Monday, December 29, 2008

More time

There's a guy who used to play volleyball with my beach group--he was very good, better than pretty much anyone else who plays with us. (I am decidedly average, myself.) Unlike many people who give unwanted or unhelpful advice, he was good at pinpointing how someone could play better. One of his favorite comments was, "You have more time than you think you have."

He said it when a hard serve came over the net and someone (like me) spazzed toward it awkwardly, flailing and then shanking the ball far out of bounds. He said it when a low set sailed toward a post and someone (like me) jabbed at it, panicking, and hit the ball right into the net. He was always right, and it's one of the most helpful pieces of advice I've gotten. The better players have a lovely economy of motion, like Neo in The Matrix--realizing they have enough time to do what they need to do and do it calmly, which makes everything go better.

So why this volleyball reverie on a cancer blog? Because I'm going to assert that it's true for cancer, too: You have more time than you think you have. True as a philosophical statement, true on many levels. You have more time to make decisions in the very beginning--it's not necessary to rush into surgery in 3 days and rush into treatment after that. It's OK to take the time to make the decisions well. You may have more time in life than your diagnosis suggests, who knows; my aunt Sylvia lived for 11 years past her prognosis of 2. My grandma, who died of lung cancer, outlived her prognosis by a couple of years.

Perhaps most important, though, you have more time than you think you do right now. Cancer is easy to obsess over, but think of all the time it claims that way--time it takes away from living life.

It's a good mantra in general, I think. You have more time than you think you do.

Thursday, December 25, 2008

"Chaos" within a breast cancer cell

The New York Times publishes a short piece today about how cancer cells have their DNA rearranged in odd ways, and the graph below illustrates scientists' identification of that rearrangement in a breast cancer cell. I just think it looks cool.


Christmas

Tonight, we watched It's a Wonderful Life, from beginning to end. I haven't watched it that way for a long time. You see all the awkward editing cuts, you spot the few ludicrous moments (she swoons!), you really notice details like "Ernie and Bert," and where the end-credit logo for thirtysomething came from.

And yet that Capra optimism, that sweet message, can't be dimmed by its sincerity and lack of ironic distance. It is a wonderful life, just having it; having the cold winter rain outside and the warm blankets inside; having the family members who make you want to pull your hair out, because they are family members whom you love dearly and want the best for; having trivial frustrations that feel large, like a bump on your tongue, and then walking with your dog by the marina at sunset and watching pink-gold light flood the masts.

During chemo, I would gaze at my own hand sometimes, waving my fingers and thinking about the complex miracle of chemistry and consciousness that made the bones move and the tendons stretch. Of course, I was thinking about how that stops, someday. And that's part of what makes life wonderful, too: that it hasn't stopped yet.

I'm not a religious person, though I was raised celebrating Christmas, and each year the holiday does become a bit removed, for me, from its religious intentions. But this year, when our whole country has decided to unmoor it from commerce, when my household is giving gifts of water buffaloes and debt reduction, when we're quiet and contemplative and watching It's a Wonderful Life on Christmas Eve, the meaning creeps back in.

So let me wish everyone out there--those who know me, those who don't, those who are dealing with active cancer right now, those who are fervently hoping or praying it doesn't come back, those who have lost loved ones, those who are holding on to them--a deeply enriching and peaceful Christmas. I hope you have a day in which you can be fully alive, and rejoice in it.

Sunday, December 21, 2008

What I Eat

I've promised many times to post my post-cancer diet. "Diet" is right and wrong; eating this way helped me lose almost 40 pounds (so far), but it's not about dieting the way our society tends to think of it, and it's not about being thin for vanity's sake. It's about a lifelong way of approaching food and nutrition so that these things are part of making me healthy (being thinner so that I don't have fat as a risk factor; exercising for even more risk reduction). It's about a changed relationship to food.

First and foremost, the idea is to eat as close to nature as possible. We hear all the time about the crazy toxins and contaminants in food. Even if you eat stuff right out of the garden, of course, who knows what jet fuels and refinery emissions have settled on your zucchini. So (as I ponder just below) no, there is no absolute control. However, we can do a whole lot by cutting down on overly processed foods, with their extra chemicals; and we can shift things so that most of the calories come from real nutrition, rather than from fillers or corn syrup.

The second major principle (really a cluster of principles) is about evidence-based practices--that is, using food in ways that solid research has shown to reduce cancer risk, specifically. Low fat (10-20% of calories only), high fiber (30-35g per day), lots of antioxidants (green tea, cinnamon, turmeric, cruciferous vegetables)--all of these have a central role.

It's funny, because at first it was enormously difficult for me to eat this way. Then it became a way of life. Then I kind of backslid, while teaching, out of laziness and a reversion to the "comfort foods" of old habit. Since my class ended, I've been pretty strict again (I tell Noah I'm "hitting the reset button") and it has been ridiculously easy. So it can be tough to start this kind of habit, but it's really not tough to maintain. (My comrade-in-cancer, though, who just finished chemo, utterly refused the nutritional oncology approach. As a trained chef, she has too much value for butter. I can certainly understand priorities. Who knows how long we have, and perhaps for some people a butter-less life is not as worth living!)

In any case, at long last, here's the basic outline. I'm skipping a lot of detail because the specifics of the diet are copyrighted by Rachel Beller, my nutritionist, but this will still tell you a lot.

Breakfast:
3/4 c bran cereal (Nature's Path Smart Bran is my favorite; Fiber One has the most fiber)
3/4 c almond milk
OR
1 c greek yogurt (fat free) w/1/2 t cinnamon
1 mini bran muffin

Snack:
something like fruit (1/2 banana, some blueberries, etc.)

Lunch:
vegetables (e.g., salad) and lean protein (e.g., fish)
For example: large (3-4c lettuce + other veggies) salad with salmon, using plain balsamic vinegar as a dressing; or perhaps using a locally-made dressing called Galeo's miso caesar, which tastes amazing and is super low-fat. (Commercial nonfat dressings are a no-no because of chemicals.)

Snack:
tomato soup (no cream) or gazpacho, raw veggies, etc.

Dinner:
vegetables, lean protein, salad, soup
For example: 2-3 lbs grilled veggies (asparagus, broccoli, chard), grilled halibut, side salad and miso soup

Snack:
yogurt, popcorn, or something else

It's pretty plain when written out like this, but it really leaves a lot of flexibility in terms of preparations, seasonings; I can have Indian or Mexican or Italian or Chinese food this way, as long as I watch out for the fats and privilege veggies and fish above bread or cheese.

Anyway, at long last there is the basic diet, and I hope it is somewhat helpful for someone out there!

Wednesday, December 17, 2008

Control

Watching a close family member deal with the early days of cancer treatment is reminding me of cancer's biggest lesson: You Are Not In Control.

Those first few days and weeks were mind-numbing (or head-spinning; or both). You don't have enough information to make decisions, but you have to make decisions immediately. You are tasked with quarterbacking your own medical care though you do not have the lifetime of learning and experience that your doctors have. You must choose between providers without knowing what defines quality, or how it's measured. There is absolutely no way to find a shortcut solution to the months of pain and fear and difficulty that await you; and once treatment starts and you're pumped full of poisons and you're thrown vehemently off balance by nausea or bone pain or sadness or dying cells, there is exactly nothing that you can do that restores that balance until time and healing take their own natural courses.

I have always been a person who saw exactly what I wanted in any situation, and could figure out pretty quickly how to attain it. I am not passive. I confront, I pursue, I accomplish.

But cancer doesn't care about any of this. It laughs at initiative, scoffs at competence. The most painful loss in cancer is the loss of belief in control. Unlike a body part, removed surgically and cleanly under anesthesia, control is ripped away painfully--bloody and ragged and unwilling.

Recovering from cancer restores some of the illusion of control, but I gotta tell you, it is now impossible to revert to the full belief. There are situations happening in my life--I so wish I could share them, but for so many different reasons, and to protect so many different people, I simply can't. But I face these difficult situations and all I can see is that every alternative is fraught and imperfect, and there is exactly nothing that I can do to sidestep all pain and trouble. Perhaps I'd have learned this lesson without cancer. But I learned it with cancer, and life just keeps reviewing the lesson.

Tuesday, November 25, 2008

The Case of the Disappearing Cancer

I've been sent articles several times already about this Norwegian study that concluded that some breast (and other) cancers may spontaneously disappear, without treatment. I don't really have much comment of my own, because before I could really think deeply about the study, I read this fantastic response by a "skeptical OB-GYN," who writes a terrific, point-by-point analysis. Some highlights:
The study only looks at incidence of cancer. It does not look at outcome and life expectancy. If it turns out that the women in the study group have a much lower incidence of death from breast cancer, because they are treated early and aggressively, it will justify the apparent over diagnosis of breast cancer.
And,
there is no way to tell the difference on mammography, or by any other technique, between the cancers that will disappear and the ones that will go on and kill the woman.
To me, these two quotes really say everything we need to know at this point. However, as winter comes and my summer tan fades, and I note in the mirror greater evidence of the premature aging effects of chemo; as I read on the web that a close family member's kind of lung cancer is often treated with Taxol, and I think back on the bone pain and the horrible allergic reactions; as I think about the months of my life "lost" to sitting miserably on the couch; as I think of the awfulness that is cancer treatment, I certainly hope that researchers follow up on this study and find a way to make the important distinctions. Let's get rid of chemo for anyone for whom we can!

Tuesday, November 11, 2008

"Good" cancers

I've been gone for a long time. Mostly that is because of work--I've had a highly absorbing course to plan and then start teaching. I'm still in the midst of it, and it leaves little time for anything else. A little less, it's because I reached a point of feeling exhausted by the constant recognition of being a cancer survivor. It'll probably never be possible to see cancer as something that happened in the past, like that one embarrassing drunken night in college with my guy friend, which the two of us immediately pretended never happened; or the period of my life when I was unable to have an effective argument because I'd lose track of the logical flow of speech. Those things will never happen again. Cancer might.

Anyway, on that topic (somewhat), here's a blog piece that appeared in the NY Times today, by a guy with prostate cancer who rails against the notion of "good" cancer.

And let me just send a shout-out to a loved one who also has prostate cancer, but on top of that is in the hospital recovering from surgery for lung cancer, which most people would decidedly not call a "good" cancer. He is enormously healthy and I think he is as likely as anyone to beat cancer down again. (He had it once before, over 4 years ago, and was treated successfully with surgery--this is a new primary cancer, not a recurrence.) But again, cancer sucks. It just sucks. It keeps hitting all these damn people I care about, and even if they (we) survive, it still takes things away. Months... Years... Lungs... Breasts... And any illusion that any part of life is the smallest bit fair.

I want to end on that angry note, but I can't. I'm also enormously excited and have to acknowledge the election of Barack Obama. This is a man whose mother and grandmother both died of cancer. He knows the cost. In his infomercial, he said that his mother's death taught him that you have to seize opportunities when they happen, and suggested that that's one reason why he chose to run for President so early. He has a lot of critical priorities and I don't know where cancer falls on his list, but I can't help but feel hope, that this President really understands what a scourge cancer is, and how unfair and brutal it is, and how we absolutely must defeat it. Now that's a war I can get behind.

Saturday, September 06, 2008

There's a new ad on my blog

Look in the right-hand column. See the bobbing head? (I am not wild about that, but it came with animation, so there we are.)

Ryan, a Hodgins lymphoma survivor, took the lemons of his cancer diagnosis and made lemonade--and lemon hats, lemon shirts, lemon coffee mugs... Seriously, I like the irreverent attitude and non-pinkness of this swag, so if you or your cancer-stricken/cancer-surviving loved ones are looking for the perfect statement, go buy from Ryan. (I don't even get a cut!!)

Here's the one I'm planning to get (clickable image):

Sunday, August 31, 2008

Almost unimaginable

When I was first diagnosed, my oncologist talked seriously with Noah and me about whether we wanted to have children. Chemo often puts women around my age--late 30s and up--into early menopause. Sometimes it's temporary, just during treatment (as it turned out in my case); other times, it just keeps going after treatment.

We were advised to consider carefully whether we wanted to pursue egg harvesting or in vitro before I started chemo. It took about 2 seconds to decide that no, if the dice rolled that way, we were perfectly willing to adopt one of the many children out there needing a family and a better life; let's get going and cure me now, thank you.

As easy as that decision was for me, I'm sure it's quite tough for many women. And it seems unimaginably agonizing to think of learning you have breast cancer while you're already pregnant. The NY Times' latest thought-provoking breast cancer article is a long piece about the current state of treatment. It's really amazing--it appears that pregnant mothers can receive chemo through most of pregnancy without apparent harm to the developing child. Nonetheless, the depiction of new mothers--having just given birth, dealing with a newborn, and now going through more rounds of chemo--just makes me shudder. It is hard to go through cancer treatment. I stand and salute the women who do it with that much more at stake, and that much more to make it tough!

Thursday, August 21, 2008

Role Models and Broken Records

I was really surprised, and then really happy, to see that Christina Applegate is being so open about her response to her breast cancer. In case you've been on a desert island for the past few days--her mom struggled with breast cancer, surviving it twice, and Christina tested positive for the BRCA-1 gene. This puts her at high risk for getting breast cancer again in the future, so she opted for a double mastectomy, and then went on a morning talk show to tell the world about it.

As a starlet prized for her appearance, this has to be tough, but her attitude is great. And I just love the message it sends to all women who face the reduction or removal of breasts as a result of this disease: You don't have to be ashamed, you don't have to feel invalidated, and your life is far more important than your boobs. Oh, and along with those other women rushing out to buy fake ones anyway, remember you'll have perky ones in the nursing home.

It's no less traumatic to face a mastectomy, I'm sure, just because a celebrity has talked about hers. But it's just one more area of life in which we don't have to be silent, to hide in shame; we can speak out and own our experience, and know that we are still worthwhile and valuable even though something has been taken from us. Damn right!

Finally, I've said it before and I will keep hollering about it: We can cut our risk enormously by just watching what we eat and really exercising. Apparently most Americans already know this, and yet we're still not doing it. Watch a slightly fluffy treatment of the topic by CNN's Sanjay Gupta:

(It's looking like the embed might not be working; if not, here's the link.)



Now, I know it's hard. After losing 37 pounds post-treatment, I recently gained 6 of them back, and now I am having to watch my food strictly once more. (Exercise I have covered, with beach volleyball--go USA!!--at least 6 hours a week.) As I forego bread and use balsamic vinegar in place of salad dressing, I feel some pain. But a) eating healthfully is a lot more fun than going through chemo; and b) my life is too important not to do it!

Edited to add: I've already gotten rid of 3 of the 6, in just a few days. Yay.

Monday, August 18, 2008

A-ha...It's a theme

Following up on my post from a few days ago: Today, salon.com's advice columnist replies to a letter-writer who, in her 30s, has survived cancer and isn't sure she wants to go back to her exact pre-cancer life. It must be really tough to be filled with a fire for living and have everyone else standing around you with buckets.

The letters section already has a little debate going (and, as of this writing, there are only 5 or 6 letters). Should she do what she wants, bucket brigade be damned, in the spirit of living her life to the fullest? Or should she rein in those impulses, recognize the precious gift that is a community of loved ones in her life, and accept some limitations in exchange for those ties that bind her to others and to this world? It's a hard question, and heck if I know the answer.

Monday, August 11, 2008

Who I was/Who I am

The NY Times, in its ongoing fabulousness, has an article today about coping with identity changes, and I love it.

Two quotes in particular stand out. First,

A critical illness is like a great permission, an authorization or absolving. It’s all right for a threatened man to be romantic, even crazy, if he feels like it. All your life you think you have to hold back your craziness, but when you’re sick you can let it go in all its garish colors.

This is so true. And once the critical illness is over, the permission fades. You were allowed to deviate, given lots of leeway, even permitted to say NO to things and to live your life to maximize health rather than busy-ness. But as time passes, people stop thinking that you are delicate and must be handled with care; they start thinking it's time you stopped whining and started being like everyone else again.

The other quote I loved:

I wanted to be someone, a recognizable personality, a full-blooded, memorable human being, and not just a cancer patient. I had already lost the person I used to be, that healthy, energetic 45-year-old woman. I wasn’t capable of losing more. Other friends had their own spins on claiming individuality in the cancer world.

I alluded to this in an early blog post. At first, I wanted so much to maintain my professional identity, to be the smart, strong person who just happens to be going through cancer treatment. I didn't want to be like those grey, wispy, shadowed people sitting in the waiting room in their headscarfs and their wheelchairs. When I had surgery and couldn't wash my own hair, it was hard to accept help because it just drove home my incapability. When I couldn't walk outside for a full half hour at a time, I felt the loss of my physicality more than I had ever felt its presence.

What the writer doesn't say, and what happened too slowly for me to watch, is that you really can go back to something like your old life, and leave that self-loss behind; but it's almost like a projection of your old life, one rendered in all the same colors and moving in the same patterns, but against a different screen, parallel to the old but never quite touching.

I actually have to fight with myself not to just go the straight denial route, and turn my back on the truth that I had cancer, and ignore anything to do with cancer. Someone close in my social circle just started chemo (her first treatment was on the 2-year anniversary of my last treatment). It is surprisingly hard for me to see her go through this, in part because I just want to deny, deny, deny; and, unexpectedly, her reality becomes a constant undercurrent for me, reminding me of what I experienced and what I am as a result.

Wednesday, July 30, 2008

What Not to Say

Wow, this is a great summary of how to interact with people who have cancer--and it was posted on Craigslist, of all places! Craigslist is totally tha bomb.

I found it thanks to the Imagine Bright Futures blog, one I haven't linked to previously--but will.

Friday, July 25, 2008

Sad news

Randy Pausch has died.

Cancer isn't a test. It doesn't separate the good people from the bad, it doesn't spare those who deserve sparing, it doesn't teach benevolent lessons and then release those who learn properly. It just kills people, indiscriminately, hastily, unfairly, too early and too often.

Thursday, July 24, 2008

All Clear

The MRI results came back--completely normal. :-)

I go back in 6 months for my regularly-scheduled mammogram, and an ultrasound just for better imaging.

Every time I get news like this it's like I just got my life back again. Which is great. You can find me this weekend, on the beach, playing volleyball. (Or, after dark, analyzing data and writing papers!)

Sunday, July 20, 2008

Not quite on topic, but very important

Hi folks--
If you read this blog at all, if you are reading this post, please click over to this other blog, by the family of a 14-year-old girl with a mysterious, undiagnosed, and rapidly degenerative neuromuscular disease. She is running out of time to find a diagnosis and effective treatment--imagine if there were no known treatment for breast cancer, or if we didn't really even know what the problem was! The family is just looking for ANYONE, anywhere, who has experienced similar symptoms--so if you are (or know) a doctor who might have seen such a patient, or if you are (or know) such a patient, please contact them. (The father is a professor in my field at another university.)
Thanks, and this just underscores yet again how randomly cruel life can be.

Friday, July 11, 2008

Needles

One thing I thought cancer might do for me was take away my fear of needles. I always hated them, in any setting. Never worry that I might become a junkie, I always said: the first time I poised that syringe over my delicate inner elbow, I would definitely be scared straight.

I became pretty stoic during the 4 months of chemo (I did not have a port or a pic line--it was a new needle in my left hand, every time; we managed to keep the same vein going for a long time before it threw in the towel and said "find someone else!"), even though I never reached truly blasé. I always asked the lab techs to "stick me" while I wasn't looking; I whimpered a little--no, a lot--when, toward the end of chemo, Lilia had to poke around for a while to find a cooperative vein. But still. I didn't have knots in my stomach beforehand, I wasn't truly freaked out, and it all seemed pretty under control. I figured it was a new era for me, needle-wise.

But it didn't last.

This has been quite the needle week for me. I had to have some fillings repaired by the dentist, and that required numbing my right jaw. I had them give me nitrous oxide while he administered the shots. Of course, I probably could have handled it, but I was a whole lot happier floating several feet away from my body while that needle was probing around my jaw hinge.

And today, I had an MRI. Now, some of you may be thinking that organizing this post around needles is a pretty back-handed way to tell you I had an MRI, so let me be informative. In late spring, I was trying on some clothes when I realized that I had increased a bra cup size on the left (that's the non-cancer side), even though I hadn't really gained any weight. And then I started noticing some aching that didn't seem to correspond with a hormonal cycle. So I called Christy, who said "It's almost certainly nothing," but endorsed the idea of my visiting one of the surgeons out of an abundance of caution.

I saw a new surgeon (Mel has moved on from USC--though I have to admit, I might track him down if I ever need a scalpel wielded again). He did a thorough exam, said it was probably nothing, but felt some lumpiness in the same area where my gynecologist found some lumpiness in December '06. At that time, I had an MRI and ultrasound, and though for a while the medical team thought there might be something to biopsy (again, out of the "abundance of caution"), by the time they went in with a hollow needle, there was no spot looking suspicious anymore.

Well, since it was lumpy again in that area--and I should mention, I am apparently just an extra-lumpy kind of gal--he ordered a new ultrasound. Which was completely, 100% clear and normal. But (always with these abundances of caution) he also ordered an MRI. Which I had today. Which I'll find out about sometime soon. Which I'll let you know about.

And which necessitated another needle--this one in my arm, for an IV push of "contrast dye," which helps illuminate all the booby tissue for better diagnosis. Anyway, this time I was anxious about the needle just like in the old days before chemo. It was like that whole toughening-up experience never happened. Funny. I have been really happy for the "reset" on so many things (getting my hair back, getting my health back, getting my life back). Too bad I also have to get back some things I didn't really miss.

Wednesday, July 02, 2008

Good eats

Much silence from me lately! This reflects both good news (trip to Europe, getting work done, playing lots of volleyball) and not so good news (I'm feeling resentful about my involuntary association with the world of cancer, partly because of its effect on my own life, and partly because someone very close in my social circle--and younger than me--has just been diagnosed and is being dragged into this world herself).

I break my silence with little to say about my own life. But the NY Times strikes again with another great piece on nutrition. This is just a general "what you should eat" article, but most of these items are on my nutritional oncologist's list of things to eat every day.

Bon appetit!

Saturday, May 24, 2008

Living (off topic, but not really)

I am not a traditionally religious person at all, but this story of a street preacher in Oakland just blows me away. One thing that cancer taught me was the importance of living fully and authentically, with courage, following the deepest part of your soul. I also feel that there must be some meaning, some way that we build something that will outlive us--whether through creative works, or academic articles (me), or through the impacts we can have on others. Well, this guy is like the poster child. I just find it very moving.

Then there's this piece from the NY Times, which also moved me on several levels. First, it's an echo of The Wire, my favorite TV show, which depicts the complexities and heartbreaking realities of the life of a modern city. The show and the article both focus on Baltimore, on inner-city kids who don't have much of a future to hope for and about whom most of the world doesn't really care. The article, which is about a lottery for inner-city kids to get into a new prep school, reminded me also of cancer--of that lottery of luck in which your wheel spins agonizingly and stops, the black ball dropping into that slot and a year of surgery and chemo and radiation and weakness and hair loss becoming your prize. Such random fates distinguish the blessed from the forgotten. I got cancer, and lost that particular lottery; generally, in life, I'm quite blessed, and have the kinds of fortune that others might dream about. There's nothing at all fair about any of it, and nothing understandable.

Thursday, May 22, 2008

Ted Kennedy = attention to cancer

I was of course very sad to hear about Ted Kennedy's diagnosis of brain cancer. But it is prompting some useful attention to cancer issues. Given that there's been a major oncology conference happening in the past week also, there's been lots of useful cancer news. Here's my favorite one for today:

From CNN, a terrific piece on "what to do when you're diagnosed with cancer." It is a terrific road map for the steps that need to be followed in those first, crazy, terrified days.

Next, be sure to check the comments section from my last post, where a kind reader posted the web address for an article on how vitamin D helps with breast cancer treatment.

Wednesday, May 14, 2008

In the news

I have certainly been reticent lately. (That's reticent, not reluctant!) The blessing and the curse of being back to "normal life" is that I am mired in the quotidian tasks of work and errands. The good news is, we will be going on vacation in a couple of weeks, to Northern Italy, Slovenia, and Croatia. I am very excited. It'll be a 3-week trip, hitting lots of lovely places (Alps, Venice, seaside Istrian resorts...). And our house and dog won't be lonely, since there will be visitors throughout our time away, enjoying the beach life in our absence.

But I'm here for business, so let me get to it. The other day, NPR had a very interesting story about a new study (published in JAMA if you want to go get the actual study; full paper here, subscription required; the NPR audio is here) regarding diagnostic technologies. Apparently mammography plus ultrasound found 28% more tumors in women with dense breast tissue (like me!) than did mammography alone. That's a rather whopping increase, I think. The procedure was recommended (by the authors) primarily for women at high risk, rather than those undergoing routine screening. As someone who's already had breast cancer, some sources say that I am at high risk, so I will be talking to my doctor before my next annual mammogram!

And a second important story. Now people--does anyone out there really still not get it that we need to exercise? That we really, really need to? That all the rationalizations and justifications in the world do not prevent breast cancer, but that moving our butts even a little bit will start to help, and moving them a lot will really help? (Plus all those other benefits, like fitting into jeans.)

Anyway, now I hope that everyone with a daughter starts to make it a priority to be sure that she does not sit on her own butt, become a couch potato, shun PE (as I did!!), or otherwise grow up without learning that physical activity is a really fantastic part of life. If you can't do this for her enjoyment, then do it for her life. Another new study published this week found that adult breast cancer risk was substantially cut for women who had exercised as girls and teenagers. That's right--it's not enough to turn women loose to discover exercise once they're grown. We need to start them early, so that the next generation can have a better shot at avoiding induction into the Breast Cancer Club.

I hope all my friends, family, and kind readers will take this to heart for the young women-to-be whom they love!

Thursday, April 24, 2008

More problems--and one solution!

I'm sure everyone has been following the latest bad news about Nalgene and baby bottles? The regulatory focus has been on baby products, since the chemical in question--bisphenol A--poses risks to development. But the chemical is also implicated in breast cancer (see the end of the article). I'm glad to see that Nalgene is changing its plastic, and that there are tips available to minimize BPA exposure. But as a longtime drinker from Nalgene bottles (and eater of canned foods), I also wish this information had come out earlier.

Now onto the good news. I've been complaining (even more off-blog than on) about the fact that modern corporate farming and food distribution has led to less-nutritious, less-tasty food that poses greater health risks. I've been wishing that I had the time to grow my own food, or that we had a direct line to people who farm organically and could get us fresh produce, not stuff picked a few weeks ago and left to ripen in a dark truck.

Well, it doesn't take much internet sleuthing to find that this is entirely possible. Community-supported agriculture may be a relatively new movement, but it's well organized! I've found 2 potentially good farms in my area. The costs are higher than at the grocery store, I think--and that stinks, because again, healthy food should not be something available only to rich people. But for us, the costs are pretty manageable, and I'll be looking into this more. Just think--peaches and tomatoes that really taste like peaches and tomatoes. Keep you posted!

Tuesday, March 18, 2008

And more...

I'm sure almost everyone has heard the story that broke last week, about pharmaceuticals in our drinking water. The linked article highlights estrogens as one component commonly polluting our water. Now, my breast cancer was hormone negative, but the vast majority are stimulated by estrogen or progesterone, or both. As women worry about avoiding soy milk, I wonder if they think about the risks in drinking water--risks that can't be avoided, apparently, by switching to bottled waters. (They can be avoided through the right home filters--which is its own challenging issue.)

And I'm feeling just a little bit guilty about flushing my own toxins (e.g., the post-bladder remains of Adriamycin) during chemo...

Monday, March 17, 2008

To fight cancer, we have to fight a lot of other things...

...like our government's refusal to protect our individual lives, in favor of protecting corporate profits.

I know a lot of readers visit this blog looking for support and perspective on dealing with breast cancer, and I don't mean to offend anyone's political sensibilities. But this is germane. I struggle to maintain my survivorship by trying to control whatever I can control: to eat healthy food (not polluted, not full of chemicals, and grown to maximize nutrient value); to exercise a lot; to give my body both motion and rest, challenge and care; and to stay balanced emotionally.

And then, as much as we try to do these things, we live in a world that could either support our efforts, or be a hostile environment against which we have to fight. And when our White House decides it will lean on the agency charged with helping us have a healthy world, urging it away from the strongest and most protective standards (for whatever reason, but especially for the benefit of corporations, which do not get cancer but do make big bucks)--when this happens, I'm really disgusted and angry.

Friday, February 22, 2008

I Love Manchego Cheese

Odd title, you say? Indeed. Actually, it's the mnemonic I've used for the last couple of days to try to remember the 4 things I wanted to blog about: Interview, L., Myths, and Checkup.

Let's take them in reverse order, because the biggest and best thing is my checkup--which I had earlier this week, which included my annual mammogram as well as the blood and physical exams, which was all clear, and which officially established my 2-year anniversary of surviving breast cancer. Yay!!! (Technically, it's not quite 2 years, but I think we can assume I won't relapse suddenly in the next 2 weeks.) I've said this before, but my brand of triple-negative cancer is at greatest risk for relapse in the first 2 years. Risk drops dramatically after that until 5 years, and then it drops precipitously after that. So there's no "home free"--I am knocking wood with my elbows as I type--but this is a Big Deal anniversary.

It's almost like I might start to dare to imagine a life in which breast cancer never comes back. It's an audacious thought, but I just might get there.

OK, second--myths. Recently--on blogs and websites--I came across some very credible-sounding information suggesting that I should get my subsequent gynecological care from an oncological gynecologist. The information suggested that women who have had breast cancer are at significantly increased risk of ovarian and uterine cancers, and that they (we) should be closely monitored. Note that I have not linked to this information. That's because I asked Christy, my oncologist, about this at my checkup, and learned that in fact the higher risk of reproductive cancers is only true for women with some of the genetic (BRCA) breast cancers*--not for me. And, at USC, the oncological gynecologists will not even see healthy women (including BC survivors)--it's not medically warranted.

It continues to amaze me how many myths are out there about breast cancer, and how much misinformation abounds. Of course, there are also legitimate differences of opinion among physicians, but it is so easy for false "wisdom" to take root.

Speaking of this--did anyone say "malpractice"? I've been repeating this horror story to several people recently and I still can't quite believe it.

A friend of a friend was recently diagnosed with breast cancer. She lives in a small town, not near a major university medical center or comparable breast center. After her surgery, she was told that her tumor would not be tested--since most tumors are hormone positive, she would just be treated as if hers were. That means she would have hormone therapy and no chemo. How appalling! First, hormone therapy is pretty nasty, according to my friends who are on it. It may not make you lose your hair, but you lose other things--from sleep to bone density. No one should be on hormone therapy if it's not absolutely necessary. Second, what if this woman is a triple negative, like me? In our case, chemo can be all the more important--a recent study (cited in a post below) showed that it can make all the difference in survival.

This woman is so relieved to be told she won't have to have chemo that she hesitates to push further and ask more questions. Fortunately, with our mutual friend's prompting, she has gone back and asked for more, and the pathology tests are finally being done, and I hope she will have appropriate treatment. When I told Christy, her eyes blazed and she said "Malpractice!" instantly. It's scary to think how many thousands of women out there could be being treated like this. All my blogosphere pals and support group friends tend to be well to do and urban; I worry for our sisters who are less economically blessed and who live in humbler, more rural places. Why should their lives count for any less?

Finally, interview. The one link I add.* This week, my local NPR affiliate, KPCC, ran a half-hour interview with Dr. Susan Love about breast cancer. It's a very interesting interview in which she talks about a test she's trying to develop for susceptibility to breast cancer (you put something like a bandaid on your nipple and produce some fluid, and a pregnancy-test kind of readout tells you if you have abnormal cells--kind of like a pap smear for breasts, to give early warning before cancer actually develops); a study that found that a small amount of chemo injected directly into the ducts can kill cancer cells (no more surgery??); and, frustratingly, "the 5 kinds of breast cancer," which she never actually named. Give it a listen if you have some time.

By the way, I do indeed love Manchego cheese. It's especially good with some kalamata olives and apples. Mmmm.

*I'm so sorry, but I am too lazy to link tonight. Am just trying to cram this post into a few short available minutes between work and sleep--please Google if you want to learn more, and sorry for falling short on my informational duties. I thought it was better to post at all (after my long absence!) than to wait and do it perfectly.

Wednesday, January 02, 2008

Happy 2008!

Most important to me: I was cancer-free in 2007. For the rest of my life (which I hope is very long), it will never again be trivial or easy to ignore that a year passes with good health. There is something very comforting about an entire calendar year without cancer. Yay.

I just saw an online newspaper poll asking whether readers have broken their New Years resolutions yet. It made me realize that I don't have any New Years resolutions. I have Post-Cancer resolutions, and they are basically the same ones I've had since October 6, 2006 (my last day of treatment). But because the New Year is a fine time to reaffirm them, I'll list them here, in no particular order.

  • Remember to embrace relationships in my life. With Noah, with my parents, with extended family, with friends, with colleagues--life is a social experience. I will make choices that keep me connected, as much as possible.
  • Treat my physical body as something important and valuable. It's the vessel that carries me through this life. I tend to live in my head, and for most of my life I ignored or even resented my body. No more. I will make food choices that nourish and energize me; I'll focus on pleasure in food through nourishment, not indulgence; I will exercise regularly. When I am tempted to stay in and work rather than playing volleyball for a few hours, I will remember that exercise cuts cancer risk, and that my healthy body can more easily sit at the computer for hours, later, to work!
  • Work for the joy of work--for the questions I want to answer and the things I want to say. Don't get stressed by the headlong pursuit of tenure; instead, remember that I chose a career I'm passionate about, that I care enormously about the work I do, and that I am incredibly lucky and happy to have this job. When I work (even during those weeks when I'm working 12 hours a day, every day), I'll work in this spirit.
  • Stay in touch with the spiritual side of life. For my own spiritual practice, this means setting aside time to sit and be quiet, and continuing to work on compassion and nonattachment.
So, at this New Year 2008, I reaffirm my commitment to live my life consciously and deliberately, and to keep my cancer resolutions active--not to let the elapsed year make them fade.

And I am so excited that 2008 will finally bring the end of the GWB reign! ;^)

Happy New Year to everyone--health and joy to all.