Kathy, a close friend of my daughter’s, is seeking encouragement and hope. Cancer is a lonely journey with fearful stops along the way—destination unknown.
Anger (why me?), fear of the future (how often did I compose my own obituary?) and regret (for the things I hadn’t found time to do) raced through my head. Kathy nods in agreement as I go through this checklist of frenzied emotions that had beset me when I heard the dreaded words “breast cancer.”
“Kathy, you’re about to travel on a difficult road. But, please, keep in mind...There is life after cancer,” I tell her.
As I speak to Kathy, my thoughts return to that day in March more than a decade ago. I was getting ready for my husband’s birthday party...bathing, lathering soap over my body...and there it was…a lump in my breast. Somehow, I got through the party and the next day made an appointment for a mammogram. I’d had a mammogram just six months earlier and had been told all was fine. But this time, the mammogram was followed by an ultrasound, and before I could catch my breath, I was sitting in the oncologist’s office, scheduling surgery. Sure enough, the earlier mammogram showed the lump. I’d fallen through the cracks. I’d become part of the sisterhood of more than 20,000 Canadian women who are diagnosed with breast cancer each year…The one in nine women expected to develop breast cancer during her lifetime.
I wish I could say I was stoic and brave. I wasn’t. I was simply terrified, and I was angry. I never neglected a doctor’s appointment or the annual mammogram. Why should this have happened to me? I felt betrayed by my body. I suffered from panic attacks, lack of sleep and was thoroughly depressed.
As soon as I returned from hospital after my surgery, my brother, an endocrinologist based in New York, flew to Montreal. A respected medical practitioner and teacher, my brother said: “Get on with your life. Go back to work. Incorporate the treatment schedule into your daily routine. Don’t let cancer conquer you!” It was the best advice I could have received and it sustained me through the months of chemotherapy and radiation. I worked throughout my treatment, scheduling chemotherapy for Fridays (so I could recover over the weekend) and having radiation at the end of my work day. It all became part of my daily schedule, of my life. And life continued. The frequent check-ups with the oncologist, the mammograms, ultrasounds...these were the fearful pit stops that punctuated my life for several years following diagnosis.
In retrospect, my cancer experience has had some positive results. It taught me to value each day as a gift, to value the love and support of family and dear friends. And some time after my cancer diagnosis, my daughter confronted me with this: “Mom, I always thought I could never measure up to you. But when I saw you frightened and so vulnerable, I realized that you weren’t superwoman, and I felt better about myself.”
Many advances in breast cancer treatment have occurred in the years since I was diagnosed. Tamoxifen, once the hormonal medicine of choice for all women with hormone-receptor positive breast cancer is being replaced by aromatase inhibitors such as letrozole (Femara) in post-menopausal women with hormone-receptive positive breast cancer. Herceptin (chemical name trastuzumab) is offering hope to women with metastatic breast cancer. Groundbreaking work is being done to identify women with breast cancer susceptibility mutations such as BRCA1 or BRAC2.
Sentinel lymph node biopsy is sparing many breast cancer patients the removal of all the lymph nodes in the armpit to determine if cancer has spread. (Studies have indicated that if cancer has not affected the sentinel node, it is unlikely that it has spread to other areas.) MRI imaging is helping in the detection of cancer spread. Anti-angiogenesis compounds are being tested in patients with a variety of cancers. (tumours can’t survive without a blood supply—a process known as angiogenesis).
And the good news, according to the Canadian Cancer Society, is that since 1993 the incidence rates for breast cancer have stabilized, and death rates have declined steadily.
As for Kathy, just days after her surgery, she was out jogging, full of fighting spirit and determined to beat her cancer. Keep jogging, Kathy!