flora margaret

photos: 
1) i liked the stacks of gowns and their blue hues
2) i became very skilled at fashioning my ill-fitting, all-exposing gown into a fitted, modest tunic wrap…thing
3) the bell you’re supposed to ring when you finish your radiation. after my 6 weeks of treatment, i instead chose to quietly slip out. i was never there. 

I got my own tattoos in January: just three small barely detectable dots to help line me up for radiation treatment. In November I was diagnosed with DCIS: Ductal Carcinoma In Situ—cancer light, stage zero cancer, pre-cancer. If you are going to get a breast cancer diagnosis, this is the one you want.

Such a strange time of life. At the same time I was diagnosed, my neighbor was diagnosed with throat cancer. I ran into a colleague at the Cancer Center one day: she had just been diagnosed with breast cancer. Whoa. So many people affected by cancer.

So grateful for my diagnosis, knowing how much worse it could have been. Throughout my treatment I saw so many women and men with no hair, met women with young children and people who had to travel so far for their radiation treatment. I met people who had been diagnosed years ago and people who thought they were done with treatment, but then more cancer was found.

The treatment for DCIS didn’t interrupt my life too much. I did not have to have big surgeries or chemotherapy. I took 10 days off from exercising after each of my small surgeries, but exercised throughout my radiation treatment and presented at a conference 3 days after my first surgery. (Probably not a good idea.) Working on campus near the hospital, I was able to walk 10 minutes to and from my radiation treatments. I liked the walk and getting out of the office mid –morning, except for the last couple of weeks when I was just tired and done.

Some things I learned along the way:

• One of the first questions people ask when you have a diagnosis is, how did you get it? That is the $500 billion dollar question isn’t it?It wasn’t smoking, obesity or alcohol abuse—all linked to cancer. It wasn’t having the breast cancer genes BRCA1 or BRCA2 in my genetic make-up (I now know after getting my genetic tests back).

But was it the millions of gallons of diet coke I have consumed? The secondhand smoke I was exposed to the first half decade of life before my parents stopped smoking? The fire retardants in carpeting, upholstery and pajamas? The processed foods I eat? My genetic make-up (researchers are still working to identify additional cancer genes)?

Or, as my scientist daughter puts it, was it the combination of environmental and genetic factors, entropy and random chance that one of my 37.2 trillion cells would become abnormal and acquire a large number of mutations necessary to forego all of the division checkpoint and cellular suicide mechanisms to be able to divide uncontrollably? No one knows.

• That’s something else I learned– our cells have many, many, many division checkpoints that check and fix errors and they have cellular suicide mechanisms to keep our cells from dividing uncontrollably! So amazing! Of course with 37.2 trillion cells, you can’t catch every error.

• I learned that I am not ready to give up my mammograms. There have been many articles in the past several years questioning the value of regular mammograms. (http://www.nytimes.com/2014/02/12/health/study-adds-new-doubts-about-value-of-mammograms.html?_r=0 ) The argument is that many of these cancers grow very slowly and we can wait to see if a pre-cancer, like mine, turns into something cancerous or not. Only when a palpable lump is felt would do they do something. I am someone who believes in scientific research, and the research in the article linked above says outcomes are the same. But I want more research. I think waiting to deal with something when I’m older and likely less active would just make recovery more difficult.

• Some women with DCIS opt for full double mastectomies. This was shocking news to me when I was told this by my surgeon’s nurse practitioner. It really scared me and seemed like such overkill. I did not choose this option. I chose what my surgeon recommended, which was small and barely noticeable incision for both of my surgeries. However, the more I read, the more I understand why women choose full mastectomies. First, reconstructive surgery, as Angelina Jolie has confirmed, is quite advanced and the results are very good. Second, radiation can affect your heart and lungs. If you have a mastectomy, you don’t have to have radiation. My tumors were, fortunately, in my right side, not my heart side, so I did not have to worry about radiation affecting my heart. But I have no idea if my lungs were damaged by the radiation. (I just coughed. Is that a cold or radiation damage?) Third, you don’t have to do chemotherapy. Fourth, you don’t have to do a needle localization. If you don’t know what that is, I won’t tell you. It’s doable, but not for sissies. Fifth, once you get rid of all of the tissue, you don’t have to wonder about additional cancer cells that left in your body, too small to detect YET. Sixth, you don’t have to take Tamoxifen— an estrogen modulator for hormone receptive tumors. Sometimes I wonder if I should have gone this route…probably not.

• Dr. Susan Love’s Breast Book is a great resource for anyone with a breast cancer diagnosis. My boss gave me a copy. So helpful! If you know of anyone who gets a breast cancer diagnosis, give her this book if she doesn’t already have it.

• Radiation is not a one or two time thing. Mine was 5 days a week for 6 weeks. The treatment included lying on a table and having a radiation beamed aimed at my breast for 15 seconds from one angle and then 15 seconds from another. I didn’t feel anything. Afterward, I changed out of my gown and walked back to work.

Life goes on. DCIS is a little weird because it’s not like capital letters CANCER. You’re not donning the boxing gloves to kick cancer’s ass. It’s more like, a month ago I was going to radiation, today I’m filing the paperwork one files when they find out someone else is using their social security number. (True.) There is something that seems similar between the two undertakings– just go through the prescribed steps until you’re on the other side. But you know you will get to the other side, without any ass-kicking.

Moving forward and grateful for this life. Time to get back to figuring out my life as an empty nester!