A breast cancer survivor shares her experiences with the BRCA gene.

Friday, December 11, 2009

A Lesson on Healing

Today, I ventured out for my first official errand since surgery...a trip to the farmer's market.  The market is a real treat since it carries all sorts of organic produce, wild Alaskan salmon, exotic spices and freshly baked breads, among other things.

Following doctor's orders to "ease back into things" and the "no lifting over 10 pounds" rule, my goal was to make a quick trip, buy only a few items and return home safe and sound.

Walking into the market was like entering a Christmas wonderland.  Colors and textures and aromas.  Oh, my!  Flaming red beets and orange turban squash and purple potatoes and rich green brussel sprouts.

Yes, I stayed too long, bought too much and wore myself out.  And, I discovered an interesting fact:  healthy food weighs a lot.

The Way of Love

In his book, The Five Love Languages, Gary Chapman spells out the different ways we express and want to receive love: Words of Affirmation (You're wonderful!), Quality Time (Up for a drive in the country?), Physical Touch (Well, yeah...), Receiving Gifts (Americans specialize in this)...and Acts of Service.

Although we can appreciate each of these expressions, there tends to be one that speaks to us most, in which we deeply feel loved. Unfortunately for my husband, I feel most loved by Acts of Service.  If only I could be bought off with a ring.  But, no, I prefer him hauling barrels of compost to my garden beds each spring, which he loathes.

I bring this up because during the cancer treatment process--or, I should say ordeal--people have been amazing in showering me with love.  I've received cards and books and warm pajamas.  I've been sent dozens of cards with touching sentiments.  People have told me how special I am and how I've impacted their lives.  All of these things have greatly moved me.

In addition to these gifts, the Acts of Service have carried me through the most difficult times, and I can't emphasize enough how vital it is to have people lend a hand -- and be able to accept their generosity graciously. 

I've pretty much been on the giving end of the equation, in which I was control, I was the strong one, I was capable.  I suspect this is true for most breast cancer patients.

Being on the other side, in which I was the vulnerable one, the weak one, the dependent one...well, that was hard to accept.  And a lot of that has to do with pride. It's hard to admit to yourself that you're not the all powerful, invincible super-woman you thought. You're mortal like the rest.

Once again, during this last surgery, I had friends who took the time, trouble and effort to sit at the hospital during surgery, drive me places, bring me homemade soup, walk my dog, run my errands...lend a hand anyway they could. Of course, my husband and my parents were there for me along the way.  But having friends to give them some relief was an enormous gift. They are the super-women.

Throughout my experience with cancer, I've learned many things, but one of the most crucial lessons is this: you simply can't get through cancer without the love of others.

Thursday, December 10, 2009

Reconstruction, Rebuilding, Rebooting

It's over!  I went through my final surgery and have been resting and healing this past week. 

Looking back over this process, I ask myself--based on what I know now -- was reconstruction worth it?  For the most part, I would say yes.

I love the results of what my surgeon did.  I think about how terrified I was upon hearing the words, "double mastectomy."  All I could envision was being butchered.  I never would have dreamed I could go through this and end up with a body that, frankly, I liked better than when I began.

However, I would tell anyone who is considering reconstruction that you have to be physically and emotionally up to it, because it's a long haul, requiring a lot of work and patience. 

I've been frustrated in having to accept my limitations.  I've been exhausted, not having the same stamina as I did before. I've had to dedicate long hours to rebuilding muscle that was cut.  My abdominal muscles swell when I put too much pressure on that area, which can make clothes extremely uncomfortable.  And when I'm stretching or doing some sort of exercise, my muscles can cramp, which is painful. You have to think of it like rebuilding Dresden...one stone at a time.   

It's far more involved than you realize going into it.  But worth it?  Yes, you could say that.  But, I understand now why some women don't choose the reconstruction route.  It's hard.  There's no right answer, but what feels right to you.

So, now that surgery is behind me, I will be taking it easy over the next six weeks -- no strenuous activity -- and then back to exercise...and then tattooing.  The fun never ends.

Sunday, December 6, 2009

The Mammogram Debate

The latest news being hotly debated is about moving the recommended age of women to begin mammograms from 40 to 50.  

I know statistics show that for the most part, it's not as necessary until women reach their fifties (and there are those cynics who think radiologists are fighting this because it would affect their income).

While I'm no medical expert, but from a survivor's point of view--and one who was diagnosed at 41--it concerns me since cancer grows faster in younger women due to their higher levels of estrogen. So, the earlier cancer is diagnosed in younger women, the better to catch it before it spreads.

It also seems like there are more and more younger women (pre-menopause) who are being diagnosed with the disease.  Statistics don't back me up on this, I know -- rather, it's only from my personal experience.  But almost every woman I know who has -- or had --breast cancer, was diagnosed before 50.  Maybe I'm just hanging out with the wrong crowd.

Hopefully, this issue will be discussed and debated more before they raise the age for a mammogram to be covered by insurance. We don't  need one more thing to discourage women from screening for cancer.

Saturday, December 5, 2009

Don't Worry, Be Happy

As a breast cancer survivor and BRCA-gene carrier, I appreciate Barbara Ehrenreich for acknowledging the “Think Positive!” attitude pervasive in the cancer world.

Although most people were exceptional when I went through chemotherapy, there were also well-meaning, but misguided, “positive energy” advisers. The “Be happy and you’ll be cured” superstition is all too common in cancer dialogue, which doesn’t allow space for patients to truly grieve or acknowledge their fear, pain and anger.

Thank goodness for support groups that allow people to be real in the mist of the unknown.

Friday, December 4, 2009

Speaking of Hair...

With all this focus on the cosmetic side of reconstruction, a girl can't go too long without bringing up the number 1 topic when it comes to our appearance...hair, of course.  

This past year, when gray strands started comingling with my brown ones, I decided it was time to stop the henna and take on serious coloring. However, permanent and semi-permanent hair dyes converted my hair's texture into straw, with strands floating above my head despite every product I tried to control it. 

Finally, a coworker put me in touch with a stylist who was a breast cancer survivor and used only non-toxic, organic products. I immediately made an appointment and discovered EcoColors hair color. 

Voila! The color is rich and natural and my hair's texture is soft and glossy. And, I feel better knowing I'm not infusing my scalp with toxic dyes.  Ask your stylist to try them.

Friday, November 20, 2009

Soliciting Surgery Opinions

I continue to seek opinions as to whether or not to have this minor surgery, and it's split half "do" and half "don't." 

Today, I received this advice from my friend, Anne, who is always wise and witty --

"Sounds like you’ve gotten lots of advice, so what if I add my 2 cents. Here’s my only question—does how it look or feel bother you? Honest answer (not to me, to yourself.). If it does at all, don’t try to talk yourself into thinking you’ll rise above it and get over it. You won’t. You’re too vain. (Remember, you drive all the way outside the perimeter to get facials.) And it’s only going to get more timely and costly for all our improvement/ maintenance items as we age…So, unless it HONESTLY doesn’t bother you, I’d go ahead and do it."

I was fine about not having surgery until she brought up my vanity.  Now, I may have to reconsider.  

Tuesday, November 17, 2009

Third Time's a Charm?

To cut, or not to cut. That is the question.

After last year's odyssey of reconstruction surgery, I am faced with the option of a final phase. Because I had radiation during cancer treatment years ago, one breast healed differently than the other.  That was to be expected, I was told. 

The difference in size and shape is not significant, nor is it painful.  It's just somewhat irritating and there is noticeable scar tissue.

Of course, my surgeon is all for another surgery to "tweak" everything and make me perfect.  Ah, to be perfect...such a temptation!

It may be "minor to him," since it's outpatient and the procedure takes only 30 minutes. But anytime I go under the knife and it involves general anesthesia -- not to mention needles, bloodwork, EKGs, drugs, the risk of infection and those nasty drains -- it's major to me. 

If they told me that I had cancer again, I'd go rushing to my surgeon's office in a flash.  But, it's cosmetic.  Non-life-threatening. Optional.

Do I really want to subject my body to more anesthesia and cutting and discomfort and healing time?  I've been committed all year long to exercise classes to build up muscle strength and flexibility that were lost during my surgery last year.

Surgery requires you to lay off intense exercise -- only walking -- for 6 weeks afterwards.  Don't know that I want to stop my workouts after I've made such progress. 

I've asked everyone's opion (short of the people I pass on the street).  Surgery or not?  My husband says no, that I look great and have been through enough surgery to last a lifetime.  Amen to that.  Mom votes yes, since I'm still relatively young and have health insurance.  I might change my mind down the road and then I'll be older (riskier) and may not have insurance coverage.  My friend, a former plastic surgery nurse, agrees with my husband that my body has been through enough.  Other friends have said to do it and get it over with so I won't have to worry about it any more.

This is what I lie awake at night and think about. But I don't have that many nights left since my surgery is scheduled in two weeks.  So, to keep my date with the surgeon or cancel. That is the question.  Then, there's the possibity of perfection...

Tuesday, October 20, 2009

The Thrill of It All

I see no need to ever ride a roller coaster again. Nor try bungy-jumping, skydiving or rappelling. No extreme sport can equal the death-defying thrill of being a cancer survivor.

UP...you have cancer...DOWN...treatment arrested it...UP...you have the BRCA gene...DOWN...surgery will prevent reccurence...UP...there's a questionable area on your MRI scan...DOWN...the followup MRI shows no cancer growth...UP...your blood test shows elevated markers...DOWN...your blood test is normal again.

It's the roller coaster hell of WHAT IF? that happens with every checkup, every blood test and every scan. 

Having to face the inevitable can be Good...you take nothing for granted and, hopefully, live each day to its fullest...and Bad...you worry that your life may be cut off sooner than later. 

After all the up's and down's of my ride with cancer, and I'd like to take a breather for a while.  Yesterday, I found out my markers were within normal range again.  Hurrah!  When I received the good news at the doctor's office, I broke down and cried. 

Waiting over a week for results of my latest blood test put me on edge.  Okay, over the edge.  On the surface, I thought I was doing fine, but my husband and parents noticed I was even more wired than normal.  Which says a lot, since I'm Type-A. 

I didn't tell them for the better part of a week, but finally relented when I kept snapping at everyone over the weekend.  Mom told me that harboring all this anxiety and not sharing my fears with others only makes it worse.  Talking about it with a few safe people can help get me through rough emotional times like these. 

Agreed.  But, the question is, do you drag your loved ones onto the roller coaster with you since it's a continual ride for the rest of your life?  This has been my dilema since being first diagnosed.  Why put my husband and parents through unnecessary worrying?

On the other hand, does "protecting them" by not allowing them to live through this experience really help them and me?

I don't know.  And until I resolve this issue, I can't promise that I'll handle it differently the next time.

Friday, October 9, 2009

The Quest for Less Stress

I hate when someone tells me not to be stressed or I'll get cancer.  That sends me over the edge, since they're saying that if cancer returns, then I'm to blame.  Just what a cancer survivor needs -- Guilt.  And saying that to a Type-A, high-strung personality is pretty much telling me to change who I am.  Or change my life.

To eliminate stress in my life, I would need to (1.) quit my job, (2.) end my friendships, (3.) ignore my husband and family, (4.) stop driving altogether, (5.) cancel my New York Times subscription, (6.) stay in bed all day. Essentially, quit living. 

Then, I get a call from my oncologist who tells me that I have elevated "markers" (indicating a possibility of cancer cell growth) from my visit a week ago...and you tell me NOT to be STRESSED?!

I ask you: What NORMAL human being wouldn't be stressed by all that?  We all live crazy lives and then ADD CANCER to the mix and, PRESTO!, you have my life.

So, off I went to the oncologist's office yesterday for more lab work (big needle in little veins drawing lots of blood).  

And now, the waiting game begins.  One week until I find out the results.  And you tell me to not be stressed.

Tuesday, September 1, 2009

Surgeons Lie

In case I haven't told you this before, surgeons lie.

It's true. They minimize the pain and emphasize the fabulous end result. And leave out a few details.

My first breast surgeon told me the scar would be so tiny that I could walk buck naked down the French Riviera and no one would suspect I had a lumpectomy. He was wrong, of course...not that being naked on the Riviera was ever a goal of mine.

The surgeon who performed my hysterectomy told me that "it was his best cut ever." Wrong again. I've sliced raw chuck roast at a better angle. He should have taken the knife skills cooking class with me.

My reconstruction surgeon said my "new" stomach would be flat as the wall. Maybe. I'll let you know after I complete 15 years of boot camp.

I guess surgeons think that if they appeal to your vanity, you'll gladly go under the knife. Frankly, saving my life was incentive enough for me. They could skip the false promises. But apparently they didn't trust I'd be that level-headed.

So, I'm here to tell you BRCA carriers: Get the surgery. Go under the knife. And know that you're taking the right step in helping prevent cancer's appearance or reccurence. But don't bank on being naked on the French Riviera.

Saturday, August 15, 2009

Beauty & the Beast of Breast Cancer

In today’s celebrity-obsessed culture, women are pummeled with the message that to be loved and happy, they must possess beauty and physical perfection.

It’s hard enough for the average person not to succumb to this pressure, but how much more for women battling cancer.

Breast cancer treatment can assault a woman's femininity, sexuality and attractiveness.

I asked my friend, Virginia Apperson, how to deal with this. I figured she was the best person to turn to since she's a Jungian psychoanalyst and author of the book, “The Presence of the Feminine in Film."

“We’re a superficial culture that sets certain requirements as to what is beautiful—especially for women—and if we don’t fall into these standards, we don’t feel like we have value,” she said.

"But the irony is that it’s out of suffering and illness that we deepen ourselves and discover aspects of ourselves that are more genuine than striving for outer perfection."

The reality is, there’s nothing pretty or easy about cancer treatment. However, in the midst of it, there are choices as to how to endure, she pointed out.

Virginia said you pretty much have to put on blinders and 'start living in another ‘universe’ (how Jungian). In other words, find a place where not being perfect is acceptable.

"Surround yourself with others who can commiserate with your issues, and can acknowledge what you’re going through and grieve with you," she advised. That can be found with friends, support groups, or with a therapist or a pastor.

She also suggested expressing your feelings in "physical form"-- as she put it-- through writing or art.

“We’ve so sanitized our world and been told not to have bad feelings. But, the hope is, if you confront the despair and express it, it ceases to have power over you.”

Instead, she said, it could give you a deeper understanding of who you are and what's important to you.

Another tip - avoid magazines and TV programs that emphasize beauty and glamor. There's nothing worse than picking up a copy of Vogue with a cover of an emaciated teenager airbrushed to perfection.

Virginia encourages women to seek inspiration from role models in literature and film "who allow their inner self to be valued"--"characters who have the fierceness to say, ‘I’m not playing along!’ "

A good example is the movie, "Cold Mountain." Ruby -- who is plainly in need of a makeover--displays "a life force that’s unstoppable,” as Virginia describes it. Ruby is paired with Ada, who although is beautiful, finds that beauty won't keep her alive. Ada learns how to be strong through Ruby and Ruby learns how to dress better through Ada, which all leads to a somewhat happy ending.

So toss out your latest copy of People and watch an old Betty Davis movie instead. After all, Betty was not the beauty that many starlets of her time were, but she outshone and outlasted them all.

Friday, August 14, 2009

Breast Cancer Makes You Fat

It's bad enough one has to suffer through cancer, but to add insult to injury, it can make you fat.

Jill Binkley, a physical therapist and breast cancer survivor, explains why.

Jill founded TurningPoint Women's Healthcare (http://www.myturningpoint.org/), a comprehensive rehabilitation program for breast cancer patients. It provides physical and massage therapy, as well as nutrition and exercise counseling.

“About 60 percent of women with breast cancer gain weight, which most women don’t expect…in fact, they assume they’ll lose weight,” she says.

But, due to metabolic and chemical changes from chemotherapy--plus, menopause kicking in -- the scale tips toward the upward direction for most women. Add a sizable dose of steroids to help the medicine go down and you're looking at a new dress size (or two).

A solid nutritional plan and regular exercise program -- 40 minutes per day 4-5 days per week--can help stave off unwanted pounds.

This is not only good for your wardrobe, but for your health as well--since weight gain is a risk factor for developing lymphedema and cancer recurrence.

Wednesday, August 12, 2009

Dragon Boat

I obviously need to get out more. I had never heard of a dragon boat, much less dragon boat racing. But to my surprise, it's quite the rage, especially among breast cancer survivors.

Rowing, in general, is the perfect exercise for the area that's been marred and scarred by surgery since it builds and strengthens chest-arm-back muscles. In addition to fitness, the dragon boat brings survivors together for fun, camaraderie and an enhanced body image.

Besides rowing for fitness, dragon boat teams participate in races to raise money for breast cancer research. So grab an oar, smear on some sunscreen and hit the water. It could benefit your life and others. (www.myturningpoint.org/DragonBoatAtlanta).

Benefits of PT and MT

I recently discovered a new organization aimed at helping breast cancer survivors recover from treatment.

TurningPoint Women's Healthcare (http://www.myturningpoint.org/) is a comprehensive rehabilitation program that offers physical therapy, massage therapy, exercise and nutritional advice and professional counseling.

It was founded by Jill Binkley, based on her experience as a professional physical therapist and breast cancer survivor.
“Anyone recovering from knee surgery is automatically sent to rehab afterwards,, but this isn't the case for breast cancer patients,” she says.

Binkley cites numerous problems resulting from breast cancer treatment, including limited range of motion, lack of strength and flexibility, and pain caused by scarring and swelling of tissues.

“Anywhere from 30 to 50 percent of survivors up to four years post-op have shoulder, breast/chest wall pain, as well as pain in the donor site from reconstruction,” she explains. “Overcoming pain and physical limitations can help women resume their normal activities."

Getting your body "back to normal" after all it's been through and helping you resume your life can also help ease feelings of anger, hopelessness, powerlessness and frustration that your body isn't the same as before treatment. And we all know what that feels like.

Physical therapy and massage therapy can help with range of motion issues and pain control.

Plus, massage has an additional benefit, she points out: “There are several strong studies that show massage during and after treatment increases the immune system function."

As if we really needed an excuse to get a massage...

Monday, June 1, 2009

The Real Thieves

Our fast-paced and chaotic way of living--with traffic and telemarketers and texters and twitters--along with the stress of the economy and the total uncertainty of what the future holds has gotten to me lately. You could say, I've been on edge.

Then, this weekend, Mom told me that her neighbor--who is my age with a 14-year-old daughter--is on her 3rd round of chemo for breast cancer. What she has gone through over the past year, and continues to go through in fighting this disease, floors me. I don't know that I would have her resiliency to endure so much for so long.

I was quickly reminded of how I felt when I was diagnosed as Stage 3 over eight years ago, before I began treatment, and wondering if I would be alive a year later. I remember that all my daily irritations and problems and worries fell away. They simply didn't matter. They lost their power. Only living mattered.

And when my frustrations and bad attitudes vanished, I became intensely aware of the beauty and wonder of life. I realized--as so many cancer survivors do--that focusing on all the negatives distract you from the richness of all that's good in the world. They rob you from living.

I love how the priest in Les Miserables answers people who question his decision to not bolt his door at night to prevent robbers from entering. He responds that it's not thieves who steal silver that we should fear. Rather, it's the darkness of our souls that truly robs us of all that's valuable.

So, I am once again reminded of how precious life is--despite it's constant disappointments and challenges. And in today's environment, there are many. But it's amazing how gratitude can instantly reverse your viewpoint.

Thursday, May 21, 2009

The Truth Behind Cancer Studies

I typically get an eye-roll from my oncologist whenever I present her with a ripped out newspaper article about a just-released study announcing new cancer findings.

With all the health news accessible these days, you'd think we'd be medical experts. But, in reality, the opposite is true because so much information that's reported is confusing and even incorrect.

How do you know which studies are valid? The starting point is understanding how health-related research is conducted, so I tapped my trusty source, Greg Orloff, who teaches the cancer of biology at Emory University in Atlanta, and has an award winning website about cancer (cancerquest.org).

"There's always an element of sensationalism in the media because that's how they sell their publications," Orloff says. "Consumers need to be able to interpret a study so they can factor this information into their decision-making."

He suggests the following to determine a study's validity:

1. Determine the study's purpose. Orloff says it's expensive to follow 20,000 people over 20 years.

"As a result, researchers attempt to extract as much information from a study as possible and then use the findings for multiple purposes."

A study may be designed to find out one piece of information (whether smoking increases the risk of lung cancer), but other researchers can re-analyze the same data asking different questions and come up with additional conclusions (smoking causes an increase in heart attacks).
"You need to look at the information collected and make sure that researchers are isolating the information you're interested in from other study conclusions. This is difficult to accomplish -- it's hard to analyze one single thing because humans are complex. It could be something other than what's being studied that's contributing to the outcome."
For example, let's say you're looking at the effect exercise has on breast cancer. You conduct a study involving 2,000 people and look at those who exercise 5 times a week, those who exercise 1-3 times a week, and those who don't exercise at all.
Then, you observe the rate of breast cancer occurrence over time. You may find that those who exercised 5times a week had fewer occurrences of breast cancer than those who didn't exercise at all.
But what do you think the chances are that people who exercise a lot also have a healthier diet than those who don't? So another factor -- diet, which is not what the study is about - may play a role in the study's results.
It's a matter of asking the right questions about the study.
2. Look at how the study was designed and conducted. To interpret the findings of a health-related study, consumers need to understand the nature of research and what it entails. Consider the following questions when giving credence to a study:
* How reliable is the information gathered from the participants? People can make mistakes (or not tell the truth) in recalling lifestyle choices and their family health history. This can affect a study's outcome.

* How many people did the study involve? The larger the study, the more credible the information. If the study was not conducted on a large enough population, then you should hold off making a conclusion.

* What was the length of time it was conducted? The results will differ significantly from a 5-year study versus a 20-year one.

"Often, evidence is derived from the preliminary stage -- such as 3 years into a 20-year study -- which can be misinterpreted and hyped by the press, eager to report the latest news. A longer study is better at providing the actual outcome."

* Who participated in the study? Socioeconomic and cultural variations between one population and another can impact results. A study should represent the larger population in order for researchers to make a general, relevant statement. But this is difficult to achieve.

"The challenge is how do you randomly select a population to study? Let's say you decide to study people living near a major college campus. But the problem is that a better-educated, higher-income population lives in that area, and that means they make very different lifestyle choices (such as more visits to the doctor) versus the average population. This is just one factor that will produce a bias in the study's results."

* Who conducted the study and what was their motivation? Is it to convince you to buy their product?

3. Know the difference between "correlation" and "causation."

Correlation -- is an association between two things. For example: Men who exercise have fewer incidents of colon cancer. But is it because they exercise, or that they are eating a better diet? The association between exercise and lack of colon cancer is real, but is exercise actually causing these positive results?

Causation--is a factor that leads to a specific outcome, such as smoking causes lung cancer. You can get lung cancer for other reasons, but scientists have proved that mutagens in smoking do cause lung cancer.

People often misuse those terms and misinterpret results, making a conclusion because they assume causation and correlation are the same.

4. Are studies conducted on animals relevant? Since human studies are difficult and expensive, animal studies can be beneficial since researchers know the genetics and can completely control behavior (how much daylight exposure they receive, diet, hours of sleep).

"For want of a better model system, animals are valuable," says Orloff. "People tend to dismiss animal studies, but researchers can still observe the effects of a particular treatment, which could be applicable to humans.

"At the same time, if a treatment works in an animal model, it may or may not work in humans because we're genetically designed differently."

With animal models, you need to ask if the doses that researchers are giving a reasonable amount.

5. Understand the statistics. "Studies ultimately come down to statistics, and most often, reporters and readers don't understand what those statistics mean. Statistics exist for any study with credibility.

"So, if you are interested in pursing a lifestyle change based on a study, you need to know the numbers that support the findings - is it statistically significant?"

Medical journals are a good place to find a study's statistics.

"And even if you can't interpret the data, the more information you can access, the better you are armed to ask the right questions of professionals (your doctor), who can give you the best answers."

So, despite the eye-roll, it's a good idea to check with your doctor regarding information you find in the media. They are the best source about what's true and false.

Wednesday, May 20, 2009

Cancer 101

Every day, it seems, I get an email from a well-meaning friend about a new cancer study concerning grapefruit juice, PET bottles, red meat...the list is endless. Or, a news article saying that mammograms and self-examination are a waste of effort.

Since I've recently received my umpteenth email about another presumable cancer-causer, I thought it was time to feature an interview I had with Dr. Gregg Orloff. Orloff teaches the biology of cancer at Emory University in Atlanta, and has developed an award-winning website that explains the biology of cancer: http://www.cancerquest.org/.

"Of all the environmental and behavioral factors that have been investigated for cancer, only a few have shown a clear link," Orloff says.

"It's difficult to make hard conclusions about certain activities and their impact on cancer because studies to-date haven't involved a large enough population or haven't been conducted for a long enough time period to offer anything definite. The data simply doesn't exist at this point."

Still, research has uncovered enough implications between particular behaviors and increased risk that it's worth paying attention to how lifestyle choices impact our health, he says. But in order to understand how behavior and cancer are related, we first need to know what causes cancer to form.

The Basics
"Cancer is ultimately a result of DNA damage," explains Orloff.

"We know that cancer is derived from a single defective cell that has multiplied. It occurs when a cell strikes out on its own, resulting in unregulated cell growth. These abnormal cells pile up on each other and form masses, which are commonly known as tumors."

Why does a normal cell strike out in the first place? What causes it to become cancerous?

It happens when a particular set oif genes in a cell are altered by mutagens. And, this is where lifestyle behaviors may play a role in cancer. Mutagens enter the human body by means of inhaling, ingesting and absorbing.

They derive from:
* Chemicals in the diet -- For example, charred meat from grilling (the burning process) can cause the formation of chemicals that are thought to be mutagenic.

* Infectious agents -- A problem can occur when a virus actively alters the cells. For example, cervical cancer may result after infection with the Human Papilloma Virus...a viral infection.

* Chronic infections - Cancer can result in response to an infectino. For example, hepatitis has been associated with liver cancer. When cells are killed by infection, they need to be replaced constantly, so there are high amounts of cell division occurring in these tissues. In addition, the body's immune response to fight infection is producing chemicals that can cause mutations.

* Chemicals in the envioronment -- These can be absorbed or inhaled, such as smog and industrial waste.

In other words, every time you expose your body to a cancer risk -- eating buned meat, inhaling cigarette smoke or absorbing coal tar -- mutagens enter your body. And chemicals that are mutagenic can cause DNA damage.

The Luck Factor
If we all take in mutagens, then why does one person develop cancer over someone else?

"In order for a single, normal cell to turn into a cancer cell, it must acquire five to six different changes from mutagens. So, it's a cumulative effect," says Orloff. "Two people can be exposed to the same mutagen, but in one person, the cell dies or remains the same, while the other perosn acquires a mutation in an important gene and develops cancer.

"That's why you see some people smoke their entire lives and not get cancer, and others who 'do all the right things' develop cancer. Luck plays a big role as to who gets cancer and who doesn't. "

In the Genes
There are genetic components to cancer, as well.

"A person can inherit defective genes -- such as BRCA1--which by itself doesn't necessarily cause cancer," Orloff adds. "But a defective gene can increase your chances that some important key genes will be affected by a mutation, giving you a higher risk for cancer."

Another genetic factor that can impact whether one person develops cancer versus another is possessing better DNA repair genes, which respond to DNA changes differently.

In addition, the way your body processes toxins can affect your chances of getting cancer. For example, the liver has enzymes to process and eliminate toxins -- making them soluble so they can be excreted. But this detoxification process can convert a chemical into a mutagen.

Consequently, two people may be exposed to the same risks, but their bodies may process toxins differently.

Risky Business
Whatever your body's genetic makeup, DNA can be damaged by certain behaviors.

The following factors are known to have an associated risk of cancer because of their mutagenic properties:

* Smoking -- Full of mutagens, smotking as well as second-hand smoke is connected to almost all cancers.

* Sun damage -- UV rays are mutagenic and have been proven to cause skin cancer.

* Diet & obesity -- Obesity carries an increase risk of breast and colon cancers. Certain diets can alter the level of growth factors and nutrients (protiens, lipids, sugars) in the blood, which, in turn, can stimulate normal cells to become cancerous, or cause existing cancer cells to grow.

* Alcohol -- Particularly a risk factor for breast, colon and esophageal cancers, alcohol is toxic and must be detoxified, causing stress on the body. The detoxification process can cause DNA damage.

* Medications -- Certain drugs can potentially cause a problem. For example, female children of women who took DES (now outlawed) while pregnant have higher incidences of cervical and uterine cancer.

Healthy Choices
On the other hand, there appear to be certain behaviors that may help reduce your risk of cancer:

* Exercise - In some studies, exercise has been shown to have positive beneficial effects on breast and colon cancer. The benefits of exercise may be due to a wide variety of effects, ranging from enhanced immune system function to increased GI motility.

* Diet -- Overall, a well-balanced diet with fruits, vegetables and nuts is beneficial. Specifically, foods that contain antioxidants (such as leafy green and cruciferous vegetables) have cancer fighting possibilities.

This is because our bodies produce oxygen radicals, which are highly reactive molecules in cells that act as mutagens and can cause DNA damage. Antioxidants act as interceptor missiles, neutralizing oxygen radicals before they affect DNA.

In addition, studies have indicated that Vitamin D, selenium and calcium might potentially prevent or limit cancer growth.

"None of these things, alone, offers a huge reduction in cancer risk," warns Orloff. "But we know enough from studies to advise people to take care of their body."

The Bottom Line
"There's no holy grail in that if you do this set of behaviors, you won't get cancer," says Orloff. "All you can do is limit your risks.

"It's like avoiding a car accident," he says. "You can limit your risks by wearing a seat belt, not driving late at night, and not driving while talking on the cell phone. But all these things still can't guarantee that you won't get killed in a car accident."

"The same goes for cancer. Individuals have to decide what risks they want to live with."

Tuesday, May 19, 2009

Off Balance

After breast reconstruction, I found myself falling over easily...and often. In fact, I lost my balance so much that I feared I had developed a brain tumor. Not that I obsess...

It wasn't until I heard about other women with breast reconstruction who also experienced the loss of balance after surgery. I finally surmised that because we had our core muscles cut, we no longer have the abdominal strength to balance us.

Therefore, if you're slipping and falling frequently, fret not. Instead, sign up for a strength training class to build back your core. Since I've been working out with my personal trainer -- who, incidentally had me hauling concrete blocks and stepping up and down on a bus stop post last week -- I realize I've been stumbling less.

It's painful, but it will keep you from injury in the long run. So, go find some concrete blocks and start moving.


I was slogging through rush-hour traffic in Atlanta the other night while listening to Terry Gross with"All Things Considered" interviewing Elizabeth Edwards about her just-released book, "Resilience."

At the interview's end, Gross asked Edwards how she defined resiliency. Edwards' answer was so profound that I practically drove off the road trying to write it down. Since I haven't purchased her book yet, I will paraphrase what Edwards said:

"Resiliency is accepting the new reality of your life after loss-- and live it fully -- rather than long for the past and what it held."

If ever there was a quote for cancer survivors, this is it. I don't know about you, but sometimes I am wistful of life before cancer -- without all the surgery scars and missing pieces...when I was stronger and more flexible...when I had eyebrows (sigh)...when I could remember every detail (before chemo deleted my brain)...when I was innocent and naive, thinking I was invincible and immortal.

I don't obsess about these things, but every now and then, I get frustrated trying to be the "old me." And that person doesn't exist.

The new reality is an older, scarred, wiser woman who knows first-hand the body's limitations and the eventual result of death.

On the other hand, she also knows she has more courage in the face of fear than she ever imagined. That she doesn't take a single day of life -- or a single relationship -- for granted. That every day counts. Every interaction. Every choice. Every action. It all matters.

She also knows that she is loved far more than she ever realized. She knows that pain and suffering produce depth and insight. She understands what's truly important and what needs to be discarded or not taken so seriously.

Life after cancer is my new reality. I can never run away from or ignore what has happened to me. I can't go back and recapture my youthful self.

But, as Edwards points out, resiliency is the ability to "live fully" in your new life. That takes on a different meaning for each cancer survivor. For me, it's accepting my physical limitations, while at the same time, appreciating that I have a better grasp of what is true and valuable.

Tuesday, April 28, 2009

Advice from A Fitness Expert

This is an email my fitness instructor sent me recently:

"I met someone today in my bodywork class. She wanted ideas to rebuild her abs, since she was cut for breast cancer surgery and reconstruction.

This is the third person I've come across in a similar predicament, so I am planning to do some intensive research on exercise for women who have had breast cancer.

I hate to see breast cancer survivors frustrated with their bodies, when everyone seems amazed by how far you have come , medical teams happy with the results...you seem to be the only ones left with a feeling of unfinished business...and indeed it's not over for you.

You have a different body, you are and you are not the same person. You need to assess these changes and how slowly they will be part of you from now on. You need to work with these changes that you may not quite understand or even know about.

Your battle is not over, and everybody has left.

I believe strongly into the amazing ability of the body to heal repair and adapt, but also in the power and relation the mind has on this process.

Your will and courage is your victory. We, as instructors, need to wake up to this specific growing demand and try to work together with the health professionals to assure not only recovery, but long term health , happiness...and fitness!

Women who have had breast cancer need to work specifically on core, abs and upper body strength--which seems to be the 2 areas of most changes and trauma...psychologically, physically and physiologically.

See you in class!"

Helene Villinger
AFAA Certified Personal Fitness Instructor

Wednesday, April 1, 2009

When Rubbish Happens-Part 2

Recent layoffs among several people I know have prompted responses from well-wishers, telling the newly unemployed they'll "be in a better place" one day and "when one door shuts, another opens"...blah, blah, blah.

While I believe these statements can be true, there's a catch. It's up to you to open the next door to get to a better place. It doesn't automatically open. This pertains to jobs, or cancer, or any other disappointment in life.

Some people I know responded to their layoff by aggressively applying for jobs, networking, heading to the gym and keeping a positive attitude--which ultimately lead them to their dream job. Others headed to the bar, sat on their backsides and decided to be bitter.

A friend shared his fear of wasting his life due to working long hours and not having a Hemingway-like adventure every weekend. While I don't endorse workaholics or couch potatoes, it's not a job or lack of fun that wastes a life.

Rather, it's wallowing in anger, depression, fear and bitterness in response to life's challenges. Instead of moving forward with courage, you become paralyzed in your grief.

Life CAN be better when bad things happen to good people if you rise to the occasion. It's becomes better because it changes you -- you grow up, get a new perspective, learn to handle problems. Tough times can deepen you, pulling you out of your self-centered, self-absorbed, childish, all-about-me context.

And becoming a deeper, less selfish person is what allows you to live a richer, more fulfilling life.

Changing for the better is earned the hard way--the way we all try to avoid--through pain and suffering. But in the long run--by plowing ahead with courage--you can look back and say, "I'm in a better place because this happened."

When Rubbish Happens-Part 1

A friend, who is younger than I, is now in hospice, dying of cancer. It has not escaped my notice that I've survived cancer for the time being, while she did not. This begs the question--why her and not me? Why did she get the death sentence while I was spared?

This has always been a tricky question that arises when life throws you a curve ball (or in the case of cancer, when life throws you a grenade). I don't claim to have the answer. But I do know, that as modern day Americans, we've come to expect a Disney ending to tragic things of life. And it's just not so.

Why did I get life over others in my condition? It's not because I'm exceptional, or that God loves me more, or that prayers for me outweighed prayers for others. I've known far better and nicer people--with much greater faith--to experience an early death while I lived. You have to wonder why.

After pondering this over time, here's what I hold to be true: "To whom much is given, much is required."

My writer-counselor friend, Sue, wrote a poem, "The Scarecrow” in which she points out that our life experiences "make our stuffing deep, rich and available for God’s use, whenever and however He decides to scatter it."

So, until the day comes when I'm in hospice, I'm in a strategic position to be a blessing to others. After all, it's what's required.

Monday, March 30, 2009

1 Year Later

It's been a year since my double mastectomy, oophorectomy & reconstruction (phase 1), so time for a progress report.

My reconstruction surgeon said my right breast needed some "tweaking" since it's smaller than my left. The reason for the size discrepency is I had radiation in my right breast during cancer treatment years ago. Tissue in a "radiated breast" responds differently to surgery than a non-nuked breast. Translation: I need a larger implant.

Tip: If you must undergo radiation, ask your doctor how it will affect your breasts long-term. It's good to know for a variety of reasons.
Surgery to exchange an implant is an outpatient procedure (yaay!), but nevertheless involves anesthesia, tests, needles, blood, drains (%&#*!), nausea, and no exercise except walking for 6 weeks.

Right now, I'm not up for all the pain (from needle jabs) and suffering (from lack of food) this surgery calls for. So, like Scarlett, I'm going to think about it another day.

A small breast is no big deal. What is a big deal is that my stomach is still expanded like Demi Moore on the cover of Vanity Fair. (And that's the only similarity between my body and her pregnant one.)

I ask--what happened to "your stomach will be flat as this wall," as my surgeon swore?
Instead, after a year of surgery, when I was sliced in half, my abdomen has a small "pooch" like I'm in my first trimester.

What they don't tell you is that all the cutting and stitching of your abdominal muscles causes them to expand whenever you place any pressure on that area. Exercise, lifting & moving objects, gardening, housework...and myriad other daily activities can cause your stomach to swell. Swell, isn't it?

And, an expanded abdomen = no clothes with a fitted waist=forget summer fashions and swimsuits.

No one forwarned me that I needed to invest in maternity clothes after this procedure. From the way my surgeon talked, I was going to be a runway model at 50. (Tip: surgeons lie.)
Therefore, I enlisted the help of my French water aerobics instructor, who is also a kickboxing intructor and personal trainer.

My surgeon endorsed my decision, saying that building my core muscles were key to getting a flat stomach. NOW he tells me.

So, last Saturday at 7:30 AM, I am in Helene's basement (aka, the torture chamber) punching boxing bags, throwing weighted balls, jumping rope, doing pushups...and then going outside in the freezing rain and sprinting up the hill in her front yard. Alas, what we do for vanity.

It was then that I discovered a critical insight -- I have no muscle strength. ZERO.

After a year of surgery in which most of the time I wasn't allowed to do any exercises except walk, my body weakened overall.

This means a long, hard road before me with lots of Saturday morning sprints up Helene's hill.
But I'm up for the challenge. After all--for all the pain and suffering that Helene inflicts, it doesn't involve needles and anesthesia and lack of food.

Friday, March 27, 2009

Embracing Calm & Chaos

The call interrupted my dinner preparations, and my world immediately switched from a relaxing Sunday evening with my husband to a sleepless night of fear and agony.

My usually stoic younger brother was sobbing on the other end of the line, as he told me that my 14-year-old niece had fallen 21 feet off a ski lift. She was skiing in West Virginia with her mother for the first few days of spring break before coming to Atlanta to spend the remaining time with me. All that changed with one poor decision.

My brother was at home when he got the news. Consequently, he was receiving sporadic information from the hospital. He knew that my niece’s spleen and kidney had been lacerated, but it wasn’t confirmed whether she had suffered spinal cord or other critical injuries. I envisioned my precious niece in a wheelchair for the rest of her life, and it was unbearable.

My niece was conscious when I called ICU after I got off the phone with my brother. “Aunt Julie, I want you to come see me.” That’s all it took, and I was determined to go to her--whether her parents wanted me around or not.

Adding to the drama, my older brother (who is a pilot) flew both my younger brother and me the next morning through fog and rain to West Virginia--worrying my mother because her three children were traveling in the same small plane in inclement weather.

Fast forward to the end of the week, after spending my vacation sleeping in a recliner and eating hospital cafeteria food (is it me, or do I always seem to be spending my vacations in hospitals?) and my niece is back home. No spinal cord injury and the spleen and kidney are healing just fine. Her judgment is another matter…

I must say, this put a damper on my resolve to reduce anxiety in my life. I was so proud of myself for not panicking every time the phone rang, thinking it would bring bad news. Didn’t my niece realize this when she refused to put down the bar on her chairlift?! (According to 14-year-olds, it’s not cool to have the bar down.)

Life has a way of messing up our best laid plans.

So far this year, I’ve attended the funerals of my favorite aunt, one of my breast cancer mentors and a friend’s mother (who died of cancer). My brother has been experiencing chest pains, and my forever strong dad has suffered dizzy spells and exhaustion. I’ve also mourned a coworker with liver cancer who got the news she would not recover. I could go on, but I realize that everyone has sadness and tough situations to deal with.

While in the hospital, I read C.S. Lewis’ spiritual autobiography, “Surprised by Joy." He mentions a friend who believed in not running from pain, fear, loss and trouble, but rather, experiencing all of life to its fullest -- even the negative aspects.
When we avoid pain at all costs, we end up creating fake lives of distractions and shallowness and emptiness. He points out that even pain and rough times can offer a kind of richness…because it’s all part of the human experience.

He writes: "Jenkin seemed to be able to enjoy everything; even ugliness. I learned from him that we should attempt a total surrender to whatever atmosphere was offering itself at the moment..on a dismal day to find the most dismal and dripping wood, on a windy day to seek the windiest ridge...There was a serious determination to rub one's nose in the very quiddity of each thing--to rejoice in its being (so magnificently) what it was."

Fear doesn't add anything to our experience because it's not real -- there's nothing tangible about it that transforms you (like grief and pain) or enlightens you (like coming to terms with your faults). All it does is cast you into an altered state.

Not that I’m welcoming bad news, but it struck me that maybe I need to celebrate the joys of everyday and also, live through the painful moments I try so hard to avoid. Maybe it’s better in the long run to experience it all.

All the Rage

I took a break from blogging over the past few weeks and, instead, spent time thinking about all the anxiety and frustration that cancer has introduced to my life.

I finally hit a wall after listening to umpteen “experts” providing dire cancer predictions if I did the least thing wrong. My oncologist wants me to avoid soy. My nutritionist said red meat and dairy are cancer-producers. I’m told that exercising 40 minutes every day reduces cancer’s recurrence—so, get moving! And in the news recently, there’s a study linking alcohol to breast cancer. And, on and on it goes. It seems like everything is off-limits, including rest.

All this has brought up anger about how much I've had to alter my lifestyle over the past decade regarding things that bring me pleasure, such as:

· Gardening: Dirt + Overwork= Lymphedema
· Wine: 1 glass of Pinot Noir = Breast cancer
· Gourmet cooking: No Meat + Dairy + Soy = Limited Menu Options.
· Eating: Processed/packaged Foods = Soy=Cancer; Sugar products = Cancer Risk.
Even CHOCOLATE contains soy!

This leaves me with nuts, grains, beans, fruits and vegetables. Now, I’m all over these food choices – in fact, they’ve always been a mainstay of my diet. But to constantly hear that putting a spoonful of yogurt in my mouth, or buttering my French bread will cause my early demise…well, that puts me over the edge.

I've cut back on everything -- obeying everyone's "orders" and "rules" for my life. I eat mostly vegetarian meals and fish; organic produce. Drink gallons of water. Avoid desserts and never touch fast food or junk food. I take vitamins and exercise daily...I'm the ultimate "good girl."

While I enjoy a healthy lifestyle, I'd prefer that it be my choice rather than a requirement in order to live.

So, how does one attempt to live a calmer, less stressful life when she has all these hysterics coming after her!

My feeling is-- if I have to give up everything that brings me joy in order to stay alive, what's the point of living? (This is a rhetorical question -- I'm not contemplating dying).
This is a challenge for a lifelong Romantic, who tries to create rich experiences whenever and wherever possible.

My fantasy is to run an organic farm & vineyard along with a gourmet restaurant in the countryside. I'd be outdoors, working the land, cooking great food, connecting with people. But gardening, meat, cheese, wine—they’re all off limits! So, find another dream?

This begs the question: “What would JC do?!” (Julia Child, that is!) She’d eat a slab of meat, followed by a stiff drink. She ate (lots) and drank (lots) and was a breast cancer survivor and lived until 92. To that, I say, “Bon Appetite!”

Monday, March 2, 2009

Another Survivor's Viewpoint

The following post is by a friend, who battled lung cancer last year.

While My Shoes collected Dust . . .

Anyone who knows me knows I have an intense love of shoes…some would call it a shoe fetish.

I like to think of them as essential items of clothing--as necessary as blouses, sweaters, dresses or pants. The difference is women’s shoes are a strong expression of an individual’s personality in a way that clothes don’t always equal. (Don’t get me wrong, I love clothes, too.) So, I shopped the shoe departments anywhere I could, regardless of whether there was a great sale or not.

I recently discovered something my husband had said was pitifully true—my shoes had collected dust!

Neatly arranged in our spacious walk-in closet, my shoes sat two by two with a fine layer of visible dust on all of them. That’s when the full impact of it hit me--the “it” being the unexpected and intense ordeal of my year-long battle with cancer, including months in the hospital and then months at home recovering baby-step by baby-step.

My journey isn’t about my shoes, but they are indeed a metaphor for leaving the way of life as I knew it.

I’ve learned a lot of wonderful and surprising things along the way about myself, my husband, our families, friends and the human spirit. While the shoes in a closet might get dusty, human kindness, care, concern and love never do.

I’ve discovered that everything I’d been taught about what was important in life is true. Not that I didn’t believe it, but I hadn’t “lived” it so completely before. You believe that accidents and/or complications from illnesses are something that happens to other people…certainly, not to you or the ones you love.

Well, guess what? Not true. And if you’re the “one” it happens to, to say that you question everything you’ve ever learned about life is an understatement.

On my first trip to a mall (shoe department), when I tried on a great pair of edgy flats in a metallic color, my husband voted them out and insisted I buy the red ones. Red flats? Red wasn’t me. But when a stranger who was trying on shoes next to me agreed with my husband, I ended up buying both pairs.

New shoes mean you have new places to go and new things to do. They signified my return to life as I knew it when the concerns of the day were mundane ones. There’s one big difference though: nothing will ever be mundane again. Nothing.

When you realize that all of us take much of our lives for granted, that realization takes you to a different place. I wanted to put up billboards asking people to take a long, slow look at their lives. But, if I had seen such a billboard, would I have paid attention to it? Probably not. So, what’s my point? To inhale life deeply, joyfully and slowly.

This Spring, I’m going to put on those red shoes and let them take me into my new future. I won’t have any preconceived expectations about what it’ll be or where it’ll take me. I’ll smile at things that used to make me frown and embrace problems that used to make me run. I now know what “the bottom” looks like--and it isn’t pretty. It comes unexpectedly and, like a roller coaster, when it comes, you’d better hold on for dear life.

All of us know that in times of trouble you find out who stands with you, beside you and for you. You also find out who doesn’t. Finding out who doesn’t, was one of the many things that for a long time, I wished I hadn’t learned. But, I came to understand that finding out who you can’t count on is of equal importance as finding out whom you can.
And, while that may sound negative, it isn’t. It gives one the freedom to weed your personal garden and focus on new plantings. You view your commitment to friends in a new light, and you find yourself promising to nurture and care for them with the better understanding you have now. True friendship takes on such a different meaning.

You realize you are walking in new shoes on a different journey--and it’s a second chance. After all, how many people gain a lifetime of experiences ---- both good and bad---- in a single year’s time?
I incessantly asked the questions: “Why me? Why now? Why this?” And, it’s taken more time that I care to admit, but finally, I discovered the reason for this experience isn’t what’s important.

I started to look at all of the things I hadn’t lost as opposed to what I had.

I had to look at what I faced now, and found myself looking at a big, open blank book. One that was waiting to be filled with steps of the journey: stories, drawings, sketches, jokes, diary entries and/or anything that came to mind or came along. You’d think that it would be very exciting for a creative person like me but it was not only daunting, it was downright frightening.

I’d always had a script for my life and I’d followed it to the last detail. What do you do without your script? No one told me that my story might need a major rewrite midway through.

Realizing that fact left me suffering from the ultimate creative block. I couldn’t focus or concentrate on the very things that used to propel me forward, so how on earth was I supposed to develop that new script?

Where you do start and how do you begin? I figured a good place to start was to make a list of what I had deemed important. Next, to reflect on how my life had changed. Then, I created a second list, detailing what mattered now. That would require some serious soul-searching.

I spent long hours thinking about what I used to value. First, was my good health. Well, so much for that.

Next was my career. I had a successful one by all measures, and one I worked very hard to develop. I’d never thought about leaving my career. Now, I could scratch that off the list as well.

Tackling my second list, I realized the most important thing on both lists was my husband. Next, was the amazing support we had around us. We had no concept of how many people would come to our side. It was mind-boggling. My husband and I found out this past year that we’re only as strong as the people in our lives.

Another important discovery through my illness was the wonderful new people who came into our lives—people we’d never have met any other way and now are like family to us.

It taught me that you never know who’s looking up to you for whatever reason. Your attitude and actions can have such an impact and, often, you don’t even know it. The thoughtfulness and laughter they brought was infectious and helped heal us. They showed us by example how you can help to restore life to the living.

One of our favorite phrases now is it was one of the worst ways in the world to meet some of the most wonderful people.

I also thought about my second “career.” What shoes did its journey call for? As I began to heal physically, I became impatient over the next phase of my life. As I’d always done, I felt the urgency for a new script right away. Right now and right here. I expected myself to come up with instant answers. Wouldn’t it be convenient if life worked like that? But, a life journey takes planning, time and work, so I knew no instant answers were available.

I wish I could tell you how this new journey will unfold, but I can’t even tell myself. What I do know is that day in the shoe department, when I purchased not only the metallic pair—but the red ones as well—was a turning point for me. To try something new. And I’m going to make sure my new shoes don’t collect any dust.

A Survivor's Advice

After reading your blog, I want to tell you that thoughts of death hover for a long time after cancer/surgery, etc.

After my mastectomy, I had visions of my own funeral forever it seemed -- whenever anything would remind me of my vulnerability -- and there are lots of reminders out there.

Your last blog spoke to me and brought that all back. I want to encourage you that it does pass, so, hooray for stepping off the bandwagon for awhile.

It takes more courage to say no to things than to say yes for those of us raised as people-pleasers and blessed with talents that make that possible.

Your Friend

What I'm Giving Up for Lent

I’ve realized that I’ve been following the “live today since I may not have tomorrow” creed these days. This has translated into me cramming a year’s worth of life into each day. To be honest, I've always lived this way -- going “90 to nothing” and then collapsing. But now that I've had cancer and the constant threat of death hovering over, I’ve accelerated this mindset & lifestyle to burn-out.

My vulnerability of wanting to be loved (make that adored) and significant are what drive me to exhaustion. I try to be the perfect daughter, niece, wife, friend, coworker. Can't say that I actually achieve that, but, boy, do I try!

So, I’ve taken my minister’s sermon yesterday to heart. While others are giving up addictions like chocolate, or bad habits like texting while driving, I've decided to give up my calendar.

For the next 40 days, I'm going to live each day at a time rather than pencil in activities and commitments for two months out. I'm going to spend time in my wilderness with God – reading, journaling, meditating…having my spirit refreshed & renewed. By the way, my minister pointed out that “Lent” means “spring.” I never knew that!

It’s not to say that I won’t get together with friends, but it does mean that I’m not going to make a single commitment in advance. I don’t intend this to be my way of operating from now on – but just for Lent, I’m going to slow down, not overcommit, and listen to His voice instead of all my fears.

Tuesday, February 3, 2009


It's no surprise that I'm a wee bit tense these days. After surgery last year, when they found precancerous cells on my fallopian tube and the possibility ovarian cancer lingering over me until the second operation proved otherwise...followed by an "ambiguous MRI of my leg bone in December"--well, a girl can only endure so much waiting and wondering before she cracks.

Friends and family have noticed that I'm a little more "on edge," a little quicker to anger, more easily startled. But they don't know the extent of my anxiety, which is more like a volcano waiting to explode. On the surface, I've resumed my everyday activities. But underneath a facade of normalcy, fear is brewing and spewing. Thoughts of death hover over me--mine and everyone I care about.

As a friend pointed out, I've faced death at a much younger age than the general population. Most people don't come to terms with their mortality until late in life. I think about death all the time.

Last week, for instance, my water aerobics didn't show up for two classes, which was unlike her. The gym didn't know what had happened to her...so I envisioned some catastrophe befalling her or one of her children.

When I finally tracked her down, I discovered she had been sick, and had, indeed, called the gym--the person she had spoken to didn't pass along her message.

I think about how my mind races to the worst-case scenario whenever something is out of the ordinary. I'm waiting for the next bomb to go off.

When I shared this with a friend who is Jewish, she referred to the Hebrew expression, "L'chayim" -- to life.

She said that although it's important to be outward-focused, it's also critical to take care of ourselves. She asked how I spent my time off from work-- if I did anything fun and relaxing...if I took time for myself. She said that part of the healing process is engaging in activity that brings us joy. I needed to lighten up, loosen up and have some fun. In fact, play, darn it!

So, I've decided to volunteer at a community garden this spring. I need to spend time outdoors with things that are alive and growing. I need to connect to the beauty and wonder and richness of the world. I need to celebrate life. L'chayim.

Monday, February 2, 2009

Loss of a Survivor

My mom lost a close, childhood friend the other day. This group of 12 women--who named themselves the "Sunshine Girls"--had been friends since high school. Some even from elementary school days.

They've supported one another throughout the years--hosting wedding and baby showers for daughters, celebrating birthdays and anniversaries, attending funerals of family members. They were there for each other through sickness, heartbreak and loss. They celebrated joys & triumphs.

Whenever they gathered, they rekindled their sense of humor and girlhood spirit. They vacationed at the beach each year, and took many roadtrips as well. There were always hints of wild times and scandalous conversations -- never to be shared with children and husbands. ("What goes on at the beach, stays at the beach.")

Their friendships spanned a longer period of time than husbands or children. Their bond was closer than family.

JoAnn Scott meant a lot to me, not only because she had been part of my life as a "Sunshine Girl" since I was a child, but also, as an adult, she was a breast cancer survivor who served as my advisor.

When I was first diagnosed eight years ago, she participated in a breast cancer walk in my honor. She reached out to my hurting and scared mother and gave her support. Fast-forward several years later, and JoAnn was on the scene again, advising me on surgery options for my mastectomies and reconstruction. She was honest, forthright and caring. She always had a smile and a laugh...a lighthearted spirit who loved life and people.

I mention this because I think of this culture in which we worship fame and celebrity, but have bought into a lie. Because it's the common, everyday people we know who make the most dramatic impact on our lives. JoAnn Scott was one of the people who made a difference for me.

The other thing that struck me about her death--besides being the first of the Sunshine Girls to die--is that she didn't die of breast cancer...but from a blood clot.

I think that, as cancer survivors, we get obsessed about dying of cancer. Although this is certainly a reality, we may not die of cancer at all--but from something entirely different. And all that worrying about cancer reoccurrence may be for naught. I might be hit by a bus instead.

All to say, JoAnn Scott played a huge role for me. I learned from her in life--all about breast cancer--and, I learned from her in death--that I can't obsess about cancer.

Therefore, I need to live as JoAnn lived -- with a bright, vibrant spirit that affected everyone she came into contact with. God bless her.

Wednesday, January 28, 2009

Crash Landing

I couldn't help but notice that after US Air 1549 recently crash-landed on the Hudson--and everyone on board survived--one passenger responded by praying and thanking God. Another passenger went to a hotel lobby and ordered a martini.

I can understand how they both felt. After getting news yesterday that my follow-up MRI was normal (i.e., no sign of cancer growing in my bone marrow!), I was torn between praise & thanksgiving...and heading to a bar. I did say a prayer of thanksgiving...and then took my dog for a walk.

Not since my first diagnosis of cancer--when everything was an unknown about my chances for survival--have I felt this close to death. When cancer hits the bone, that's bad news. I thought I had come through so much last year, with all the surgery and my close call in beating ovarian cancer. And, then, to find a mysterious mark on my leg in December--that's when I realized I could never fully escape cancer hovering over me. It's a fact of my life forever.

So many thoughts coursed through me during this month-long waiting period for the 2nd MRI to see if the area had changed, signifying if there was cancer. I thought about my short time on earth and how scary facing death is. I thought about how 50 years have flown by...and how I can never recapture the years I took for granted. I thought about how I wanted every day and every relationship to matter. I even found myself angry at people in my life who are acting petty right now. What a ridiculous waste of time.

Somehow, my latest potential bout with cancer has made me more serious about the time I have left. And although I escaped bad news this go-around, I know that as a human being, I will eventually face my end on earth.

But until then, I'm going to keep praying...and have a martini.