Thursday, December 08, 2011

You Are Now Entering Cancerland. Next Services 457 Miles.

I spent some of today reading about topics formerly unheard of or of little interest, now much more captivating: radiation treatment, ductal carcinoma in situ (DCIS), recurrence risk. I called the nurse educator at SFMC to ask for her help interpreting some things Dr. R. said. I think such conversations are probably a little tricky for her, as she is herself not a doctor, and probably also does not want to appear to contradict any doctor, no matter what goofy thing the doctor has said.

For instance, Dr. R. mentioned something about a recurrence risk of 30-40%, regarding which the nurse educator said politely that perhaps he meant with surgery alone. For my diagnosis, this figure does not appear to be accurate.

I also finally understand the difference between cancer stages and grades, which I couldn’t grasp even when my mother had cancer earlier this year. Of course, she didn’t explain it quite as clearly as I’m about to. Stage has to do with the extent of the cancer: the size of the tumor, if it’s spread, whether the cancer is invasive or not. DCIS is always Stage 0. Grade, as Dr. R. correctly said, has to do with how abnormal the cancer cells look under a microscope and therefore how quickly they are likely to spread.

Beyond that, there are many other aspects of a breast cancer diagnosis, including whether the tumor has receptors for estrogen and/or progesterone, meaning that treatment might include blocking the effects of those hormones. Mine has both kinds of receptors. I also learned that the word “tumor” is used even if there’s not a lump as such. I have no lump (and don’t want one) and there is nothing that could be felt by the human hand even if one knew just where to go, but it’s still called a tumor, meaning a growth of tissue.

When I had the hysterectomy in late October, to treat symptoms that weren’t in themselves troublesome but that could potentially develop over time into uterine cancer, I didn’t have my ovaries removed. I figured it would be good to let them do their thing—make estrogen—until they stop on their own, which can’t be long off, anyway, but what I should have done—what was I thinking?—is divine that less than six weeks later, I’d be diagnosed with hormone-positive breast cancer and have them removed with the rest. Oh, well, I’ll definitely do it the next time I have my uterus removed.

So far, my life looks about the same, but things feel quite different, as if a sheet of glass has slid between me and the rest of the world. I can see everything and everyone just as clearly as before, but I’m in some other place where I have to travel alone, where no one can truly accompany me. It’s a little lonely at moments. Who knows now when I’ll get to make that trip to see my family?

But I was reflecting today that things are as they are, and one way things are is that I’m quite alive, with every likelihood of remaining so for the time being. Even if I knew I was going to die in two weeks, would I want to spend all of those final moments thinking, “Oh, my god, I’ll be dead in two weeks”?

My meditation practice is helping immensely. The night of the day I was diagnosed, I sat for 45 minutes, even though it was already 11:30 p.m., in gratitude for all I have received. I love knowing that whenever I’m meditating, there is someone elsewhere doing the same, and that whatever feeling or experience I’m having, I’m not alone. During the time that I’m sitting, if someone in another city or country says, “I know there is someone else meditating right now,” I have made that true.

As shocking as this seems at moments, it also strikes me as considerably less dire than when my mother was diagnosed with cancer. Maybe it’s just easier when it’s you having the problem instead of your mother having it. I guess I’m more scared of her dying than I am of myself dying, and when it seemed that could possibly be on the horizon, I had to do a lot of interior work which helped then and might be helping again now, at this time of strange parallels.

As a friend said, “I know you love your mother, but just because she had cancer and a hysterectomy doesn’t mean you have to have cancer and a hysterectomy.” Too late.
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