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Don’t waste time wondering “Why you?”, because it is you.

September 8, 2009

Guest blogger, Jean Stephens, sent me an account of her journey with breast cancer.  Read her inspirational story about learning she had cancer and how she was not going to give in to the disease.  Knowing is power and knowing what to expect during treatment can help allay some of the fear.

“You have breast cancer.” By Jean Stephens

Jean and her friend Lisa, bald as cue balls

Jean and friend Lisa, bald as cue balls

Four words that, before Friday, April 21, 2006, I never expected to be directed at me.  Cancer happens to other people.  Isn’t that what we all think?

As I was lying on the floor earlier that month, finishing my post-running stretch, I reminded myself I was two months overdue for my annual mammogram.  I felt the area of fibrous tissue in my right breast that had been the subject of a sonogram the year before.  It seemed firmer than a year ago and was at times painful.  That spurred me to make an appointment.

Two days after the mammogram the imaging facility contacted me to request I come back for a diagnostic mammogram.  This is where they compress the breast to make as thin a layer of tissue as possible so that nothing can hide.  The technician showed me the films from the first mammogram and circled the “areas of interest”.  Diagnostic mammograms are, in a word, painful.  I especially like the technician’s instruction “not to breathe” when snapping the image.  Not a difficult request to comply with.

While waiting for the results of the mammogram I mentioned the sonogram performed the previous year and why (fibrous tissue).  The radiologist decided to perform a sonogram to be sure everything was ok.  Instead of hearing what I expected, that all is well and they would send me a reminder next year, he asked me to come with him to look at the results.  The diagnostic mammogram did not reveal anything unusual.  The sonogram did. 

I went back two days later, husband in tow, for a core needle biopsy.  The doctor cuts a small flap of skin, inserts a hollow needle into the tumor, and extracts a tissue sample.  The doctor who performed the biopsy was very honest and very direct; he was 95% certain we were dealing with breast cancer.  As soon as the doctor left the room I fell into my husband’s arms, sobbing.  The official diagnosis came the next day – malignant tumor in the right breast.  The journey to becoming a breast cancer survivor had begun!

The first order of business was to throw myself a Pity Party.  I cried, I ranted, I cursed, and I threw things.  I didn’t want to die, I didn’t want my daughter to grow up without a mother, I didn’t want my husband to grow old alone, I didn’t want my mother to have to bury one of her six children – the list goes on.  I spoke with a very dear friend, herself a three-year survivor at the time, and she gave me the single best piece of advice that helped me start and keep moving forward:

Don’t waste time wondering “Why you?”, because it is you.

The second order of business was to find doctors.  I definitely needed a surgeon.  I also might need an oncologist, a radiation oncologist, and a plastic surgeon.  If you’ve read any breast cancer survival guides you’ll be familiar with the term “Dream Team”.  This refers to the suite of doctors you surround yourself with to treat and hopefully cure you.  I called my OB/GYN for a surgical referral.  He gave me the name of the doctor that handled his mother-in-law’s breast cancer.

At this point you may be wondering if I had been performing monthly self-exams.  Yes, I had.  My surgeon told me it would have been nearly impossible for me to feel the tumor because it was buried in the fibrous tissue.

After reviewing the mammogram films my surgeon ordered a breast MRI.  This would give him a three dimensional view of the tumor, and tell him the exact location and size.  This procedure required me to lie on my stomach with my breasts stuck in two holes in the table.  The technicians had to reach up into the holes from underside of the table and make sure I was all the way in.  I felt like I was being milked.  I also underwent a bone scan and a CT scan; both were negative.

There were two options for surgery to remove my “ductal carcinoma” – lumpectomy or modified radical mastectomy.  The MRI indicated the tumor was a little over an inch in diameter and located just above the areola.  The location and size did not lend themselves to a lumpectomy.  As my oncologist so aptly put it, I would have been left with a “cosmetically unacceptable outcome”.  We elected a modified radical mastectomy, which is removal of the breast tissue but not the underlying muscle.  Recovery is easier than from a radical mastectomy and does not require formal physical therapy.

For a typical modified radical mastectomy the surgeon makes a horizontal elliptical incision.  Because of the location of the tumor and the fibrous tissue in which it was hiding my surgeon had to abandon that approach and make an incision that began from the upper right side of the breast.  The decision to perform the modified radical mastectomy turned out to be a fortunate one.  A biopsy revealed six cancerous lesions in the removed breast tissue.

The first phase of breast reconstruction began immediately after the mastectomy with the insertion of a tissue expander under my pectoral muscle.  The plastic surgeon who performed this part of the procedure has been working with my surgeon for many years.  Add one more to my Dream Team, and I didn’t even have to look for him!  The plastic surgeon replaced the tissue expander with a permanent implant last year.  I should have a vanity plate that reads “50NPRKY”.

When I came home from the hospital I stripped to the waist and stood in front of the mirror.  What a site!  Bruising, stitches, saggy breast tissue, and that wretched drain.  The drain is a plastic tube inserted into the surgical site with a collection bulb at one end.  I had to empty the bulb three times a day and note how much fluid my body was producing.  Fluid production is a normal part of the healing process.  The drain helps prevent swelling.  The drain had to stay in until I was producing less than 25cc of fluid for three consecutive days.  From what I had read and what I was told I could expect the drain to be removed in 7-10 days.  Three weeks later it was still in.  I showed the daily collection numbers to my surgeon during a follow-up visit and he decided it was time for the drain to come out.  Thank goodness!

Don’t waste time wondering “Why you?”, because it is you.

The surgery was my cure because it removed all known cancer from my body.  However, the size of the tumor dictated we go through chemotherapy and radiation “just in case”.  Add two more to my Dream Team – Oncologist and Radiation Oncologist, both affiliated with my surgeon.  I can’t say enough good things about the staff at the cancer center.  They are kind, supportive, and knowledgeable.

Chemo sucks.  The doctor told me I would lose my hair 14-17 days after the first treatment.  True enough, my brush starting filling up on the 14th day.  By the 16th day I had to go outside to brush my hair because of the volume.  I made an appointment with my haircut lady to shave my head.  Sitting by my side, holding my hand as the razor slid over my head was my good friend Lisa.  Lisa was diagnosed with inflammatory breast cancer two weeks after my surgery and had already started chemo.

The effects of chemo are cumulative, meaning it takes you a little longer after each treatment to feel ok.  I’m sure those who have been through some form of chemo will agree – you just get tired of feeling bad.  I took advantage of some effective anti-nausea drugs and kept to my exercise schedule.  I continued working at my job through my treatments, taking only the day of my treatment as a sick day.  It helped to have something to keep my mind occupied.  Finishing the fifth of my eight treatments gave me a huge psychological and emotional boost.  I now had more behind me than I did in front of me.  There are times, such as when I’m in the throes of an especially violent hot flash, that part of me wishes I was still bald.

Radiation treatments were a nuisance because of the schedule – a treatment five days a week for six weeks.  It took longer to change into a gown than it did to have a treatment!  This is another phase in which regular exercise helped me cope physically.  I did not experience any of the fatigue side effects you read about.

Don’t waste time wondering “Why you?”, because it is you.

Do I ever think about a recurrence?  I’d be lying if I said no.  When thoughts of “What if?” enter my head I don’t dwell on them.  I focus on what I want to be doing forty years from now and do what I can to make sure I get there.

For me, attitude plays a huge role in how I deal with my life, from the insignificant to the seemingly insurmountable.  I can’t approach life any other way than “the glass is half full.”  Smile, laugh, surround yourself with family and friends, and you too can kick breast cancer’s sorry ass to the curb.

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