cancerBrat

February 28, 2015
by cancerBrat
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cancer survivors find hope

Esophageal cancer (EC) sneaks up on people. My husband, Michael Ratner, (owner of a trendy Phoenix restaurant), was diagnosed with EC on my birthday, October 9, 2008. He had difficulty earlier in the week after he swallowed a piece of carrot, which left him coughing when it became lodged in his esophagus. Two days later, after an endoscopy, the diagnosis was official—adenocarcinoma esophageal cancer.

As an RN, I knew Michael’s health grades were excellent except for a history of recurrent gastroesophageal reflux disease (GERD), which he frequently treated with Tums. He bicycled 20+ miles twice a week, worked out three days a week and watched his diet and weight. None of those things would save him.

I didn’t know much about esophageal cancer when I heard the diagnosis, except that most patients with this disease did not survive. It didn’t take me long to research it online and in the hospital’s medical library. The grim news became the first secret between us. I kept an upbeat disposition, a smile on my face, and for the first time since we married, I wasn’t honest with him.

I’m now an expert on esophageal cancer. As many as 15 million Americans experience heartburn every day. Persistent heartburn (two or more times per week) or GERD can cause stomach acid to splash into the esophagus, producing cellular changes that can ultimately result in cancer.

About three million Americans currently have what is known as Barrett’s Esophagus, a precancerous condition that results in as much as a 125-fold increase in an individual’s chance to develop esophageal cancer. Often, esophageal cancer is not discovered until it has reached advanced stages.

The good news is that new medical techniques have been developed that can virtually cure patients if detected at an early stage.

The Group

I quickly became an astute student of the transhiatal esophagectomy (THE), a surgical procedure which would be performed when my husband had his business and personal matters settled, as one surgeon advised. When I looked at my husband, a robust man, I wondered what the results of this surgery might be—a surgery which entails removing ¾ of the esophagus and stretching the stomach vertically to replace the removed muscle, leaving behind a portion of the stomach.

A month after Michael’s THE procedure, I went searching for an EC support group, not just for him, but for both of us—patient and caregiver.

The formation of the lecture series came about after I called several well-known Phoenix cancer centers looking for a support group for EC patients and their families. After finding no specific groups for EC, due to low survivor rates, I decided to start my own. This is how our lecture series started 13 years ago.

Our goal is to continue to offer comfort, teach coping skills, and provide a place for people to share their experiences. The group began and continues with unique attendees. Some come to learn about a specific disease process while others attend because they are supporting a family member or friend.

One of our original attendees, Deanne Poulos, lost her brother to esophageal cancer two weeks before his 50th birthday. She attended our first lecture meeting, passed around a photo of her late brother, and said, “I’m here to honor my brother and to support all of you.” Poulos attended every lecture. Another member, Harold Riffer, our 22-year cancer survivor (he’s 88-years old), occasionally plays Klezmer music on his saxophone during special occasions. Ken Lange, a 19-year survivor, had been blessed with surviving cancer twice.

Michael died on November 16, 2010, after a 25-month EC battle with metastasis to the spine, bone, and liver. He missed only one lecture before he died—when he was hospitalized. It is in honor of him, that we offer the Michael Ratner Memorial Lecture Series to all patients, their families and friends, and the community.

By the Numbers

The American Cancer Society estimated 20,640 Americans will be diagnosed with esophageal cancer in 2022. The estimates include:

16,510 men diagnosed
4,130 women diagnosed
16,410 deaths

If you’re interested in setting up a cancer support group in your city, email tjrwriter@icloud.com and find out more about the group at mrmlectureseries.com.

Terry Ratner was married to Michael Ratner and formed the Michael Ratner Memorial Community Support Association. Here are links to newspaper articles about the group:
Arizona Republic
Phoenix North Central News

August 11, 2014
by cancerBrat
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a slice of paris

Those of you who have followed my column, you know about my October 2013 diagnosis of breast cancer. Before you start feeling sorry for me and saying, “What a shame she has cancer”, I want you to know that I am a lucky person. My dream came true in May when I traveled to New York followed by Paris. No matter what else occurs in my life, I’m blessed to be able to say, “I spent eight wonderful nights in Paris.” I’d like to share my journey with all of you.

Paris is heaven for most women. It’s a place where their fantasies come alive: hot men, beckoning pastries, sexy lingerie, the latest trends in fashion, mouth-watering chocolates, colorful umbrellas, and don’t forget the fabulous shoes.

Landing midday at Orly began the magical journey. After finding a taxi, I felt like a child in a candy store as I pressed my nose to the cab’s window to take in the changing landscape. As we drove closer to the city, I couldn’t help but ask my driver to slow down while I snapped some photos of the colorful architecture and the people walking the boulevards of Paris.

We arrived at the Hotel Pas de Calais (named after a state and major ferry port in northern France) just after 1:00 PM. The town of Calais came to be called the ‘brightest jewel on the English Crown’ which became our sentiments as well.

I noted the French bathrooms which are sometimes a rare find. Toilets were usually located in a small room with cracks in the wall, separate from sinks and -electric hand dryers. There always seemed to be a shortage of soap and paper towels.

This charming family-owned establishment combined comfort with historical significance. The structure, built in 1750 as a residence, was home to famous writer and philosopher, Chateaubriand and later transformed into a hotel in 1810. Madam, whose father bought the property in 1930, still lives in the hotel six months out of the year. We had the honor of meeting her and her grandson, Alexi. She told us that her father was born at this hotel and died there. We sat them in the lobby on our last night sipping rosé and talking about the hotel’s colorful history; a meeting place for Jean-Paul Sartre, Simone de Beauvoir and J. Greco. When we inquired about Hemingway, she replied, “Oh no, he stayed at the Ritz.”

Alexander Calder and Jan Voss were some of the artists who stayed there. Madam added with a smile, “My father tossed Jan Voss out in the street when he couldn’t pay for his room. Then he burned some of his early paintings that were offered up as payment.”

We loved everything about the hotel from its magnificent tended orchids in the front lobby to the narrow decorative elevator which allowed only two ‘very friendly’ people to use the lift at one time.

Streets were cobblestoned and narrow. People drove fast in small cars with loud horns and liked to park on the sidewalk; sirens screamed from police cars just like in the movies. American music played in stores and eateries. Motorcyclists and bicycle riders without helmets raced by us. Gypsies begged on street corners and homeless people sat on benches and curbs. One indigent man sat under an ATM machine. There seemed to be a constant movement on the streets; men and women sitting in front of cafes sipping wine, people with their dogs (mostly French bulldogs), people on cellphones and smoking cigarettes. Shop keepers had a steady stream of customers and Parisians in general, seemed calmer than Americans.

On my last day in Paris, I remember the cab ride to Charles De Gaulle airport. I rolled my window down and enjoyed the soft misting of rain. Looking like a paparazzi, not wanting to miss any part of the city, I videoed all that I could. A tremendous wave of nostalgia mixed with a premature yearning for a place I had not yet left overwhelmed me. I kept snapping photos—in hopes of bringing a slice of Paris home with me, not knowing when or if I’d ever return. Looking out the window, I watched the twilight descend and the capital became bathed in a translucent misty lavender glow.

You can view my New York and Paris photo gallery by clicking here.

July 26, 2014
by cancerBrat
6 Comments

dogs, lovers, and lumps

You have to listen real hard to hear anything at all: the sound of tippy-toes on wood stairs, the soft tap of a paw on the bedroom door, the digging around in her bed to find a perfect spot for the night, the shuffling of cards as she shakes off excess water, and the gentle click from the flap on her dog door.

We bought a Bedlington terrier on Memorial Day, 2013. We were spending the weekend on my boyfriend’s sail boat in Harbor Island when we scheduled a meeting with a breeder.

We talked about getting a dog for months before beginning our search on the Internet, looking for dogs late at night. We called it dog-dating, but just like all Internet dating, we are reduced to making judgments based on physical appearances, and as anyone who’s hoping for a lifetime of companionship knows, looks are the least of it.

We met her for the first time outside of a Subway restaurant when an elderly woman standing in a shaded area appeared holding a nine-week-old dog in the palm of her hand. It’s difficult not to fall in love with a puppy that fits perfectly in your arms and whose hair is softer than a favorite stuffed animal, but I didn’t let myself get taken with the ‘Ah, she’s so cute’ routine. I told myself, “It’s just another pup and along with raising a dog comes extra work.”

The holiday weekend fell five days after I found a lump on my right breast. Not sure if I should use “on” or “in” because both words define the characteristics of this lump. I hadn’t told my boyfriend about my discovery, partly out of fear that it might somehow change our direction, and because there was so much about this lump that I didn’t know, so why bring it up now.

My hesitation included our relationship as a couple. We had been living together for five months and I seemed to be stuck in the “dating” mode, not wanting to ruin the newness of our romance for daily routines. There is something to be said for the beginning of a relationship: it’s fresh, sexy, romantic, and exciting. I wasn’t prepared to give that up.

We returned to the boat to think things over. My boyfriend seemed excited to bring her home. He kept asking me if I wanted her. I’d reply, “She’s cute and so sweet.” I left out the rest of my thoughts: Not at this time.

I couldn’t say what I felt to him because I knew he had already fallen for her. Gracie, he named her the day we picked her up, stayed curled in my lap for the entire ride home to Phoenix.

When we arrived, I didn’t let myself get attached. He was the one who set his alarm to go off at 3 AM and 6 AM to feed her and take her for walks. He taught her to use the dog door and trained her to sit and stay. I kept our relationship at a distance.

I lived with Gracie and my lump for the same amount of time before having surgery. After an ultrasound in June, the radiologist told me that it was “probably benign.” That seemed to appease me for a while, but I still needed more scientific proof to ease my mind.

During the weeks leading up to surgery, Gracie greeted me each day after work. She was my daily yoga, my meditation, and my personal therapy dog. She seemed to know when I needed her to comfort me—the way she rested her long face against my neck and snuggled her small, soft body next to mine, and when I picked her up like a small child, she rested her right front paw around my neck.

Gracie and my boyfriend stuck by me through the initial surgery, which diagnosed the cancer, and the lymph node biopsy that followed. She allowed me to snatch her up in my arms and tickle her underside after each of my brachytherapy sessions.

The bonding between us happened despite my efforts to stay unattached. Even when she ate my favorite pair of underwear, had accidents on the carpet, bit my best friend (very lightly without consequence), I took her side.

Sometimes love does not have the most honorable beginnings, and the endings, which I try not to think about, will sometimes break you in half. It’s everything in between we live for.

OK, say goodnight Gracie.

Send comments to info@terryratner.com

July 20, 2014
by cancerBrat
0 comments

deformity

My right breast is deformed. Two surgeries and a five-day intensive radiation treatment have changed the structure of a perfectly beautiful breast. The skin is still smooth and the nipple looks identical to the original—it’s the implant itself that has dropped leaving the right breast lower than the left breast. The lumpectomy, sentinel node biopsy, and radiation treatments have altered the shape along the right quadrant causing a dimpling in the skin leaving my right breast an anomaly.

It’s now more than a month since the radiation was completed. It’s six months since the lumpectomy and four months after the sentinel node biopsy. I rejoiced on the last day of radiation. I wonder now what I was celebrating.

I thought the cancer was behind me, that the radiation killed every cancer cell in the area, but that’s just what I and every cancer patient wants to believe. The fact is that I have cancer. I am not a cancer survivor and will never call myself one. There is no such thing as a cancer survivor because one never knows when or if this terrible disease will sneak up on them, attack the same area or a different one. All of us who have had a diagnosis of cancer live with the likelihood of having cancer return sometime in their life. The trick is to learn to live life as if you were never touched by this awful disease or to live as if it the cancer will never return.

I’m afraid I’ve failed horribly at my own advice. I’m feeling worse now than before treatment or during the treatment. I try and think about people who suffered a far greater loss than me; a girl in her twenties on crutches with only one leg. And yes, she was smiling. Then there was a man sitting in a wheelchair who lost both legs. He also smiled at me. I remember another man walking down the halls in the hospital where I worked with two silver hooks that sparkled in the light. I asked him about his life and how he managed. We walked to my office and his artificial hands picked up papers, pens, and books, whatever he wanted. He smiled as he performed everyday tasks that we all take for granted.

These encounters were all before my breast cancer diagnosis, except for the girl with an above the knee amputation who had no prosthesis. This beautiful young girl with blond hair, freckles, and a huge smile, entered the salon and glided past me with grace as if the crutches were her wings. I almost didn’t notice a missing limb. Her eyes met mine and there was a strong connection. This occurred a week before I underwent radiation—a week when I had doubts about the treatment and its aftereffects. I wanted to talk with her, but thought it best not to. The strength I needed didn’t require a conversation or necessitate an explanation of what had happened to her. The image of her smile seemed to put things in perspective—then and now.

June 22, 2014
by cancerBrat
1 Comment

tattoo

A permanent reminder
of a time in one’s life

I’m being chauffeured to my first radiation appointment by my boyfriend. The only sound is the faint hum of traffic around us. He isn’t sure what to say to make things better and I’m to blame for that. I don’t make it easy for him. I’ve been difficult to live with since the diagnosis, sometimes asking him to leave and not worry about me, other times trying to drive him away with erratic behavior. He never once left me, not even in anger.

I glance over at his face while he drives and notice the lines around his eyes and mouth. They seem to be etched into his skin as if someone pushed down on a pencil to deepen the marks. I’m sure this is from worry about me and how I will handle the cancer treatments. My thoughts drift to whether or not my right breast will be deformed after the radiation or if I’ll experience scar tissue, sun burn, or any other side effects.

Two tiny pills are packed in a small Ziploc bag inside my purse just in case I decide to take something for the pain. I peek under the top of my dress to look at my right breast. Except for a small lumpectomy scar, my skin is soft and flawless—as if it belongs to a baby. I rub my fingertips over my breast like a magician casting a spell hoping my skin stays smooth and supple.

My radiation treatment of choice is brachytherapy, pronounced ‘brak-e-therapy’ with the first ‘a’ sounding like the ‘a’ in bra. It’s a partial breast irradiation in which tissue adjacent to the original breast lump is radiated using thin catheters inserted around the tumor site. The five day treatment is eight minutes, twice a day, and six hours apart.

Ten catheters are inserted under local with a CT scanner to insure correct placement. The procedure itself isn’t difficult except for having to lie on your back for two hours. While I wait for the CT results, I lift up the dressing and check for bleeding and swelling. It’s not only my nursing instinct that comes to play here, but also my vanity. It’s tribal looking, like a tattoo for a cult that is shaped like a kite, similar to the Big and Little Dipper with small buttons which form the artwork. The tiny white dots line up in a triangular position a quarter inch above my nipple. Under my right armpit are ten corresponding buttons with numbers ‘like a ‘connect the dots illustration’ to assist the physicist with his treatment plan. I have to remind myself in mantra style that this is temporary, it will heal soon, it may not scar, and that the radiation lasts only five days.

I feel the lidocaine wearing off as my upper chest and right arm begin to ache, as if I worked out too hard. The pain effects every change of position: dressing, bending, eating, computer work, and bathing. My body adjusts to the catheters and although I’m sore, it is tolerable. I wear a black sports bra which I change intermittently after my daily sponge baths. I sleep on my back for fear of dislodging the catheters.

A nurse friend comes over during the weekend to clean in-between the buttons with a special solution. We go quietly into the bathroom, as if we are performing a ritual. She is the only one allowed to see the tattoo, my rite of passage, my mark of status and rank, a decoration for bravery. I find myself turning my head away from the site while she dabs solution with a Q-tip around the buttons.

I remember as a child looking for the North Star by finding the most recognizable asterism in the night sky. As I trace the Big Dipper on my chest, I feel it rotating around the north celestial pole through the night and through the seasons. Knowing it will always be a part of me, I look for the handle of the Little Dipper and let the North Star guide me home.

May 30, 2014
by cancerBrat
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hiatus

I’m working out with weights in the gym—pressing 17.5 pounders above my head and then squatting and bringing them down to my ankles. After counting 16 reps, I stand the weights upright in front of me and look at myself in the mirror. I watch a thirty-something young man in back of me perform his reps with grunts that turn his face beet red and cause me to be prepared to resuscitate in case he has a health emergency. Then I focus on my own face and wonder if anyone can tell if I have cancer.

What does cancer look like? Is it based on the after effects of chemo or radiation, or is it a combination of an abrupt lifestyle change coupled with a fear of dying a slow and horrifying death? Does it make one pale or old before their time? Sometimes I feel a pain in the area of my right breast and wonder if the cancer is secretly stealing all the nutrients to feed its selfish cells and preparing to ravish me from the inside out.

I begin to cry. It’s not a weeping that others might notice, but more of a quiet sorrow with tears slowly making an entrance down the sides of my cheeks. I wonder if anyone at the gym has cancer or is a cancer survivor. I think about announcing it to the room full of men and women working out, but instead I stay focused and continue my lifting, squatting, and grunting as I work myself up to 20 pounders.

It’s a Wednesday night before the holidays. I call my father in the morning. He doesn’t answer, so I leave a message for him to call me back. He’s 98 years old and lives in Chicago with a woman who is 31 years younger. She and I speak only formalities even though we’ve known each other for years.

Father has dementia. It has worsened in the last six months. I want to tell him about my cancer. I want to hear his “I’m so sorry” or “Don’t worry or “Everything will be fine.”

He calls me back that evening. His wife most likely dialed the number for him. I tell him nothing about the cancer diagnosis because I know he won’t understand or else he will say something that is inappropriate. I want to tell him how much I miss mother, his first wife who died in a pedestrian accident 20 years ago. I stop myself for fear that he won’t remember the woman he spent 52 years with or he won’t understand what I’m saying. There is a silence of ten or fifteen seconds between us. I press the mute so he won’t hear me crying. He’s confused and I hear him say to his wife, “Something happened. I don’t know where she is.”

I compose myself and bring the phone back to my ear. “I love you Dad.”

“I love you too,” he says in his cheery weak voice that breaks up with each word as if he has a bad case of laryngitis.

Less than a week later, Father takes a turn for the worse.

Now I have a reasonable justification for delaying radiation therapy. I no longer need to use the usual excuses like, “I have to do more research,” or “I’m not sure which method is best for me,”, or “I don’t think I want to undergo any type of treatment.”

Father died on Christmas day. I have to fly to Chicago, attend the funeral, and deal with family matters that surface after a death. My new research focuses on buying airline tickets, making hotel reservations, and dealing with a loss. Radiation treatments can wait. Chemo treatments can be set aside. I’m putting my cancer on hold.

May 7, 2014
by cancerBrat
0 comments

x-rayted

The fear of cancer is legitimate: how we manage that fear, our responses to it, our emotions around it—can be manipulated, packaged, marketed and sold, sometimes by the very forces that claim to support us. That can color everything from our perceptions of screening to our understanding of personal risk to our choices in treatment.

My diagnosis of Invasive Ductal Carcinoma was followed by a regiment of procedures. The first test, an MRI (Magnetic Resonance Imaging) of both breasts was performed a week after my initial surgery. I was instructed to lie belly down on the table placing both breasts in a small boxed area for about 35 minutes. My head rested uncomfortably on a hospital pillow. Not only did this position seem awkward, but uncomfortable for my neck and spine. The pulsing and knocking, produced by metal coils in the machine, were similar to a woodpecker wielding a jackhammer. I managed to survive the procedure without any premedication by concentrating on positive thoughts. The surgeon called me the next day with the results—no additional nodules or inconsistencies in the breast tissue. I jumped up and down, clapped my hands and danced around like a school girl who had just aced an exam. I needed to hear positive news.

There is a traditional path one tends to follow after being diagnosed with breast cancer, for that matter any cancer. It’s a physician directed protocol usually adhered to in a timely manner. The most common response to a cancer diagnosis is, “I need to do everything. I don’t want to die.”

I took a different route. Instead of following the customary timeframe after being diagnosed, I tended to vacillate with each of my decisions. Perhaps it was my attempt to make it disappear. If I didn’t start the treatments immediately—a lumpectomy, sentinel node biopsy followed by radiation, I could at least pretend it never happened. That only worked for so long. The threat of what might occur if I did nothing became apparent in my conversations with caring friends and family and in my nightmares.

So I dove into a series of discussions with radiation oncologists and talked with other breast cancer patients. My homework consisted of reading the latest research on different radiation techniques and their outcomes. Each doctor listed reasons why their method would work the best and what was likely to occur if I decided to try another option: brachytherapy verses tomotherapy, verses whole breast or partial breast radiation. Some of the doctors I interviewed were more like car salesmen than physicians. They would call me on my cell phone once or twice a week wanting to know what I decided. I even received a registered letter from one of them. The problem was and still is—they criticized each other’s method with scare tactics; telling me I could develop scare tissue, permanent markings, infections, and other nasty side effects. This is one of my reasons for delaying my radiation treatment.

I postponed the lumpectomy and sentinel node biopsy for six weeks after my initial diagnosis. My friends would say, “Why don’t you just have it done? Don’t wait. If it were me, I’d do anything to get rid of the cancer.” These were typical remarks from good friends, people I’d known for years—girl friends who began to think, “What if this happened to me?”

Cancer in your breast doesn’t kill you. It’s when the disease metastasizes and spreads to other organs or the bones that it becomes deadly. Early detection is based on the theory that the disease progresses consistently, beginning with a single rogue cell, growing sequentially and at some invariable point making a lethal leap. Curing it, then, assumes to be a matter of finding and cutting out a tumor before the metastasizing happens.

This isn’t necessarily the course of events. There is no evidence that the size of a tumor predicts whether or not the cancer has spread. My tumor is small and the sentinel node pathology report states: one lymph node with micrometastic carcinoma (1 mm), which according to my surgeon is considered negative and something to celebrate. I don’t find the word “metastatic” to be worthy of any kind of celebration.

April 25, 2014
by cancerBrat
3 Comments

Whammy

The surgery for an excision of a lump on my right breast was performed on a Monday morning. I’m groggy after my outpatient procedure and stumble around the house trying to act normal; clumsily fixing myself something to eat, tidying up the kitchen, and playing with my dog. After two hours, I tell my boyfriend I’m going upstairs to rest. I don’t remember much after getting into bed except when I opened my eyes again it was four hours later.

The biopsy results will be in tomorrow or the next day. The surgeon asked me to call his office on Wednesday for the pathology report. I went to work the following day feeling confident that my lump was benign and I had no intention of calling the doctor for the results. I knew if the report wasn’t favorable, I’d hear from the surgeon.

I’m working at my desk the next morning when my surgeon dropped by.

“I’m so glad to see you,” I said as he walked in and pulled up a chair next to mine. “I want you to take a look at the incision.”

“Let’s not worry about that now,” he said.

“Are you bringing me bad news?” I asked him knowing the answer by studying his mannerisms; his directness, his somber looking face, and hearing the sternness in his voice.

“I just received your pathology report. The news isn’t good. You have Invasive Ductal Carcinoma.”

Just like that, I passed through an invisible membrane that separates the healthy from the ill.

“How bad is it?” I asked holding in a cry which I knew was forthcoming sometime in the future but not now. No, not at my office with an open door to patients, their families, the community—the same group of people who would often come here after receiving this type of news. I couldn’t cry at my desk. Not yet.

I placed my right hand on the doctor’s left thigh and said, “I can’t believe the news.” I wondered if my intimate action had breached some type of doctor \ patient relationship. I didn’t really care. I had known him for years, worked with him, and respected him. He was the only one here to comfort me. We had this secret. Thinking back, the simple gesture of touching his thigh with my fingertips was a way for me to feel closeness with another human, a kind of support I needed after hearing the devastating results of the biopsy. It was a silent way to communicate.

The surgeon and I had a long history—he operated on my husband when he was diagnosed with esophageal cancer. He thought he got it all. He thought it might not spread. He was deeply moved when he told us six months later that the cancer had metastasized and he had tears in his eyes a year later when I told him I had just buried my husband.

“I’m hoping we caught it early. This is what you’ll need to do,” he told me as if he had a list prepared in his head.

“Wait one minute,” I said as I opened up Microsoft word on my computer and positioned my fingers on the keyboard. “I’ll need to take notes because I’ll never remember what you’re about to tell me.”

Somehow it helped me to comprehend the news by concentrating on the next steps needed for treatment. It was a way to process the information by categorizing it, organizing the instructions in terms of what to expect, what was to come, the exact order, including time constraints between each treatment.

Small Grade I

Invasive Ductal Carcinoma

Within a week \ MRI of both breasts

Second surgery in two weeks (Sentinel Lymph Node Biopsy)

Oncotype DX test follows

Brachytherapy radiation versus partial breast radiation

Chemotherapy?

I thanked the surgeon for personally coming into my office to discuss the results. I sat in shock after he left trying to digest what he said, trying to convince myself it wasn’t a dream, it really happened. I have breast cancer.

April 20, 2014
by cancerBrat
3 Comments

I Hate Pink

My breast lump is tiny and pokey. It measures 0.6 x 0.3 x 0.2 cm, a circumscribed tumor nodule with a parallel orientation at the 11:00 position, approximately 9 cm from the nipple. Reading over the interim print report, I could only smile about the coincidence of my scheduled 11:00 AM Monday surgery and the position of the nodule. It sounds better to call it a nodule than a tumor.

“Why did this happen to me?” I wondered aloud. What did “doing everything” to prevent cancer really mean? There are days I skipped sun screen. I don’t exercise as much and as hard as I should. And, oh yeah, I live in a highly polluted urban area of the United States, but I eat healthy and try and keep my stress to a minimum.

Two weeks before I discovered the lump, I read an interesting article in the New York Times Magazine about breast cancer along with the pop culture of advertising it over the last ten years. It began with a disclosure that the author was a breast cancer survivor, so I naturally thought it would be a positive article on the strides in breast cancer that science and the Komen organization has made over the last few years. Not exactly the case. The article talked about the flaws of Komen recommending mammograms as a way to prevent breast cancer. While Komen, along with the American Cancer Society are credited with raising the profile of the disease, encouraging women to speak about their experience and transforming “victims” into “survivors,” the Komen pink-ribbon culture has become less about eradication of breast cancer than self-perpetuation: maintaining the visibility of the disease and keeping the funds rolling in.

For the last ten years, I have felt a certain disgust in seeing how the pink-ribbon culture has narrowed our awareness of what is being done in research to prevent breast cancer: Pink ribbons on high-rise buildings, pink garbage trucks, pink gloves and pink spike shoes on football players, pink stockings, and pink ballet shoes—its relentless marketing has made the pink ribbon one of the most recognized logos of our time. It has come to symbolize both fear of the disease and the hope it can be defeated.

One hundred and eight American women die of breast cancer each day. Some can live for a decade or more with metastatic disease, the median life span is 26 months. I don’t want to be part of the statistics.

On the Friday before my scheduled surgery, I walked over to the breast center to request the radiologist report. I wanted to study it over the weekend, find a weak link in it, a mistake, something that might lead me to discover some inconsistency in the results. I opened the door to find six ladies with large pink ribbons in their hair. They stood around a table set for a party: a cake as the center piece with bright pink frosting, cupcakes with pink and white sprinkles, pink plastic forks and pink napkins, and purple punch with a pink ribbon painted on the glass pitcher.

“What’s going on here?” I asked.

“We are having a mammogram party,” a lady told me in between bites of cake.

After signing the release consent, the receptionist handed me my ultra sound report. I said goodbye to the giggling women just as one of them was called into an exam room. I wished them luck and left.

I didn’t quite understand the concept of the party. It was a sort of celebration before the mammogram study. I couldn’t believe they were resorting to “parties” at the breast center, but then again I had nothing to celebrate yet.

April 19, 2014
by cancerBrat
4 Comments

Oblivious

Being diagnosed and treated for cancer is tantamount to being lead into the showers at a concentration camp under the pretenses of being deloused.

Oblivious / Part 1

I have a lump on my right breast. It might be benign or it may be cancerous. I had to type the word “benign” before the “C” word, as if to convince myself that it was second in line, inconsequential, a low probability, a word in the distance.

I discovered the nodule on May 16 while taking a bath. As I washed my chest area, I felt a marble size hardness on the lateral left side. I had never felt a breast lump on myself or anyone else. It’s not at all good when your nodule is “palpable” from the outside. Cancer, if that is what it is, works cunningly from the inside out. Detection and treatment often work more slowly and gropingly from the outside in. As a nurse, I’ve always been aware of the possibility, but it was something that happened to someone else–a lover, a patient, a friend, or a person of high profile.

There is an automatic course of events which follow after one finds a lump. The cycle begins with panic and shock. An appointment with the internist is next even though you know how they will respond. I hoped to hear, “that doesn’t feel like a lump we need to be concerned about” or “it’s probably a cyst.” But instead my doctor took his hand and felt around the area in question and said, “You need to follow up with a mammogram and ultrasound early next week.”

The radiologist at the breast center came into the exam room after viewing my results and told me, “It’s definitely a nodule, not a cyst, but it looks benign. I’d advise you to wait six months and repeat the ultrasound.” That is the type of response I needed to hear, the kind of wishful diagnostic statement that makes you clap your hands, stamp your feet and say, “Hallelujah, thank you God.” But at the same time I wondered if it was prudent to wait six months.

“Why do you think it’s benign?” I asked him. I needed to know what he based his assumption on.

“We have certain criteria we go by and your nodule doesn’t appear to be cancer,” he said as he handed me his written report which reflected those exact words. Probably benign. Advised patient to wait six months and repeat ultrasound. I wanted to know more about the word “criteria” but it seemed to be either a secret he couldn’t or preferred not to divulge.

It was the beginning of summer and I wanted to believe what he said. I wasn’t going to dispute or examine the criteria with him, as if I was his colleague looking at a case study. I’d been living with my boyfriend for the past six months and I didn’t want anything to interfere with the relationship, no problems to complicate things. I felt as if I deserved to enjoy my new life to the fullest: sexy seaside vacations, fancy dinners out with friends, trips to Napa and New York, and building merging family relationships. There was no place for surgical procedures, incisions, scars, a possible mastectomy, radiation, catheters, chemo were all to be avoided—the regiment that follows with most breast cancer diagnosis. I’m a nurse. I know too much.

I keep the newly discovered lump from my boyfriend, family, and friends. I don’t want to think about it and besides, I knew exactly how they would react. They would tell me to have it biopsied, no matter what anyone said. Then they would listen to my lame excuses and beg me to be sensible. They would ask me what I would tell them to do under the circumstances. So I avoid that conversation.

It’s been three years since my husband died from cancer. I’m just beginning to live again and I’m not going to let a tiny lump spoil things. Not now. Not ever. So I’ll continue my life as if nothing has changed. But every time I undress or shower, I’m aware of this tiny foreign object inside of me. I find myself sliding my fingertips over it at night, hoping my boyfriend won’t accidently feel it while we’re making love, hoping it might shrink into nothing after a month or two. Hoping it might disappear as suddenly as it appeared.