The radiation center in the San Francisco Bay Area, where I go for treatments, is giving out a pinup calendar. This one is pretty cute. It’s called Pinups for Purpose and features local breast cancer survivors as models.*
Like most people, I choose a calendar based on the photos used at the holidays and on my birth month. Imagine my surprise when I flipped to the month of August and saw a male model! His name is Burt. He’s standing in a stream holding a fishing rod. And he’s just snagged a silver-polka-dotted pink bra.
The photos are the work of Jeanette Vonier, a photographer whose mother is a two-time breast cancer survivor. Ms. Vonier has posed her subjects in 1950s vintage settings because, “The women in vintage pinups seem to retain some innocence. They find themselves in common situations that everyone can relate to with humor.” Money raised from the calendar’s sale is given to many charities. Two of these are: “To Celebrate Life Breast Cancer Foundation” and the “Sutter North Bay Women’s Health Center.”**
There is a short biography of each of the models at the beginning of the calendar. What strikes me is the common thread running through their stories. One woman sees cancer as the “biggest gift” of her life, forcing her to slow down and take stock. Another talks about it being a “gift of time, awareness and empathy.” Still another views it as a “positive and life changing experience.”
I keep thinking of something I just read in the book Breast Cancer - The Complete Guide. The authors, doctors Yashar Hirshaut and Peter I. Pressman, write, “No sane person would choose to have breast cancer or, having had it, would say it was an ennobling experience.” I’m mystified. How can one look back on breast cancer as a “gift.”
I suppose we all want things to happen for a reason. What if getting cancer is just bad luck? Some might say it happened “to make one a finer person.” Well, what if one was a pretty fine person to begin with? Or, perhaps it happened so one would learn to “stop and smell the roses.” Hey, I’ve stopped for plenty of roses over the years. Nope, at the moment there seems to be no rhyme or reason for having been stricken with breast cancer. Maybe, when time has softened the experience, I will see the why of it. I suppose that I, too, would like to think it happened for a reason.
*Pinups for Purpose: http://www.pinupsforpurpose.com/
**To Celebrate Life Breast Cancer Foundation: http://www.tocelebratelife.org/
**Sutter North Bay Women’s Health Center: http://www.ucomparehealthcare.com/
Monday, March 29, 2010
Tuesday, March 23, 2010
A few days ago my husband and I were surprised by a generous gift. The owner of his company had two tickets for a winemaker dinner, which he could not attend. So he gave the tickets to us.
The evening was hosted by the founders of Williamson Wines in Healdsburg, Calif.* The winemakers chose the Solbar, a Michelin Star restaurant in Calistoga, as the site for their dinner.** I cannot speak for the wine, as alcohol does not agree with me, but the meal was nothing short of fantastic. My husband can speak for the wine. He says it was very good indeed.
We arrived home from the Solbar at one o’clock the next morning. The company was that enjoyable, the evening that memorable. When I asked my husband what his favorite memory was, he told me what he’d told his boss. “The best part was seeing my wife laughing and having a blast. I haven’t seen her do that in six months.”
Sometimes my husband, a man who is not so expressive, amazes me. As a foodie, I definitely thought he’d mention the stinging nettle soup or the foie gras confit with poached apricots. As a lover of good wine, I thought he’d talk about the Sovereign, which Bill Williamson poured toward the end of the evening. Bill has bottled only one hundred magnums of this wine, for public sale, at $1,000 per bottle.
Upon reflection, I have to admit I have not been on the happier side of the emotional scale in quite a while. There is a range of feelings that accompanies breast cancer. Laughing with abandon is not one of them.
In their book Breast Cancer - The Complete Guide, doctors Yashar Hirshaut and Peter I. Pressman talk about there being no “particular program” for coping with the emotions of breast cancer. “No sane person,” they write, “would choose to have (the disease) or, having had it, would say it was an ennobling experience. Nobody who has had a grave illness, or who has lived through the experience of surgery, or who has worried about the effects of powerful treatments, would mouth such a platitude.”
Hirshaut and Pressman note that most women experience their highest levels of depression and anxiety right after surgery. How right they are. Until that point, they say, “There has been an enormous amount to get through from the time they first realized something was wrong, through the period of evaluating their choices and making decisions, through the surgery itself. Now they must face picking up their lives again and also coping with whatever further treatment has been decided upon.”
Of course, then come the fears that must be faced before each treatment begins. And the worry about their immediate and long-term effects. And knowing that family members nearby and time zones away are worrying as well.
“Everyone reacts differently to trouble,” write doctors Hirshaut and Pressman. “There is no ‘correct’ way to cope with or get over an experience as trying as breast cancer.” But, according to the doctors, “women are in fact coming through it with intelligence, sensitivity, and a very moving gallantry.”
Why is that not surprising?
*http://www.williamsonwines.com/
**http://www.solagecalistoga.com/
The evening was hosted by the founders of Williamson Wines in Healdsburg, Calif.* The winemakers chose the Solbar, a Michelin Star restaurant in Calistoga, as the site for their dinner.** I cannot speak for the wine, as alcohol does not agree with me, but the meal was nothing short of fantastic. My husband can speak for the wine. He says it was very good indeed.
We arrived home from the Solbar at one o’clock the next morning. The company was that enjoyable, the evening that memorable. When I asked my husband what his favorite memory was, he told me what he’d told his boss. “The best part was seeing my wife laughing and having a blast. I haven’t seen her do that in six months.”
Sometimes my husband, a man who is not so expressive, amazes me. As a foodie, I definitely thought he’d mention the stinging nettle soup or the foie gras confit with poached apricots. As a lover of good wine, I thought he’d talk about the Sovereign, which Bill Williamson poured toward the end of the evening. Bill has bottled only one hundred magnums of this wine, for public sale, at $1,000 per bottle.
Upon reflection, I have to admit I have not been on the happier side of the emotional scale in quite a while. There is a range of feelings that accompanies breast cancer. Laughing with abandon is not one of them.
In their book Breast Cancer - The Complete Guide, doctors Yashar Hirshaut and Peter I. Pressman talk about there being no “particular program” for coping with the emotions of breast cancer. “No sane person,” they write, “would choose to have (the disease) or, having had it, would say it was an ennobling experience. Nobody who has had a grave illness, or who has lived through the experience of surgery, or who has worried about the effects of powerful treatments, would mouth such a platitude.”
Hirshaut and Pressman note that most women experience their highest levels of depression and anxiety right after surgery. How right they are. Until that point, they say, “There has been an enormous amount to get through from the time they first realized something was wrong, through the period of evaluating their choices and making decisions, through the surgery itself. Now they must face picking up their lives again and also coping with whatever further treatment has been decided upon.”
Of course, then come the fears that must be faced before each treatment begins. And the worry about their immediate and long-term effects. And knowing that family members nearby and time zones away are worrying as well.
“Everyone reacts differently to trouble,” write doctors Hirshaut and Pressman. “There is no ‘correct’ way to cope with or get over an experience as trying as breast cancer.” But, according to the doctors, “women are in fact coming through it with intelligence, sensitivity, and a very moving gallantry.”
Why is that not surprising?
*http://www.williamsonwines.com/
**http://www.solagecalistoga.com/
Thursday, March 18, 2010
The gamut of emotions I’ve experienced since being diagnosed with breast cancer is very typical, from what I’ve been able to discern. One thing I’ve done that, apparently, is not typical is that I’ve not joined a support group.
I use the word “apparently” because my women friends always seem surprised when I tell them I haven’t joined up. “Why not?” they ask in almost startled fashion.
The answer isn’t so easily summed up. In the beginning, I suppose, I didn’t want to feel any weaker than I already did. And going to a group of strangers for support not only felt weak to me, it seemed cold.
There was a time, during the worst of the chemotherapy treatments, when I thought about finding such a group. But I didn’t have the strength to go. When I did feel better, I wanted to surround myself with healthy, upbeat people who could take my mind to a happier place.
Had the chemotherapy gone longer than three months, I think I would have sought out a group with like experiences. It had become wearying, explaining to family and friends what was happening with me before I could get a hug in return. That was all I wanted most of the time. No advice. No sympathy really. Just a hug.
In Dr. Susan Love’s Breast Book, she writes: “Sometimes, when you’re having chemotherapy, the people who were supportive in the beginning start to dribble off.” She hit that right on the nose. People who were there when I was diagnosed, and through two surgeries, began to fade away when chemotherapy began. Who could blame them? As the patient, I longed to get on with life, get back to “normal.” According to Dr. Love, when the interest from others fades, that’s a perfect time to find a support group.
Dr. Love talks about a “peculiar sort of funk” that sets in when surgeries and treatment end. She notes that support groups can even be sought out then. I hadn’t considered that. With the end of my treatment scant two weeks away, I find myself with a litany of questions that are, apparently, very typical:
--Am I cured?
--When there is no more chemotherapy or radiation going into my body, are the cancer cells waiting to coalesce and strike?
--My body betrayed me once, will it again?
--Will there be after effects from the treatments that will cause trouble in the future?
--What can I do with diet and exercise to reduce the likelihood of recurrence?
--The oncologists at my HMO are sure to want to push me into taking a hormone suppressant. What of the side effects and after effects from these?
I have talked with women who are in touch, seventeen years later, with friends made in their support groups. There is much, I hear, to be said in their favor. Once the preoccupation with treatment is behind me, I may yet join one. It’s been a traumatic whirlwind and it might be good to discuss it with people who have been there.
The American Cancer Society has a nice online article that goes through the things to consider when searching for a group. According to the article, “Some needs are best addressed in a support group. Examples are the need for information, such as how children typically react to a parent’s diagnosis, how to explain your diagnosis at work, or how to communicate better with your doctor. The intensity of your feelings about a situation will also help you to decide about attending a group. You may feel so upset about your situation that the idea of discussing it with others makes it worse.”
Here are a few links to support groups for those who might need one:
--American Cancer Society
http://www.cancer.org/docroot/ESN/esn_3.asp?sitearea=ESN
--National Cancer Institute
http://www.cancer.gov/cancertopics/wyntk/breast/page13. Information specialists at 1-800-422-6237 and at LiveHelp (http://www.cancer.gov/help) can help locate programs, services, and publications.
--Susan G. Komen
http://ww5.komen.org/breastcancer/support.html. Breast care helpline at 1-877-465-6636 for more information. The breast care helpline provides free, professional support services to anyone with breast health or breast cancer questions or concerns.
I use the word “apparently” because my women friends always seem surprised when I tell them I haven’t joined up. “Why not?” they ask in almost startled fashion.
The answer isn’t so easily summed up. In the beginning, I suppose, I didn’t want to feel any weaker than I already did. And going to a group of strangers for support not only felt weak to me, it seemed cold.
There was a time, during the worst of the chemotherapy treatments, when I thought about finding such a group. But I didn’t have the strength to go. When I did feel better, I wanted to surround myself with healthy, upbeat people who could take my mind to a happier place.
Had the chemotherapy gone longer than three months, I think I would have sought out a group with like experiences. It had become wearying, explaining to family and friends what was happening with me before I could get a hug in return. That was all I wanted most of the time. No advice. No sympathy really. Just a hug.
In Dr. Susan Love’s Breast Book, she writes: “Sometimes, when you’re having chemotherapy, the people who were supportive in the beginning start to dribble off.” She hit that right on the nose. People who were there when I was diagnosed, and through two surgeries, began to fade away when chemotherapy began. Who could blame them? As the patient, I longed to get on with life, get back to “normal.” According to Dr. Love, when the interest from others fades, that’s a perfect time to find a support group.
Dr. Love talks about a “peculiar sort of funk” that sets in when surgeries and treatment end. She notes that support groups can even be sought out then. I hadn’t considered that. With the end of my treatment scant two weeks away, I find myself with a litany of questions that are, apparently, very typical:
--Am I cured?
--When there is no more chemotherapy or radiation going into my body, are the cancer cells waiting to coalesce and strike?
--My body betrayed me once, will it again?
--Will there be after effects from the treatments that will cause trouble in the future?
--What can I do with diet and exercise to reduce the likelihood of recurrence?
--The oncologists at my HMO are sure to want to push me into taking a hormone suppressant. What of the side effects and after effects from these?
I have talked with women who are in touch, seventeen years later, with friends made in their support groups. There is much, I hear, to be said in their favor. Once the preoccupation with treatment is behind me, I may yet join one. It’s been a traumatic whirlwind and it might be good to discuss it with people who have been there.
The American Cancer Society has a nice online article that goes through the things to consider when searching for a group. According to the article, “Some needs are best addressed in a support group. Examples are the need for information, such as how children typically react to a parent’s diagnosis, how to explain your diagnosis at work, or how to communicate better with your doctor. The intensity of your feelings about a situation will also help you to decide about attending a group. You may feel so upset about your situation that the idea of discussing it with others makes it worse.”
Here are a few links to support groups for those who might need one:
--American Cancer Society
http://www.cancer.org/docroot/ESN/esn_3.asp?sitearea=ESN
--National Cancer Institute
http://www.cancer.gov/cancertopics/wyntk/breast/page13. Information specialists at 1-800-422-6237 and at LiveHelp (http://www.cancer.gov/help) can help locate programs, services, and publications.
--Susan G. Komen
http://ww5.komen.org/breastcancer/support.html. Breast care helpline at 1-877-465-6636 for more information. The breast care helpline provides free, professional support services to anyone with breast health or breast cancer questions or concerns.
Wednesday, March 17, 2010
Over dinner a few nights ago, a friend in my book club asked me how my radiation treatments were going. I told her, “So far, so good.” She volunteered that, one day, what is currently the standard of care for cancers of all types will seem arcane.
As my friend is a microbiologist running her own firm, I asked what she thought future therapies for cancer might be like. “Maybe a regimen of pills and shots,” she volunteered.
We both agreed that a vaccine would be nice. However, as the causes of cancer--especially breast cancer--still seem a mystery, a vaccine will be difficult to develop. One can dream.
In Dr. Susan Love’s Breast Book I found this tantalizing mention of vaccination: “We have always dreamed of finding something distinctive about the cancer cell and developing a therapy specific to it. We would then give the antibody, kill or control all of the cancer cells, and do little or no harm to the rest of the body.”*
In a section of the book called, What Is Coming, Dr. Love describes ongoing research. She says promising new findings are “already in the pipeline. It’s not fantasy; it’s a question of how soon we’ll know what to do with our knowledge.”
What she wrote next really surprised me: “In the future breast cancer may be as treatable as high blood pressure and diabetes are today. These diseases can be effectively treated by controlling the symptoms with medication without totally eliminating the underlying disease. The rehabilitation of the cancer cell may be an effective treatment so that the patient, while still having cancer, will be alive and well.”
“Even better,” Dr. Love goes on, “we will be able to stop breast cancer at its source--destroy the cells lining the milk ducts where all breast cancer starts. In this way, we will be able to prevent it all together.”
As Dr. Love notes in the dedication of her book, “We are working hard toward the day when our daughters and nieces will never have to hear the words ‘you have breast cancer.’”
Wouldn’t that be just fantastic?
*Dr. Susan Love's internet site: http://www.dslrf.org/breastcancer/
As my friend is a microbiologist running her own firm, I asked what she thought future therapies for cancer might be like. “Maybe a regimen of pills and shots,” she volunteered.
We both agreed that a vaccine would be nice. However, as the causes of cancer--especially breast cancer--still seem a mystery, a vaccine will be difficult to develop. One can dream.
In Dr. Susan Love’s Breast Book I found this tantalizing mention of vaccination: “We have always dreamed of finding something distinctive about the cancer cell and developing a therapy specific to it. We would then give the antibody, kill or control all of the cancer cells, and do little or no harm to the rest of the body.”*
In a section of the book called, What Is Coming, Dr. Love describes ongoing research. She says promising new findings are “already in the pipeline. It’s not fantasy; it’s a question of how soon we’ll know what to do with our knowledge.”
What she wrote next really surprised me: “In the future breast cancer may be as treatable as high blood pressure and diabetes are today. These diseases can be effectively treated by controlling the symptoms with medication without totally eliminating the underlying disease. The rehabilitation of the cancer cell may be an effective treatment so that the patient, while still having cancer, will be alive and well.”
“Even better,” Dr. Love goes on, “we will be able to stop breast cancer at its source--destroy the cells lining the milk ducts where all breast cancer starts. In this way, we will be able to prevent it all together.”
As Dr. Love notes in the dedication of her book, “We are working hard toward the day when our daughters and nieces will never have to hear the words ‘you have breast cancer.’”
Wouldn’t that be just fantastic?
*Dr. Susan Love's internet site: http://www.dslrf.org/breastcancer/
Saturday, March 13, 2010
I have now been zapped by a linear accelerator for five days running. One week of radiation therapy down, three more to go. So far, this breast cancer treatment has been much easier to withstand than chemotherapy, for which I’m glad.
Sometimes I think about the story a friend of mine told me. She’d planned a dream vacation to Alaska with her sister. When treatment for an aggressive cancer weakened her sister, there was some debate over going forward with the plans. But the sister wasn’t sure about her chances for survival, so the trip was on. My friend ended up making the arrangements, driving their rented motor home, and handling all the details during their vacation. Her sister, so independent in the past, seemed incapable of doing anything.
I know how easy it is to feel like an invalid, a victim. Friends and family can be very kind after learning that a loved one has been diagnosed with serious illness. People offer to bring meals, drive the patient wherever she needs to go, and take care of the house. When one is recovering from surgery, or felled by chemotherapy, it is easy to accept.
The time does come when the patient feels better. And yet, the invalid mindset persists. “I’m still weak, how far can I drive? How much exercise can my body safely do? Should I push myself or should I rest? Should I make my plans or take a pass for now?”
I had the invalid mindset for about two weeks. Now my mind has flipped in the opposite direction. Oncologists say the effect of radiation is cumulative. Fatigue can set in fairly soon. So I want to get everything on my list accomplished at once. All I missed out on during the surgeries and chemotherapy must be handled now. Plans for my own dream vacation must be fast tracked. The outline for the non-fiction manuscript I am writing must be done yesterday.
What lesson from my illness have I forgotten? It went like this: Family and friends first. All the rest in good time. How quickly one forgets.
Sometimes I think about the story a friend of mine told me. She’d planned a dream vacation to Alaska with her sister. When treatment for an aggressive cancer weakened her sister, there was some debate over going forward with the plans. But the sister wasn’t sure about her chances for survival, so the trip was on. My friend ended up making the arrangements, driving their rented motor home, and handling all the details during their vacation. Her sister, so independent in the past, seemed incapable of doing anything.
I know how easy it is to feel like an invalid, a victim. Friends and family can be very kind after learning that a loved one has been diagnosed with serious illness. People offer to bring meals, drive the patient wherever she needs to go, and take care of the house. When one is recovering from surgery, or felled by chemotherapy, it is easy to accept.
The time does come when the patient feels better. And yet, the invalid mindset persists. “I’m still weak, how far can I drive? How much exercise can my body safely do? Should I push myself or should I rest? Should I make my plans or take a pass for now?”
I had the invalid mindset for about two weeks. Now my mind has flipped in the opposite direction. Oncologists say the effect of radiation is cumulative. Fatigue can set in fairly soon. So I want to get everything on my list accomplished at once. All I missed out on during the surgeries and chemotherapy must be handled now. Plans for my own dream vacation must be fast tracked. The outline for the non-fiction manuscript I am writing must be done yesterday.
What lesson from my illness have I forgotten? It went like this: Family and friends first. All the rest in good time. How quickly one forgets.
Wednesday, March 10, 2010
This past weekend my hand must have brushed across my head a thousand times. It was so automatic, I didn’t realize I was doing it. On Sunday afternoon my husband finally said, ever so matter-of-factly, “Your hair is growing back.”
“Really?” I asked. “So that’s why it feels different. But I can’t see anything.”
Sure enough, when I inspected my head in the mirror I could see peach fuzz about an eighth of an inch high. Poking through the few strands of hair I never did lose through chemotherapy, the new hair is totally white. Doctors tell patients that the new growth can come in completely grey. It can take up to two years for the full pigment to come back.
There are other signs of rebirth. I managed to hold onto my eyelashes (some women lose those, too). But the lashes that had fallen out before my chemotherapy regimen began had created open spaces. Now there are tiny stubs where the lashes are coming back.
The first sign of regrowth I noticed was in the fingernails. They’d turned red and looked a bit brittle during the time their growth was interrupted. Now, near the cuticle, there is a quarter-inch of healthy color where they are growing out.
It’s odd to see the body regenerate. My husband likens it to watching a baby’s growth. The hair coming in. Cutting the first tiny fingernails. Observing the little one for every sign of maturation, of becoming a real person.
The difference is that a baby doesn’t know what’s happening. Adults do. I doubt I’ll ever take my full head of thick hair or my healthy fingernails for granted again. Lord, please make them grow as fast as you can!
“Really?” I asked. “So that’s why it feels different. But I can’t see anything.”
Sure enough, when I inspected my head in the mirror I could see peach fuzz about an eighth of an inch high. Poking through the few strands of hair I never did lose through chemotherapy, the new hair is totally white. Doctors tell patients that the new growth can come in completely grey. It can take up to two years for the full pigment to come back.
There are other signs of rebirth. I managed to hold onto my eyelashes (some women lose those, too). But the lashes that had fallen out before my chemotherapy regimen began had created open spaces. Now there are tiny stubs where the lashes are coming back.
The first sign of regrowth I noticed was in the fingernails. They’d turned red and looked a bit brittle during the time their growth was interrupted. Now, near the cuticle, there is a quarter-inch of healthy color where they are growing out.
It’s odd to see the body regenerate. My husband likens it to watching a baby’s growth. The hair coming in. Cutting the first tiny fingernails. Observing the little one for every sign of maturation, of becoming a real person.
The difference is that a baby doesn’t know what’s happening. Adults do. I doubt I’ll ever take my full head of thick hair or my healthy fingernails for granted again. Lord, please make them grow as fast as you can!
Tuesday, March 9, 2010
I had my first “zapping” under the linear accelerator yesterday. It took all of ten minutes, eight for positioning me in place and waiting for the machine to move around, and two when the radiation beams were actually on.
The $2.5 million-dollar linear accelerator is huge. My husband was impressed at the alacrity with which it circulated around the table I was lying upon. I noticed that, when the beams were on, everyone scurried from the room and my husband was shooed out. I wonder why it’s safe for me to be in there, yet others run out? I will have to ask the oncologist about that when I see him.
My husband drove me to the radiation center, which is not far from our home. We had no idea whether I’d be uncomfortable or fatigued afterward. As it turned out, I felt fine. I understand that, with this treatment, the effects are cumulative. “Sunburn” at the treatment site, tenderness, and fatigue are the most common side effects.
I have to say that this whole breast cancer “episode” feels a bit like being in a science fiction movie. The director says, “This is what you have. This is what we do. This is how long it takes. If you want to live, you’ll get with the program.”
We all want to live, so we get with the program. The radiation routine will last four weeks, after which I will be sprung. Yippee. In the meantime, there is an oddball list of dos and don’ts I’m to follow. The “dos” include good nutrition, hydration, light exercise and adequate rest. Also, I’m to report any new or worsening side effects to the doctor. I’m to use mild soap, wear comfortable loose clothing, and keep the treated area out of direct sunlight.
The list of “don’ts” starts with not using deodorants containing aluminum. (The aluminum can burn under the radiation beam.) No underwire or sports bras. No vitamin A, C, or E supplements. No lotions, creams, or powders before treatments. No shaving in the treated area. No excessive rubbing.
None of these is difficult. It’s just remembering to do, or not do, what the doctor recommends. I’m sure that, by the time the routine becomes second nature, it will be over. Meantime, I thought I’d include a photo of the linear accelerator. Impressive, is it not?
The $2.5 million-dollar linear accelerator is huge. My husband was impressed at the alacrity with which it circulated around the table I was lying upon. I noticed that, when the beams were on, everyone scurried from the room and my husband was shooed out. I wonder why it’s safe for me to be in there, yet others run out? I will have to ask the oncologist about that when I see him.
My husband drove me to the radiation center, which is not far from our home. We had no idea whether I’d be uncomfortable or fatigued afterward. As it turned out, I felt fine. I understand that, with this treatment, the effects are cumulative. “Sunburn” at the treatment site, tenderness, and fatigue are the most common side effects.
I have to say that this whole breast cancer “episode” feels a bit like being in a science fiction movie. The director says, “This is what you have. This is what we do. This is how long it takes. If you want to live, you’ll get with the program.”
We all want to live, so we get with the program. The radiation routine will last four weeks, after which I will be sprung. Yippee. In the meantime, there is an oddball list of dos and don’ts I’m to follow. The “dos” include good nutrition, hydration, light exercise and adequate rest. Also, I’m to report any new or worsening side effects to the doctor. I’m to use mild soap, wear comfortable loose clothing, and keep the treated area out of direct sunlight.
The list of “don’ts” starts with not using deodorants containing aluminum. (The aluminum can burn under the radiation beam.) No underwire or sports bras. No vitamin A, C, or E supplements. No lotions, creams, or powders before treatments. No shaving in the treated area. No excessive rubbing.
None of these is difficult. It’s just remembering to do, or not do, what the doctor recommends. I’m sure that, by the time the routine becomes second nature, it will be over. Meantime, I thought I’d include a photo of the linear accelerator. Impressive, is it not?
Sunday, March 7, 2010
Some statistics you never forget. In my mind, I am cured of cancer. The tumor’s been removed. I’ve had chemotherapy. Yet, according to oncologists, there is a twenty to forty percent chance that cancer can return to the same area without radiation treatment. It’s too bad because I’m close to feeling “normal” again and would just as soon skip this next phase.
But twenty to forty percent is a large number. And so I start radiation treatment Monday. With trepidation at all the things that can go wrong. With fears of long-term after effects and immediate side effects. Lying under the gigantic linear accelerator where I had my “dry run” last week.
The chief radiation oncologist at my HMO told me that doctors have tried to cherry pick cases, those with good prognosis, to see whether they could get away with doing no radiation. No one’s been successful at that, apparently.
Radiation shrinks the odds of local recurrence (in the same area) to five percent, the oncologist told me. Put another way, the chance of preserving the breast with radiation is close to ninety-five percent. “In terms of cosmetic outcome,” he said, “it’s hard to beat keeping what you have. Put that together with our ability to cure you to be the same, breast conservation is a very good choice. That’s the reason for doing the radiation.”
I asked why the whole breast has to be zapped. Why not just beam the area where the tumor was removed? It seems there has been some research in that department. According to my oncologist, the option is interesting but likely will not become standard because the cosmetic outcome isn’t as good. There is more fibrosis and a denseness of the area that is treated.
We discussed other forms of treatment. Radiation can be delivered from inside the breast through an array of needles. Evidently, women haven’t been clamoring to have this procedure because it is more invasive. However, there are studies that show it is effective. And the array of catheters in the breast is only there over a three-day period.
Another form of radiation therapy is delivered at the time of surgery. A balloon, through which radiation is delivered, is sewn into the lumpectomy cavity of the breast. This is a fairly new procedure, so not enough data is available on its effectiveness. “On top of that,” said the oncologist, “it’s probably only treating about a centimeter of tissue around the cavity.”
A couple of journals, Radiology Today and Medical News Today, have reported on another technique that appears to hold promise. Called intraoperative electron radiation therapy (IOERT), it is “the application of electron beam radiation directly to a tumor or tumor bed during surgery,” according to Radiology Today.
Not everyone is a candidate for the IOERT technique. But what a blessing for those who can make use of it. The tumor area is radiated while the wound is open. The surgery to remove the tumor and the radiation treatment are, potentially, done in one day. Any microscopic cancer cells near the area of the tumor can be hit while they are most vulnerable. Healthy skin that might be radiated with conventional external-beam radiation can be spared.
Of course there are obstacles. Most operating rooms are not equipped with mobile electron linear accelerators. And transporting a patient in the midst of an operation to a shielded area where there is a conventional linear accelerator presents risks and challenges. Then there is the high cost, which helps explain why few hospitals are equipped to administer IOERT therapy.
Still, some of these new techniques show a lot of promise. I can only hope that, one day, the notion of going to a cancer radiation center every day for four to ten weeks will seem arcane. And wouldn’t that be a blessing?
But twenty to forty percent is a large number. And so I start radiation treatment Monday. With trepidation at all the things that can go wrong. With fears of long-term after effects and immediate side effects. Lying under the gigantic linear accelerator where I had my “dry run” last week.
The chief radiation oncologist at my HMO told me that doctors have tried to cherry pick cases, those with good prognosis, to see whether they could get away with doing no radiation. No one’s been successful at that, apparently.
Radiation shrinks the odds of local recurrence (in the same area) to five percent, the oncologist told me. Put another way, the chance of preserving the breast with radiation is close to ninety-five percent. “In terms of cosmetic outcome,” he said, “it’s hard to beat keeping what you have. Put that together with our ability to cure you to be the same, breast conservation is a very good choice. That’s the reason for doing the radiation.”
I asked why the whole breast has to be zapped. Why not just beam the area where the tumor was removed? It seems there has been some research in that department. According to my oncologist, the option is interesting but likely will not become standard because the cosmetic outcome isn’t as good. There is more fibrosis and a denseness of the area that is treated.
We discussed other forms of treatment. Radiation can be delivered from inside the breast through an array of needles. Evidently, women haven’t been clamoring to have this procedure because it is more invasive. However, there are studies that show it is effective. And the array of catheters in the breast is only there over a three-day period.
Another form of radiation therapy is delivered at the time of surgery. A balloon, through which radiation is delivered, is sewn into the lumpectomy cavity of the breast. This is a fairly new procedure, so not enough data is available on its effectiveness. “On top of that,” said the oncologist, “it’s probably only treating about a centimeter of tissue around the cavity.”
A couple of journals, Radiology Today and Medical News Today, have reported on another technique that appears to hold promise. Called intraoperative electron radiation therapy (IOERT), it is “the application of electron beam radiation directly to a tumor or tumor bed during surgery,” according to Radiology Today.
Not everyone is a candidate for the IOERT technique. But what a blessing for those who can make use of it. The tumor area is radiated while the wound is open. The surgery to remove the tumor and the radiation treatment are, potentially, done in one day. Any microscopic cancer cells near the area of the tumor can be hit while they are most vulnerable. Healthy skin that might be radiated with conventional external-beam radiation can be spared.
Of course there are obstacles. Most operating rooms are not equipped with mobile electron linear accelerators. And transporting a patient in the midst of an operation to a shielded area where there is a conventional linear accelerator presents risks and challenges. Then there is the high cost, which helps explain why few hospitals are equipped to administer IOERT therapy.
Still, some of these new techniques show a lot of promise. I can only hope that, one day, the notion of going to a cancer radiation center every day for four to ten weeks will seem arcane. And wouldn’t that be a blessing?
Friday, March 5, 2010
One of the grandsons, twelve-year-old Stephen, called me last night. He wanted to know how I was feeling with my breast cancer and hoped I would be okay. I told him I was fine and would be fully cured. He allowed that that was good, then asked whether I wanted to hear about the snail races. Absolutely.
Stephen explained that his brother had set up two tracks for several snails to “run,” one lane with foil and another with sandpaper. It took seven to eight minutes. Eventually, one of the snails did make it to the end of the track. I grinned as he told me all the details in his breathy, little-boy voice. Snail races sounded like a lot of fun.
We talked about the Olympics. Stephen loved watching Shaun White, naturally. As Stephen snowboards, that is what he wants his profession to be. He’s targeting the 2014 winter Olympics in Sochi, Russia. That’s great. Goals are good to have.
Stephen told me about his dog, a labradoodle named Indy. The dog is hypoallergenic, he said, which is good because Stephen has a few allergies.
I asked about school, of course. Stephen loves it and his teacher. The best part, he said, is fixing up old bicycles to give away to kids whose parents can’t afford bikes. Stephen and his classmates have learned to spiff up the used bikes pretty well.
“Would you like to hear a fun fact I learned today?” Stephen asked. “The continent of South America is moving at the rate your fingernails grow every day. One day, maybe two billion years from now, South America will be a separate continent.”
That’s pretty cool, Stephen. And so are you, kiddo. So are you.
Stephen explained that his brother had set up two tracks for several snails to “run,” one lane with foil and another with sandpaper. It took seven to eight minutes. Eventually, one of the snails did make it to the end of the track. I grinned as he told me all the details in his breathy, little-boy voice. Snail races sounded like a lot of fun.
We talked about the Olympics. Stephen loved watching Shaun White, naturally. As Stephen snowboards, that is what he wants his profession to be. He’s targeting the 2014 winter Olympics in Sochi, Russia. That’s great. Goals are good to have.
Stephen told me about his dog, a labradoodle named Indy. The dog is hypoallergenic, he said, which is good because Stephen has a few allergies.
I asked about school, of course. Stephen loves it and his teacher. The best part, he said, is fixing up old bicycles to give away to kids whose parents can’t afford bikes. Stephen and his classmates have learned to spiff up the used bikes pretty well.
“Would you like to hear a fun fact I learned today?” Stephen asked. “The continent of South America is moving at the rate your fingernails grow every day. One day, maybe two billion years from now, South America will be a separate continent.”
That’s pretty cool, Stephen. And so are you, kiddo. So are you.
Thursday, March 4, 2010
No one knows what causes breast cancer. There are many factors that are believed to elevate the risk. According to the The National Cancer Institute’s booklet What You Need To Know About Breast Cancer, there are a number of “risk factors.” I’ve reproduced the list from the booklet, for the most part, here:
--Age: Most women are diagnosed with breast cancer when they are over sixty years old. The chance of getting the disease increases with age.
--Personal history: Having cancer in one breast increases the risk of getting it in the other. Having certain types of abnormal cells in the breast also increases the risk.
--Family history: If a mother, father, sister, or daughter had breast cancer a woman’s chance of getting it is higher.
--Genes: Changes in certain genes, such as BRCA1 or BRCA2, increase the risk.
--Radiation therapy to the chest: Women who’ve had radiation therapy to the chest before age thirty are at increased risk.
--Race: Caucasian women are at higher risk than African American, Hispanic, Asian, American Indian, or Alaska Native women.
--Breast density: Women whose breasts have more dense and fatty tissue are at higher risk.
--Weight: Women who are overweight after menopause are at increased risk.
--Physical activity: Physically inactive women may be at higher risk.
--Alcohol: Studies suggest the more a woman drinks, the greater her risk.
--History of DES: Some pregnant women were given DES in the United States between about 1940 and 1971. Women who received DES are at slightly higher risk.
Reproductive and menstrual history:
--The older a woman is when she has her first child, the greater the risk of her having breast cancer.
--Women who’ve never had children are at higher risk.
--Women who began the menstrual cycle before age twelve are at risk.
--Women who experienced menopause after age fifty-five are at increased risk.
--Women who’ve taken menopausal hormone therapy for many years are at higher risk.
--Age: Most women are diagnosed with breast cancer when they are over sixty years old. The chance of getting the disease increases with age.
--Personal history: Having cancer in one breast increases the risk of getting it in the other. Having certain types of abnormal cells in the breast also increases the risk.
--Family history: If a mother, father, sister, or daughter had breast cancer a woman’s chance of getting it is higher.
--Genes: Changes in certain genes, such as BRCA1 or BRCA2, increase the risk.
--Radiation therapy to the chest: Women who’ve had radiation therapy to the chest before age thirty are at increased risk.
--Race: Caucasian women are at higher risk than African American, Hispanic, Asian, American Indian, or Alaska Native women.
--Breast density: Women whose breasts have more dense and fatty tissue are at higher risk.
--Weight: Women who are overweight after menopause are at increased risk.
--Physical activity: Physically inactive women may be at higher risk.
--Alcohol: Studies suggest the more a woman drinks, the greater her risk.
--History of DES: Some pregnant women were given DES in the United States between about 1940 and 1971. Women who received DES are at slightly higher risk.
Reproductive and menstrual history:
--The older a woman is when she has her first child, the greater the risk of her having breast cancer.
--Women who’ve never had children are at higher risk.
--Women who began the menstrual cycle before age twelve are at risk.
--Women who experienced menopause after age fifty-five are at increased risk.
--Women who’ve taken menopausal hormone therapy for many years are at higher risk.
Wednesday, March 3, 2010
When the body is otherwise healthy, it is easy to dismiss symptoms that something might be going wrong. More than three years ago, there was a brief period of time when I noticed a wild pinching sensation in the OFB (offending body part). The pinching subsided, then came and went. Over time, I got used to it. After the cancerous tumor was removed from my breast in October 2009, the pinching disappeared. Lesson number one, listen to what your body is telling you.
The National Cancer Institute (NCI) has produced a booklet called What You Need To Know About Breast Cancer. In one section, the booklet notes that early breast cancer usually has no symptoms. As the tumor grows, it can change the look and feel of the breast. I’ve listed the common changes from the booklet here:
--A lump or thickening in or near the breast or in the underarm area.
--A change in the size or shape of the breast.
--Dimpling or puckering in the skin of the breast.
--A nipple turned inward into the breast.
--Discharge (fluid) from the nipple, especially if it’s bloody.
--Scaly, red, or swollen skin on the breast, nipple, or areola (the dark area of skin at the center of the breast). The skin may have ridges or pitting so that it looks like the skin of an orange.
These symptoms are often not due to cancer, according to the booklet. Another health problem could cause them. Any of these symptoms should be evaluated by a woman’s doctor so they can be diagnosed and treated.
The NCI recommends that women in their forties and older have mammograms every one or two years.
The National Cancer Institute (NCI) has produced a booklet called What You Need To Know About Breast Cancer. In one section, the booklet notes that early breast cancer usually has no symptoms. As the tumor grows, it can change the look and feel of the breast. I’ve listed the common changes from the booklet here:
--A lump or thickening in or near the breast or in the underarm area.
--A change in the size or shape of the breast.
--Dimpling or puckering in the skin of the breast.
--A nipple turned inward into the breast.
--Discharge (fluid) from the nipple, especially if it’s bloody.
--Scaly, red, or swollen skin on the breast, nipple, or areola (the dark area of skin at the center of the breast). The skin may have ridges or pitting so that it looks like the skin of an orange.
These symptoms are often not due to cancer, according to the booklet. Another health problem could cause them. Any of these symptoms should be evaluated by a woman’s doctor so they can be diagnosed and treated.
The NCI recommends that women in their forties and older have mammograms every one or two years.
Tuesday, March 2, 2010
The great food experiment continues. As sugar turns to fat in the body, and is also known to feed cancer (once the body has cancer), white refined sugar has been jettisoned from my house.
I do still like things sweet, so I’m taste-testing several sweetener alternatives I recently picked up at the market. The favorite, by far, is Gipson’s Golden Blackberry Honey. Raw and unfiltered, it comes from Santa Rosa, Calif. It’s delicious. But it does add its own flavor to beverages.
If the blackberry flavor isn’t one that’s desired in tea or coffee, what else will work? There are the traditional ersatz sugars, such as Equal, Splenda, and Sweet ‘N Low. Plenty of people swear by these. They’re not my favorite, so I’ve checked around for other products that might work.
There is pure cane sugar, washed and raw, from C&H--the people who bring us the white refined stuff. It comes in a resealable bag and contains molasses naturally. It does the job of the white sugar, but is a bit less sweet.
I’ve tried a brand of raw cane sugar called Full Circle. It is organic, also comes in a resealable bag, and calls itself “demerara” cane sugar. It’s a product of Brazil and Paraguay. The internet site http://www.wisegeek.com/ maintains that the sugar is named after a colony in Guyana, which first began producing and selling it in volume. According to the site, “To make demerara sugar, sugar producers press sugar cane and steam the juice of the first pressing to form thick cane syrup. The cane syrup is allowed to dehydrate, leaving behind large golden brown crystals of sugar. Because demerara sugar is not heavily refined, it has a rich, creamy, molasses-like flavor which enhances baked goods.”
My last pick is Light Agave Nectar. I haven’t yet used it. A quick taste reveals that it has a very different flavor. We’ll see how it does in tea and coffee. It’s a product of Mexico, is organic, and is extracted from the agave cactus plant. According to the label, it is twenty-five percent sweeter than sugar and has a low “glycemic index to prevent a spike in blood sugar.”
So far, to be honest, the sugar that does the job best for me is the cane sugar that comes from C&H. Breaking off the sweet stuff is hard to do.
I do still like things sweet, so I’m taste-testing several sweetener alternatives I recently picked up at the market. The favorite, by far, is Gipson’s Golden Blackberry Honey. Raw and unfiltered, it comes from Santa Rosa, Calif. It’s delicious. But it does add its own flavor to beverages.
If the blackberry flavor isn’t one that’s desired in tea or coffee, what else will work? There are the traditional ersatz sugars, such as Equal, Splenda, and Sweet ‘N Low. Plenty of people swear by these. They’re not my favorite, so I’ve checked around for other products that might work.
There is pure cane sugar, washed and raw, from C&H--the people who bring us the white refined stuff. It comes in a resealable bag and contains molasses naturally. It does the job of the white sugar, but is a bit less sweet.
I’ve tried a brand of raw cane sugar called Full Circle. It is organic, also comes in a resealable bag, and calls itself “demerara” cane sugar. It’s a product of Brazil and Paraguay. The internet site http://www.wisegeek.com/ maintains that the sugar is named after a colony in Guyana, which first began producing and selling it in volume. According to the site, “To make demerara sugar, sugar producers press sugar cane and steam the juice of the first pressing to form thick cane syrup. The cane syrup is allowed to dehydrate, leaving behind large golden brown crystals of sugar. Because demerara sugar is not heavily refined, it has a rich, creamy, molasses-like flavor which enhances baked goods.”
My last pick is Light Agave Nectar. I haven’t yet used it. A quick taste reveals that it has a very different flavor. We’ll see how it does in tea and coffee. It’s a product of Mexico, is organic, and is extracted from the agave cactus plant. According to the label, it is twenty-five percent sweeter than sugar and has a low “glycemic index to prevent a spike in blood sugar.”
So far, to be honest, the sugar that does the job best for me is the cane sugar that comes from C&H. Breaking off the sweet stuff is hard to do.
Monday, March 1, 2010
The Olympic flame has been extinguished in Vancouver, British Columbia. For sixteen days we were treated to spectacular athleticism, stunning beauty, and the raw power of sport. It was marvelous to watch and to feel, however fleetingly, a kinship with so many countries around the globe.
Years ago, when I skied with a ski club, I would feel great excitement at the time of the winter games. I could only imagine what it would take to push the body to that level of competitiveness. This year, watching from a body depleted by illness, I had a different perspective on the games.
I watched skiers popping through the mogul field and wondered what their knees would be telling them years hence. I saw bobsledders eject onto the course and wondered what that was doing to their backs. I listened to the list of injuries athletes skated, skied, and raced through and thought how terrific to be at an age where it was possible to forge through injuries in that fashion.
All in all, the games were an amazing spectacle. The heights snowboarders reached were incredible. The speed at which bobsledders hurtled down the track were amazing. Who will ever forget the image of a figure skater sending kisses to the heavens after a performance following her mother’s sudden death? Who can forget the U.S. goalie’s collapse on the ice after hockey team Canada sent the winning puck into the net?
How quickly the games got to be an old friend. I shall miss their company and the lift to the spirit they provided.
Years ago, when I skied with a ski club, I would feel great excitement at the time of the winter games. I could only imagine what it would take to push the body to that level of competitiveness. This year, watching from a body depleted by illness, I had a different perspective on the games.
I watched skiers popping through the mogul field and wondered what their knees would be telling them years hence. I saw bobsledders eject onto the course and wondered what that was doing to their backs. I listened to the list of injuries athletes skated, skied, and raced through and thought how terrific to be at an age where it was possible to forge through injuries in that fashion.
All in all, the games were an amazing spectacle. The heights snowboarders reached were incredible. The speed at which bobsledders hurtled down the track were amazing. Who will ever forget the image of a figure skater sending kisses to the heavens after a performance following her mother’s sudden death? Who can forget the U.S. goalie’s collapse on the ice after hockey team Canada sent the winning puck into the net?
How quickly the games got to be an old friend. I shall miss their company and the lift to the spirit they provided.
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