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Second Post-lumpectomy Mammo

8 Oct

I have already announced the results on Facebook, but for those who don’t know me in that context, I finally, finally, finally, finally got my second post-lumpectomy mammogram.  It was twenty months after the first follow-up one, which was fourteen months after they wanted me to have one.  (And the first follow-up one was three months after they recommended me to have one.  Can you tell I’m not crazy about mammograms???)  Two psychics and an intuitive had told me I was cancer-free, but I did the mammo for peace of mind for myself and for any friends who had concerns.

I was able to make the one-hour trip to the hospital free of anxiety.  I was able to walk to the receptionist and then the radiology department anxiety-free.  I was even okay while the technician lifted each breast into place, squashed them, and radiated them.  I also felt fine while waiting for her to upload the films to the radiologist who was off-site that day.  (Apparently the social worker scheduled me on a day when the radiologist was not on-site.  Those with a history of breast cancer are supposed to come Mondays and Tuesdays.  Fortunately the technician kindly allowed me to continue with the mammo that Wednesday due to the fact that I had made an hour-long trip to get there.)  (I live in a tiny mountain town in Colorado, one hour from the two nearest hospitals.)

But even though I didn’t consciously feel any anxiety, after I heard the results I was amazed at how relieved I felt.  “You are free and clear,” she said.  Phew.  It was like I finally let go of the breath I hadn’t realized I was holding.  I had thought that I’d probably ultimately be fine, but I thought (like the last few times) there would be something “suspicious” or “disturbing” that they’d want to investigate further.  At some level I just expected them to want to do extra x-rays (like they had before) or ultrasounds (like they had before) and then to want to do various rather invasive, uncomfortable biopsies (like they had before.)  Somehow I was not prepared for:  You’re good to go!

I felt so incredibly light walking out of that hospital.  I felt like I was floating.  I continued to feel joy for the rest of the day.

I am so very, very grateful for this gift.

And I am sending much, much, much love to the numerous friends who have not been so blessed.

Stalling on Getting Another Mammogram

30 Jun

(I wrote this on April 16, 2013.  It’s now June 30th.  Clearly I’m stalling not only on getting a mammogram, but on sharing this with you all.)

Hi folks.  I decided it’s time to admit to you all (and me) that I have been stalling.  My last mammogram was January of 2012.  It’s now fifteen months later and I still haven’t gotten another one.  For the average woman, this would be just fine.  But I was diagnosed with early breast cancer (DCIS – ductal carcinoma in situ) during the summer of 2011.  General practice is to get six-month mammograms for a year or two after that to keep tabs on things.  I rejected that recommendation for reasons listed in a previous blog (concerns about radiation, etc.) however even I know that I’m kind of pushing the envelope here.  I was going to compromise and get a mammogram at ten months.  Then I pushed it back to one year.  And here I still haven’t had one.

Initially I tried to get one but found it too difficult.  I still don’t have health insurance and I was surprised to find that there weren’t any free or discounted mammograms available.  Or at least none that I could easily find.  Then I was caught up in caring for my parents, preparing for and leading a retreat, packing up and moving to Colorado, and I just didn’t feel I could put anything else on my plate.

I confess I am of two minds.  There is one part of me that is worried I might have cancer again.  I continue to second-guess myself about choosing not to follow the allopathic recommendations of my surgeon and the oncologists – ie, drugs and radiation.  I haven’t been as pure with my diet as I should be and I have gotten lax with taking the supplements that would help me.  (It’s kind of mind-boggling that I have let myself get so lax with the supplements.)

There is another part of me.  This is the positive-thinking, spiritual side of me.  (Some might call it a Pollyanna rose-colored glasses side.)  Although I may not be perfect in the care of my physical body, I have made great strides in the care of my emotional/mental/spiritual side.  I have made changes in my life that feel really good to my spirit.  I’ve moved to a place that makes me happy, I am doing work that I love, I have very little stress, and I am immersed in more spiritual practices than I have been for a long time.  I know of cases in which cancer has disappeared when the person began making much-needed changes and began living the life they always wanted to live.  There is a part of me that believes I am so on the right track now.  Haven’t I learned the lessons of cancer and embraced a new life for myself?

On the other hand, I worry that if I focus on cancer – ie, get a mammogram, I will be calling it to me.  As I write that last sentence I kind of cringe at how dumb that sounds.  Simply getting a mammogram does not exactly equate with “focusing on cancer.”  I’m quite sure the average person would say, “Just get the darn mammogram so you can set your mind at ease!”

I still have reservations about mammograms.  I still think they are unhealthy in many ways – not just the radiation, but the squishing of a breast that has already faced trauma multiple times.  It just doesn’t feel like a very respectful or safe way to treat an already injured breast with previous cancer cells.  (Why doesn’t someone invent another method???  Come on now!)

I realize if I get the darn mammogram and it looks clear, I don’t have to have these small niggling worries.  On the other hand, if it shows a possibility of cancer again, yikes.

I’m noticing I’m reluctant to share this post with my friends.  They’re going to get on my case and tell me to hop to it.  I know they are.

Well, I guess it’s time to be brave and ‘fess up.  I need a mammogram.

When Fear Raises Its Head – Again

4 Nov

When Fear Raises Its Head – Again

November 1, 2012

Whenever someone has been diagnosed with breast cancer, the specter of fear is always waiting, ready to haunt again. After taking a long hiatus, it raised its ugly head again recently.

There is a beautiful Cherokee elder who lives in Bucks County.  I had met her many years ago and recently had the opportunity to reconnect with her because she knows my housemate well.  One day a couple months ago, we sat down and had a nice long chat on the back patio.  In the course of the conversation, I had casually mentioned I’d had a health scare last year.  When she asked for more details, I told her briefly and afterwards I noticed her gazing at my chest a few times, as if trying to discern something.

She showed up again the end of September and knocked on my door.  She asked me if I’d be interested in trying some mushroom medicine she had.  (Turkey tail mushroom has had remarkable success in altering the course of some people’s cancers.)  She also wanted to pray for me.

We were outside at this point and I stood facing her with my hands upturned in a receiving posture.  She placed her hands over mine facing downward but not touching, and then she began to sing in a loud and clear voice this beautiful prayer in the Cherokee tongue.

I stood there in humble gratitude with a huge smile on my face, filled with the grace and beauty of this prayer.  The prayer came to an end and then she spoke a prayer in English so that I would understand.

Interesting, isn’t it, that such an act of grace and beauty would subsequently begin, once again, the niggling dance of fear?

I found myself thinking, ‘What did she see?  What does she know?  Do I have cancer again?’

I found myself looking for other clues.  I began to notice that once again my breast, after being completely pain-free for many months, would sometimes be a little achy/uncomfortable/sore.  (And no, it is not related to my menstrual cycle which has been “on hold” for a few months now.  And yes, I’m quite aware that this could be psychosomatic.  But that doesn’t mean it’s not  uncomfortable and disconcerting.)

I decided to do an inventory of my dreams from the last month, as the elder had indicated I might have a significant one.  I noticed the following:

  • I was startled to remember I’d had a “cancer dream” just a couple days before  the Cherokee prayer.  At the end of the dream I said, “Okay, I’ll get myself checked out.”
  • In the first dream after her visit, I wrote in my journal:  “Waiting for a little message.  Instead it’s a big wave – an over-the-heads, can’t-be-ignored, get-everything-clean message.”  (That’s all I remember about the dream and it’s all I wrote down.)
  • I had two doctor dreams.  In one, a doctor was helping me birth a baby.  He knew I was stubborn and literally prayed I would come to my senses and do things in a way he felt was safe.
  • There is a coffin-sized box downstairs with someone in it.  I am freaked out by the thought of that coffin.  (Yes, I’m sure this is symbolic of me being afraid of death.)
  • In another, I am signing into a cancer center.  In this cancer center, the patients are expected to dance every day.  I am dancing – kind of cha-cha-cha-ing backwards, and am full of joy.  It’s fun!
  • Three young women approach a health food store.  It’s dark and looks closed.  The door appears to be locked.  But then I see them inside walking down the aisles.
  • I have a few dreams of family members being sick or in dangerous situations or being suicidal.
  • I have one dream of an explosion, and one dream of a gun being fired.
  • I have two dreams about rats.  In one, I am being bitten on the toe by a rat and call out, “Help me help me help me help me help me!”
  • I dream also of sharks (they don’t appear ominous), and I have a wonderful dream of a praying mantis on a flying carpet-type leaf which comes to land on me, and also a dream about finding beautiful feathers that look like they belong to a phoenix.

In the face of all this, I have decided to get another mammogram. The last one was in January.  My breast doctor wanted me to get another one in July.  A November mammogram will be my compromise.

I also started acknowledging my fears to a few friends, which helped emotionally but did not necessarily help the fears to fade.  Then I found myself voicing my fears to my therapist, and that helped greatly.  (Thank goodness for both good friends and good therapists!)

Meanwhile, I am getting back on track with my supplements.   And my diet.   My diet is largely “not bad,” but there is certainly room for improvement!  I confess I do still veer off-track with my food choices, but I come back on track more quickly and stay on track longer.  (I don’t know if I’ll ever be the kind of person who can be totally strict and rigid with anything.  But I am the kind of person who can keep fairly balanced.)

This is my update, friends.  I share it not so that you’ll worry about me, but so that any women out there in a similar boat will know that this dance with fear is normal.

(And yes, I will keep you updated.)

May you be well.

The Courage to Say No

13 Aug

So today I called to cancel my doctor appointment for September.   It was a regular follow-up/check-up with my breast surgeon – a little over one year after my lumpectomy.

My doctor/surgeon wanted me to get another mammogram prior to the appointment.  She wants me to get them every six months, for the time being.  My girlfriend, Julia, a breast cancer survivor, said this is typical after a cancer diagnosis.

The problem is I know a mammogram every six months following a cancer diagnosis is the standard recommendation for the first year or two.  But I don’t like it.

I have already voiced my concerns multiple times in this blog about the problem of the primary diagnostic method in this country also being a risk factor for contracting the very disease it is supposed to be diagnosing.  It’s a little crazy, to me, that we could be endangering ourselves while attempting to diagnose ourselves.  But there’s another issue.

Every time there is a mammogram that shows a slight irregularity – ie, microcalcifications, or something that could be either a tumor or a cyst, they’re going to want to do a biopsy.  And many of these biopsies are somewhat invasive – at least from my perspective.  When there are microcalcifications, they must do a stereotactic biopsy in order to properly locate the problem area.  For me, this was a painful procedure.  Twice.  And it does leave a little scar.  I could be wrong, but I have some concern that there will be several times my mammograms are “concerning,” and then several times I’ll have to have a subsequent biopsy, and before you know it, I’ll have received several extra doses of radiation and several more scars on my breasts.

I know what you’re probably thinking.  If it catches cancer in time, then of course it’s worth it!

But here’s the thing.  Most of us carry a few cancer cells in our body at any given time.  This is actually normal.*  The problem is when they multiply.  But if we live right – ie, eat well, keep our stress level low, exercise, keep our weight down, and stay away from toxins, excess estrogen, and radiation(!), those cancer cells will likely not multiply.  What particularly interests me is knowing that most vegetables and fruits, as well as some other foods like seaweed, nuts, beans, and grains, can actually prevent those rogue cells from multiplying.

So my own personal choice is this:  get off the clinical hamster wheel.  I don’t want a steady succession of mammos, followed by biopsies, potentially followed by more lumpectomies.  It feels like it could happen repeatedly – and with each time I’m sure I would experience the resulting stress and fear – all of which can further cause dis-ease!!!  Instead, I want to TRUST that I know what to do within my own inner wise self.  And I want to trust that my beautiful wise body can fight off cancer when I live right and eat right.

 

And I can guess what many of you are thinking.  ‘But I know so-and-so, and she has been a vegetarian and a yoga practitioner for years!  And she got cancer!’  Well, who knows what other factors were present in her life?  Who knows what part genetics played in her health?  Who knows what kind of emotional stressors or psychological issues were at play?  And besides, that’s not the point.  I am talking now only about me.

FOR ME, at least for now, I will do occasional mammograms and check-ups.  But I am NOT going to obsess about it and do it every six months. FOR ME, the obsession adds to the fear factor and is counterproductive to my health.

For whatever various reasons, I feel healthy now.  I’ve been healthy my whole life until last year and I trust that I got the message, I heard the wake-up call, and I responded by making some changes.  I feel back on track.  I am trusting my feelings.  I believe that I am cancer-free right now.

 

My current plan is to get another mammogram in December or January.  That will be eleven to twelve months since my last one.  And if that’s good, I will probably get the next one two years later.

This may sound wayyyy too risky or crazy for many of you.  And I get that and I honor your opinions and choices.  But I know I need to listen to my inner voice.  And I believe in her wisdom.

 

My hope is that gradually, I will shift my lifestyle to one that breeds truly exceptional health.  As I get my ducks in a row – greater financial abundance, more exercise and yoga, more consistent exceptionally healthy eating, wonderful healing herbs and supplements, and a joy-filled, love-filled life, I trust that I will live to a very ripe and wise old age.

But in order to stick with this plan, I have to have the courage to say no to many of the recommendations of the medical establishment.  And believe me, it does take courage to stand up to these clinicians.  I am very blessed with a practice who, though somewhat traditional in terms of allopathic recommendations, also respects the right of their patients to make their own choices.  And even so, I have felt extremely nervous voicing my own opinions.

When I spoke with the office manager on the phone yesterday, she was very nice and very respectful.  And I still had knots in my stomach just from talking with her and “sticking to my guns.”  My very non-invasive, intuitive, first-do-no-harm, personal choice guns.

 

I know I will probably receive a few comments from some readers and friends who will be worried that I’m not being aggressive enough in keeping tabs on what’s happening in my body.  But I ask that you please respect my choices.  I am choosing a slightly more moderate, less fear-based road.   For now.  If I find myself getting too far off-track, or if my intuition or dreams start ringing alarm bells, I promise to make an appointment for a mammogram immediately.

 

May you be blessed and healthy and happy and well.

 

* “Cancer is a perfectly natural process. A very small percentage of cells in every person who has ever lived turn cancerous. And the body usually gets rid of those cancerous cells before they do harm. This process has been going on for eons. It is only when more cancer cells are being created than the body can get rid of that the problem comes. With increased toxins, viruses, carcinogens, etc. our immune systems have become significantly overworked and weakened.” (http://www.angelfire.com/az/sthurston/understanding_cancer_and_cancer_cells.html)

 

Six-month Follow-up Doctor Visit

14 Mar

March 12, 2012

 

So, last Thursday I went for my six-month follow-up appointment with my breast surgeon.

 

The first thing of note happened when I was updating my information with the receptionist.  She asked, “Is Dr. Kracht still your primary care physician?”  “Yes,” I replied.   “And _____________, _______________, and _____________?”  I stared at her blankly. “I don’t know what you’re talking about,” I said.   She said, “That’s odd.  They’re right here on your chart.”  I was puzzled also. Then she must have said something about oncologists and the light bulb went off.  I said, “Oh!  I chose not to go to them.”

 

When my doctor arrived to the examining room she was very warm and friendly but also surprised and a little disappointed that I didn’t at least go and talk to the oncologists.  (One was a radiation oncologist and one a hematology oncologist.)  I replied that I hadn’t been interested in either the radiation therapy or the anti-estrogenic drug and I knew it would be hard to stand my ground if I had been face to face with them.   I knew they’d be pushing for me to go the direction they thought was best.

 

(All things considered, I still agree with my decision FOR ME!  I needed to do my own research and come to my own conclusions and decisions before allowing “experts” to exercise their sway.  However, I do, OF COURSE, honor all those who choose differently from me.  We are each individuals and we have to make our own choices.)

 

Okay, back to the doctor visit.  As I suspected, she wants me to get a biopsy.  A stereotactic biopsy.   For those who have been following my blog, my experience with a stereotactic biopsy last August was NOT pleasant.  In fact, that was the most unpleasant of all my breast-related experiences to date.  However it’s not the fear of discomfort which makes me hesitate.  It is the following two factors:

 

  1. I worry about my body having to process additional radiation.  If I were to get this biopsy done in the next month or two, that would mean that during the course of one ten-month period, my body would have been subjected to about 15 x-rays (about  7 or 8 “shots” per set of mammograms) plus two stereotactic biopsies – which would entail at least two more x-ray views each time.  That’s a LOT of radiation.  And radiation, as you know, is a great risk factor for getting cancer!  (“According to Dr. Gofman, MD, PhD, in Radiation and Human Health: A Comprehensive Investigation of the Evidence Relating Low Level Radiation to Cancer and Other Diseases, ionizing radiation is a known carcinogen, there is no safe exposure level to ionizing radiation, and the effects of radiation exposure are cumulative throughout one’s life.”  http://www.holisticcarehawaii.com/Stereotactic.htm)
  2. There are a few articles which express concern about the wisdom of “poking around” surgically or otherwise in an area that already exhibits the presence of cancer cells or cancer growth. The very act of having more surgery at that site could potentially spread that cancer farther.

 

I expressed my concerns and she heard them.  Her concern is that the one calcification showing on my January films could mean something.  If I had had radiation therapy, that one calcification could be (likely would be) a by-product of the RT.  But I didn’t, so to be safe she feels I should check it out.

 

Of course, doctors have to anticipate worst-case scenarios, while I as the patient, want to be aware of them but NOT focus on them!

 

She did say she would like me to have another set of mammograms done before the next six-month follow-up appointment.  I asked her if there were ANY alternatives.   I again expressed my concern about the radiation involved with mammograms. She reiterated that thermographs aren’t able to find anything at this earlier stage of the game.  They are not an adequate early diagnostic tool.  She said they’re working on diagnostic ultrasound technology, but it’s not ready yet.

 

So, in a nutshell, it seems I have three choices:

 

  1. Do neither of these clinical/diagnostic options (neither biopsy nor mammogram) and trust that my natural course of treatment is sufficient.
  2. Skip the biopsy and get another set of mammograms in six months’ time.
  3. Get the biopsy and then go from there.

 

When I left the office yesterday, I was leaning toward Option #2.  However last evening and this morning, I’m leaning toward the last option.  Because if this calcification represents a benign condition, then I feel I can safely wait at least a year for another set of mammograms.  If it proves to be a spot of cancer, then it would be good for me to know this now, rather than later.  However I am choosing not to worry about those decisions until I know what I’m working with!

 

Okay, it sounds like I’ve just talked myself into the stereotactic biopsy.   I guess I’d rather know for sure what is going on in my body.  Or perhaps, if I’m very lucky, I’ll be able to have the opportunity to say, “See! I’m doing just fine!”   And that would feel very good indeed.

 

Thanks for listening.

 

PS  When I woke in the middle of the night the day of my doctor appointment, I found myself thinking about my right breast and what to do about it.  I must have dozed off because I suddenly realized I’d seen an image of my breast with a vertical knife next to it.  I think that perhaps that was a sign that some surgery (a biopsy) is a good idea.

Playing the Second-Guessing-Myself Game

11 Feb

January 26, 2012

Fighting Doubts

So, here is the latest.  I went to pick up my radiology report at the hospital. As I suspected, they rated my most recent mammogram results a BI-RADS 3.   This indicates that the one microcalcification they found near the site of my surgery is “probably benign” but that some follow-up with my doctor would be wise.

I looked at the digital image of my films.  I am clearly not an expert at reading films, but I did see one big bright white spot, which is what I assume is the calcification to which they were referring.

How interesting:  “one bright white spot.”  So what is the bright side of all this?  The bright spot is I am more acutely conscious of my health and have made significant lifestyle changes as a result. The bright spot is I am learning a lot and I have the opportunity to share some of that knowledge with others.  The bright spot is I AM ALIVE and I have both my breasts and I feel quite good!  I can’t ask for much more than that, can I?!

Here, however, is my current challenge:  to stay in this place of gratitude and trust, even when I am the recipient of someone else’s fears and concerns for me.   I am noticing that when I read a message that is fearful, it takes great will for me to stand balanced in my own internal knowing and not get knocked off-course.  This does not mean that I am unwilling to consider alternate points of view, however I truly don’t want to “catch” other people’s fears or projections. I don’t believe that serves me..

Here are a couple examples of messages I have received recently:

  •  “From someone who has used diet for cancer for over 35 years … the people with the greatest success use a combination of standard treatment, meditations for guidance (spiritual help), and clean diet. Especially when caught early and handled aggressively. Once certain cancers get a foothold it is very hard otherwise. (Emphasis mine.)  If I had it to do over I would have had a complete mastectomy like I was guided to to do with my visions back in 2003 instead of the skin sparing one I opted for. So here I am dealing with it a third time. It is my diet and chemo that helped keep it local though. Don’t mess with breast ca, it ain’t leukemia that has been documented to go into remission with dietary changes alone. :)”
  • “I too was diagnosed with DCIS. That was 5/1/2008. Because by accident the US tech found another suspicious area on the day of my biopsy, that also turned out to be cancer, I decided to have a mastectomy. Good thing, the pathology study found that my entire breast had DCIS. A lumpectomy and radiation would not have been a cure for me. That was my left breast.
    I have to be honest, I worry for you. Lumpectomy without radiation is not standard treatment for DCIS. The radiation is done to kill any cells left behind. Since nothing showed on my Mammo for the second spot on my left breast, and nothing at all on the MRI, but pathology provide my entire breast had DCIS, I believe we need to go the full course. (sic)
    Certainly healthy eating will help, but I worry about you using that as a cure.
    When any woman is diagnosed with breast cancer, all women are affected. Just want you to have a long, happy life.
    Be well.”

So, just reading these comments, my guess is that you, too, will start worrying for me.  Fear is insidious, isn’t it?

Here is what  I told  myself  after reading the above comments from  very well-intentioned friends or  readers:

  1. Obviously both these women have had more aggressive or widespread cancers.  And, I believe in both cases (but I could be mistaken), the technology used originally missed something important.  Understandably, these women therefore have a greater fear of cancer and are in favor of more aggressive treatment.
  2. There are untold numbers of women who treated their cancer conservatively – with surgery alone, and survived/thrived.  So one could argue either way.   ie, Either be safe and fight this with all the tools the medical establishment throws your way, or take your time and choose what feels right for you because most cancers are slow growing and some never do  threaten  our lives.

Here are some reasons I am suggesting moderation is also an appropriate tool FOR ME:

First of all, ductal carcinoma in situ (DCIS) is not considered life-threatening. The problem with DCIS is sometimes it develops into a more invasive form of cancer and sometimes it doesn’t.  Approximately 80% of the time, it never escalates into a more serious form of cancer.

One site says the following:

“DCIS is considered noninvasive (meaning it has not spread), but does have the potential to spread to other parts of the breast if not treated. (Usual treatments include lumpectomy with or without radiation, use of tamoxifen after lumpectomy, or mastectomy.)” (Italics mine.)  http://health.msn.com/health-topics/breast-cancer/breast-calcifications

Meanwhile, an article about UCSF breast cancer oncologist Shelley Hwang, MD says the following:

“…(U)nlike invasive breast cancer, DCIS is not life-threatening.

Unfortunately, women who are diagnosed with DCIS have a higher than average risk of developing invasive breast cancer later – although some never will. (Italics mine.) As it stands, there is no proven way to predict which women diagnosed with DCIS will eventually develop invasive breast cancer. But because of the elevated risk, surgery to remove DCIS – generally a lumpectomy with radiation, or mastectomy – has become standard treatment. Treatment options are the same as for early-stage invasive breast.”  (Italics mine.) http://www.ucsf.edu/news/2009/03/8165/dcis-not-invasive-breast-cancer-and-might-not-require-surgery

I think most people consider radiation following a lumpectomy standard treatment.  However there are most certainly many women who choose not to go the radiation route.

I do want to mention that I am very grateful I got the lumpectomy.   It does give me an element of piece of mind.  It’s everything else the medical establishment recommends after the surgery that I personally have concerns about, although if I had a more aggressive form of cancer, I would likely consider them much more seriously.

Oh dear.  Guess what.  I was doing research to try to back up my point of view.  And in the process, I am finding that I really am going against the grain of  recommended treatment.  Here is something I just read which is concerning me:

“Of all the debates surrounding the diagnosis and treatment of breast cancer in recent decades, the most persistent and perplexing one involves a very early cancer called D.C.I.S., or ductal carcinoma in situ.

This cancer is noninvasive, confined to the milk duct where it arose. Some of these cancers will eventually become invasive, others never will. In autopsies, about 10 percent of women are found to have a ductal carcinoma that never became evident.

Then it is up to the pathologist to determine whether cancer is present, and if so, what type of D.C.I.S. it is. There are two main categories, a more aggressive type called comedo, which resembles a blackhead because it contains a core of dead cancer cells, and noncomedo. The comedo type may become an invasive cancer and, thus, less curable in three to five years; the noncomedo type may not progress to invasive cancer for a decade. (Italics mine.)

The guide continues, “Lumpectomy without radiation therapy is usually considered an option only for women with small areas of low-grade D.C.I.S.” An eight-year study of 814 women found that radiation after lumpectomy significantly reduced the risk of recurrence. Radiation also greatly reduced the risk of a later invasive cancer.  http://www.nytimes.com/2005/02/22/health/22brod.html

And this:

“In the case of DCIS, cells multiply rapidly and are different from normal ductal cells—they’re different in size, shape, and architectural arrangement and more closely resemble invasive cancer, says Arnold Schwartz, professor of pathology at George Washington University Hospital in Washington and a member of the NIH panel. Not all DCIS is alike; there’s a spectrum. The less closely the cells resemble their normal parent cells, the greater the potential danger seems to be, particularly in the presence of necrosis (dead cells) and in younger women (among other risk factors). All those factors suggest a potentially more-aggressive form of DCIS that may recur or become invasive cancer, says Schwartz.”   http://health.usnews.com/health-news/family-health/cancer/articles/2009/10/22/the-confusion-over-dcis-what-to-do-about-stage-zero-breast-cancer

I confess “my” DCIS is the comedo type.  And it was not graded a 1 but a 2-3 out of 4.

So in the process of writing this blog I find myself, once again, faced with some nagging doubts.

Can I fight cancer with diet, herbs, and supplements alone?  Actually, that’s not my entire plan of attack.  I have heard multiple stories of advanced cancer disappearing when the person chose to live the life they always wanted to live.  There are certainly emotional/psychological factors that affect our healing and I will continue to work on these issues as well.

My current intentions include the following:

  • Eat a primarily vegetarian diet.
  • Strive to make 75% of my diet vegetables and fruits.  (I’m not there yet.)
  • Eat as many greens as possible.
  • Eat more raw foods.
  • Keep my body in the alkaline zone.
  • Take the following supplements, all of which aid in preventing cancer, inhibiting tumor growth, eliminating toxins, helping to neutralize the effects of radiation, and/or aiding in the proper metabolism of excess estrogen (The cancer I was diagnosed with was estrogen receptor positive.)  Vitamin D, Vitamin C, flaxseed, DIM-3, kelp, curcumin, garlic capsules, a mushroom product called Agrigold, and a product called Natural  Cellular Defense are all now a part of my health regimen.
  • Exercise more.

In addition, I am going to a healer next week.

So, friends, the process continues.  Can I trust my intuition to guide me?  Can I get healthy following my own instincts?  Am I doing enough to prevent a recurrence or a more invasive cancer?  Or  (I am challenging myself to be brutally honest here) was I perhaps more afraid of the treatment than the disease?

Whichever is the case, I am determined to not let fear rule my life.  I am claiming good health.  I will feed myself not only with healthy and healing foods, but with success stories.  Stories of people who have healed themselves of cancer abound.

I think I will save that for another blog.

As always, thanks for “listening.”  May you be blessed with abundant health and happiness.

First Mammogram Post-Lumpectomy

16 Jan

January 13, 14, and 16, 2012

So, on Friday I returned to the scene of the mammogram which catapulted me on an unexpected journey last year.   Last year’s mammogram – the one with the “suspicious abnormalities” – took me on my journey to a DCIS (ductal carcinoma in situ) diagnosis and lumpectomy.  This was to be my first follow-up mammogram – almost five months after my bilateral surgery on August 22nd of last year.

I went there feeling calm.  I was not future-thinking or worrying and stressing.  But truthfully, that was probably because I was multi-tasking big time – trying to communicate and coordinate with a sister, a niece, and another caregiver about a doctor appointment for my mother that morning which had been scheduled just the night before.  I wasn’t thinking about the mammogram; I was just concerned with getting there on time while simultaneously making about five phone calls.

Anyway, long story short, the (really wonderful) technician took two x-rays of each breast and showed them to the radiologist who then ordered close-up shots of the surgery site.  The upshot is he found “one calcification”  – right next to the place where tissue had been removed during the lumpectomy.  We’re not quite sure what to make of it.  Does that mean they didn’t get it all after all?  Even though the pathology report said that the margins were clear last August?  Or is this something that happened as a result of surgery?  Apparently calcifications can form after cell injury.  Apparently it’s not unusual to have some appear after surgery and radiation.

This particular  radiologist hadn’t seen me since May 31, 2011.  He hadn’t known until he saw my surgeon’s order for this mammogram that I’d been diagnosed with DCIS and had had surgery on each breast.  He also didn’t have access to my pathology report, so he didn’t seem to have a clear idea of what that “one calcification” meant.  (Or if he did, he wasn’t letting on.)  He said he would call my surgeon to talk with her.

I kind of thought I might have heard from her by now, but alas, no such luck.

I guess I was a bit surprised by what they found but I don’t think any shock or panic showed on my face.  Instead I continued to smile, be polite, ask a question or two.  (Feels kind of strange admitting that, but smiling is usually fairly second nature for me.)  He did ask me a few questions about whether I’d had radiation therapy (RT) or not.  I’m not positive why he was asking.  It could be he was surprised I didn’t get RT (which is how I took it at the time) or it could be because apparently RT can result in some calcifications. (I found this out during later research.)   I suspect he was trying to get a feel for how “suspicious” this one lonely calcification was.  I kind of feel sorry for him having to do a report on this.  How is he going to rate this one little calcification?  How will he determine how “concerning” it is?  (To use a term mentioned in my radiology report last June.)

Mammograms are rated using the BI-RADS system (Breast Imaging and Reporting Data System.)  Radiologists rate their findings 0 through 5. You may recall that my mammograms and ultrasounds last year “earned” a 4.

The wonderful chart explaining these ratings would not copy to this blog.  However here is the verbal description of how a radiologist determines a rating:

“A negative diagnostic examination is one that is negative, with a benign or probably benign finding (BI-RADS 1, 2 or 3).
In BI-RADS 3 the radiologist prefers to establish the stability of a lesion by short term follow-up.
In the evaluation of your BI-RADS 3 lesions the malignancy rate should be < 2%.
A positive diagnostic examination is one that requires a tissue diagnosis (BI-RADS 4 and 5).
In BI-RADS 4 the radiologist has sufficient concern to urge a biopsy (2-95% chance of malignancy).
In BI-RADS 5 the chance of malignancy should be > 95%.” http://www.radiologyassistant.nl/en/4349108442109

The radiologist seemed to be unsure what to make of this one microcalcification, so I’m going to guess he’ll rate it a 3 or 4 based on what my surgeon tells him.  I imagine they won’t be able to say it’s definitively benign, so I’m guessing it won’t be a 2.

By the way, macrocalcifications are not concerning.  It’s only the microcalcifications which are.  For those late to this party, here is a brief summary on breast calcifications:

“On a mammogram, breast calcifications can appear as large white dots or dashes (macrocalcifications) or fine, white specks, similar to grains of salt (microcalcifications). Macrocalcifications are almost always noncancerous and require no further testing or follow-up. Microcalcifications are usually noncancerous, but certain patterns can be a sign of cancer. If calcifications are suspicious, further testing may be necessary, including additional mammograms with magnification views or a breast biopsy.”  http://www.mayoclinic.com/health/breast-calcifications/MY00101

How do I feel about all this?  Well, on the one hand, ONE calcification can’t be too scary.   First of all, there’s a great possibility it is a byproduct of the surgery itself and therefore completely benign.  And if it is cancerous, it’s only one little spot of it.  But to be honest, one of the things I started to do after listening to the radiologist was second-guess my decision not to do radiation therapy.  RT is supposed to get whatever stray cells weren’t removed during surgery.   It is usually considered “standard  operating  procedure”  to get radiation therapy following a lumpectomy.  Perhaps I was hasty in my decision to not go that route.  Perhaps I should have considered it after all.

I have discovered that microcalcifications often form at the lumpectomy “bed.”  In a study of 402 patients who had a lumpectomy followed by radiation therapy, 68 developed new calcifications.

The results of the study were: “In 63 cases (93%), the new calcifications developed in the same quadrant as the primary tumor. None of the calcifications initially interpreted as BI-RADS category 2 (n = 40/68; 59%) and category 3 (n = 19/68; 28%) represented recurrent disease. Nine (13%) of 68 calcifications were initially classified as BI-RADS category 4 or 5; six (67%) of the nine were malignant and three (33%) were benign at biopsy.”  http://www.ajronline.org/content/188/2/393.full

You realize, of course, that I am no expert AT ALL on any of this stuff.  The purpose of this blog is to share my experiences, my thoughts, my emotions, and the research I do.  I imagine in a few months or years some of my thoughts and conclusions will seem incredibly naive or even ridiculous, but you are getting a view of what it’s like for a woman as this stuff happens.

Anyway, after worrying a bit, I decided to pull a couple cards from some oracle decks.  The card that resonated with me the most spoke about the power of the words we use and suggested it was a good time for affirmations.  “Say it is so – and it will be so,” the author declared.  SO!  I declare that I am healthy!  (And I do feel healthy!)  I do believe that if I continue to be vigilant with my diet, I will be healthier than I’ve been for many years.  (In fact,  already I have lost weight  and have much more energy.)

Perhaps the whole reason for this one little calcification is to remind me to continue to be vigilant.  I can’t afford to get complacent.  I have to be very conscious of my choices.  My health absolutely depends upon what I feed my body and how I care for my physical, emotional, and spiritual self.

I do want to conclude by reminding myself that even though I can let myself get a bit worried, what I am experiencing is NOTHING compared to what many people on the planet are experiencing.  I am supremely conscious of my friend who only a short month or so ago discovered that her excruciating back pain was the result of cancer which had, unbeknownst to her, formed in multiple places throughout her body.  I think of her often.  It certainly helps me keep my tiny little health issue in perspective.

However, even though my health issue may be minor compared to others’ issues, I know it’s important for me to document this process so that women who go through a similar journey can learn and/or perhaps not feel so alone in their process.  Also, when I write, it helps me to process things.  Also, it’s much easier to write this blog post than to tell every friend and acquaintance the details of what happened!

Thanks for rooting for me, everyone!

May you be blessed.