Since I'm not going to have radiation or chemotherapy, then what exactly am I doing to treat the breast cancer? Critics may think that since I'm not choosing standard treatment, then I am, therefore, doing nothing. Not so. I am definitely doing something! In short, I am doing whatever I can, within reason, to keep my body strong and healthy so that it can function as it is designed: to fight and kill any cancerous cells that may remain in my body.
When I first met with the oncologist, he showed me a report with ten year survival statistics based on women with my same diagnosis, and it contained four different scenarios. The first scenario was for women who chose to do nothing--no radiation, no chemo, no hormone therapy. Each subsequent scenario added a treatment choice, and, of course, the survival rate increased with each scenario, leaving the highest survival rate for the scenario in which the women received all three treatments. What I found interesting was the first statistic--the one in which the women did nothing. That statistic showed that women who pursued none of the standard treatment options still had a 50% chance of surviving ten years. I think it's pretty significant that I have a 50/50 chance of living ten more years without pursuing any treatment. And considering the fact that I am pursuing treatment--just not the standard treatments--I think my outlook is even better.
As soon as I knew the diagnosis, I immediately changed my diet to an anti-inflammatory, cancer-fighting diet. I had known about the anti-inflammatory diet for years thanks to my knowledgeable chiropractor, who is also a nutritionist, and I had followed it "loosely" in the past, but the time had come to get very serious about it. I eliminated "junk food" from my diet, all refined/processed foods, all store-bought dairy and meat, and ate exclusively raw, fresh fruits and vegetables, eggs and Atlantic salmon. As for the "cancer-fighting" part of the diet, I simply started researching: I would search the internet with phrases like "cancer fighting foods," "cancer killing foods," "estrogen lowering foods," etc. It wasn't hard to find tons of information, and it is amazing how many foods and herbs have specific cancer fighting or cancer killing nutrients in them!
One of the most noticeable and unexpected results of my dietary changes was that I lost 30 pounds over the span of three to four months. I did not count calories or keep track of how much I was eating, and I didn't exercise any more than I had been. It was simply due to eating foods that are full of nutrients instead of foods that are full of calories. Many people have asked me to tell them what "diet" I'm on. I do not have a specific diet or protocol that I follow, so I can't just give out "copies of my diet." I will devote a future post/posts to details of what I'm eating and not eating because that subject entails lots and lots of information--and I continue to learn new things and incorporate new nutrients into my diet.
Foods that are living and fresh are absolutely necessary in the human diet, yet the Standard American Diet is full of refined grains and sugars, chemical-laden foods, GMO contaminated foods, processed foods in which any good nutrients have been destroyed, and unhealthy eggs, meat, and dairy from unhealthy animals that are fed an inflammatory diet and given hormones and antibiotics that all make their way into our bodies when we consume them. It is very true that "you are what you eat."
Good nutrition is the fundamental building block of a healthy, correctly functioning body, and there are almost never any negative side effects from eating a nutritious diet. It amazes me how many people will take drugs, all of which have negative side effects, to treat symptoms of health issues which could be completely cured or significantly reduced simply by proper nutrition. But don't expect to find the truth about nutrition from the medical field or government agencies.
My views on nutrition and cancer treatment are also based largely on my worldview and my faith. I believe wholeheartedly that God created (yes, GOD CREATED--not "evolved by chance over millions of years") our bodies in an unfathomably complicated, intricate, wonderful design--and He didn't make any mistakes! He created our bodies with an incredibly complex immune system including "fighter cells" and "killer cells" that attack and destroy harmful viruses, bacteria, and rogue cells like cancers. Our bodies can and do fight and destroy cancer cells! It is critical to realize this. The majority of all people currently have or have had cancerous cells in their bodies. But they don't have cancer now because their bodies did what God designed them to do and took care of those cancer cells before they could multiply enough to be harmful. He also created an amazing variety of living foods that provide all the nutrients necessary for our bodies to function optimally. He did NOT create our bodies to need man-made drugs in order to survive and thrive--what a cruel trick that would have been! Yet today, so many people think modern medicine is the answer for everything. I believe Hippocrates said, "Let food be thy medicine, and let medicine be thy food." I think ancient peoples understood better than modern medicine does about the effectiveness and benefits of natural medicines found in God's creation. There are plants, herbs, nutrients, and foods that can help or treat just about any condition or illness--but drug companies can't patent and make money off natural substances. Fortunately, I think there is a growing awareness of this, and a movement to go back to real, healthy foods and natural remedies. Many people are recognizing that modern medicine's approach is not necessarily the healthiest or best, but I think there will still always be a segment of the population more willing to suffer the consequences of prescription meds or other invasive procedures rather than change to a healthy diet and lifestyle.
Other things I am doing include receiving regular chiropractic and acupuncture treatments to keep my body functioning properly, reasonably limiting my exposure to some environmental toxins, focusing on getting adequate exercise, fresh air, sunshine, and sleep every day, and trying to eliminate or deal with stress in a healthy way as much as I can. I also did some detoxing for several months. There is not one "magic bullet"--it takes a comprehensive approach to achieve true health.
I indicated that I am doing whatever I can, within reason, to fight this cancer. There are many alternative cancer treatments out there, but they can be very expensive, especially since they usually aren't covered by insurance. I have no intentions of bankrupting my family to pursue every option available. I don't see any honor or benefit in that.
As a young child, I trusted in Christ as my Savior, and I know beyond a shadow of a doubt that when my shell of a body expires on this earth, I will have the eternal joy of being in heaven with Him. So I am not tied to this earth, and I don't feel the need to preserve my life here at all costs. It would be heartbreaking to leave my Love a widower and my children without a mother--and this is the one thing that causes me to get very emotional when I consider it, but I don't fear death, because I know it's not the end. I also believe in the complete sovereignty of God and the fact that He already knows when I'm going to die and how. It may be from breast cancer; it may not. It may be within five years, or ten years, or I may live to a ripe old age. God's omniscience--His all-knowingness--gives me comfort and freedom. Comfort that I don't have to worry and stress about what's going to happen to me or my family because He already knows, and His ways are perfect. Freedom in not having to fret and constantly second-guess my decisions regarding treatment because God's is not limited by my treatment choices--no pressure! If it is His will that I die from breast cancer earlier rather than later, then that is what will happen no matter what treatment I have. If it's His will that I live another 40 or 50 years, then I can trust Him to bring it to pass. My goal is to live a life pleasing to Him and to be a faithful steward of the body and life He has given me.
Tuesday, November 19, 2013
My Views on Standard Treatment
Long before I was personally diagnosed with breast cancer, I held the opinion that it didn't make sense to poison the entire body while attempting to destroy some cancerous cells. The most important thing the body needs to fight cancer is a strong, functioning immune system--but chemo severely weakens and compromises the immune system. Unfortunately, chemotherapy does not simply consist of sacrificial side effects touted as "temporary discomfort" for the greater good of beating cancer. It actually promotes the very disease it is supposed to be destroying.
And radiation isn't far off. It, too, attacks healthy cells as well as the cancerous cells and carries a risk of causing more cancer down the road.
It's true that significant improvements have been made in some areas of cancer treatment, but basically the options are still the same as they were 30 years ago: cut it out (surgery), burn it out (radiation), and poison it (chemotherapy). Surgery options have dramatically improved--doctors no longer automatically perform complete radical double mastectomies with removal of axillary lymph nodes every time a woman has a tumor in one breast (thank goodness!). Attempts are being made to target radiation and chemo better to avoid the widespread damage to healthy cells, but these treatments still leave a lot to be desired.
As for hormone therapy...messing with the body's endocrine system is another major intervention with a myriad of side effects. Of course, if you don't like the drugs, then you can just have major surgery to remove your ovaries. Thank you, no. Both the drugs and the surgery cause early menopause and all the loveliness that accompanies it. Maintaining a healthy body weight and diet actually help a lot in preventing overproduction of estrogen. Plus there are foods that naturally lower estrogen levels in the body. Going back to weight...a common side effect of the drugs is weight gain which increases your estrogen level, and also increases your risk of cancer. This seems a little counterproductive to me.
Call me crazy, but I have a serious problem with the standard medical treatments for cancer when they can be worse than the disease they're supposed to be fighting, and they aren't even guaranteed to work. I'm well aware that these treatments aren't horrible for every cancer patient, and I'm aware that there are many cancer patients who have undergone one or both of these treatments and lived many years afterward, sometimes with no cancer recurrences. But my bet is that there are extremely few of those individuals who can say they have zero long term side effects from the treatments.
If radiation and chemo were guaranteed to permanently cure cancer--shoot, if they even had high percentage success rates!--then it would be a no-brainer. But they're not. Not even close. It saddens me that so many people resign themselves to treatments with horrible side effects only to end up dying of the same cancer or a new, different cancer caused by the treatments five, ten, or twenty years down the road. I do not want to trade one cancer for another.
It also saddens me that there are so many doctors who think that this state of affairs is to be expected and that there are no viable alternatives. I do not think that all doctors are evil and wish ill on their patients--nothing of the sort! But doctors only teach and prescribe what they know. And what they have been taught for the most part is that any disease and illness in the body must be treated with medical intervention--drugs (every single one of which has side effects!) and surgery. There are definitely times when medical intervention is absolutely necessary. But there are also far too many times when simpler, more natural, less invasive techniques would be far more safe and effective, but doctors choose to intervene anyway because they can, and because that's what they know. (Incidentally, we have seen them turn perfectly normal human processes, which usually require no outside intervention at all, into opportunities to intervene just because they can--like childbirth. Modern western medicine has turned the most natural, beautiful phenomenon into one series of invasive, completely unnecessary medical interventions after another--from the beginning of pregnancy through delivery! But that's a subject for another time.) Just because you can doesn't mean you should.
Medical doctors are not even trained in basic nutrition, let alone any alternative treatments for cancer. Let me repeat that: medical doctors are not trained in real nutrition. Most receive 2-6 hours of class time on the subject during medical school. I have personally spent at least ten times that many hours on my own research! Mind-blowing! Nutrition is the foundation of all functions of the human body, yet there is no required training in nutrition to become a doctor. In fact, nutrition and alternative treatments are demonized by the medical establishment even when those treatments have proven to be successful. Why? It's very simple, just follow the money! Doctors, medical institutions, and medical organizations are heavily influenced by the pharmaceutical industry, and Big Pharma is only in it for the money--they could care less about the real health (or lack thereof) of real patients. Doctors and drug companies can't make money if patients aren't taking their drugs and their treatments. Can you imagine how much money the healthcare industry/Big Pharma would lose if cures for cancer were really discovered? There is no doubt in my mind that on some level the medical establishment has no intention of finding a cure--and when alternative treatments claim to have a cure that threatens the lucrative business of cancer treatment, they are summarily silenced and shut down through whatever means necessary. So we continue to see the same failed treatments administered decade after decade with, in reality, very little improvement, and millions of people still dying of cancer--or of conditions caused directly by the cancer treatments. Doesn't it make you wonder--even a little bit?
Another very important point about nutrition and alternative treatments is that they can be used in conjunction with standard treatments--which can result in the standard treatments being more effective and the nasty side effects being greatly reduced. This causes one to wonder again why medical doctors do not inform patients of these options. Not a single doctor or nurse I saw ever mentioned one word about nutrition. I find that alarming and, frankly, inexcusable.
Following are links related to how much nutrition training doctors receive:
http://healthland.time.com/2013/10/10/the-need-for-better-obesity-education-in-medical-schools/
http://www.naturalnews.com/036702_doctors_nutrition_fatalities.html#
http://www.nytimes.com/2010/09/16/health/16chen.html?_r=0
The following links relate to the American Medical Association's targeting of natural cancer cures:
http://www.naturalnews.com/023195_AMA_the_home.html
http://www.naturalnews.com/042622_American_Medical_Association_scientific_oppression_natural_cures.html
http://www.naturalnews.com/032998_Burzynski_cancer_cures.html#ixzz2iYLSTa76
http://www.naturalnews.com/027020_cancer_AMA_treatment.html#ixzz2iYLueYbN
http://www.naturalnews.com/027004_cancer_coffee_juice.html
http://www.naturalnews.com/042688_natural_medicine_cancer_cures_government_agencies.html
(These links are all from Natural News, but the articles have different authors, and within the articles are more links for source information. You can also research it on your own.)
Do I hate doctors? After reading previous posts, it should be obvious that this is not the case. I went to see my doctor as soon as I found the lump; I had surgery to remove it; I am following up with an oncologist. Doctors and their knowledge and expertise are invaluable. But they are not infallible, and as I said earlier, they can only recommend what they know. I just think what they know can be unduly influenced and tainted by powerful forces that make decisions based on what is best for them and not necessarily what is best for the patient. I believe it is almost always in the patient's best interest to get second and third opinions, question, investigate, and research any recommendation until satisfied that it is the best course of action.
Do I think people who do choose standard cancer treatments are "wrong"? No, not at all! As I said before, and as honest doctors have admitted, there is no one right answer for cancer treatment. People must make the decisions that are best for them--for their particular types of cancer, and for their unique situations.
I will never forget what my oncologist told me during our first consult. After I told him my views on chemo, he said, "You're right--chemo is poison. It is. And it's not fun--it sucks. And there are no guarantees. Unfortunately none of us ever knows which patients are going to survive and which ones aren't. But I don't want you to think of me as some kind of chemo salesman. It's bad stuff, and I know what it does to my patients. But you have to understand that I'm presenting to you the options that we as doctors have. These are the tools in our toolbox. I wish we had better tools, but these are the tools we have to work with right now." One of these days I will be brave enough to tell him, "You need to add some new tools to your toolbox!"
And radiation isn't far off. It, too, attacks healthy cells as well as the cancerous cells and carries a risk of causing more cancer down the road.
It's true that significant improvements have been made in some areas of cancer treatment, but basically the options are still the same as they were 30 years ago: cut it out (surgery), burn it out (radiation), and poison it (chemotherapy). Surgery options have dramatically improved--doctors no longer automatically perform complete radical double mastectomies with removal of axillary lymph nodes every time a woman has a tumor in one breast (thank goodness!). Attempts are being made to target radiation and chemo better to avoid the widespread damage to healthy cells, but these treatments still leave a lot to be desired.
As for hormone therapy...messing with the body's endocrine system is another major intervention with a myriad of side effects. Of course, if you don't like the drugs, then you can just have major surgery to remove your ovaries. Thank you, no. Both the drugs and the surgery cause early menopause and all the loveliness that accompanies it. Maintaining a healthy body weight and diet actually help a lot in preventing overproduction of estrogen. Plus there are foods that naturally lower estrogen levels in the body. Going back to weight...a common side effect of the drugs is weight gain which increases your estrogen level, and also increases your risk of cancer. This seems a little counterproductive to me.
Call me crazy, but I have a serious problem with the standard medical treatments for cancer when they can be worse than the disease they're supposed to be fighting, and they aren't even guaranteed to work. I'm well aware that these treatments aren't horrible for every cancer patient, and I'm aware that there are many cancer patients who have undergone one or both of these treatments and lived many years afterward, sometimes with no cancer recurrences. But my bet is that there are extremely few of those individuals who can say they have zero long term side effects from the treatments.
If radiation and chemo were guaranteed to permanently cure cancer--shoot, if they even had high percentage success rates!--then it would be a no-brainer. But they're not. Not even close. It saddens me that so many people resign themselves to treatments with horrible side effects only to end up dying of the same cancer or a new, different cancer caused by the treatments five, ten, or twenty years down the road. I do not want to trade one cancer for another.
It also saddens me that there are so many doctors who think that this state of affairs is to be expected and that there are no viable alternatives. I do not think that all doctors are evil and wish ill on their patients--nothing of the sort! But doctors only teach and prescribe what they know. And what they have been taught for the most part is that any disease and illness in the body must be treated with medical intervention--drugs (every single one of which has side effects!) and surgery. There are definitely times when medical intervention is absolutely necessary. But there are also far too many times when simpler, more natural, less invasive techniques would be far more safe and effective, but doctors choose to intervene anyway because they can, and because that's what they know. (Incidentally, we have seen them turn perfectly normal human processes, which usually require no outside intervention at all, into opportunities to intervene just because they can--like childbirth. Modern western medicine has turned the most natural, beautiful phenomenon into one series of invasive, completely unnecessary medical interventions after another--from the beginning of pregnancy through delivery! But that's a subject for another time.) Just because you can doesn't mean you should.
Medical doctors are not even trained in basic nutrition, let alone any alternative treatments for cancer. Let me repeat that: medical doctors are not trained in real nutrition. Most receive 2-6 hours of class time on the subject during medical school. I have personally spent at least ten times that many hours on my own research! Mind-blowing! Nutrition is the foundation of all functions of the human body, yet there is no required training in nutrition to become a doctor. In fact, nutrition and alternative treatments are demonized by the medical establishment even when those treatments have proven to be successful. Why? It's very simple, just follow the money! Doctors, medical institutions, and medical organizations are heavily influenced by the pharmaceutical industry, and Big Pharma is only in it for the money--they could care less about the real health (or lack thereof) of real patients. Doctors and drug companies can't make money if patients aren't taking their drugs and their treatments. Can you imagine how much money the healthcare industry/Big Pharma would lose if cures for cancer were really discovered? There is no doubt in my mind that on some level the medical establishment has no intention of finding a cure--and when alternative treatments claim to have a cure that threatens the lucrative business of cancer treatment, they are summarily silenced and shut down through whatever means necessary. So we continue to see the same failed treatments administered decade after decade with, in reality, very little improvement, and millions of people still dying of cancer--or of conditions caused directly by the cancer treatments. Doesn't it make you wonder--even a little bit?
Another very important point about nutrition and alternative treatments is that they can be used in conjunction with standard treatments--which can result in the standard treatments being more effective and the nasty side effects being greatly reduced. This causes one to wonder again why medical doctors do not inform patients of these options. Not a single doctor or nurse I saw ever mentioned one word about nutrition. I find that alarming and, frankly, inexcusable.
Following are links related to how much nutrition training doctors receive:
http://healthland.time.com/2013/10/10/the-need-for-better-obesity-education-in-medical-schools/
http://www.naturalnews.com/036702_doctors_nutrition_fatalities.html#
http://www.nytimes.com/2010/09/16/health/16chen.html?_r=0
The following links relate to the American Medical Association's targeting of natural cancer cures:
http://www.naturalnews.com/023195_AMA_the_home.html
http://www.naturalnews.com/042622_American_Medical_Association_scientific_oppression_natural_cures.html
http://www.naturalnews.com/032998_Burzynski_cancer_cures.html#ixzz2iYLSTa76
http://www.naturalnews.com/027020_cancer_AMA_treatment.html#ixzz2iYLueYbN
http://www.naturalnews.com/027004_cancer_coffee_juice.html
http://www.naturalnews.com/042688_natural_medicine_cancer_cures_government_agencies.html
(These links are all from Natural News, but the articles have different authors, and within the articles are more links for source information. You can also research it on your own.)
Do I hate doctors? After reading previous posts, it should be obvious that this is not the case. I went to see my doctor as soon as I found the lump; I had surgery to remove it; I am following up with an oncologist. Doctors and their knowledge and expertise are invaluable. But they are not infallible, and as I said earlier, they can only recommend what they know. I just think what they know can be unduly influenced and tainted by powerful forces that make decisions based on what is best for them and not necessarily what is best for the patient. I believe it is almost always in the patient's best interest to get second and third opinions, question, investigate, and research any recommendation until satisfied that it is the best course of action.
Do I think people who do choose standard cancer treatments are "wrong"? No, not at all! As I said before, and as honest doctors have admitted, there is no one right answer for cancer treatment. People must make the decisions that are best for them--for their particular types of cancer, and for their unique situations.
I will never forget what my oncologist told me during our first consult. After I told him my views on chemo, he said, "You're right--chemo is poison. It is. And it's not fun--it sucks. And there are no guarantees. Unfortunately none of us ever knows which patients are going to survive and which ones aren't. But I don't want you to think of me as some kind of chemo salesman. It's bad stuff, and I know what it does to my patients. But you have to understand that I'm presenting to you the options that we as doctors have. These are the tools in our toolbox. I wish we had better tools, but these are the tools we have to work with right now." One of these days I will be brave enough to tell him, "You need to add some new tools to your toolbox!"
Radiation, Chemotherapy, and Hormone Therapy
RADIATION
It is a well known and proven fact that ionizing radiation (the kind of radiation in x-rays, mammograms, CT scans, PET scans, and radiation cancer therapy) is a known carcinogen. Radiation causes cancer. It is also proven that radiation treatment for cancer can cause secondary malignant cancers. Secondary cancers are new cancers resulting directly from cancer treatment. The secondary tumors may not show up for months or even 10-15 years later. It is reported that the risk of developing secondary tumors is small (read below about relative statistics) and that the benefits of radiation treatment outweigh the risks. The actual risks depend upon the patient demographics (age, smoking status, etc.), disease specifics, and specifics of the radiation treatment (radiation dose, type and volume of tissue irradiated). Radiation treatment kills cancerous cells, but it can also cause DNA mutation in healthy cells, causing them to become cancerous. Other side effects of radiation therapy include skin irritation/redness/burning/peeling, armpit discomfort, chest pain, fatigue, heart problems, lung problems, and lowered white blood cell counts. It is reported that most side effects are mild, and that they come on gradually.
Radiation, like surgery, is a local treatment. External radiation is probably the most common type of radiation, followed by internal radiation. Intraoperative radiation is a newer type where a single high dose of radiation is concentrated on the tumor site during lumpectomy surgery while the underlying tissue is still exposed. It takes a matter of minutes, then the incision is closed as normal. Since this is a relatively new treatment, it is not available at all treatment centers, and doctors do not agree on whether it is more effective or beneficial than whole breast irradiation after lumpectomy. Doctors are trying to develop new ways of better targeting cancer cells, thus limiting damage to healthy cells.
As I wrote in the "Surgery" post, my surgeon recommended either a lumpectomy with radiation, or a mastectomy and then radiation wouldn't be necessary. He told me that women who have a lumpectomy and choose not to have radiation have a 30% higher risk of a recurrence. After doing my own research, I learned that the 30% number is a relative statistic not an absolute statistic--and when I asked the surgeon if that was true, he agreed that it was. The absolute or actual reduction of risk could be considerably lower. It is best to get the absolute percentage for your specific diagnosis, age range, etc., and then make a decision whether the risks and side effects of radiation outweigh the benefits. Here is a link to an article which does a great job of explaining the difference between relative and absolute statistics, as well as how the medical industry uses these deceptive calculations to sway patients. http://www.breastcancerchoices.org/rr.html What I have found is that mainstream doctors and medical websites claim that radiation reduces the risk of recurrence, but there are also studies and doctors (yes, medical doctors) who disagree and say that radiation actually increases the risk of recurrence, especially for younger women.
CHEMOTHERAPY
Chemotherapy is a systemic (whole body) treatment which travels throughout the whole body targeting cancer cells at the tumor site as well as cancer cells which may have spread to other parts of the body. Chemotherapy consists of one or more toxic medicines designed to prevent cancer cells from growing or spreading by either destroying them or preventing them from dividing. The problem is that chemotherapy, like radiation, does not only affect cancer cells; the toxins affect normal cells as well. Chemotherapy drugs specifically target rapidly dividing cells which include cancer cells, but also include normal cells in your blood, hair, mouth, intestinal tract, nose, nails, and vagina. Common side effects include anemia/low red blood cell counts, diarrhea, fatigue, fertility issues, hair and nail changes, infection, memory loss ("chemo brain"), menopause and menopausal symptoms, mouth and throat sores, nausea and vomiting, neuropathy in the feet and hands, changes in smell and taste, vaginal dryness, and weight changes. Less common but more serious side effects include bone loss/osteoporosis, heart problems, and vision/eye problems. The type and intensity of side effects vary depending on the type of chemo drugs used, and they vary by person; not all patients on the same chemo meds experience the same side effects.
I was shocked to learn that recent studies have shown that chemotherapy actually causes cancer to grow and spread and become resistant to chemotherapy. This clearly explains the cancer patients who undergo chemotherapy which seems to destroy the cancer, and they are cancer free or in remission for some period of time. But then they relapse (often within a matter of months), and the cancer is stronger than ever and now resistant to the chemo, making it necessary to use different stronger chemo meds to attack it again--and the cycle repeats. I have included several links below which cover this information.
http://www.nydailynews.com/life-style/health/shock-study-chemotherapy-backfire-cancer-worse-triggering-tumor-growth-article-1.1129897
http://news.yahoo.com/chemotherapy-cancer-worse-092400059.html
http://www.globalpost.com/dispatch/news/health/120805/chemotherapy-can-backfire-and-cause-cancer-new-study-has-found
http://www.naturalnews.com/029042_cancer_cells_chemotherapy.html#
http://www.naturalnews.com/037148_chemotherapy_stem_cells_regeneration.html
http://www.mcancer.org/research/stem-cells/introduction
Using the knowledge from studies like these, they are trying to develop new chemo treatments that can more specifically and narrowly target cancer cells without so much damage to healthy cells.
HORMONAL THERAPY
Hormonal therapy is used for estrogen receptor positive breast cancers. It's a systemic treatment using medicines to either lower the amount of estrogen in the body, or to block the action of estrogen in the body in order to prevent recurrence of early stage ER+ breast cancer or to slow the growth of/shrink the tumors of late stage/metastic breast cancer. The most common recommendation is for women to take the hormonal therapy drug Tamoxifen for five years; I've also read where doctors are considering prescribing it for 10 years. In pre-menopausal women, since the ovaries are still producing estrogen, it is often recommended to also either take medication in order to temporarily shut down the ovaries or surgically remove the ovaries to permanently shut them down.
Needless to say, hormonal therapy medicines cause early menopause in pre-menopausal women and come with a host of side effects including bone/joint pain, nausea and vomiting, hot flashes, fatigue, headaches, insomnia, increased sweating, dizziness, weight gain, blood clots, stroke, endometrial cancer, increased bone/tumor pain, mood swings, depression, hair thinning, constipation, dry skin, loss of libido. Less common side effects include leg cramps, swelling, flu-like symptoms, hypercalcemia, rash, vaginal discharge/bleeding, vision problems/dry eyes, diarrhea, sore throat, low back pain, stomach/abdominal pain, injection site pain.
It is a well known and proven fact that ionizing radiation (the kind of radiation in x-rays, mammograms, CT scans, PET scans, and radiation cancer therapy) is a known carcinogen. Radiation causes cancer. It is also proven that radiation treatment for cancer can cause secondary malignant cancers. Secondary cancers are new cancers resulting directly from cancer treatment. The secondary tumors may not show up for months or even 10-15 years later. It is reported that the risk of developing secondary tumors is small (read below about relative statistics) and that the benefits of radiation treatment outweigh the risks. The actual risks depend upon the patient demographics (age, smoking status, etc.), disease specifics, and specifics of the radiation treatment (radiation dose, type and volume of tissue irradiated). Radiation treatment kills cancerous cells, but it can also cause DNA mutation in healthy cells, causing them to become cancerous. Other side effects of radiation therapy include skin irritation/redness/burning/peeling, armpit discomfort, chest pain, fatigue, heart problems, lung problems, and lowered white blood cell counts. It is reported that most side effects are mild, and that they come on gradually.
Radiation, like surgery, is a local treatment. External radiation is probably the most common type of radiation, followed by internal radiation. Intraoperative radiation is a newer type where a single high dose of radiation is concentrated on the tumor site during lumpectomy surgery while the underlying tissue is still exposed. It takes a matter of minutes, then the incision is closed as normal. Since this is a relatively new treatment, it is not available at all treatment centers, and doctors do not agree on whether it is more effective or beneficial than whole breast irradiation after lumpectomy. Doctors are trying to develop new ways of better targeting cancer cells, thus limiting damage to healthy cells.
As I wrote in the "Surgery" post, my surgeon recommended either a lumpectomy with radiation, or a mastectomy and then radiation wouldn't be necessary. He told me that women who have a lumpectomy and choose not to have radiation have a 30% higher risk of a recurrence. After doing my own research, I learned that the 30% number is a relative statistic not an absolute statistic--and when I asked the surgeon if that was true, he agreed that it was. The absolute or actual reduction of risk could be considerably lower. It is best to get the absolute percentage for your specific diagnosis, age range, etc., and then make a decision whether the risks and side effects of radiation outweigh the benefits. Here is a link to an article which does a great job of explaining the difference between relative and absolute statistics, as well as how the medical industry uses these deceptive calculations to sway patients. http://www.breastcancerchoices.org/rr.html What I have found is that mainstream doctors and medical websites claim that radiation reduces the risk of recurrence, but there are also studies and doctors (yes, medical doctors) who disagree and say that radiation actually increases the risk of recurrence, especially for younger women.
CHEMOTHERAPY
Chemotherapy is a systemic (whole body) treatment which travels throughout the whole body targeting cancer cells at the tumor site as well as cancer cells which may have spread to other parts of the body. Chemotherapy consists of one or more toxic medicines designed to prevent cancer cells from growing or spreading by either destroying them or preventing them from dividing. The problem is that chemotherapy, like radiation, does not only affect cancer cells; the toxins affect normal cells as well. Chemotherapy drugs specifically target rapidly dividing cells which include cancer cells, but also include normal cells in your blood, hair, mouth, intestinal tract, nose, nails, and vagina. Common side effects include anemia/low red blood cell counts, diarrhea, fatigue, fertility issues, hair and nail changes, infection, memory loss ("chemo brain"), menopause and menopausal symptoms, mouth and throat sores, nausea and vomiting, neuropathy in the feet and hands, changes in smell and taste, vaginal dryness, and weight changes. Less common but more serious side effects include bone loss/osteoporosis, heart problems, and vision/eye problems. The type and intensity of side effects vary depending on the type of chemo drugs used, and they vary by person; not all patients on the same chemo meds experience the same side effects.
I was shocked to learn that recent studies have shown that chemotherapy actually causes cancer to grow and spread and become resistant to chemotherapy. This clearly explains the cancer patients who undergo chemotherapy which seems to destroy the cancer, and they are cancer free or in remission for some period of time. But then they relapse (often within a matter of months), and the cancer is stronger than ever and now resistant to the chemo, making it necessary to use different stronger chemo meds to attack it again--and the cycle repeats. I have included several links below which cover this information.
http://www.nydailynews.com/life-style/health/shock-study-chemotherapy-backfire-cancer-worse-triggering-tumor-growth-article-1.1129897
http://news.yahoo.com/chemotherapy-cancer-worse-092400059.html
http://www.globalpost.com/dispatch/news/health/120805/chemotherapy-can-backfire-and-cause-cancer-new-study-has-found
http://www.naturalnews.com/029042_cancer_cells_chemotherapy.html#
http://www.naturalnews.com/037148_chemotherapy_stem_cells_regeneration.html
http://www.mcancer.org/research/stem-cells/introduction
Using the knowledge from studies like these, they are trying to develop new chemo treatments that can more specifically and narrowly target cancer cells without so much damage to healthy cells.
HORMONAL THERAPY
Hormonal therapy is used for estrogen receptor positive breast cancers. It's a systemic treatment using medicines to either lower the amount of estrogen in the body, or to block the action of estrogen in the body in order to prevent recurrence of early stage ER+ breast cancer or to slow the growth of/shrink the tumors of late stage/metastic breast cancer. The most common recommendation is for women to take the hormonal therapy drug Tamoxifen for five years; I've also read where doctors are considering prescribing it for 10 years. In pre-menopausal women, since the ovaries are still producing estrogen, it is often recommended to also either take medication in order to temporarily shut down the ovaries or surgically remove the ovaries to permanently shut them down.
Needless to say, hormonal therapy medicines cause early menopause in pre-menopausal women and come with a host of side effects including bone/joint pain, nausea and vomiting, hot flashes, fatigue, headaches, insomnia, increased sweating, dizziness, weight gain, blood clots, stroke, endometrial cancer, increased bone/tumor pain, mood swings, depression, hair thinning, constipation, dry skin, loss of libido. Less common side effects include leg cramps, swelling, flu-like symptoms, hypercalcemia, rash, vaginal discharge/bleeding, vision problems/dry eyes, diarrhea, sore throat, low back pain, stomach/abdominal pain, injection site pain.
Recurrences
A simple (local) recurrence is a new mass of the same kind of cells as the original cancer, located in the breast tissue or nearby muscle. These most often occur within 3-5 years after the primary breast cancer is treated. Life expectancy statistics are excellent for a simple recurrence; new lumps can be removed just as the primary tumor was.
A secondary recurrence is a new mass of a different kind of cancer cells than the original cancer, and can be located in any type of body tissue. Secondary recurrences can be caused by the same processes which caused the original cancer, by hormone therapy (liver cancer), radiation therapy (new breast cancer, blood cancer, lung cancer), or chemotherapy (blood or bone cancer). These cancers can take more than 10 years to grow to a noticeable size. Prognosis and treatment for secondary cancers depend on what type of cancer it is.
Metastasized (distant) recurrence is a new mass of the same kind of cells as the original cancer, but located anyplace except in breast tissue. Metastases can occur at any time, but may take up to 8 years before they are visible. Unfortunately, there are no cures or reliable treatments for metastasized cancer.
Age is a factor in likelihood of recurrence; the older you are when diagnosed with breast cancer, the less likely you are to suffer a recurrence. Also, post-menopausal women who have a lumpectomy, with or without radiation, rarely have a recurrence.
Other factors affecting the likelihood of a recurrence include tumor size (the larger the tumor, the greater likelihood of recurrence), tumor grade (higher grade means more chance of recurrence), lymph node involvement (cancer in nodes = higher recurrence risk), presence of hormone receptors (risk increases; progesterone receptors are a better indicator than estrogen receptors), HER2 receptors indicate a worse prognosis overall.
There is an increase in recurrence rates among those who refused radiation, but a simple recurrence is not life threatening and can be handled by another lumpectomy or a mastectomy at that point.
A secondary recurrence is a new mass of a different kind of cancer cells than the original cancer, and can be located in any type of body tissue. Secondary recurrences can be caused by the same processes which caused the original cancer, by hormone therapy (liver cancer), radiation therapy (new breast cancer, blood cancer, lung cancer), or chemotherapy (blood or bone cancer). These cancers can take more than 10 years to grow to a noticeable size. Prognosis and treatment for secondary cancers depend on what type of cancer it is.
Metastasized (distant) recurrence is a new mass of the same kind of cells as the original cancer, but located anyplace except in breast tissue. Metastases can occur at any time, but may take up to 8 years before they are visible. Unfortunately, there are no cures or reliable treatments for metastasized cancer.
Age is a factor in likelihood of recurrence; the older you are when diagnosed with breast cancer, the less likely you are to suffer a recurrence. Also, post-menopausal women who have a lumpectomy, with or without radiation, rarely have a recurrence.
Other factors affecting the likelihood of a recurrence include tumor size (the larger the tumor, the greater likelihood of recurrence), tumor grade (higher grade means more chance of recurrence), lymph node involvement (cancer in nodes = higher recurrence risk), presence of hormone receptors (risk increases; progesterone receptors are a better indicator than estrogen receptors), HER2 receptors indicate a worse prognosis overall.
There is an increase in recurrence rates among those who refused radiation, but a simple recurrence is not life threatening and can be handled by another lumpectomy or a mastectomy at that point.
Surgery
As I stated in my first post, it was assumed that surgery was the next step after being diagnosed. I did go ahead and schedule a consultation with the surgeon, but I had not made up my mind whether I would have surgery or not. This may seem ludicrous to some of you, but it is important to understand that standard medical procedures and treatments for cancer are not guaranteed to cure cancer. There are no guarantees with cancer. I was told this by my family doctor as well as my oncologist. It is also obvious when you just look around and take note of how many people are still dying of cancer despite the medical community's best efforts to cut it out, burn it out, and poison it. I also found it very telling when my family doctor told me that she wasn't even sure what she would do (as far as treatment) if she was diagnosed with cancer.
I educated myself about my specific diagnosis and all of my treatment options before my consult with the surgeon, and I was glad I did because I was already familiar with 90% of what he said during the consult. I remember the one thing that surprised me most was the fact that both a lumpectomy and a mastectomy were outpatient surgery, and I would go home the same day. I had anticipated at least a one-night hospital stay, especially for a mastectomy! I was happy about it, though, because my mindset is "the less time in the hospital, the better!"
As I looked into surgery, I found that there is some evidence that cutting into cancer can cause it to spread and grow, and also that removing primary tumors can cause secondary cancers to grow faster (primary breast cancers can secrete a substance that blocks other cancer cells from growing). Some medical websites definitively state that surgery does not spread cancer; others admit it does under certain circumstances, but that it's rare; others say it can and does. The belief that cancer being exposed to air during surgery causes it to spread, however, seems to be just a myth. Surgery is not a cure; it can miss some cancer cells, and it may spread cancer. The following link provides some good information: http://www.canceractive.com/cancer-active-page-link.aspx?n=2976.
With that in mind, I still decided to have surgery because it made sense to me to get rid of the mass that we knew was there, and then give my body a better chance to fight off any remaining cancer cells without also having to fight a large mass of cancer.
It is not uncommon for women diagnosed with breast cancer to make treatment decisions stemming from their fear of cancer; they want to do everything they can to beat this, and they want it started yesterday! Although this is completely understandable, I think it is unwise and counterproductive. Almost all the information I read (and my surgeon agreed) stated that in most cases, there is no reason to rush into surgery (or any other treatment), and the patient can comfortably schedule surgery 2-3 weeks out and use that time to make an informed decision. Who will perform the surgery? What type of surgery/how extensive will it be? What are the pros and cons to each type of surgery?
Surgery types include a lumpectomy (also called "breast sparing surgery" where only the tumor and a safe margin of normal tissue around it are removed, leaving the rest of the breast intact) or a mastectomy. There is also the likelihood of having axillary (underarm) lymph nodes removed. There are different types of mastectomies: 1. 'Partial' or 'segmental' (quandrantectomy) removes the segment of the breast containing the tumor, which could be up to one fourth of the breast. 2. 'Total' or 'simple' removes the breast tissue, but not the muscle or lymph nodes. 3. 'Modified radical' removes the breast, chest wall muscle lining, and some axillary lymph nodes. 4. 'Radical' removes all that a 'modified radical' would remove plus all the muscle--this surgery is not often used anymore.
If a mastectomy is done, then there are decisions regarding reconstruction--whether or not to have it, what type, and when. Again, I would recommend researching all the options and the respective pros and cons and making an informed decision. This decision does not have to be made before the mastectomy. While some women choose to have reconstructive surgery done at the same time as the mastectomy, there is nothing wrong with waiting. In fact, some women feel better about their decisions and have more confidence in them if they wait and take the time to make their decision some time after surgery.
The surgeon's recommendation for me was either a lumpectomy and sentinel lymph node biopsy followed by radiation treatment, or a simple mastectomy. Sentinel lymph node biopsy is when a radioactive dye is injected near the nipple to track where fluids from the tumor area drain, allowing the surgeon to see the primary (or sentinel) 1-3 lymph nodes to which the ducts drain. The surgeon will then remove those 1-3 lymph nodes so that a biopsy can be done to determine if cancer has spread to the lymph nodes.
Before the consult I was already certain that I was going to refuse radiation and chemotherapy (I will discuss those treatments later), which affected the surgical procedures I chose. I briefly considered having a mastectomy due to the fact that in my case, follow-up radiation wasn't recommended with a mastectomy, and I had the cowardly thought that I might be able to avoid a confrontation on refusing radiation if I just had the mastectomy. As I said, I only briefly considered that option; in the end, I decided to go with the less invasive lumpectomy and sentinel node biopsy.
I had learned that for tumors up to 4 cm in early stage breast cancer, mastectomy offers no advantage in survival rates over lumpectomy with or without radiation--survival rates for all three options are exactly the same.
On a side note, choosing to have a mastectomy or double mastectomy purely as a prophylactic--to prevent breast cancer from occurring even when there is no evidence of breast cancer in one or both breasts (like Angelina Jolie's highly publicized double mastectomy because she found out she carries the 'breast cancer gene')--has not proven to be at all effective. Removal of the breasts does nothing to guarantee that breast cancer won't occur. In fact, by removing the breasts, since the more easily treated breast tissue has been removed, the cancer can appear in the chest wall muscle or other areas which are much harder to treat.
Just a couple days before my scheduled surgery, I discovered another bit of information that changed my decision again. I learned that the only reason for doing the sentinel node biopsy is to use the results to stage the cancer and recommend further treatment (i.e., if the nodes are positive for cancer, chemotherapy would be recommended). Therefore, if a patient has already decided to refuse chemotherapy--or, conversely, has already decided to have chemotherapy--no matter the result of the node biopsy, then it is a better option to just keep the lymph nodes in tact and avoid the more invasive surgery which has a longer recovery time and potentially more negative side effects. I knew I would be missing the information about whether or not the cancer had spread to my lymph nodes, but my decision regarding chemo wasn't based on that information anyway, and the results of the node biopsy wasn't going to change it. It made sense to me to keep my lymph system in tact so that it could function optimally, to not deal with a longer recovery due to muscle and tissue being cut under my arm, and to avoid further side effects like lymphedema.
I had assumed that one purpose of removing lymph nodes was to remove more cancer if it was present in the nodes. After looking into it a little more, I called my surgeon and told him that I was now leaning toward having just the lumpectomy without the sentinel node biopsy. I explained why and then asked him if it was true that the purpose of the node biopsy was for staging and treatment recommendation as opposed to removing more cancer. The surgeon confirmed that this was indeed the case. I was surprised at how quickly he accepted my request to skip the node biopsy. He didn't try to convince me to change my mind or indicate by word or even voice inflection that he thought I was making a foolish decision. He may have thought me foolish, but I really appreciated the way he handled it, and it was a huge relief for me. There were no outward signs of cancer in my lymph nodes--no swelling, redness, etc.--but I wouldn't be surprised if the cancer had spread there due to the tumor being located so close to my armpit.
The surgery was scheduled on Thursday, June 20, 2013. The admissions process went very smoothly since we had experienced it all just 17 days earlier when my husband, Bob, had surgery on his broken ankle. Bob's experience didn't go nearly as well as mine, but we learned a lot from it and were much better prepared when it was my turn. Our 17 year old daughter also accompanied us--she wanted to be there with me, plus we needed a driver since I wouldn't be allowed to drive after the surgery, and Bob couldn't drive with his broken ankle. Our pastor and his wife met us at the hospital. Pastor read Scripture and prayed with us, and we visited for a bit before they left. It was a huge encouragement having them there, and we are very thankful for them and the rest of our church family! I didn't feel nervous at all, but apparently I was more nervous than I thought because my blood pressure was higher than normal when the nurse took it--which we joked about. After surgery when she took it, it was back down to normal.
I had a procedure done before the actual surgery--which surprised me because I had not been told about it ahead of time. They took me to radiology where they used ultrasound to locate the tumor and insert a thin wire into it to mark the exact location for the surgeon. I felt like a Cyborg with the four inch piece of wire sticking out of my chest (they did tape it down, so I wouldn't lose an eye!). The surgery lasted one hour twenty minutes; I awoke in recovery less than an hour after surgery, and I left the hospital to go home less than two hours after that. Other than a dry mouth, I felt great! I drank and ate right away, walked down the hall to use the bathroom with no problem, and felt completely lucid and awake. I don't know how it could have gone any better or faster! I never experienced any pain after surgery, so I never used the pain meds they prescribed. I was a little tired later that day and snoozed in the recliner for a bit. I had taken the following day (Friday) off work, but I seriously could have gone to work--I felt that good! I attended church on Sunday, and returned to work on Monday as normal.
I was again impressed with the attitudes of all of the medical personnel at the hospital. Every single person with whom I had interaction was very kind, considerate, and understanding, yet willing to show some humor. I specifically remember two nurses. The first one wheeled me into surgery, and when we came to a very steep downhill incline on the way I said, "This could be fun! Do you ever run down the ramp?" She answered that she actually did, especially when the patients are children. So we had a laugh about that. The second was the O.R. nurse. While she was getting me set up on the operating table, we were chatting, and she mentioned the procedure. I told her I actually wasn't getting the sentinel node biopsy and explained why. Her enthusiastic response astounded me. She said, "Good for you! I see women come through here all the time who are scared and just blindly follow their doctor's recommendations--not that you shouldn't listen to your doctor, but so many women have no clue what's going on or what their choices are. That's great that you did your research and are making informed decisions!" Let me tell you, that was a big confidence booster!
When I had scheduled my surgery, it was for three weeks out, allowing me three weeks to detox and strengthen my immune system as much as I could. I also had two acupuncture treatments a week up to and following surgery. The acupuncturist told me that acupuncture helps with bleeding during surgery and with pain and faster recovery after surgery. This was interesting because since I currently had no symptoms whatsoever, I could not gage whether or not the acupuncture treatments were actually doing anything. They were relaxing, but I never really felt any different. The proof for me was after surgery when I came out of recovery amazingly fast with no side effects other than a dry mouth.
The "side effect" of surgery that bothered me the most was not being able to play basketball for awhile! For the past few years I have been playing basketball at an open gym at the high school every Tuesday and Friday starting at 5:00 a.m. Other than one high school girl who used to play occasionally, I'm the only female who plays, but I'm pretty much considered "one of the guys" now. The early morning time is perfect since Bob is usually leaving for work anyway, and I'm usually home before the kids even wake up, so I don't have to give up spending time with my family to participate. Besides that, I love playing basketball, and it's easy motivation to get up and get a workout. I waited about a month after surgery before I played again. My incision healed quickly and well, and during that time I walked every day for my exercise. After a couple weeks I started jogging some as well to build up my endurance and test how things felt while I was running. When I was pretty comfortable with everything, I started playing again.
Only a couple of the guys knew about my diagnosis and surgery before I stopped playing, but I figured they would spread the word while I was gone. The first morning I showed up after surgery, it was pretty heartwarming. I was a little late, and they had already started playing the first game. When I walked in, several guys called to me and waved from the floor while they were playing. When there was a pause in the action, they jogged over, greeted me and gave me fist bumps and high fives. No one made a huge deal out of it, but they did make it clear they were glad to see me back--which was perfect.
The surgical margins around the tumor were clear, so to the best of our knowledge, the surgeon got all of the cancer that was there. At my two-week follow-up appointment with the surgeon, everything looked great, and he said he didn't need to see me again unless I developed some concerns. Next step--the oncologist.
I educated myself about my specific diagnosis and all of my treatment options before my consult with the surgeon, and I was glad I did because I was already familiar with 90% of what he said during the consult. I remember the one thing that surprised me most was the fact that both a lumpectomy and a mastectomy were outpatient surgery, and I would go home the same day. I had anticipated at least a one-night hospital stay, especially for a mastectomy! I was happy about it, though, because my mindset is "the less time in the hospital, the better!"
As I looked into surgery, I found that there is some evidence that cutting into cancer can cause it to spread and grow, and also that removing primary tumors can cause secondary cancers to grow faster (primary breast cancers can secrete a substance that blocks other cancer cells from growing). Some medical websites definitively state that surgery does not spread cancer; others admit it does under certain circumstances, but that it's rare; others say it can and does. The belief that cancer being exposed to air during surgery causes it to spread, however, seems to be just a myth. Surgery is not a cure; it can miss some cancer cells, and it may spread cancer. The following link provides some good information: http://www.canceractive.com/cancer-active-page-link.aspx?n=2976.
With that in mind, I still decided to have surgery because it made sense to me to get rid of the mass that we knew was there, and then give my body a better chance to fight off any remaining cancer cells without also having to fight a large mass of cancer.
It is not uncommon for women diagnosed with breast cancer to make treatment decisions stemming from their fear of cancer; they want to do everything they can to beat this, and they want it started yesterday! Although this is completely understandable, I think it is unwise and counterproductive. Almost all the information I read (and my surgeon agreed) stated that in most cases, there is no reason to rush into surgery (or any other treatment), and the patient can comfortably schedule surgery 2-3 weeks out and use that time to make an informed decision. Who will perform the surgery? What type of surgery/how extensive will it be? What are the pros and cons to each type of surgery?
Surgery types include a lumpectomy (also called "breast sparing surgery" where only the tumor and a safe margin of normal tissue around it are removed, leaving the rest of the breast intact) or a mastectomy. There is also the likelihood of having axillary (underarm) lymph nodes removed. There are different types of mastectomies: 1. 'Partial' or 'segmental' (quandrantectomy) removes the segment of the breast containing the tumor, which could be up to one fourth of the breast. 2. 'Total' or 'simple' removes the breast tissue, but not the muscle or lymph nodes. 3. 'Modified radical' removes the breast, chest wall muscle lining, and some axillary lymph nodes. 4. 'Radical' removes all that a 'modified radical' would remove plus all the muscle--this surgery is not often used anymore.
If a mastectomy is done, then there are decisions regarding reconstruction--whether or not to have it, what type, and when. Again, I would recommend researching all the options and the respective pros and cons and making an informed decision. This decision does not have to be made before the mastectomy. While some women choose to have reconstructive surgery done at the same time as the mastectomy, there is nothing wrong with waiting. In fact, some women feel better about their decisions and have more confidence in them if they wait and take the time to make their decision some time after surgery.
The surgeon's recommendation for me was either a lumpectomy and sentinel lymph node biopsy followed by radiation treatment, or a simple mastectomy. Sentinel lymph node biopsy is when a radioactive dye is injected near the nipple to track where fluids from the tumor area drain, allowing the surgeon to see the primary (or sentinel) 1-3 lymph nodes to which the ducts drain. The surgeon will then remove those 1-3 lymph nodes so that a biopsy can be done to determine if cancer has spread to the lymph nodes.
Before the consult I was already certain that I was going to refuse radiation and chemotherapy (I will discuss those treatments later), which affected the surgical procedures I chose. I briefly considered having a mastectomy due to the fact that in my case, follow-up radiation wasn't recommended with a mastectomy, and I had the cowardly thought that I might be able to avoid a confrontation on refusing radiation if I just had the mastectomy. As I said, I only briefly considered that option; in the end, I decided to go with the less invasive lumpectomy and sentinel node biopsy.
I had learned that for tumors up to 4 cm in early stage breast cancer, mastectomy offers no advantage in survival rates over lumpectomy with or without radiation--survival rates for all three options are exactly the same.
On a side note, choosing to have a mastectomy or double mastectomy purely as a prophylactic--to prevent breast cancer from occurring even when there is no evidence of breast cancer in one or both breasts (like Angelina Jolie's highly publicized double mastectomy because she found out she carries the 'breast cancer gene')--has not proven to be at all effective. Removal of the breasts does nothing to guarantee that breast cancer won't occur. In fact, by removing the breasts, since the more easily treated breast tissue has been removed, the cancer can appear in the chest wall muscle or other areas which are much harder to treat.
Just a couple days before my scheduled surgery, I discovered another bit of information that changed my decision again. I learned that the only reason for doing the sentinel node biopsy is to use the results to stage the cancer and recommend further treatment (i.e., if the nodes are positive for cancer, chemotherapy would be recommended). Therefore, if a patient has already decided to refuse chemotherapy--or, conversely, has already decided to have chemotherapy--no matter the result of the node biopsy, then it is a better option to just keep the lymph nodes in tact and avoid the more invasive surgery which has a longer recovery time and potentially more negative side effects. I knew I would be missing the information about whether or not the cancer had spread to my lymph nodes, but my decision regarding chemo wasn't based on that information anyway, and the results of the node biopsy wasn't going to change it. It made sense to me to keep my lymph system in tact so that it could function optimally, to not deal with a longer recovery due to muscle and tissue being cut under my arm, and to avoid further side effects like lymphedema.
I had assumed that one purpose of removing lymph nodes was to remove more cancer if it was present in the nodes. After looking into it a little more, I called my surgeon and told him that I was now leaning toward having just the lumpectomy without the sentinel node biopsy. I explained why and then asked him if it was true that the purpose of the node biopsy was for staging and treatment recommendation as opposed to removing more cancer. The surgeon confirmed that this was indeed the case. I was surprised at how quickly he accepted my request to skip the node biopsy. He didn't try to convince me to change my mind or indicate by word or even voice inflection that he thought I was making a foolish decision. He may have thought me foolish, but I really appreciated the way he handled it, and it was a huge relief for me. There were no outward signs of cancer in my lymph nodes--no swelling, redness, etc.--but I wouldn't be surprised if the cancer had spread there due to the tumor being located so close to my armpit.
The surgery was scheduled on Thursday, June 20, 2013. The admissions process went very smoothly since we had experienced it all just 17 days earlier when my husband, Bob, had surgery on his broken ankle. Bob's experience didn't go nearly as well as mine, but we learned a lot from it and were much better prepared when it was my turn. Our 17 year old daughter also accompanied us--she wanted to be there with me, plus we needed a driver since I wouldn't be allowed to drive after the surgery, and Bob couldn't drive with his broken ankle. Our pastor and his wife met us at the hospital. Pastor read Scripture and prayed with us, and we visited for a bit before they left. It was a huge encouragement having them there, and we are very thankful for them and the rest of our church family! I didn't feel nervous at all, but apparently I was more nervous than I thought because my blood pressure was higher than normal when the nurse took it--which we joked about. After surgery when she took it, it was back down to normal.
I had a procedure done before the actual surgery--which surprised me because I had not been told about it ahead of time. They took me to radiology where they used ultrasound to locate the tumor and insert a thin wire into it to mark the exact location for the surgeon. I felt like a Cyborg with the four inch piece of wire sticking out of my chest (they did tape it down, so I wouldn't lose an eye!). The surgery lasted one hour twenty minutes; I awoke in recovery less than an hour after surgery, and I left the hospital to go home less than two hours after that. Other than a dry mouth, I felt great! I drank and ate right away, walked down the hall to use the bathroom with no problem, and felt completely lucid and awake. I don't know how it could have gone any better or faster! I never experienced any pain after surgery, so I never used the pain meds they prescribed. I was a little tired later that day and snoozed in the recliner for a bit. I had taken the following day (Friday) off work, but I seriously could have gone to work--I felt that good! I attended church on Sunday, and returned to work on Monday as normal.
I was again impressed with the attitudes of all of the medical personnel at the hospital. Every single person with whom I had interaction was very kind, considerate, and understanding, yet willing to show some humor. I specifically remember two nurses. The first one wheeled me into surgery, and when we came to a very steep downhill incline on the way I said, "This could be fun! Do you ever run down the ramp?" She answered that she actually did, especially when the patients are children. So we had a laugh about that. The second was the O.R. nurse. While she was getting me set up on the operating table, we were chatting, and she mentioned the procedure. I told her I actually wasn't getting the sentinel node biopsy and explained why. Her enthusiastic response astounded me. She said, "Good for you! I see women come through here all the time who are scared and just blindly follow their doctor's recommendations--not that you shouldn't listen to your doctor, but so many women have no clue what's going on or what their choices are. That's great that you did your research and are making informed decisions!" Let me tell you, that was a big confidence booster!
When I had scheduled my surgery, it was for three weeks out, allowing me three weeks to detox and strengthen my immune system as much as I could. I also had two acupuncture treatments a week up to and following surgery. The acupuncturist told me that acupuncture helps with bleeding during surgery and with pain and faster recovery after surgery. This was interesting because since I currently had no symptoms whatsoever, I could not gage whether or not the acupuncture treatments were actually doing anything. They were relaxing, but I never really felt any different. The proof for me was after surgery when I came out of recovery amazingly fast with no side effects other than a dry mouth.
The "side effect" of surgery that bothered me the most was not being able to play basketball for awhile! For the past few years I have been playing basketball at an open gym at the high school every Tuesday and Friday starting at 5:00 a.m. Other than one high school girl who used to play occasionally, I'm the only female who plays, but I'm pretty much considered "one of the guys" now. The early morning time is perfect since Bob is usually leaving for work anyway, and I'm usually home before the kids even wake up, so I don't have to give up spending time with my family to participate. Besides that, I love playing basketball, and it's easy motivation to get up and get a workout. I waited about a month after surgery before I played again. My incision healed quickly and well, and during that time I walked every day for my exercise. After a couple weeks I started jogging some as well to build up my endurance and test how things felt while I was running. When I was pretty comfortable with everything, I started playing again.
Only a couple of the guys knew about my diagnosis and surgery before I stopped playing, but I figured they would spread the word while I was gone. The first morning I showed up after surgery, it was pretty heartwarming. I was a little late, and they had already started playing the first game. When I walked in, several guys called to me and waved from the floor while they were playing. When there was a pause in the action, they jogged over, greeted me and gave me fist bumps and high fives. No one made a huge deal out of it, but they did make it clear they were glad to see me back--which was perfect.
The surgical margins around the tumor were clear, so to the best of our knowledge, the surgeon got all of the cancer that was there. At my two-week follow-up appointment with the surgeon, everything looked great, and he said he didn't need to see me again unless I developed some concerns. Next step--the oncologist.
Explaining My Diagnosis
Based on the biopsy of the tumor after surgery, my specific diagnosis is IDC, Grade III "poorly differentiated", ER/PR positive, HER2 unamplified, 2.2 cm, Stage IIA or IIB. My diagnosis was slightly worse after surgery; the pre-surgery biopsy was Grade 2, 1.7 cm, ER/PR positive. I know that is probably a bunch of confusing gibberish to many of you, so I will do my best to explain what it all means!
Invasive Ductal Carcinoma (IDC) is the most common form of breast cancer with about 80% of all breast cancers being this type. The definition of IDC is a cancer that initially formed inside a milk duct, but has broken through the wall of the duct and begun to invade the surrounding breast tissue. It is sometimes also referred to as "Infiltrating Ductal Carcinoma."
The Grade of the cancer is determined by a pathologist after examining the cancer cells under a microscope. There are three grades: Grade I, Grade II, Grade III. The lower the grade, the more closely the cancer cells resemble normal breast cells, the more slowly they grow, and the less likely they are to spread. The higher the grade, the more abnormal the cancer cells are in appearance and behavior (the more "wild" they are) and the more likely to grow and spread. Grade I cells are "well differentiated"--they look and act somewhat like healthy cells. Grade III cells are "poorly differentiated." There is one more level within Grade III, and that would be "undifferentiated", which is the worst. So the Grade of my tumor is bad, but it's not the worst. I was not surprised about the Grade because typically, the younger you are (pre-menopausal as opposed to post-menopausal), the worse the cancer is.
The Endocrine/Hormone Receptor Assay determines if the cancer cells have receptors for estrogen and progesterone. If the cells do have these receptors then they are "estrogen receptor positive" (ER+) and/or "progesterone receptor positive" (PR+). This means that the cancer cells grow in response to estrogen and/or progesterone. About 75% of breast cancers are ER+, and about 65% of those are also PR+. Endocrine therapy is standard treatment for ER/PR positive tumors and is supposed to help prevent recurrence by blocking the estrogen receptors on the cancer cells and preventing estrogen from binding to them. The most common drug given for ER/PR positive tumors is Tamoxifen which is taken for up to five years after initial treatment. Drugs called aromatase inhibitors actually stop production of estrogen in post-menopausal women; pre-menopausal women cannot take aromatase inhibitors. Of ER/PR positive tumors, about 60% of them are likely to respond to endocrine therapy. If the cells do not have these receptors, they would be ER/PR negative; only 10%-15% of these tumors respond to endocrine therapy, and ER/PR negative cancers are more rare and more serious than ER/PR positive cancers. My diagnosis is ER/PR positive.
Twenty to twenty-five percent of breast tumors produce too much of a protein called HER2/neu. These cancer cells also have too many HER2 receptor sites on the cell surface, which causes the cells to pick up too many growth signals. These tumors tend to be much more aggressive and fast-growing. Standard treatment for HER2 positive cancers is a drug called Herceptin which is supposed to reduce recurrences and is given along with chemotherapy. Herceptin blocks the cell receptors so they don't pick up as many growth signals. Tykerb is another drug used if Herceptin fails. Tykerb interferes with HER2 activity from inside the cell by limiting the amount of energy the cells have for growth and multiplication. My diagnosis is HER2 "unamplified" which means it was indeterminate--neither clearly positive nor negative.
Triple Negative breast cancers (ER/PR negative, HER2 negative) make up roughly 10%-17% of all breast cancers, and generally the prognosis is poorer than for other types of breast cancer; this is a rare and aggressive cancer. There are no targeted drug therapies for Triple Negative breast cancer, but they can respond to chemotherapy.
Size of the tumor helps in staging the cancer. Generally, a tumor measuring less than 2cm would be Stage I; a tumor measuring 2-5cm would be Stage II; and a tumor measuring more than 5cm would be Stage III. My diagnosis is a tumor measuring 2.2cm, so it would be at least Stage II.
Cancer staging involves many factors, but the three main factors are the size of the cancer, whether it is invasive or non-invasive, and whether it is in the lymph nodes. Stage 0 is non-invasive--no cancer cells have broken out of the part of the breast in which they started and invaded nearby normal tissue. Invasive cancers are always at least Stage I. Stage IA is when the invasive tumor is less than 2cm, has not spread outside the breast, and no lymph nodes are involved. Stage IB is when either no tumor is found in the breast but small groups (less than 2mm) of cancerous cells are found in the lymph nodes; OR when the invasive breast tumor is less than 2cm and the lymph nodes are involved. Stage IIA is when there is no tumor but small groups of cells measuring more than 2mm are found in 1-3 axillary (under arm) lymph nodes or in the lymph nodes near the breastbone; OR the tumor is 2cm or less and has spread to the axillary lymph nodes; OR the tumor is larger than 2cm but less than 5cm and has not spread to the lymph nodes. Stage IIB is when the invasive tumor is more than 2cm but less than 5cm and small groups of cancer cells less than 2mm are found in the lymph nodes; OR the tumor is larger than 2cm and less than 5cm and the cancer has spread to 1-3 axillary lymph nodes or lymph nodes near the breastbone; OR the tumor is larger than 5cm but has not spread to the axillary lymph nodes. Stage IIIA is when no tumor is found in the breast or a tumor is of any size and cancer is found in 4-9 axillary lymph nodes or lymph nodes near the breastbone; OR the tumor is larger than 5cm and small groups of cancer cells less than 2mm are found in the lymph nodes; OR the tumor is larger than 5cm and cancer has spread to 1-3 axillary lymph nodes or lymph nodes near the breastbone. Stage IIIB is when the invasive tumor can be any size and cancer has spread to the chest wall and/or skin and caused swelling or an ulcer; AND may have spread to up to 9 axillary lymph nodes OR spread to lymph nodes near the breast bone. Stage IIIC is when there can be no sign of cancer in the breast or any size tumor which has spread to the chest wall and/or skin of the breast; AND the cancer has spread to 10 or more axillary lymph nodes; OR the cancer has spread to lymph nodes above or below the collar bone; OR the cancer has spread to axillary lymph nodes or lymph nodes near the breastbone. Stage IV (advanced/metastic) is when the cancer has spread beyond the breast and nearby lymph nodes to other organs such as lungs, liver, brain, skin, bones, or distant lymph nodes. My diagnosis is Stage IIA or IIB because the invasive tumor is more than 2cm, but we don't know if it has spread to any lymph nodes. There are no outward signs of cancer in my axillary lymph nodes (i.e. swollen nodes or swelling under my arm); however I wouldn't be surprised if there is cancer in some lymph nodes just because of the location of the tumor (this thought is my personal opinion, not anything a doctor has told me). The tumor was in my right breast located at about 10 o'clock (looking at the breast from the front) and very close to my armpit.
The prognosis statistics for Stage IIB cancer are significantly worse than those for Stage IIA. This is definitely something to keep in mind; however, statistics are just that...statistics. They are generalizations based on the results of thousands of women with the same diagnosis. It is important to remember that not every woman falls into neatly divided statistical categories; each individual woman, each case is unique. What works for the statistical majority may not work for every woman; likewise, if the statistical outlook is bleak, there are some women who defy the odds and outlive the statistics.
Looking at statistics alone can cause undue fear...or undue overconfidence. I have chosen to arm myself with as much knowledge as I can and make educated, logical decisions based on that knowledge.
Invasive Ductal Carcinoma (IDC) is the most common form of breast cancer with about 80% of all breast cancers being this type. The definition of IDC is a cancer that initially formed inside a milk duct, but has broken through the wall of the duct and begun to invade the surrounding breast tissue. It is sometimes also referred to as "Infiltrating Ductal Carcinoma."
The Grade of the cancer is determined by a pathologist after examining the cancer cells under a microscope. There are three grades: Grade I, Grade II, Grade III. The lower the grade, the more closely the cancer cells resemble normal breast cells, the more slowly they grow, and the less likely they are to spread. The higher the grade, the more abnormal the cancer cells are in appearance and behavior (the more "wild" they are) and the more likely to grow and spread. Grade I cells are "well differentiated"--they look and act somewhat like healthy cells. Grade III cells are "poorly differentiated." There is one more level within Grade III, and that would be "undifferentiated", which is the worst. So the Grade of my tumor is bad, but it's not the worst. I was not surprised about the Grade because typically, the younger you are (pre-menopausal as opposed to post-menopausal), the worse the cancer is.
The Endocrine/Hormone Receptor Assay determines if the cancer cells have receptors for estrogen and progesterone. If the cells do have these receptors then they are "estrogen receptor positive" (ER+) and/or "progesterone receptor positive" (PR+). This means that the cancer cells grow in response to estrogen and/or progesterone. About 75% of breast cancers are ER+, and about 65% of those are also PR+. Endocrine therapy is standard treatment for ER/PR positive tumors and is supposed to help prevent recurrence by blocking the estrogen receptors on the cancer cells and preventing estrogen from binding to them. The most common drug given for ER/PR positive tumors is Tamoxifen which is taken for up to five years after initial treatment. Drugs called aromatase inhibitors actually stop production of estrogen in post-menopausal women; pre-menopausal women cannot take aromatase inhibitors. Of ER/PR positive tumors, about 60% of them are likely to respond to endocrine therapy. If the cells do not have these receptors, they would be ER/PR negative; only 10%-15% of these tumors respond to endocrine therapy, and ER/PR negative cancers are more rare and more serious than ER/PR positive cancers. My diagnosis is ER/PR positive.
Twenty to twenty-five percent of breast tumors produce too much of a protein called HER2/neu. These cancer cells also have too many HER2 receptor sites on the cell surface, which causes the cells to pick up too many growth signals. These tumors tend to be much more aggressive and fast-growing. Standard treatment for HER2 positive cancers is a drug called Herceptin which is supposed to reduce recurrences and is given along with chemotherapy. Herceptin blocks the cell receptors so they don't pick up as many growth signals. Tykerb is another drug used if Herceptin fails. Tykerb interferes with HER2 activity from inside the cell by limiting the amount of energy the cells have for growth and multiplication. My diagnosis is HER2 "unamplified" which means it was indeterminate--neither clearly positive nor negative.
Triple Negative breast cancers (ER/PR negative, HER2 negative) make up roughly 10%-17% of all breast cancers, and generally the prognosis is poorer than for other types of breast cancer; this is a rare and aggressive cancer. There are no targeted drug therapies for Triple Negative breast cancer, but they can respond to chemotherapy.
Size of the tumor helps in staging the cancer. Generally, a tumor measuring less than 2cm would be Stage I; a tumor measuring 2-5cm would be Stage II; and a tumor measuring more than 5cm would be Stage III. My diagnosis is a tumor measuring 2.2cm, so it would be at least Stage II.
Cancer staging involves many factors, but the three main factors are the size of the cancer, whether it is invasive or non-invasive, and whether it is in the lymph nodes. Stage 0 is non-invasive--no cancer cells have broken out of the part of the breast in which they started and invaded nearby normal tissue. Invasive cancers are always at least Stage I. Stage IA is when the invasive tumor is less than 2cm, has not spread outside the breast, and no lymph nodes are involved. Stage IB is when either no tumor is found in the breast but small groups (less than 2mm) of cancerous cells are found in the lymph nodes; OR when the invasive breast tumor is less than 2cm and the lymph nodes are involved. Stage IIA is when there is no tumor but small groups of cells measuring more than 2mm are found in 1-3 axillary (under arm) lymph nodes or in the lymph nodes near the breastbone; OR the tumor is 2cm or less and has spread to the axillary lymph nodes; OR the tumor is larger than 2cm but less than 5cm and has not spread to the lymph nodes. Stage IIB is when the invasive tumor is more than 2cm but less than 5cm and small groups of cancer cells less than 2mm are found in the lymph nodes; OR the tumor is larger than 2cm and less than 5cm and the cancer has spread to 1-3 axillary lymph nodes or lymph nodes near the breastbone; OR the tumor is larger than 5cm but has not spread to the axillary lymph nodes. Stage IIIA is when no tumor is found in the breast or a tumor is of any size and cancer is found in 4-9 axillary lymph nodes or lymph nodes near the breastbone; OR the tumor is larger than 5cm and small groups of cancer cells less than 2mm are found in the lymph nodes; OR the tumor is larger than 5cm and cancer has spread to 1-3 axillary lymph nodes or lymph nodes near the breastbone. Stage IIIB is when the invasive tumor can be any size and cancer has spread to the chest wall and/or skin and caused swelling or an ulcer; AND may have spread to up to 9 axillary lymph nodes OR spread to lymph nodes near the breast bone. Stage IIIC is when there can be no sign of cancer in the breast or any size tumor which has spread to the chest wall and/or skin of the breast; AND the cancer has spread to 10 or more axillary lymph nodes; OR the cancer has spread to lymph nodes above or below the collar bone; OR the cancer has spread to axillary lymph nodes or lymph nodes near the breastbone. Stage IV (advanced/metastic) is when the cancer has spread beyond the breast and nearby lymph nodes to other organs such as lungs, liver, brain, skin, bones, or distant lymph nodes. My diagnosis is Stage IIA or IIB because the invasive tumor is more than 2cm, but we don't know if it has spread to any lymph nodes. There are no outward signs of cancer in my axillary lymph nodes (i.e. swollen nodes or swelling under my arm); however I wouldn't be surprised if there is cancer in some lymph nodes just because of the location of the tumor (this thought is my personal opinion, not anything a doctor has told me). The tumor was in my right breast located at about 10 o'clock (looking at the breast from the front) and very close to my armpit.
The prognosis statistics for Stage IIB cancer are significantly worse than those for Stage IIA. This is definitely something to keep in mind; however, statistics are just that...statistics. They are generalizations based on the results of thousands of women with the same diagnosis. It is important to remember that not every woman falls into neatly divided statistical categories; each individual woman, each case is unique. What works for the statistical majority may not work for every woman; likewise, if the statistical outlook is bleak, there are some women who defy the odds and outlive the statistics.
Looking at statistics alone can cause undue fear...or undue overconfidence. I have chosen to arm myself with as much knowledge as I can and make educated, logical decisions based on that knowledge.
Start Swimming
For many years I have occasionally wondered when my
family was going to go through a serious, life-changing trial. I
have known many relatives and friends who have experienced really
tough struggles over the years, and I guess in the back of my mind I
have just been waiting for our turn. The Bible speaks a lot about trials
and testing in the believer's life--that we should expect them, the benefits of
them, and how we are supposed to respond to them. We have had our share
of less severe trials like anyone else such as temporary job lay-offs and
unexpected financial strain, but God has always proven Himself faithful in
meeting our needs.
Count it all
joy, my brothers, when you meet trials of various kinds, for you know that the
testing of your faith produces steadfastness. And let steadfastness have
its full effect, that you may be perfect and complete, lacking in
nothing. James 1:2-4
So when I found a lump in my breast on Sunday, May 5, 2013, I
just had a feeling that this was IT. I wasn't surprised or
overwhelmed by shock and disbelief; I did experience this weird
feeling of calm acceptance. Of course the logical part of my brain
pointed out that I didn't know that it was cancer yet--it could be,
after all, just a benign cyst or something. Still, the feeling that
it was cancer persisted.
Do not be
anxious about anything, but in everything by prayer and supplication with
thanksgiving let your requests be made known to God. And the peace of
God, which surpasses all understanding, will guard your hearts and your minds
in Christ Jesus. Philippians 4:6-7
I told my husband, Bob, about the lump the same day I found
it, but we chose not to tell anyone else until after we had a firm
diagnosis. I guess I didn't want to cause unnecessary worry and concern
if it turned out to be nothing, and I didn't really want to field a lot of
questions from well-meaning people until I had some solid answers. The
diagnosis didn't come until three weeks later, and during that time of waiting
Bob and I went through the days pretty normally, occasionally discussing
upcoming appointments privately. I did share with him my feeling
that the lump was going to be cancerous, but I also admitted I had no
solid reason to think that. Of course it was on our minds, and I did
spend time thinking about possible scenarios and how I would handle them.
I also prayed for wisdom and grace for myself and my family to handle whatever
came.
If any of
you lacks wisdom, let him ask God, who gives generously to all without
reproach, and it will be given him. James 1:5
Bob accompanied me to see my family doctor four days after
finding the lump, Thursday, May 9. My doctor basically said, "Yes,
there's something there alright; we'll have to check it out." A
mammogram was scheduled for two weeks later, Thursday, May 23, with enough time
to also do an ultrasound and biopsy if necessary. I had to wait two weeks
to schedule the mammogram because we were in Michigan the weekend of May 16 for
our niece's wedding. The wedding weekend was a lot of fun, but it was
weird spending so much time with family knowing they had no idea about my
situation.
God is our
refuge and strength, a very present help in trouble. Psalm 46:1
The day of my mammogram appointment, I didn't feel overly
nervous--probably because I was expecting bad news, but not dreading
it. I had never had a mammogram before, and I thought there was going to
be some pain or discomfort, so I was pleasantly surprised when it was a breeze.
(Maybe having nursed five babies had something to do with that.) The
lump in my right breast showed up, but the left one was clear. Next was
the ultrasound which showed that the mass was solid (not a good
sign), necessitating a biopsy which was done under local
anesthetic. I didn't find any of these procedures very uncomfortable; in
fact I joked with the technicians about the discomfort not even coming
close to delivering five babies without any pain meds. The pain of
childbirth has a way of putting things in perspective! Several
tissue samples were taken, and a marker/tag was inserted into the
lump. Then another mammogram was taken to make sure the marker was
in the right spot.
I want to mention how impressed and thankful I was that every
single person I encountered that day, from the desk receptionists to the
technicians, was so kind and friendly. It was very apparent that they all
understood how scary and serious these procedures could be, and they did a
fantastic job of being kind without being patronizing. I made small talk
and joked a bit with the mammogram tech, the ultrasound tech, and the
radiologist who did the biopsy, but despite the fun the potential seriousness
was not minimized. The radiologist said he was going to do everything he
could to lean on the lab to get the results to him the next day (Friday),
so that I wouldn't have to go through the weekend not knowing the
results. When I gave them my work number so he could call me with the
results, the ultrasound tech was concerned that I was going to be okay getting
the news at work. I appreciated that. But I assured them I would be
fine, and that I had a strong support team at work. I work at a
chiropractic office, and the doctor and his wife are friends more than
they are my bosses. One of my two coworkers is my pastor's wife whom
I've known since I was 13 years old, and the other I also count a friend.
Oops, I lied when I wrote that we didn't tell anyone else--I did tell my
boss right away because I value his support, knowledge, and medical
advice, and because as my employer, I wanted him to know what was going on.
He is not
afraid of bad news; his heart is firm, trusting in the Lord. Psalm 112:7
The radiologist did call me at work the next day
over the lunch hour and gave me the news that it was indeed cancer--Invasive
Ductal Carcinoma. He said it's the most common kind of breast cancer, and
that I caught it "early." Again, he was very kind. He
said a nurse would be calling me to schedule a consultation with a surgeon
since surgery is usually the next step. The nurse called within the hour,
and that was slightly awkward since I had to set up the appointment
with a surgeon even though I wasn't familiar with any of
the surgeons! So we picked one, and then I checked him out
with a few different sources before the consult appointment. (It
turned out that the surgeon I chose was highly recommended. I was even
able to check with a surgical nurse I know who works with this surgeon
regularly. She said that she would trust him completely, and that he
had operated on one of her close friends as well. That was good
enough for me!) We have instant messaging through Skype on our office
computers as well as our home computers, so I was able to tell Bob the
news when he messaged me after he got home from work. I did have to
finish the rest of the work day, but I wasn't upset or distraught--I just had a
calm acceptance. Actually, it was kind of a relief to end the weeks of
wondering and have a definite answer.
Fear not,
for I am with you;
be not
dismayed, for I am your God;
I will
strengthen you, I will help you,
I will
uphold you with my righteous right hand. Isaiah 41:10
The next issue was deciding whom to tell and when to tell
them. We had considered not telling our kids immediately since they only
had a week and a half of school left, and they were in the middle of final
exams. But we realized that we couldn't tell anyone else without risking
the news getting back to them, especially to our teenage daughters.
So that night Bob and I sat down with our five children and broke the news to
them. We have always been honest and straightforward with our kids, and I
saw no reason to handle this situation differently. There were lots
of tears and some questions from them, and I'm sure they were imagining the
worst. Through her tears my seven-year-old cried, "You don't
know what it's like to think your mom is going to die!" Wow.
It was heartbreaking to watch my children suffering! In fact, that is
what bothers me the most--thinking of the possible effects on my husband and
children. We reviewed several of God's promises, and we prayed
together. I also reminded them that none of us knows when we are
going to die--and that I could die in a car accident long before I die of
cancer! It was a rough night for all of them, but they seemed better the
next day when we resumed our normal activities. I also called my parents
and Bob's parents to tell them the news that night, and then I sent a couple
emails--one to all of our siblings, and one to our pastor so that he could
share the news with our church family. The whole evening was kind of
surreal, yet I definitely experienced God's peace that is beyond all
understanding.
And the
peace of God, which surpasses all comprehension, will keep your hearts and
minds through Christ Jesus.
I asked our relatives and church family not to post anything
publicly on Facebook about my diagnosis until I posted something myself,
although I encouraged them to share the emails with others. My
reasoning for this was that I wanted to gather more information on my condition
and future treatment before going "worldwide" with the news.
Over the next couple days, the loving response from our
immediate family and from our church family was comforting and
heartwarming. It is an amazing experience to be covered in prayer by
so many people from around the country and even around the world.
This was the first time we had been on the receiving end of such care instead
of on the giving end, and it was an inspiring and humbling
experience.
Apparently God decided we could handle more, and He doubled
down on the testing! One week after my diagnosis, Sunday, June 2, my
husband fell and broke both bones in his right ankle, requiring surgery and
8-12 weeks of recovery before he could go back to work. (He had been
playing Frisbee golf--and winning!--with one of our teenage daughters. His
shoe caught on the concrete tee pad causing his ankle to twist and then go over
the edge of the cement, breaking both bones. He ended up with a metal
plate and seven screws on the side with the spiral fracture, two screws on
the other, and forever unable to pass through a metal detector without setting
it off. Bob was very emotional and couldn't believe that this had
happened when he wanted and needed to be there for me. I was a little
stunned at the timing myself, but when we were in the emergency room waiting to
see the doctor I hugged him and said, "This is the perfect
time." He looked at me incredulously with tears in his eyes and said
that it couldn't be a worse time! I choked up too, but replied,
"Well, God allowed it to happen now, and His timing is perfect, so even
though it doesn't make sense to us, this is the perfect
time." We prayed again, asking God to help us trust His will,
heal Bob's ankle, and meet our needs once again.
And we know
that for those who love God all things work together for good, for those who
are called according to his purpose. Romans 8:28
Bob's accident caused a financial strain since he was unable
to work for at least two months--during the first time in our 19 years of
marriage when we faced large medical bills--and the 60% disability pay wouldn't
quite cut it. We have a high deductible health insurance plan, so we
would have to pay thousands of dollars before the insurance covered
anything. Fortunately, once that deductible is met, everything is covered
at 100%! Ha--we ended up meeting that deductible more than twice
over. Due to all the appointments for doctors and surgeries between the
two of us, I missed at least one day of work per week for several pay periods
in a row, causing a further pinch in the pocket book. But our God is
faithful, and He used many people to bless our family by
their generosity and willingness to help. We had no unmet
needs. The glory is His alone!
Bob was able to accompany me to all of my appointments, but
the funny thing was that I had to point out that I was the
patient--not the guy with a cast and crutches hobbling along with me.
As soon as I found out I had breast cancer, I began
researching every aspect of my specific diagnosis. I had some
preconceived ideas about cancer and cancer treatments, but I wanted as much
knowledge as possible in order to make well-informed decisions. In future
posts, I will share what I learned and how that information, coupled
with my faith, shaped my treatment decisions.
For God
alone my soul waits in silence; from him comes my salvation. He alone is
my rock and my salvation, my fortress; I shall not be greatly shaken.
Psalm 62:1-2
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