Some deja vu experiences are more pleasant than others. Well, actually, a deja vu is more of a mildly surprising attention-grabber. A vague, indistinguishable memory. Really, more perplexing than anything else. Today, my deja vu was neither pleasant nor vague. Instead, it felt more like the opening of a barely-closed, deeply painful wound.
My friend and neighbor met me at the door, her face still tear-stained, and abruptly announced that she had breast cancer. She pulled her shirt aside, revealing a surprisingly bright-colored bandage. "They did the biopsy yesterday. I've got cancer." That bandage had no business being so bright, not in the presence of what I was hearing.
I always seem to respond in the same way to this news. Before I go on, and please forgive me for so obviously and unimaginatively directing your attention, but I want you to take notice of that last sentence; that I "always respond in the same way." I want you to take issue with the fact that I have heard this news not once, not twice, but more times than I care to even count here. And I want you to take issue with not only this dreadful news, but also the frequency with which so many of us have had to hear this news. Cancer is an unacceptable, oft-times preventable, epidemic. The plague of the 21st century.
All digressions aside, I do respond in the same way. And, in the midst of my response, I always become acutely aware of what I am saying and I begin to worry that my response is inadequate, unwelcome, unexpected. I worry that, in that moment when perhaps a hug is what is needed, my response is, somehow, cold and uncaring. My response has, however, remained unchanged.
After an initial stunned silence and a long embrace, I automatically switch into "doctor mode." I want to know the details. What, exactly, did they say? What tests were done? What tests will be done? Is it estrogen-receptor positive? What is being recommended and why? And then I start talking about what must be done nutritionally. That nutrition is, ultimately, going to be what gets you back on the road to health. That, in fact, adequate nutrition is critical for the successful treatment of cancer.
All details aside, I do care. I do care about this business of living, this business of loving my friend and neighbor, this business of loss. And, as I drive away, the gravity of the news begins to settle. And all of the diagnostic and treatment details coalesce into the reality of the mental pain, the emotional pain, and the physical pain that comes with a cancer diagnosis. And my tears come. Always, in my car, where calm and strength are no longer required, I weep. Deja vu. Again.
Friday, November 30, 2012
Monday, March 26, 2012
Hope
Today was my first visit to the illustrious Mayo Clinic. It is, at least, impressive to behold with its marble floors, leather seating, and rich wood texture. I couldn’t decide whether I was in a Las Vegas hotel, where the odds are stacked against you, or a clinic. And, as I walked up the marble stairs to the 10th floor, I couldn’t help but consider the integrity of a health care system that boasted such opulence while engendering such poor outcomes. After all, “it is hard to ignore that in 2006, the United States was number 1 in terms of health care spending per capita but ranked 39th for infant mortality, 43rd for adult female mortality, 42nd for adult male mortality, and 36th for life expectancy.” (1) I was wending my way up into a house of cards.
The 10th floor housed ‘Cancer and Genetics.’ I was accompanying my dear friend, Amy, who has been receiving treatment for Inflammatory Breast Cancer. We have come to learn the results of her MRI and to meet with the surgeon to make a decision about having a mastectomy. We have come with hope in our hearts. Last week’s PET scan held positive results. The cancer was at bay. The MRI a mere formality to rule out a cloud on the PET scan. That’s what they had called it, a cloud.
No amount of opulence can disguise the fact that you are sitting in a clinical exam room. The instruments, the biohazard containers, the generic nature scene on the wall. As soon as we were seated, Amy’s demeanor changed, visibly and audibly. Her foot started to bounce up and down. Her breathing quickened. I focused on the picture on the wall. A lush, healthy green forest. My eye was drawn to a bright spot in the very center of the scene. A single, bright mushroom amongst a blanket of green.
The surgeon arrived and sat himself down in front of that picture. The look on his face produced the first crack in the hope in my heart. The words that followed could hardly be comprehended. The MRI revealed more cancer. The PET scan, the same one that had earlier given us hope, actually held more questions than answers. And because the cancer was not contained, the surgeon’s services would not be needed. Amy’s breath was ragged now. My own chest constricted as my mind struggled to comprehend what I was hearing. I understood the terminology but none of it made sense. All I could do was to focus on the bright spot in the picture hanging above this surgeon’s head. Although my head was swirling, I did not miss the absolute irony of that bright spot, that single mushroom in a field of green, hanging on the wall of the cancer section at Mayo Clinic. For research shows that medicinal mushrooms “ interfere with the processes related to carcinogenesis.”(2)
The surgeon left and the oncologist came. I am not sure what I should’ve expected from the oncologist, but it certainly wasn’t what I heard. “You’ve responded wonderfully to treatment.” Confusion. Amy questions his optimism, pointing out that the results seem to indicate that the cancer has spread. Hence, the treatment, perhaps, was not so effective. The oncologist repeats his assertion, as if we did not hear him the first time or that we were somehow not grateful. “You have responded wonderfully to treatment.” No matter how she pressed, we heard the same response over and over again. A disturbing laugh-track in a very bad sit-com. Ultimately, treatment would continue and Amy would be monitored closely. And so we were encouraged to depart, trembling, from this house of cards.
Amy stared straight ahead as we waited to hear when she would return for her next appointment. I watched her in profile, a marble bust blending beautifully into the waiting room. With my own heart feeling like a stone in my chest, I reached out to hold her hand, support her. My purpose for being here. She turned, slowly. Her eyes, welling with tears, looked unwaveringly, grimly into my own. And she said it. “It’s not good, is it?” With my own tears rolling down my face, I could only grip her more tightly. As if she was my rock. Or, maybe, to keep from losing her.
To keep from losing her. To keep from losing her, there would be no time to waste. We would start by walking right back down those 10 flights of stairs we had climbed earlier. Because higher levels of physical activity are associated with “improved survival in women diagnosed with breast cancer.” (3)
At lunch, we ordered vegetables because “current research shows that, at every step along the road to malignancy, plant chemicals tend to reduce the likelihood of transmission to the next stage.” (4) And, being in an Italian restaurant, it seemed appropriate to discuss the research article I had read the previous evening. The research indicated that olive oil was a proven adjunctive therapy in the particular type of breast cancer expression that Amy was now determined, more than ever, to beat. (5) And, additionally, fish oils act as an “anti-cancer” cocktail for this same type of cancer. (6)
Certainly, there is no magic bullet for cancer. Just as in the Las Vegas casino, you probably don’t want to pin all your hopes, all your bets, on one therapy. For Amy, we will consider all determinants of this disease – toxicity, inflammation, lifestyle, stress, sleep disturbances, protein malnutrition, vitamin and mineral deficiency, genetics, hormones, immune dysfunction, and infection. And we will consider all options for healing. Including medicinal mushrooms. A bright spot of hope.
1) http://www.nejm.org/doi/full/10.1056/NEJMp0910064
2) http://www.ncbi.nlm.nih.gov/pubmed/22339703
3) http://cebp.aacrjournals.org/content/18/1/306.short
4) Marwick, C. Learning how phytochemicals help fight disease. JAMA. 1995;274:1328-1330. Nov 1, 1995.
5) http://www.ncbi.nlm.nih.gov/pubmed/15642702
6) http://www.ncbi.nlm.nih.gov/pubmed/17134970
NOTE: For the purposes of this blog, I have changed the name of my friend to Amy.
The 10th floor housed ‘Cancer and Genetics.’ I was accompanying my dear friend, Amy, who has been receiving treatment for Inflammatory Breast Cancer. We have come to learn the results of her MRI and to meet with the surgeon to make a decision about having a mastectomy. We have come with hope in our hearts. Last week’s PET scan held positive results. The cancer was at bay. The MRI a mere formality to rule out a cloud on the PET scan. That’s what they had called it, a cloud.
No amount of opulence can disguise the fact that you are sitting in a clinical exam room. The instruments, the biohazard containers, the generic nature scene on the wall. As soon as we were seated, Amy’s demeanor changed, visibly and audibly. Her foot started to bounce up and down. Her breathing quickened. I focused on the picture on the wall. A lush, healthy green forest. My eye was drawn to a bright spot in the very center of the scene. A single, bright mushroom amongst a blanket of green.
The surgeon arrived and sat himself down in front of that picture. The look on his face produced the first crack in the hope in my heart. The words that followed could hardly be comprehended. The MRI revealed more cancer. The PET scan, the same one that had earlier given us hope, actually held more questions than answers. And because the cancer was not contained, the surgeon’s services would not be needed. Amy’s breath was ragged now. My own chest constricted as my mind struggled to comprehend what I was hearing. I understood the terminology but none of it made sense. All I could do was to focus on the bright spot in the picture hanging above this surgeon’s head. Although my head was swirling, I did not miss the absolute irony of that bright spot, that single mushroom in a field of green, hanging on the wall of the cancer section at Mayo Clinic. For research shows that medicinal mushrooms “ interfere with the processes related to carcinogenesis.”(2)
The surgeon left and the oncologist came. I am not sure what I should’ve expected from the oncologist, but it certainly wasn’t what I heard. “You’ve responded wonderfully to treatment.” Confusion. Amy questions his optimism, pointing out that the results seem to indicate that the cancer has spread. Hence, the treatment, perhaps, was not so effective. The oncologist repeats his assertion, as if we did not hear him the first time or that we were somehow not grateful. “You have responded wonderfully to treatment.” No matter how she pressed, we heard the same response over and over again. A disturbing laugh-track in a very bad sit-com. Ultimately, treatment would continue and Amy would be monitored closely. And so we were encouraged to depart, trembling, from this house of cards.
Amy stared straight ahead as we waited to hear when she would return for her next appointment. I watched her in profile, a marble bust blending beautifully into the waiting room. With my own heart feeling like a stone in my chest, I reached out to hold her hand, support her. My purpose for being here. She turned, slowly. Her eyes, welling with tears, looked unwaveringly, grimly into my own. And she said it. “It’s not good, is it?” With my own tears rolling down my face, I could only grip her more tightly. As if she was my rock. Or, maybe, to keep from losing her.
To keep from losing her. To keep from losing her, there would be no time to waste. We would start by walking right back down those 10 flights of stairs we had climbed earlier. Because higher levels of physical activity are associated with “improved survival in women diagnosed with breast cancer.” (3)
At lunch, we ordered vegetables because “current research shows that, at every step along the road to malignancy, plant chemicals tend to reduce the likelihood of transmission to the next stage.” (4) And, being in an Italian restaurant, it seemed appropriate to discuss the research article I had read the previous evening. The research indicated that olive oil was a proven adjunctive therapy in the particular type of breast cancer expression that Amy was now determined, more than ever, to beat. (5) And, additionally, fish oils act as an “anti-cancer” cocktail for this same type of cancer. (6)
Certainly, there is no magic bullet for cancer. Just as in the Las Vegas casino, you probably don’t want to pin all your hopes, all your bets, on one therapy. For Amy, we will consider all determinants of this disease – toxicity, inflammation, lifestyle, stress, sleep disturbances, protein malnutrition, vitamin and mineral deficiency, genetics, hormones, immune dysfunction, and infection. And we will consider all options for healing. Including medicinal mushrooms. A bright spot of hope.
1) http://www.nejm.org/doi/full/10.1056/NEJMp0910064
2) http://www.ncbi.nlm.nih.gov/pubmed/22339703
3) http://cebp.aacrjournals.org/content/18/1/306.short
4) Marwick, C. Learning how phytochemicals help fight disease. JAMA. 1995;274:1328-1330. Nov 1, 1995.
5) http://www.ncbi.nlm.nih.gov/pubmed/15642702
6) http://www.ncbi.nlm.nih.gov/pubmed/17134970
NOTE: For the purposes of this blog, I have changed the name of my friend to Amy.
Thursday, March 22, 2012
It Takes A Village
It’s been a bustling week at our house! The kids have had friends sleeping over for much of the week. Generally, sleepovers aren’t the norm on school nights, but this week is an exception. For these are exceptional circumstances. Our young friends have each, within the last year, lost their mom to breast cancer. Two young men related only by tragic loss.
The young man sleeping on the blow-up mattress in my son’s room is staying while his dad is out of town on a business trip. Sleepovers have become familiar to him since his mom died. He needs a familiar place to stay when his dad is required to travel for work.
Earlier in the week, our other young friend was excited to sleep over. For him, about to turn six in a couple of days, sleeping at a friend’s house was a big adventure. The details as to why he was staying with us were lost on him. His mom, still grieving the loss of her life partner to breast cancer, was to leave very early the next morning to go to Mayo Clinic. She was scheduled for a PET scan to find out if the treatments she had been receiving for inflammatory breast cancer had been effective. The PET scan was to be a big determinant for what would come next in the lives of the people I love. That night was momentous. Some of us slept, blissfully exhausted. Others of us lay awake and wondered.
Tonight, after all the kids are safely tucked in their beds, I drink my tea and I can’t help but feel that this past week is merely a scene from a post-apocalyptic work of fiction. After all, how can so many people be so affected by this ugly disease? I have no choice, however, but to accept the reality of a 10-year old boy who, late at night, crawls from his bed crying for a mom that he will never see again. A mom he has lost to breast cancer. And I have no choice but to accept the reality of a boy who has very recently lost his adoptive mom to breast cancer and now, on the eve of his 6th birthday, faces the possibility of losing his birth mom to the same ugly disease. That same soon-to-be-six-year-old will soon lose his grandmother to cancer. His grandmother, who has cancer of the liver and the large intestine, has been given a week to live. The family suspects that the cancer started in the breast, but we don’t know for sure. Biopsies, diagnosis, and treatment have all been refused. Regardless, any day now, a little boy will lose yet another loved one to cancer.
Perhaps it is the apocalypse. The apocalypse of cancer.
At the end of World War II, a woman’s lifetime risk of breast cancer in the United States was 1 in 22. Today, the risk is 1 in 8. 1 in 8! These statistics have very little to do with genetics and very much to do with environment and lifestyle. In fact, “the increasing risk of breast cancer and other cancers has paralleled the proliferation of synthetic chemicals since World War II.”(1) And, “after smoking, obesity is the highest preventable cancer risk.”(2) Sure, genetics play a factor. But, environment and diet and lifestyle are leading, preventable cancer risks. Statistically speaking, we have the capability to eliminate 2/3 of cancer!
It has been said that it takes a village to raise a child. In our village, where the well has been poisoned, we cobble together families to support each other and to help tend the motherless children. We do live in exceptional times. Apocalyptic times when cancer is no longer the exception, but the rule.
It’s time to change the rules.
Stay tuned.
1. http://tuftsjournal.tufts.edu/archive/2003/february/oped/index/shtml
2. http://www.newscientist.com/article/dn12856-obesity-increases-the-risk-of-cancer.html
The young man sleeping on the blow-up mattress in my son’s room is staying while his dad is out of town on a business trip. Sleepovers have become familiar to him since his mom died. He needs a familiar place to stay when his dad is required to travel for work.
Earlier in the week, our other young friend was excited to sleep over. For him, about to turn six in a couple of days, sleeping at a friend’s house was a big adventure. The details as to why he was staying with us were lost on him. His mom, still grieving the loss of her life partner to breast cancer, was to leave very early the next morning to go to Mayo Clinic. She was scheduled for a PET scan to find out if the treatments she had been receiving for inflammatory breast cancer had been effective. The PET scan was to be a big determinant for what would come next in the lives of the people I love. That night was momentous. Some of us slept, blissfully exhausted. Others of us lay awake and wondered.
Tonight, after all the kids are safely tucked in their beds, I drink my tea and I can’t help but feel that this past week is merely a scene from a post-apocalyptic work of fiction. After all, how can so many people be so affected by this ugly disease? I have no choice, however, but to accept the reality of a 10-year old boy who, late at night, crawls from his bed crying for a mom that he will never see again. A mom he has lost to breast cancer. And I have no choice but to accept the reality of a boy who has very recently lost his adoptive mom to breast cancer and now, on the eve of his 6th birthday, faces the possibility of losing his birth mom to the same ugly disease. That same soon-to-be-six-year-old will soon lose his grandmother to cancer. His grandmother, who has cancer of the liver and the large intestine, has been given a week to live. The family suspects that the cancer started in the breast, but we don’t know for sure. Biopsies, diagnosis, and treatment have all been refused. Regardless, any day now, a little boy will lose yet another loved one to cancer.
Perhaps it is the apocalypse. The apocalypse of cancer.
At the end of World War II, a woman’s lifetime risk of breast cancer in the United States was 1 in 22. Today, the risk is 1 in 8. 1 in 8! These statistics have very little to do with genetics and very much to do with environment and lifestyle. In fact, “the increasing risk of breast cancer and other cancers has paralleled the proliferation of synthetic chemicals since World War II.”(1) And, “after smoking, obesity is the highest preventable cancer risk.”(2) Sure, genetics play a factor. But, environment and diet and lifestyle are leading, preventable cancer risks. Statistically speaking, we have the capability to eliminate 2/3 of cancer!
It has been said that it takes a village to raise a child. In our village, where the well has been poisoned, we cobble together families to support each other and to help tend the motherless children. We do live in exceptional times. Apocalyptic times when cancer is no longer the exception, but the rule.
It’s time to change the rules.
Stay tuned.
1. http://tuftsjournal.tufts.edu/archive/2003/february/oped/index/shtml
2. http://www.newscientist.com/article/dn12856-obesity-increases-the-risk-of-cancer.html
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