by Kathy Foushee
When most people hear the words “breast cancer” they think of a thin, flat-chested, bald woman with pale skin. For many, that is the reality. Chemotherapy can rob a woman of her hair, make many food tasteless, or worse, impossible to keep down. A mastectomy removes one of the most obvious symbols of femininity, the breasts. These Pink Warriors go through hell but somehow find a way through to the other side, to their “new normal.”
For others, though, the signs are subtler. They may look “healthy,” appear “normal.” They may go to work, tend to their families, and go about their daily lives with no one the wiser. Women with a lower stage of breast cancer often choose lumpectomy over mastectomy. Some require radiation alone, instead of in conjunction with chemotherapy. For these women, the outward effects are almost unnoticeable. But they suffer the same pains, insecurities, and fears as their sisters in cancer.
When I was diagnosed, the nurse said, “This is not bad.” At the initial consultation, the surgeon said, “This is not fatal. This will not be what kills you.” They meant to be reassuring and kind. And at first, I took comfort from them. After all, if medical professionals were telling me it wasn’t horrific, no matter what I thought, it must not be. Their seemingly casual dismissal of my condition made it seem…not terrible? Something like the flu, perhaps. A thing to be treated and forgotten. A co-worker, on hearing the news said, “But you look so healthy.” She meant it as a compliment, I think. Instead, their words had the opposite effect.
My treatment plan didn’t consist of the usual chemotherapy regime. Instead I had a lumpectomy, radiation, and hormone blocker therapy.
A lumpectomy involves the removal of the tumor and the small amount of tissue surrounding it as well as some lymph nodes to determine whether the disease has spread. Pain, swelling, limited motion of the arm, and nerve damage which may take months to heal are common with this procedure. Lymph node removal increases the chance of lymphedema, a painful condition caused by a buildup of lymph fluid. To reduce this risk, patients who have had lymph nodes removed are cautioned not to have blood draws or blood pressure done on the affected side.
Radiation is usually done after surgery, to help prevent recurrence. The procedure itself is painless and quick. Many women have said getting undressed takes longer than the treatment. Side effects include redness similar to a sunburn, sometimes resulting in open sores. Women are cautioned not to wear underwire bras as they can make this worse. Fatigue, lasting weeks to months after treatment, is frequently reported. Radiation also causes tissue shrinkage. For breast cancer patients, this often means the treated breast is smaller than the other. Healing from radiation therapy can take a year or more.
In addition, women whose cancer is hormone driven, whatever their diagnosis and treatment, are often advised to begin a regimen of medication to suppress the production of the hormone that feeds their tumors. For younger women, this results in premature menopause, with the attendant hot flashes, night sweats, mood swings, and insomnia. Many of these women, on the advice of their doctors, choose to have their ovaries removed, to further reduce the hormone levels in their bodies. Those who have gone through “the change” report other side effects, most noticeably joint pain and bone loss, although these can affect younger women as well
As I began to go through treatment, I started to see those words in a different light. I began to feel guilty. If this was “not bad” and “wouldn’t kill me” why did I feel so awful? Why was I in such pain and discomfort? Why was I so scared? Guilt set in. So many women had it worse than I did. I wasn’t going to DIE from this. A little extra makeup and some loose tops meant my appearance didn’t even change noticeably.
I started to question myself, my feelings. If it was “not fatal” did that mean that I shouldn’t be worried? Did “non-aggressive” indicate that I wasn’t entitled to be a part of the support group I had recently joined, a group that has given me unconditional love and encouragement and patiently answered my many questions? When my husband took me in his arms, were the tears that soaked his shirt unwarranted because I “looked healthy”? Should I be happier, less depressed, less angry? No, no, a million times no. Because I HAVE CANCER.
While I kept my breasts and my hair, I still had over a dozen medical procedures in a span of three months, not counting radiation. We have thousands of dollars of medical bills. My skin is still discolored and sensitive a month after treatment. My breast is swollen. The scar is still tender four months post-surgery. Because my cancer was hormone positive, I will have my ovaries removed later this year, which will cause me to go into full menopause at the age of 46.
I only had two lymph nodes removed, but even that low number increases my risk of getting lymphedema, so I will have to get all blood work and blood pressure done on my left arm. This may not seem like a big deal, but I’m left-handed, and my veins move. Having blood drawn, necessary to monitor my continued health and hormone levels, leaves me sore and bruised. For the next five years, I will have to see an oncologist every three to six months. I will have annual check-ups for the rest of my life.
None of these things are news to any woman who has had breast cancer. They’re routine, part of what must be done to monitor our health and ensure we remain NED (no evidence of disease – the best we can hope for). There is no cure for breast cancer. There is only treatment, monitoring, and hope that it won’t return.
Most people think of breast cancer patients as flat-chested and bald. And for way too many of us, that’s the case. But some of us “look healthy.” Some of us have a “non-fatal” form. But ALL breast cancer survivors, no matter their diagnosis, go through hell. Our lives are turned upside down and inside out. We work very hard to discover our “new normal” – whatever that may be. We are all Pink Sisters, members of a club that no one ever wants to join. So the next time you see a woman wearing a pink ribbon, don’t assume that she’s supporting a mother, sister or friend, just because she fills out her shirt and has a full head of hair. She may be one of us, too.
I am a 45 year old wife, cat mother, and university library employee. On December 5, 2016, I also became a breast cancer survivor. I wrote this partly as a rebuttal to all those people who feel the need to tell me how fortunate I am that my cancer isn’t worse, and the ones who look at me and don’t see a cancer patient because I still have both breasts and all my hair. This is my journey so far.