Crazy Glasses on a weird looking kidThe 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.

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