit will help the cancer warrior be a survivor. Anger, un forgiveness and bitterness put the body into a stressful and acidic environment. Learn to have a loving and forgiving spirit. Learn to relax and enjoy life.

16. Cancer cells cannot thrive in an oxygenated environment. Exercising daily, and deep breathing help to get more oxygen down to the cellular level. Oxygen therapy is another means employed to destroy cancer cells.

CANCER UPDATE FROM JOHN HOPKINS HOSPITAL , U. S.

1. No plastic containers in micro.

2. No water bottles in freezer.

3. No plastic wrap in microwave.Johns Hopkins has recently sent this out in its newsletters. This information is being circulated at Walter Reed Army Medical Center as well. Dioxin chemicals causes cancer, especially breast cancer. Dioxins are highly poisonous to the cells of our bodies.

Don't freeze your plastic bottles with water in them as this releases dioxins from the plastic. Recently, Dr. Edward Fujimoto, Wellness Program Manager at Castle Hospital was on a TV program to explain this health hazard. He talked about dioxins and how bad they are for us. He said that we should not be heating our food in the microwave using plastic containers. This especially applies to foods that contain fat. He said that the combination of fat, high heat, and plastics releases dioxin into the food and ultimately into the cells of the body. Instead, he recommends using glass, such as CorningWare, Pyrex or ceramic containers for heating food. You get the same results, only without the dioxin. So such things as TV dinners, instant ramen and soups, etc., should be removed from the container and heated in something else. Paper isn't bad but you don't know what is in the paper.It's just safer to use tempered glass, Corning Ware, etc. He reminded us that a while ago some of the fast food restaurants moved away from the foam containers to paper. The dioxin problem is one of the reasons. Also, he pointed out that plastic wrap, such as Saran, is just as dangerous when placed over foods to be cooked in the microwave. As the food is nuked, the high heat causes poisonous toxins to actually melt out of the plastic wrap and drip into the food. Cover food with a paper towel instead.