Tag Archives: 4 Time Breast Cancer Survivor

It’s My Cancerversary…And I Don’t Feel Like Celebrating


image

After 4 breast cancers since 1988, I’ve lost track of the usual markers of cancerversaries. I can remember month and year of diagnoses but can no longer keep specific dates in my head. Also, there is confusion about what date to use for 3 of my cancers where the words and behavior of mammogram technicians and doctors resulted in my”knowing” I had cancer before the official biopsy results were in.

In any event, February 1988 marked my first breast cancer diagnosis at 29. That makes it 27 years of “living on borrowed time” as that first cancer was caught by me through a fluke of accidentally touching the right place at the right time and following up immediately with my doctor. Had it not been for the accidental touch, the tumor would have continued to grow and may well have spread into Stage 4 cancer.

Last year, I was very excited about making it to 26 years since first diagnosis. Maybe part of what makes me uneasy about claiming 27 years of survival is that I had a total of 4 breast cancers during this period. Other people seem to count their survival status as cancer free time and start counting again from zero once they have had a recurrence. If that is the “right” way to do things, I guess I am only a 3.5 year survivor as my last breast cancer was in July, 2011. Do people think I am a fraud claiming 27 years of survivorship when many of those years were spent in treatment for new primary cancers and recurrences? I am always careful to say 27 years from first diagnosis so I don’t think I am misleading anyone.

What really has me bothered this year is that for the last 6 weeks or so, my Facebook feed has been filled by the deaths of so many young breast cancer patients. It seems every 2 or 3 days, someone from one of my Facebook groups has passed on, leaving a young family behind.

This year I felt uncomfortable announcing 27 years of survival from first diagnosis under the circumstances of all the surrounding death in the air. Some people say they draw hope from my longevity, particularly in light of the multiple bouts of triple negative cancer, my BRCA1 status, and my lack of what would now be considered optimal treatment for someone with my history.

On the other hand, I don’t doubt that it strikes resentment in some people’s hearts that I continue to live despite all the odds stacked against me while others die shortly after diagnosis or after being told their prognosis was excellent as their cancer was detected early, they received aggressive treatment, and they were BRCA negative.  Announcing 27 years of longevity in this atmosphere, seems a bit like bragging or gloating, which is the last thing I want to do. I have no idea why I am still alive considering all the cards stacked against me. All I can do is get philosophical and say this just isn’t my time to die. I have no secrets for longevity or avoiding Mets and we all know I have no secrets for avoiding recurrences!

Along with the tragic death announcements, there has been an increase in the  amount of posts from women speculating on what caused their cancer and what they can do to prevent a recurrence. I have no answers for either causation or prevention. I have said before that cancer seems pretty random to me striking both triathlete vegans and self-admitted couch potatoes and everyone in between. I have yet to see a strong pattern or have an aha moment where all the pieces of the puzzle fall into place for me. The same goes for recurrences and metastasis. Those who radically change their eating habits and make other lifestyle changes seem as likely to have their cancer come back as a recurrence or a metastasis as do those who change very little. After 27 years of watching cancer prevention tips come and go and sometimes be turned completely around (I just read that high doses of soy are good for preventing cancer after 20 years of it being cited as a cancer promotor), I personally have little faith in these promises of prevention or a cure.

Along with the string of deaths, there seem to be an unusually high number of women experiencing either local recurrences or Mets. The combination of the deaths and the disease progression have created high levels of anxiety in the support groups. You start to wonder if you are next in line for some cancer catastrophe to strike your life. This probably explains all the comments about cancer causation and prevention.

I want to feel good about my 27 years of post-diagnosis survival. The road has been hard and bumpy and like everyone else, I have no idea what is around the next corner. I have spun the cancer Wheel of Fortune 4 times now and have been lucky to have only local recurrences. But how many times can you spin that wheel and avoid the slots marked for metastasizes and death? I think I have used up all my get out of jail free cards and if forced to spin again, I don’t anticipate a 5th local recurrence.

image

Intellectually, I know the deaths and disease progressions will level out in time. But in the meantime, these events are extremely stressful for everyone involved. It’s not a good time to be celebrating a long-term
cancerversary in the midst of all this pain.

So I will be privately pleased to still be alive and able to watch my children grow up. At the same time, I will continue to mourn for the lives lost or forever altered by new recurrences or metastic disease. This will be a very quiet celebration of life and one that I will not take for granted. Thinking of my fallen pink sisters, I think “there but for the grace of God go I”.

Sharon Greene. February4, 2015

Posted from WordPress for Android

Advertisements

Is There A Hypochondriac In The House?


image

Ask almost any cancer survivor about whether they have become a bit of a hypochondriac, and the answer is usually a resounding yes. I have a confession to make. I swing from extreme hypochondria to total denial of any symptoms I may have. When you have a disease that can travel to your lungs, bones, liver, and brain (and sometimes skin, pancreas, ovaries, and uterus, particularly if you have a BRCA mutation), that pretty much covers most of the human body.

Most of us didn’t start off as hypochondriacs. It almost seems to be a standard side effect of the disease. It doesn’t help to be living in a time where medical symptoms and their potential causes are a mere Google search away.

We are not stupid people. We know that we can get non-cancer related illnesses like the flu, arthritis, and broken bones due to trauma. But still the aches and pains of everyday living take on a new urgency when they could be the early signs of bone or liver or brain metastisies, particularly if we don’t recall doing anything that would have brought the pain on in the first place.

Reading metastic disease questions and answers can really put a scare into you. Someone will invariably ask, “how did you know you had bone or brain or lung Mets?” and the answer is often a vague recollection of pain in a hip or frequent headaches or breathlessness. And it is so easy to think I have pain in my hip or bad headaches or trouble catching my breath when I climb up a flight of stairs. That realization combined with a short visit to Dr. Google can be enough to convince you for an hour or a night or a week that you too have metastatic cancer.

It really doesn’t matter if the medical literature says that rarely do bone Mets strike below the knee or elbow. Google cancer of the hand or foot and you are bound to find a case study or 2 of some poor person who had this rare metastasis strike them. If they can get it, why not you?

Much of this crazy making hypochondria strikes once treatment has ended and you aren’t due to see your oncologist for another 4 months. You don’t know if you are overreacting or if in fact you are experiencing early signs of metastisis. Many cancer agencies have a nurse on call who can help evaluate your symptoms over the phone. Your family doctor can also be a source of comfort in checking out more common reasons for your symptoms. As they taught us in law school, if you hear hoof beats outside your window, think horses, not zebras.

Some of the rules of thumb I have learned from my medical sources is to wait a few days and see, for example, if the body aches were early signs of a cold or flu or muscle strain from an activity you may have forgotten.  Keep a record of your pain – the type, duration, whether it is worse at night, and if over the counter medicines relieve it. If it is getting worse or is keeping you up at night, by all means get it checked out. It may still be non-cancer related but it needs to be checked out if only for your peace of mind. And sometimes it really is a herd of zebras rushing by your window so better to be safe than sorry.

A lot of the hypochondria does disappear with time, once you have experienced symptoms that can be explained as coming from non-cancer sources. If you have had a cancer recurrence or new primary, the hypochondria will return with a vengeance. If your body can get cancer again after surgery, chemo, and/or radiation, why couldn’t that cancer have spread before the recurrence was detected?

image

There are no easy answers. Sometimes a recurrence has already spread to distant body parts. These should be picked up by various scans or MRI’s. Other times, your bodily pains are mere coincidence or are actually brought on by the stress of a new cancer diagnosis. For example, pounding headaches, nausea, and an upset stomach can be an an emotional reaction to the stress of a recurrence being diagnosed and not a symptom that the cancer has spread elsewhere in the body.

I can give a few examples from my own life to illustrate how this has affected me. When I was first treated for cancer, every piece of scar tissue seemed like a new lump. There were a few trips back to the surgeon to be checked out, more mammograms, and even a biopsy just to be sure. After hearing the message scar tissue over and over again, I eventually calmed down and stopped looking for symptoms. Shortly before my 5 year “cure” check-up, I stepped funny off a curb and broke my ankle. I chalked it up to bad luck and went to my 5 year mammogram in a cast and on crutches. When they found a new breast tumor, I was suddenly convinced that cancer had spread to my ankle bone. No matter how many people looked at the x-ray of my ankle, I was convinced I had metastic cancer of the ankle. Finally a bone scan and ct scan ruled out any metastisis to the bone and eventually, I believed the doctors.

Something similar happened after my last cancer when I tripped on the bottom step and somehow broke my foot. It had seemed like a nothing accident and again it took a whole team of doctors to convince me this was just a freak twisting accident and not evidence of bone cancer of the foot.

Finally, I had a week of burning pains in my scalp followed by what looked like hives on one side of my face. It wasn’t scalp or skin cancer. It was shingles. Painful awful shingles on half of my scalp and face but nothing that was cancer related.

Over the 27 years of fighting cancer, I have self-diagnosed myself with a brain tumor, lung Mets, hand cancer, and a few other medical oddities. Every time I am proved wrong, I become more reluctant to have my symptoms checked out for fear of being seen as the complete neurotic I truly can be.

Some of us find it hard to draw the line between thinking the worst of every bodily pain and knowing when it is time to seriously check things out. My inner compass doesn’t function very well anymore after so many false alarms. I have swung to the other side of the pendulum, not getting things checked out in a timely manner. I ignored the raging cough that lasted for 6 weeks and left me exhausted only to find I had raging bronchitis that could have been treated weeks earlier. I am now so paranoid about being seen as a hypochondriac that I let things drag on for way too long, creating both mental and physical pain that could have been treated more promptly.

Have you found a balance between hypochondria and getting attention for legitimate health complaints? If you have any suggestions as to how to strike the proper balance, I’d love to hear from you in the comments below. If this is something you still struggle with, I’d love to hear from you too.

Sharon Greene  January 28, 2015

Posted from WordPress for Android

Having Breast Cancer 4 Times


image

Some people skip my posts as they don’t want to know that breast cancer can strike more than once. They believe that my story must be a real downer as who wouldn’t be depressed to have their cancer come back again and again and again? Others look to find differences in their stories from mine to reassure themselves that this will not happen to them. I don’t know how many people have asked me if this whole mess couldn’t have been avoided if I just had a double mastectomy with my first breast cancer at 29? Hindsight is usually 20/20 but even my oncologists aren’t convinced that would have stopped the cancer from coming back. I had new primaries, not recurrences, and it is very possible they still would have grown in my mastectomy scars. I would like to assure you my story is not all doom and gloom and there are many positive conclusions that can be drawn from my story.

I wrote at length as to why I made the treatment decisions I did in my blog post entitled. Why I Chose Not To Have A Double Mastectomy.  Basically, it was a combination of historical reasons (double mastectomies were not offered as an option in 1988 when there was cancer in only one breast), lack of the medical knowledge we have now (there was no disease called triple negative breast cancer then as the third component -herceptin – had yet to be discovered) and genetic testing did not exist until Cancer 3 and the early tests were less comprehensive than they are now. I in fact had BRCA testing in the mid-90s and was told I was negative, a “fact” I believed for the next 16 years, although I later learned I had a major BRCA1 mutation.    
                                                                    The other factor consisted of personal reasons for choosing the options I did. With no internet and no support groups for young women with breast cancer, I did not even know of young women with mastectomies, let alone double mastectomies. I was 29, then 34, and then 36 when my first 3 breast cancers struck. I was single, childless, and reconstruction surgery was not terribly advanced, and I adamantly didn’t want a mastectomy. I got one anyway at 34 when my cancer returned in the form of a new primary in the same breast that had a prior lumpectomy and radiation treatment. Mastectomy was the only option. Reconstruction was very bad and it turned me off from having a second mastectomy when cancer struck in the other breast 3 years later.

In any event, it serves no purpose to speculate if things would have turned out differently had my treatment choices been different all those years ago. I made the best decisions I could at the time in consultation with my doctors based on the state of medical knowledge at the time and my personal preferences for treatment.

To be a 4 time cancer survivor without Mets who has lived almost 27 years since the time of first diagnosis is like being a medical unicorn. There aren’t many like me around. My mother battled 4 different types of cancer in a 12 year period – breast, metastic ovarian, and 2 different types of colon cancer, the second one metastic. Other than that, I don’t know anyone else with a cancer history similar to my own. It can be a lonely feeling at times, not having any real life examples of others who have walked a similar journey. What happens next? Do I live to a ripe old age, dying for reasons unrelated to cancer? Is there going to be breast cancer 5 and if so, will this be the one that metastisizes?  Will the earlier cancers metastasize and put me into Stage 4 cancer territory? The doctors have no answers for me. So a big part of having had 4 different breast cancers is the uncertainty on the part of myself and my doctors as to what happens next.

Having cancer multiple times, plays havoc on your mind and emotions. Just when you think you are “cured” and cancer is a thing of the past, it rears its ugly head again, announcing, “I’m back…”  Having one bout of cancer is incredibly stressful to your body, mind, and spirit. Having it 4 times is downright demoralizing, with the initial thought each time that I can’t go through this yet again. But really what choice do you have? If you want a shot at living, you”ll have the surgery and take the chemo and/or radiation recommended. Having watched an aunt die from completely untreated cancer, that is not a path I’m willing to take. Unfortunately for me, experiencing the trauma of cancer over and over again, led to depression, panic attacks, and ultimately PTSD. I am finally getting the professional help I need to tackle these issues. In a culture that says breast cancer patients have to be brimming with positivity all the time, this fake front I believe contributed to my PTSD condition. Never being able to acknowledge how you really feel about going through treatment one more time, can lead to a crazy-making life.

image

Another thing that I have had to grapple with is survivor’s guilt. Why have I been able to stay Mets-free and survive 4 different aggressive triple negative breast cancers with a highly defective BRCA1 gene? Why do others get breast cancer once, have it metastasize, and die from the disease while mine functions more like a chronic disease that flares up every now and then? I have no answers to this question. No answers at all.

The flip side of survivor’s guilt is that hopefully it takes away people’s fears, at least a little bit, when the newly diagnosed hear my story. So many women come into the online Facebook groups that deal with triple negative breast cancer, already convinced they have been handed a death sentence. Others worry that they have been diagnosed with a BRCA gene and that combined with triple negative breast cancer, dooms them to a short life and an early death. I try to point out that I have had high grade triple negative cancer 4 times and have a major BRCA1 mutation and am still alive and kicking almost 27 years later. I have not been a model cancer patient by any means but I am still alive. Neither triple negative cancer nor a BRCA mutation or both necessarily mean an immediate death sentence.  I hope my story helps to reinforce this message and allows the patient reading it hope for a long future. The 4 bouts of cancer are a very rare occurrence and it is my wish that people stop fixating on the 4 times and focus on the 27 years of extended life.

Sharon Greene  January 23, 2015

Posted from WordPress for Android

Get A Tissue Or Ten *Dedicated to Sharon At 4 Times and Counting*


I found this beautiful post in my email feed and was stunned to realize it was about me. I am truly touched and overwhelmed. I am reblogging it here so I can keep it forever. The video is very inspiring as well. Thank you Looking For The Light for writing this beautiful piece for me.

Finding My New Normal After Losing My Old Normal


Iwpid-53aeeb4e69e587cd5b9d5a17633ac875.jpg

I was first diagnosed with breast cancer at 29. February,2015 will be 27 years from the time of my first diagnosis. I have spent almost half my life battling breast cancer.

“Finding your new normal” is one of those popular buzz phrases spoken by oncologists, counsellors, and other cancer survivors. I’ve always felt that this word was like a password to a secret clubhouse that everyone in Cancerland belongs to except for me. Although I know this password, I am obviously missing something that would allow me to gain entry. Maybe a special knock or a secret handshake is also required. While I can spout the phrase “new normal” without difficulty, I’ve never quite understood how those words applied to my life.

If we uttered the phrase “changes to your life” due to cancer, I could easily relate to that. I could draw up a long list of the ways my life changed with the first diagnosis,the first and second mastectomy,the bad reconstruction job,the repeated bouts of cancer,and the discovery that I lived for 16 years under the illusion I was BRCA negative when in fact I was BRCA1 positive all the time.

Maybe I have problems relating to the word “normal”. The changes that happened to my mind, body, and emotions were anything but “normal” as we usually think of the term. Losing my breasts, lymph nodes,fertility,and ovaries may be normal for BRCA positive cancer survivors and previvors but there is nothing normal about that in terms of the population at large. Being diagnosed with 3 separate breast cancers at 29, 34,and 36 is statistically improbable in the breast cancer world. Having a fourth breast cancer at 52 puts me into a rare category that very few breast cancer patients attain (or would want to attain). Top that off with all 4 cancers being of the triple negative variety (not influenced by hormones) which is a reasonably rare breast cancer, and there is very little that is normal about my world.

If we are talking about acknowledging that these things happened to me and that they form part of my present reality, I can do that. Have I fully accepted, embraced, and integrated these changes into my life in a positive and life-affirming manner? Uh no. Although I can be happy and positive much of the time, I am not happy that I had to go through these events at such a young age. I’m also not happy that I had to have my cancer come back over and over and over again. This is my life, this is my reality, this is my world but there is nothing normal about it. And there is little I can do to normalize my experiences so that they make some sort of sense in the context of the rest of my life.

I try to think back to what my old normal was. I was an only child who spent the first 12 years of her childhood growing up in a typical suburban neighborhood. My parents and I attended Baptist church every Sunday and my parents were complete tee-totalers. This “normal” existence underwent a dramatic change in 8th grade when my father went from complete tee-totaler to a full blown raging alcoholic and valium addict in the course of one year. My world was completely turned upside down and I had no idea how to deal with this “new normal”. My father’s alcoholism progressed with great speed and his moods veered between sickeningly sentimental and raging mad, with very little in between. My lifelong battle with anxiety and depression started in the 8th grade and progressively got worse throughout high school.

My mother felt the best way to protect me was to get me out of the house as soon as I graduated high school. We lived in a university town so we planned to find a major that wasn’t offered locally. We hit on Criminology as it was only available 1000 miles a way. Not the best way to plan for your future education, but it achieved its purpose and I was able to leave home at 17.

The next 12 years were the college and early employment years. I attained my BA in Criminology, gained some work experience as a probation officer, went back to university to complete law school and spent a grueling year articling (similar to interning) with a large law firm in Vancouver. I had dated widely, fallen madly in love at least twice, broken a few hearts and had mine broken in return. I never doubted that I would have a law career or that I would marry and raise a family. Those were the fun years filled with plans, hopes, and dreams about the future. After the chaos of growing up in an alcoholic home, I loved my fun filled yet hard working “new normal”.

On the eve of my entry into the legal profession, I had my first cancer diagnosis. It changed me in ways that still affect me today. The career was put on hold. The doctors said no pregnancies for 5 years or else I would die, so marriage and a family were put on hold as well. Although I only had a lumpectomy and radiation, I developed major body image issues as I knew no one even remotely in my age group who had a weird looking mismatched breast. I became shy about dating, not knowing when to break it to them that I had undergone breast cancer treatment. So dating was also put on hold. Fear,anxiety,and social unease became my constant companions after that first diagnosis and continue to haunt me today. Is this considered my first experience with cancer’s “new normal”?

I still believed that being cancer free for 5 years meant you were cured. Over that first 5 year period, I did launch my law career and began dating again. I was offered a promotion and a move to a new city hours before I went for my 5 year mammogram. I told my employer that I would be back shortly, that this mammogram was just a formality, as all prior mammograms had been clear. Unfortunately for me, this mammogram showed cancer again and a mastectomy and 9 months of chemotherapy were my only options. Good-bye promotion. Good-bye new city. And the 5 year no pregnancy rule started from scratch all over again.

I was off work for 18 months. I had lost my last illusion about being cured of cancer. Where the first cancer had brought fear and self-doubt into my life, the second cancer brought a kind of craziness. The world which I always believed was a fair and orderly place, became chaotic and events seemed completely random. Whether I lived or died seemed completely out of my control. Any plans I tried to make for my future seemed to be quashed as soon as they were made. It was clear that there were many things my oncologists did not know, many questions they could not answer. I felt a lot of confusion. It seemed that whenever fate was about to give me a big break, cancer re-entered the picture to turn my dreams to dust. Was this feeling of hopelessness and helplessness my “new normal” for my second cancer?

I had reconstruction surgery which looked bad even from the start. Even doctors and nurses at the Cancer Clinic would comment that I should see another plastic surgeon to try to fix it. My breast resembled a lumpy flattened pancake but as it had taken a long time to heal, I wasn’t eager to go under the knife again. My body image issues and self-consciousness grew considerably worse.

18 months after returning to work, a new cancer was found in the remaining breast. I had a new surgeon who said doctors had recently abandoned the 5 year pregnancy rule and that if I wanted a child, I should hurry up as I was already 36 and could have early ovarian failure due to the chemotherapy. I got married and we soon found ourselves at a fertility clinic. 2 rounds of IVF were unsuccessful so we formulated a Plan B. We started the adoption process and a year later, we had a handsome baby boy. 16 months after that, we were blessed with a beautiful baby girl.

I took one of the early BRCA tests and was declared BRCA negative. Life was good. Until one day it wasn’t. The marriage imploded, I was blindsided,and I was left as a single Mom to a 22 month old toddler and a six month old baby. Once again, my hopes and dreams were shattered and life seemed as random and arbitrary as it had during my second cancer.

The years went by, the kids kept growing, and the cancer stayed away. After 16 cancer free years, the cancer came back. I was looking at another mastectomy and more chemotherapy. Only this time around, there were children involved, ages 9 and 11. This time I really was afraid of dying as I didn’t want them to lose their mother at such young ages. The kids were scared too but wouldn’t really say so. My son wanted me to appear as normal as possible and not look like a cancer patient. He wanted me in a wig and full make-up 24/7 (didn’t happen). My daughter would feel sick with vague symptoms on chemo days or oncology visits. She wanted to accompany me to all these appointments as that seemed to make her feel more secure. It was another crazy hysterical chaotic year but we muddled through it somehow.

After cancer 4, I was encouraged to retake the BRCA test as it was now looking at things it hadn’t looked for originally. Suddenly, I was BRCA1 positive and at high risk for ovarian cancer. There was a great rush to have my ovaries and fallopian tubes removed as soon as possible.

With Cancer 4, I became a bit of a medical curiosity given that I was BRCA1 positive, had an aggressive grade of an aggressive cancer, and had survived for so long without the cancer metastasizing outside my breasts. At work,things were looked at somewhat differently. Between the cancers and the 2 adoption leaves, my coworkers saw me as someone who was rarely at work. The office atmosphere was decidedly chilly upon my return from Cancer 4. My self-esteem was plummeting, I still had side effects from chemo brain, and I started feeling incompetent in a job I had held for 25 years. A year ago, I took a medical leave and have since been diagnosed with post-traumatic stress disorder.

My “newest new normal” now has a mixed diagnosis of PTSD, depression, and anxiety. I no longer plan too far ahead for fear of jinxing any happy days that lay ahead. I worry about my children’s future – who will love them and look after them if I am gone? At the same time, I am forever grateful that I get to be their Mom. I try to live each day as if it may be my last.

Is this the “new normal” everyone talks about? Is it some combination of hard lessons learned and the feeling of walking on a trapeeze with no safety net underneath? The feeling that my luck will once again run out and I will be forced to take another spin on the Cancer Roulette Wheel of Fortune? Is it all those scary feelings combined with a fierce protective love for my children that keeps me going forward each day?

What does the “new normal” of cancer feel like to you? Have I completely missed the boat on this one? Is it supposed to be a positive thing or a negative thing? I really would like to hear your thoughts in the comments below.

Sharon Greene January 15, 2015

Making Themes Not Resolutions For 2015


image

                                                                    

Having made and promptly broken every resolution made for New Years in the  past, I’m trying something different this year. I have decided to pick 2 keywords as my themes for the year which will hopefully guide my actions in the 12 months ahead.

The words I have chosen for 2015 are “create” and “giving”.  I want to build up and not tear down. I would like to make something new, whether it is a new blog post, an article written out of my comfort zone, an e-book, or building a sense of community in my online and virtual worlds. I want to share my experiences more transparently and honestly in the hopes that even one reader will say to herself, “hey, I’m not alone feeling this way”. As I wrote in an earlier post, The Winning Ticket, I want to give back to my community, not keep taking from it. In terms of this blog, I want to create a safe place where we can exchange our stories freely, offer much needed emotional support to each other, and not worry if our stories do not resemble the”official” one of happy smiling pink-suited survivors.

As far as giving back or paying it forward, I would like to be even more candid about sharing my experiences with having triple negative breast cancer 4 Times. While I am not a doctor and can’t offer medical advice, I have almost 27 years of personal experience with this disease. I have gained a certain amount of knowledge about breast cancer and recurrences/new primaries as well as living with a BRCA1 positive gene during this time.

There was a recent post called Breast Cancer: It Is Going To Be A Bumpy Ride where I danced around the topic of whether or not I personally suffered from PTSD.  Some readers figured it out while others didn’t. Yes, I have had depression, anxiety, panic attacks and flashbacks for years but was not properly diagnosed with PTSD until 6 weeks ago. Since then, a new medication has been added to my antidepressant and anti-anxiety cocktail and I am feeling lighter than I have in years. So why did I not just come out and say that in the post? Was I so afraid of labels about my mental health that I felt a need to detach myself from this particular diagnosis?  If nothing else, I would like to turn my negative experiences into something positive that others can relate to and realize they are not alone. I have had the symptoms for PTSD for many years and now with the official diagnosis, it is finally being appropriately treated. I feel better! And that is nothing to be embarrassed or ashamed of for any cancer survivor.

I hope my themes work better than my resolutions ever did. What about you?  Are you making New Year’s resolutions or goals or themes? Why or why not? If you are comfortable doing so, please share these or any other concerns in the comments.

Have a Happy healthy joyous 2015!

image

                                                                                                                                                                                                            Together we can accomplish anything!
                                                           
   

            

image

Posted from WordPress for Android

Sharon Greene December 31, 2014

2014 in review


The WordPress.com stats helper monkeys prepared a 2014 annual report for this blog.

Here's an excerpt:

The concert hall at the Sydney Opera House holds 2,700 people. This blog was viewed about 11,000 times in 2014. If it were a concert at Sydney Opera House, it would take about 4 sold-out performances for that many people to see it.

Click here to see the complete report.

My Breast Cancer Came Back


wpid-wp-1416094864318.jpeg

I heard the whispers, words I wasn’t meant to hear. “Did you know her cancer came back?” whispered a colleague I had known for 20 years. “Is she going to die?” was the new colleague’s response. The first colleague replied, “Not likely. She just gets cancer whenever she wants time off work. She never dies.” The words cut me to the bone, leaving me hurting yet strangely numb at the same time.

There really was no need to whisper about my diagnosis at work. I never hid the fact that I had breast cancer in the past. I was surprised the gossip mill had started so soon as very few people knew I had been diagnosed with breast cancer for the fourth time. I had only just received the news myself and had told those in management I would be taking extended sick leave once again once I had a surgery date.

The comments confused me. I get cancer whenever I want time off work? Surely there are easier ways to take time off then having another mastectomy and more chemotherapy. I never die when I am diagnosed with cancer? Well that has been true so far but at that point I had not had any scans or tests to see if the cancer had spread. At that point, all I knew was the cancer was back after a 16 year reprieve since cancer number 3.

“She never dies” rang in my head the rest of the day. Do they really want me to die to prove I actually was sick? Do they not understand the physical and emotional toll breast cancer and its recurrences take on an individual? Would having a funeral make everything better for people so they could recast me as a heroic figure battling cancer to the bitter end instead of just a physically and emotionally battered woman trudging through treatment over and over again? The one thing I have learned about recurrences is that their negative effects are cumulative over time. Each recurrence is emotionally harder than the one before. Each time your recurrence is contained before it spreads throughout your body makes you feel you are living on borrowed time and that your luck will run out eventually.

The message that is repeated over and over is that once you reach the 5 year cancer free mark, you are “cured” of cancer. This may be true for many people but it is not universally true for everyone. Many people have local recurrences of cancer in the same breast where they had it the first time. They may develop new primary breast cancer in the other breast or more rarely like me, develop a new primary cancer in the same breast. The pathologists decide if it is a recurrence or a new primary cancer based on how closely the second tumour resembles the first. If the second one is markedly different than the first, or if it occurs in the other breast, it is considered a new primary breast cancer. If it is a recurrence, it is thought that surgery/radiation/chemotherapy left some cancer cells behind that grew and multiplied to form a new tumour. As long as the recurrence or new primary is confined to the breast, it cannot kill you. It is only when it spreads beyond the breast(s) or mestastisizes to another body part, that it becomes lethal. Once that happens, there is no longer any talk of curing the cancer, only treating it until the treatments stop working.

Recurrences/new primaries produce interesting responses in people. With my first breast cancer at 29, my divorced parents who hadn’t talked to each other in 8 years, rallied together and stayed with me for weeks during surgery and radiation.

When my second cancer in the same breast was diagnosed at my 5 year “cure” mammogram, my mother had died 6 months earlier and my father made many excuses why he could not make the trip a second time. This was the first cancer that happened while at work and most of my colleagues rallied around this scared 34 year old facing a mastectomy and chemotherapy. They treated me as though this was my first breast cancer. I know that the night of my mastectomy, numerous work colleagues were gathered around my hospital bed. I was groggy and in pain but was aware enough to know that they were there and they cared. In the weeks that followed, many workmates dropped off food and accompanied me to my chemotherapy appointments. I felt supported, cared for, and loved.

I felt a litle less love from the local breast cancer community. The first time around, doctors and social workers went out of their way to hook me up with other breast cancer survivors. Granted most of these women were 40 – 50 years older than me who had lived long and full lives, but I appreciated the effort. With the first cancer, I had a very proactive medical social worker who hooked me up with relaxation groups, guided meditation groups, and the only support group they had at the time for patients battling all kinds of cancer.

By the time of my second cancer, I was pretty much left on my own. No volunteers, no social worker, and I had to beg to see a real live person who had reconstruction surgery. One finally showed up the night before my mastectomy but had a completely different surgery than I was having. I had the same breast cancer surgeon as I had for the first cancer. I couldn’t help but feel he was less interested in answering my questions this time around. I guess I was one of his failures for not quite making it to the 5 year
cure mark. He just kept drumming into my head that I would have to wait an additional 5 years to get pregnant or my baby could very well be left without a Mommy. Sometimes during that experience, I felt like the medical professionals viewed me as just another Dead Woman Walking.

The cancer struck my other breast 2 years later. I had barely returned to work and then was off again for surgery and radiation. By now, I was quick to pick up the signals that something was wrong with my mammogram. The technician would call me back into the room for a few more mammograms. Then she would disappear, returning with one or more people, who would whisper among themselves. At one point, I swear a whole group of student trainees crowded into the mammogram room, looking intently at the pictures. I would say “what are you seeing?” and the original technician would tell me there was nothing to worry about, this was just routine. I’d had enough mammograms by then to know this was anything but routine. When I got the official news from a doctor a couple of days later, it wasn’t exactly an overwhelming surprise.

My Dad was too busy to come visit once ago. I had a new boyfriend who I would eventually marry (and divorce) who took good care of me. We even bought a puppy to aid in the healing process. Again, this was his first time dealing with my breast cancer so he was supportive.

By this time, my colleagues were suffering battle fatigue dealing with my illnesses. There were a few meals, a lot less visitors, and more people who felt I should bounce right back. This was my third new primary breast cancer in 7 years and I was feeling beaten down and not terribly bouncy. Cancer surgery in the late 80s and the mid 90s involved removing all the lymph nodes under the arm on the side of the cancerous breast. This procedure is not the routine anymore but at that time it was and it made even a lumpectomy a gruelling operation with an extended recovery period.

Also, each time there is a recurrence/new primary, there are a battery of scans of the liver, brain, lungs, and bones and numerous blood tests to see if the cancer has spread. Each new test is nerve wracking as you never know what may turn up. I have been very lucky so far that the cancers have been caught before they spread beyond the breast.

I noticed when I started radiation treatments after Cancer 3, the other women would be friendly while we waited our turns. If however I said this was my second time doing radiation or that this was breast cancer number 3 at age 36, the women would clutch their floral housecoats tighter around themselves and would instinctively move a little farther away from me, as if my repeated cancers were contagious.

I lucked out for the next 16 years. No cancer. I went for a routine mammogram and was called back for more pictures. The technologist told me to wait in the mammogram room while she went to check something. When she said more pictures were needed, I demanded to speak to the radiologist as I knew something was wrong. To my surprise, the radiologist did enter the mammography room. He stared at his shoes the whole conversation. He obviously didn’t talk to patients very often. He said there were calcifications on the mammograms that were highly suspicious for a malignancy. He had reviewed my prior mammograms and what he was seeing was new. I pushed him harder on what “highly suspicious” meant until he said he was almost 100% certain it was cancer again, but only a biopsy could provide the absolute truth. I was immediately sent for an ultrasound where no tumour could be found. Even after referring to the mammogram, no lump or bump could be felt. The surgeon thought this meant it was a tiny cancer caught extremely early. She was in no rush to schedule a biopsy or a surgical date.

Things started going off the rails at the biopsy. Even with the mammogram, they weren’t sure they were hitting the right spot so the needle went in over and over again. When it was confirmed to be triple negative cancer again, the scans started. My sternum lit up on the bone scan. It had been broken 4 years earlier and they couldn’t be sure if they were seeing the break or cancer. The CT scan showed a web of tiny blood clot embolisms at the bottom of my lungs. As I had a spontaneous pulmonary embolism in one lung five years before, they immediately started me on blood thinners and debated delaying the surgery. The surgery went ahead as planned and to everyone’s surprise, it was 2.7 cm in size, making it a Stage 2 cancer. The reason it couldn’t be felt was that it was deep inside, close to my chest wall. The pathologists are evenly divided as to whether this was a new primary or a recurrence that had been hiding in my body for 16 years.

By this time, my father was in a nursing home and I didn’t even tell him about the new cancer. I was a single Mom with 2 children, then aged 9 and 11. Some of my work colleagues did get together and raise money for flowers and groceries. 2 of them would visit me at least once per month while the rest kept their distance. One friend brought over her husband and brother-in-law and they and my kids did a good job housecleaning. I had a medical social worker again and she helped with getting me free rides to chemo and getting me into 2 healing touch sessions.

This month marks 3 years since I finished my last chemo. After numerous CT scans, the radiologists have concluded that the bright light on my sternum during bone scans comes from trauma not cancer. The blood clots on my lungs disappeared after 6 monthes of daily injections in my stomach with blood thinners.

Having multiple recurrences has taken a huge emotional toll on me. I no longer have faith in my body. It has betrayed me too many times. I no longer believe in an orderly universe where good things happen to good people and bad things happen to bad people. The universe seems pretty random to me. Cancer survival seems especially random to me. Every day on Facebook, I read about another woman with breast cancer who has died. Very often they are young and leave small children and a grieving partner behind. These were women who ate organic foods, ran marathons, and looked after their bodies. They did everything right and yet were struck down in the prime of their lives.

Although I have had a double mastectomy, there is no guarantee I won’t get another recurrence/new primary breast cancer again. No matter how close they cut, it is impossible to remove every single breast cancer cell during surgery. I could probably summon the emotional strength to battle a recurrence/new primary for the fifth time, if only for the sake of watching my children grow up. But what worries me is that I have been playing Russian Roulette with breast cancer for 26 years now. I have been wounded but am still sitting at the table, waiting for my turn to press the gun to my head. How many times can you stare death in the eye and walk away still alive? One of these times, a new recurrence/new primary won’t be caught and treated in time. Or like 30% of women initially diagnosed with Stage 1-3 breast cancer, there will be no recurrence, just the dreaded metastasis to brain, bone, lungs, or liver from cancer cells still lurking in my body even after the last surgery and chemotherapy.

I read in so many forums how women are terrified of having a recurrence. Please remember if it is local to the breast, it can be treated and life will go on. It is metastasis that you need to worry about as for that there is no cure.

Have you had a recurrence/new primary since your initial treatment? Did you have early stage cancer that you thought was cured but it metastisized elsewhere? Please share your experiences in the comments below.

Am I Doing Breast Cancer Right?


I have been reading about breast cancer prevention and cures since my mother was diagnosed with the disease in 1980. I picked up the pace with my own first diagnosis in 1988. Some “facts” and some trends have come and gone while others are repackaged with new names 20 years later. If you believed and tried to follow all the advice floating around the internet, you would soon drive yourself crazy. Even the experts get it wrong sometimes.

In the 70’s to the mid 80’s, the alternative cure of the day was laetrile, a compound made from apricot pits. People travelled to Mexico for this wonder cure that wasn’t available in Canada or the US. It went out of fashion as it didn’t seem to actually cure anyone and led to their early death if they were not using traditional medicine alongside it.

The next big wave of prevention and cure methods focused on the mind. Guided visualization was the rage in the late 80’s and early 90’s. Basically it was a type of meditation where you listened to a tape that encouraged you to picture your cancer as weak disorganized blobs while the strong army of chemotherapy warriors came down and slaughtered them all. The premise was that your mind could cure your cancer through these vivid images. Unfortunately for me, these images were anything but calming and empowering. I began having nightmares of raging armies chasing after me, trying to kill me. I stopped going to these “healing” sessions and felt much better for it. This was cancer failure number 1. I was a guided visualization student drop-out.

The other component to preventing or curing cancer with your mind was developing a uniformly positive attitude towards life. There was some research being cited that said optimistic cancer patients lived longer and had less recurrences and metastisies than pessimistic patients. Further research has not been able to duplicate those results.  It is now thought that a positive outlook may increase your quality of life but it won’t prevent further disease or lengthen your stay here on Earth. But at the time of my
first cancer in 1988, the positive thinking rule was firmly in place.

I wasn’t a uniformly positive person.  I was sad, angry, scared, confused and frustrated with both the disease and the effects it had on my life. Hearing that I had to remain positive at all costs did nothing but add another layer of guilt to my emotions when I found I did not always feel happy.  Now I was suddenly responsible for causing my cancer in the first place by thinking negative thoughts and would be responsible for any recurrences or metastasis that later arose.  I did not find that knowledge particularly empowering or encouraging.  That was cancer failure number 2, being more of an Anxious Annie than a Perky Penny.

My mother battled 4 types of cancer in 12 years and managed to remain optimistic under the most dire of  circumstances. She died after that 12 year battle, still visualizing until the end.  I thought that if the most positive person I have ever known could get 4 different cancers and die from the disease, what hope is there for someone like me? But at the same time, I started to get the nagging feeling that maybe, just maybe, it was the theory that was wrong and that the experts didn’t always know as much as they thought they did.

I tested this theory on my breast cancer surgeon. He had told me at age 29 (first cancer) and 34 (second cancer found at my 5 year “cure” appointment), that I would have to wait 5 years to get pregnant from the time of each new diagnosis. I asked him why this was given that my cancers were not affected by hormones. He did not give me a scientific answer but he did get me to stop asking him the question. His less than tactful answer was that if I got pregnant now, “Baby may not have a Mommy in 5 years time”. Somewhere in the back of my mind I realized that he didn’t really have an answer to the specific question I posed. His answer told me science knew very little about 29 year old or 34 year old women with hormone negative breast cancer. That made sense as most breast cancer patients are diagnosed with the disease at a much older age when pregnancy isn’t an issue and their cancers are more likely to be hormone positive. That realization was freeing as it taught me to at least question the expert advice I had been given, to do my own research, to ask tough questions, and to make my own decisions. Now that was empowering knowledge!

My suspicions about my surgeon’s lack of answers to the pregnancy question were confirmed 2 years later with cancer number 3. I had a new surgeon and posed the pregnancy question to her.  She said that doctors no longer applied the 5 year pregnancy rule. She said I was 36, had 9 months of chemotherapy, and would likely have early ovarian failure and early menopause. She said if I wanted to get pregnant, I had better do it now before it was too late. Shortly afterwards my then-husband and I found ourselves in a local fertility clinic that had never dealt with women with a past history of breast cancer before. They consulted with my Cancer Clinic about the advisability of my taking fertility hormones. The initial response from the Cancer Clinic was they had never dealt with this situation before and they would have to consult with other oncologists in other areas of the country. The end result was that I had 2 courses of IVF treatment but I didn’t get pregnant. At least I got to try and it all worked out in the end with the adoption of 2 children. Even more importantly, the mega doses of hormones I took during each IVF treatment did not kill me as my first surgeon seemed to think pregnancy hormones would do. Medical science does not know everything. You have to do your own research and make the decisions that are right for you, even if they are not popular at the time.

I have had many more cancer fails over the years. I don’t identify much with what the media seems to portray as the ideal breast cancer survivor. You know the one dressed in pink who talks about how breast cancer changed her life for the better, how treatment was just a small dip in her otherwise perfect life, and how she is now happy, happy, happy that all that bad stuff is behind her because SHE BEAT CANCER. While this may accurately represent some survivors’ realities, it doesn’t represent mine.

I was frightened at each diagnosis. I found surgery painful, radiation exhausting, and chemotherapy nauseating. I haven’t beaten cancer although I hit the 5 year “cure” mark with cancers 1 and 3 only to have it return again. I won’t have beaten breast cancer until I die from some other cause. I worry about leaving my children behind at too young of an age as my mother left me. Cancer failure number 3 – cancer was not the best thing that ever happened to me. And once again, I am not Happy, Happy, Happy all the time. It is the think positive movement all over again, except this time it is wearing a pink track suit and is “running for the cure”.

Many of these examples I have given were from the pre-internet days where you were exposed to a limited number of medical opinions from the Drs. you dealt with and the books or magazine articles you read. Now with a few minutes of googling, you can find a mountain of research and websites giving information on everything from miracle cures by diet and supplements, to using the law of attraction to bring you good health, to the latest advances in medical technology, and to lists of all the clinical trials across the world.

Trends in cancer prevention and cure come and go in the blink of an eye. One day we are supposed to take shark cartilage supplements because sharks don’t get cancer and the next day we are told that logic is just bad science. Last year seemed to be all about not letting your water bottles get warm in the sun and not wearing a cell phone in your bra. This year, it’s all about avoiding sugar, alcohol, and dairy products. When I was first diagnosed with breast cancer, lumpectomy with radiation was the popular treatment of the day. Now the tide has turned and double mastectomy is all the rage. The guided visualization sessions of the 80’s and 90’s are now mindful meditation groups. The more things change, the more they stay the same.

Are you doing breast cancer right?
Is there even a right way to do breast cancer? With so much information available about advances in traditional medicine and on the other side, complementary or alternative treatments, how can a person know what is the right thing to do?  I don’t pretend to have all the answers, but these are some suggestions for sorting the good ideas from the bad.

First, get a copy of all the records and reports that relate to your cancer. The pathology reports will provide information about the kind of tumour you have, it’s hormone status, it’s size, it’s grade and it’s stage. As the treatment varies depending on the kind of breast cancer you have and the stage it was detected at, you need this information to do any meaningful research on your particular cancer. If there are terms in the pathology report you don’t understand, an online medical dictionary is only a click away.

Secondly, ask your doctor lots of questions, even the ones you think are too dumb to say out loud. Write your questions out in advance so you don’t forget to ask something important. Bring a friend, a notebook and a pen, or a tape recorder as you may forget the information you receive, especially if it is in the early days of a cancer diagnosis when you are already feeling overwhelmed.

If you are interested in complementary holistic treatments, ask your doctor if there are any that are available to you at your hospital or clinic. If you are taking holistic supplements, tell your oncologist as some types can interfere with traditional treatments, especially chemotherapy. Contrary to popular belief, there are many oncologists who will support the use of some forms of complementary treatments.  On the other hand, you probably will not find a medical doctor who supports you taking a completely alternative approach instead of one of the traditional forms of medical treatment. Think of Steve Jobs and Farrah Fawcett, two celebrities who tried to cure their cancer in non-traditional ways. What else do they have in common besides their cancer and their celebrity status? They are both dead. Medical science may not have all the answers but it does have ways to prolong life and halt the progression of this deadly disease, at least for awhile.

Third, when doing research, consider the source you are consulting to see if it is reliable and respected. Medical research should be based on controlled scientific studies that can be duplicated by others who will get the same results. “Research” that consists solely of testimonials and celebrity endorsements is not research at all but is usually a scam to get your money. Also be wary of bold statements made in the popular press saying that scientists found this substance causes cancer or that scientists have found using this substance will cure cancer. These headlines are often misleading as the actual studies may have been done on mice or rats and human trials, if they ever get that far, are a decade or more away.

Finally, I would suggest you join a support group, especially a large online one, to pose questions and learn the different approaches being taken across the continent by others living with the same kind of cancer as you. A support group is a great place to find people who can answer your questions of what chemotherapy or radiation are really like from a patient’s perspective rather than from a doctor’s point of view. It is the kind of place where others understand your fears and concerns, having lived them too. It can be a great place for emotional support on the bad days and for congratulations on the good days when you have cleared a treatment hurdle or reached a milestone of any kind.

I no longer think there is a right way or a wrong way to live with, prevent, or treat breast cancer. There are many decisions to be made at every step along the way. You sometimes choose treatments you don’t really want to do because they will prolong your life a little or a lot, but not every decision is of the life and death variety. As so much cancer advice has a very short shelf life, it is really not necessary to jump on every new band wagon that rolls into town. Until science has more definite answers as to why 40% of us die from breast cancer while the other 60% of us do not, follow the tips that make sense to you and leave the rest behind. They will all be forgotten anyway when the next hot tip of the day comes around.

Sharon Greene November 11, 2014

Posted from WordPress for Android

Why I Chose Not to Have a Double Mastectomy


Ok, I’ll admit that the title of this article is slightly misleading. But only slightly. I now have a double mastectomy but it took 22 years from first diagnosis and 4 bouts of breast cancer to get there. I never did choose a double mastectomy. It just kind of happened when I had exhausted all other treatment options.

When people hear that I am a 4 time survivor, they shake their heads and wonder why I didn’t have a double mastectomy when I was first diagnosed with cancer. The reasons for the decisions I made were partly historical, partly personal choice, and partly based on the medical advice I received at the time.

Historical and Medical Reasons

My first diagnosis of breast cancer was in 1988. This was at a time where women’s health advocates had been fighting for years to provide women with breast conserving options after many decades of the standard treatment being the Halstead radical mastectomy. This operation bears little resemblance to today’s mastectomies as all the chest muscles and structure were removed along with the breast, leaving a large hollow on that side of the chest. By all accounts, this was a horribly disfiguring surgery that almost guaranteed the patient life long problems with the arm on the side where the breast had been removed. The 1980’s brought in a new surgery – the lumpectomy – which removed the tumour and a wide area around it which allowed women to keep part or most of their breast, depending on the size of the tumour and the size of the breast. The removal of a big tumour in a small breast would be much more disfiguring than the removal of a small tumour in a big breast. Lumpectomy combined with 6 weeks of radiation treatment was found to have comparable results for mortality and reoccurrence as a full mastectomy (removal of breast with chest muscles left intact). These same statistics hold true today, except for women like me who have a genetically based cancer. The prevailing mood of the times was that the lumpectomy and radiation regime was a huge step forward for women taking back control of their bodies from the male dominated medical profession.

The knowledge base in the 1980’s was much more limited than it is today. Today we recognize at least 5 major types of cancer: lobular, inflammatory, hormone positive, herceptin positive, and triple negative, the type that I have. In 1988, herceptin had not been discovered and without knowledge of its existence, there was no category for triple negative cancer as the triple means the cancer is not fueled by the hormones estrogen and progesterone nor by herceptin. It is now often said that triple negative cancer is the most aggressive cancer but in 1988, all that could be said was that my cancer was not caused by hormones. We now know that the prescence of triple negative cancer in a young person often leads to the conclusion that the cancer is hereditary in nature. I was diagnosed at 29. The average age for breast cancer patients is 55-60.                
             
There was no genetic testing for breast cancer as there is today. There was the knowledge that having a family history of the disease was a risk factor but there was as yet no proof that some cancers were due to a genetic mutation in the BRCA1 or BRCA2 genes. A family history was just one of many risk factors that could make a person more likely to get breast cancer, no more or less significant than failing to have a pregnancy before 20, failing to have breast fed a baby, or having an early start to menstruation. I had all of these factors working against me so while the doctors noted my young age as being unusual for this disease, the combination of all my risk factors provided some explanation. My young age in itself did not set off any warning bells as it would today.

I was given the option of either a single mastectomy or a lumpectomy with radiation. No one would have even considered suggesting a double mastectomy as the other breast was seemingly healthy. Why cut off a perfectly healthy body part in a 29 year old woman? It was pretty much assumed by the doctors that I would go the lumpectomy route as I was a young unmarried woman with no significant other and no children. I did agree to meet with a plastic surgeon to see how they could reconstruct my breast if I chose a single mastectomy. Let’s just say reconstruction surgery has progressed tremendously in the last 25 years. Looking through the book of photos that the plastic surgeon proudly showed me,  I was appalled and horrified at the results. Thanks but no thanks! I”ll have the lumpectomy if you don’t mind. Doctors, family, and friends all assured me I’d made the right decision.

I stayed healthy and was cancer free until I went in for my 5 year check-up. I always thought that if you made it to 5 years, your cancer was cured. Unfortunately, another lump was found in the same breast. Lumpectomy was no longer an option as you can only have radiation treatment on the same breast once. My only option this time was a mastectomy and 9 months of chemotherapy. I was 34 when I had a mastectomy on my left breast. The pathology report again said I had hormone negative cancer but it was much more aggressive than the first tumour had been. The pathogists concluded that this wasn’t a recurrence of the first cancer but was a brand new primary cancer. I was told that even if I’d had a mastectomy at 29, I still would have gotten cancer again 5 years later. Again, no one suggested a double mastectomy as triple negative cancer still hadn’t been discovered and genetic testing wasn’t available.

Two years later at 36, a mammogram of my right breast showed a tiny cancer that was too small to be felt. Having breast cancer 3 times in 7 years at my age was highly unusual but my family doctor was the only one to push me towards a second mastectomy. Genetic testing was now just becoming available so I agreed to having a lumpectomy immediately and would have a second operation for a mastectomy if I was found to have a genetic cancer. The type of genetic testing that was available at the time only looked for the wrong “lettering” in the parts of the BRCA 1 and 2 genes that had been decoded to date. In other words, if the code was supposed to be ” “abcd” and your code read “abcf”, the test would catch it and would compare your code with others with the same lettering to see if it had been linked with breast cancer. They did find one wrong letter in my coding but it was of “unknown significance” (and still is 18 years later) as there weren’t enough people with this particular variation to determine if it was associated with breast cancer or not. I was basically told that unless I heard otherwise, to assume I did not have a hereditary cancer. The doctors called it a new primary cancer as it was in the other breast but assured me that as it was caught so early, the likelihood of recurrence or metastisis was miniscule.   (We now know that early detection doesn’t always work that way and many people do have recurrences and metastasis even when caught at such an early stage). So the breast stayed after a lumpectomy and another 6 week stint of radiation.

I was cancer free for the next 16 years, only going for yearly mammograms. I felt pretty damn safe after all that time. Cancer was a thing of the past, something I had seemingly outgrown. But in 2011, the mammogram
picked up some calcifications in my right breast that were highly suspicious for cancer. I had my second mastectomy in 2011 followed by a different type of chemotherapy than I had when I was 34. It was at this time that I learned I was having my fourth battle with triple negative cancer. The pathologists had retested the old tumours to come up with this finding. They saw that each cancer was progressively more aggressive than the one before. The pathologists are divided as to whether this was my fourth new primary cancer or if this was a recurrence with the previous cancer cells hiding and evolving in my body for 16 years. I was urged to be genetically retested as the tests could now also look for things other than rearrangement of the coding letters. The retest showed that I was missing a large portion of genetic material at the end of my BRCA1 gene. The genetic counsellor described it as being like a book with the last 4 chapters ripped out. It took 22 years to learn I had genetic triple negative breast cancer. The deletion in my BRCA1 gene also put me at a high risk of getting ovarian cancer so after chemotherapy was over, I had my ovaries and tubes removed as a preventive measure. Just as having a mastectomy does not guarantee you won’t get breast cancer again either in the scar tissue or metastisized to some other organ, ovary removal does not mean you can’t get cancer where your ovaries used to be. But I’m keeping my fingers crossed that 4 bouts of cancer are enough for one person!

Personal Reasons

My first three cancers occurred in my 20’s and 30’s. While there were support groups available, I never met anyone who was even remotely close to me in age. I thought I was the only one my age going through this. I was single, trying to re-enter the dating market, and couldn’t imagine doing so without a breast. (After all, who wants to date the only 29 year old woman in the world without a breast?) The reconstruction pictures I saw at 29 were frightening and the actual reconstruction I got at 34 was even worse. I was not anxious to do the whole thing over again at 36 when it was such a tiny cancer that had been caught early. And by 36, I had done my due diligence, gone for genetic testing, and had been cleared for hereditary cancer. Coupled with that, my mother had a lumpectomy without radiation in 1980 and her breast cancer never came back. By the time of my first cancer diagnosis, she had not only survived breast cancer, but she had also battled ovarian cancer 3 years earlier. By the time of my second cancer, she was dead from her second bout of colon cancer but her breast cancer never came back.

Call me vain and shallow for wanting to keep my breasts as long as I could. That’s okay. It was a different world then. Breast cancer was still stigmatized, I was insecure, I was scared, and I had no idea my genetic make-up predisposed me to having cancer after cancer. My present oncologist believes I still would have had multiple breast cancers even if I had double mastectomies back in 1988 as like my mother, I get new primaries not recurrences.

I try to imagine what I would have done had medical science been more advanced, had complete genetic testing been available, and had I been living in a world of online support groups for young women. A world like today where breast cancer is fully mainstream and there is a whole month of the year dedicated to raising awareness of the disease. Would I have done things differently? Maybe, but I don’t know for sure. Even if all my choices were wrong, breast cancer is such a crap shoot that I find myself still alive and kicking 25 years later while so many others who did everything right are dead. Breast cancer isn’t just or fair. I carry my fair share of survivor’s guilt but that is a topic for a whole other post.

Sharon Greene November 5, 2014

Posted from WordPress for Android