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10 Years 'After' Breast Cancer

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Ten years ago, on Aug. 3, 2002, I was mindlessly applying apricot scrub in the shower, thinking it was going to be just another forgettable summer weekend day. Instead, my hand froze on a spot just above my right nipple. An electric jolt of fear coursed through my body and landed in my teeth with a tingling shudder: My God, what's that hideous thickening under my skin?

It's not a lump, it's not a lump, I kept telling myself. That's good, right? It's not a lump. No, it definitely wasn't a lump. It wasn't smooth or round like a pea or a marble. And it didn't move when I pushed and probed at it. I couldn't describe what it was, actually. My breast, just above my right nipple, felt thick, as if the skin had stuck to the flesh beneath it. This thickened area had no shape, and I couldn't discern its size. I sat down on the shower floor and let the water wash over me, running the pertinent facts over and over in my mind.

I was just 36 years old. I had just had my baseline mammogram 12 months before, and it was clear. Well, not clear exactly, in that the radiologist's report said that my breast tissue was dense. But certainly, there were no calcifications, no shadows, no... thickenings. I was healthy. I ran or biked daily. I was slim. I had become pregnant with my first child by the time I was 30. I had spent a total of 24 months nursing my two sons (altogether, not each). I ate healthy foods. I hadn't spent any significant time on the birth control pill. And it wasn't a lump! No! It was just a... thickening!

I got out of the shower and dried off. My husband was shaving at the sink. We were supposed to be getting ready for six friends to come over for a day of sunshine, cocktails and grilling. He saw my face and asked me what was wrong.

"I think there might be something wrong with me," I whispered, "With... with my... breast." As I described for him what I had felt, I suddenly remembered a dream I had had the night before: that I had found multiple tumors in my breast. Well, at least this wasn't a lump, I kept telling myself.

Monday morning, I showed up at my OB/GYN's office, without an appointment. She laughed. "It's just a cyst," she said, "Let's get you to a radiologist to confirm that, and you'll be fine."

"But if it's a cyst, then why can't you just drain it?"

"Well, not that kind of a cyst."

"What kind of cyst then?"

"More like a... mass..."

I never saw that doctor again. I took her prescription for a visit to the radiologist and made an appointment for the next day. In the meantime, I tried not to let my hands get anywhere near the thickening. If I couldn't feel it, perhaps I wouldn't think about it. Uh huh.

The next day, I had an ultrasound, and the technician pointed to two masses above the right nipple. She asked me if I wanted to feel the one that I hadn't felt before. I declined. When the radiologist read over the report, she became very quiet. Her silence filled me with panic, and I asked her, "What are you thinking? Are you thinking it's cancer?"

"I can't answer that."

No, she couldn't apparently, because first I had to have a biopsy. And they wouldn't be able to do that for another two days. For two days, I pretended that nothing was happening, even as I floated above my own body in a sea of disjointed anxiety.

Two days later, despite my pretending that nothing was happening, I brought my mother with me back to the radiologist's office, where a slim needle was inserted into the thickenings in my breast -- the one I could feel and the one that I refused to feel. The radiologist on call took the cells he retrieved into another room and looked at them under a microscope. I had no idea that he would come back less than five minutes later looking crestfallen. I had never seen a doctor looking crestfallen. I didn't like it one bit.

"Well, it looks suspicious," he said quietly.

Suspicious?! Enough with the vagueness. Please.

"It's cancer, is that what you mean?"

"It looks that way, yes," he answered.

I didn't cry. I think by this time, I pretty much already knew. And I didn't have time to cry because I was being handed a list of highly-recommended breast surgeons and being told to get an appointment as soon as possible. And I was being prepped for yet another biopsy, to confirm beyond a shadow of a doubt what we already knew.

The results of the second biopsy wouldn't be available for another day. And I filled that day with an appointment with a breast surgeon my sister knew personally. He looked at my ultrasound results and said, "It isn't necessarily cancer." I wasn't sure why we were going backward at this point. I can only surmise that doctors, or at least the ones that I met that week, really didn't like saying the "C" word to women in their 30s. Or maybe to anyone.

Of course, the next day, this doctor called to tell me that the results were "Just as we suspected."

"You mean..."

"Cancer. Breast cancer. Ductal carcinoma, with lympatic and vascular invasion."

Honestly, he had me at cancer. The rest of it was lost in a sea of "I need to remove these beastly appendages as soon as possible." My right breast had betrayed me at the age of 36. As far as I was concerned, it was the enemy and it had to go. As for the other breast, the last thing I ever wanted to do was sit through another mammogram. No, wait. The last thing I ever wanted to do was to recover from cancer at 36 only to have it diagnosed in the other breast 10 years later. Yeah, so, as far I was concerned, both breasts had to go. And I wasn't going to take no for an answer, not that anyone argued with my reasoning.

Six weeks to the day after I first felt the famous "thickening," I underwent a double mastectomy with immediate saline implant reconstruction. The surgeon I ultimately went with called me two weeks later to tell me that she had GREAT news. Turns out that there were not two but THREE tumors, one of which couldn't be seen except when the breast was cross sectioned by the pathologist, and all three of my "sentinel nodes" (the first node that lymphatic fluid from each tumor drained into) were positive. This was great news, according to my surgeon, because it meant that my decision to have a mastectomy was proven to be a sound one. Even better? Precancerous cells were found in my supposedly healthy breast. So, the decision to have a double mastectomy was proven to be sound. Awesome!

Ultimately, my cancer was staged at "2B," which meant basically exactly what the first surgeon I met told me over the phone: I had a breast cancer that had spread to some of my lymph nodes. This meant that I was definitely going to have to have chemotherapy. Further testing also showed that I was "triple positive" for something called "Her2Neu," which meant that my cancer was particularly aggressive. I already knew that, but apparently, this particular marker was often associated with breast cancer that metastasized to distant places, such as the lungs, bone and brain.

But wait! Again, this was GOOD NEWS! It meant that I was eligible to take "Herceptin," a drug that disabled whatever cellular activity the Her2Neu marker was associated with, at least in about one-third of patients who had the Her2Neu marker. At the time, Herceptin was brand new for women who were not considered to have "advanced" (metastatic) disease. And by brand new, I mean that less than a year earlier, it had received its approval for trials in women with disease that was considered "early stage," such as mine. My oncologist made sure that I was given Herceptin, rather than a control drug. And by that I mean I wasn't in any study. And I don't know how I got so lucky, and I don't know how I can call anything about this lucky. But I will just quietly count those blessings and not question it.

Making a long story shorter, following my double mastectomy I underwent six months of chemotherapy, the last three of which were accompanied by Herceptin, and I continued with bi-monthly infusions of Herceptin for another 12 months. I was allergic to something in the chemotherapy drugs, so I was dosed up with Benadryl every time I went for an infusion. And by doped up, I mean fed it intravenously. I don't remember a lot of those days. I lost all of the hair on my head two weeks after my first infusion. Three months later, my eyebrows and eyelashes fell out, which devastated me far more than having lost the hair on my head, probably because I could hide my head under a wig, but there was nowhere to hide a bald face. At three months into my chemo protocol, I became so severely anemic that I needed a transfusion, which I remember as one of the most disgusting experiences of my life. Imagine, really imagine, watching someone else's blood drip INTO your veins.

At the end of the six months of chemo, my left eye started hurting. I noticed I had a stye. No big deal, right? Well, within a day or so, one stye had multiplied to 10... on each eye. I ended up in the hospital for a full week, being treated for neutropenia, which meant that my immune system had been temporarily destroyed by the chemotherapy. When I recovered, I underwent six weeks of radiation.

Then I had my ovaries removed. The purpose of that was two-fold. First, my cancer had been estrogen- and progesterone-receptor positive. That meant that hormones fed my cancer cells. Since I already had two children, I decided that I should remove the organ that churns out all those hormones: my ovaries. Also, I figured that if I had gotten breast cancer at 36, I might be a good candidate for ovarian cancer in my 40s. Like my breasts, my ovaries needed to go. As far as I was concerned, they were nothing but time bombs ticking away inside of me.

Menopause at 36 was brutal. I had night sweats daily, had strange "shivers" at all times of day, experienced depression and a general fogginess in my mental faculties and gained 20 pounds, most of it around my waist. I also began to develop osteoporosis, for which I was given a drug called "Zometa," which is given both to post-menopausal women who have osteoporosis and to women whose breast cancer has spread to the bones. Zometa was supposed to have minimal side effects, just as Herceptin was.

Nowadays, I think that when a drug involved in the treatment of cancer is said to have minimal side effects, it means merely that it does not cause hair loss. Other than that, I cannot possibly understand what is "minimal" about any of the exhaustion, bone pain, continued weight gain and depression I experienced while taking Zometa and Herceptin.

By the summer of 2004, toxic substances were no longer being poured into my body at regular intervals, and I began to shed the weight that breast cancer had caused me to gain. In 2005, I finally accepted that my saline implants looked and felt terrible and had them replaced with silicone implants. Within a year after that, I began to understand that the silicone implants too were a failure. But I never would have done anything about it had I not suffered an accidental burn on my right breast that went all the way through every layer of skin until the implant was exposed. Luckily, the nerve damage I had experienced in my breast kept me from feeling this injury. But what I could not help but feel was very, very ill when the staph infection set in.

In 2009, I spent a week in the burn unit of a hospital, taking intravenous antibiotics and having yet another surgery to remove my right implant to improve my chances of healing from the devestating burn. A few weeks later, I had another surgery to debride the wound. I then spent several months taking hyperbaric treatments (90 minutes, every day) at the hospital to help heal my still-open wound. After a "wound-vac" (a disgustingly loud gurgling machine that sucks the lymphatic drainage out of a wound for 23 hours a day for a minimum of six weeks) failed to help, I met with a new surgeon, one who could transplant live flesh and blood from my ass to where my breasts should have been.

In the summer of 2010, I was given approval for this nine-hour surgery that I had to fly down to South Carolina to have (that was where the doctor was who could do the surgery). The surgery was a success, and for the first time since 2002, I felt whole again. I felt whole enough, in fact, that I sometimes forgot and still sometimes forget, that I went through all of this over the previous 10 years.

Why am I telling this story for what feels like the 100th time? Because I think it is important to recognize that I am just like you. I am not a hero. I am not particularly brave. I am not particularly zen. I don't believe in "The Secret," and I don't read anything by Dr. Wayne Dyer. If I could get through what I got through, then anyone can get through anything. What doesn't kill you makes you stronger, yes. But what didn't kill me should make others strong as well.

And one more thing. Put your hands on your breasts every month or so, and get to know your body. The worst that can happen is that you feel something scary and have it taken care of. If I could do it, anyone can.

And anyone includes you.

For more by Lauren Cahn, click here.

For more on breast cancer, click here.

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