October: Awareness Month

 

As I begin to write, I am reminded that 1 in 8 women will hear the words "you have breast cancer". The same words will be delivered this year to 240 males that live in Canada.  To be told you have cancer, among other reactions, must be a moment where time stands still.  No one knows how they will react until they are the one receiving the news. I have been told by several people "I just knew it was cancer before they told me".  I have also heard "I was shocked, I had no idea".  

I think I am safe in saying if we have something wrong with our bodies our first response is to check Google and see if we have cancer.  Although, Google is an amazing source for quick reference, it may leave us with severe information overload and a mild form of anxiety. I received a great piece of advice from an 18-year-old patient that had just had surgery for cancer.  He said, "never read the first search item on google".  From that day forward I have only read the first one by accident. I knew this young man had read everything that was possible to read on his type of cancer, and I was going to follow his sound advice.   

When I had students on Palliative, we would pick a day in October to recognize "Breast Cancer Awareness".  We usually wore cute little pink bandanas which were great conversation starters.  It was an opportunity for the students to educate anyone that would listen, and to learn from others.  The last year I did this we focused on breast cancer in men.  The Doctors were asked how many male patients they had that had been diagnosed with breast cancer.  Most said one or two at the most.  The results are not as favorable for men because they are late in being diagnosed, probably because they delay seeking help.  Men absolutely hate having mammograms, which I don't even need to explain why.  In retrospect in my long surgical career, I only cared for one male patient that had a mastectomy and I never cared for one man at the end of his life because of breast cancer.  

With each type of cancer if it metastasis, the cancer cells will travel by the lymphatic system to specific organs. For example, prostate cancer goes to lymph nodes and bones, it is not random like it may seem. Breast cancer is often found in the lymph but if it were to metastasis, it would go to the lung, liver, brain or bone. My experience was mainly with lung and brain metastasis.  I have to go back to my teaching days and share this information. If breast cancer metastasizes, those organs with the metastasis now have breast cancer cells, and the treatment for those organs is the same as for breast cancer.   

Treatments have improved since the good ole days.  In 1974 when I was working on a surgical floor as a student, women that had mastectomies were in hospital for 14 days.  On the tenth day they walked their fingers up the wall.  Hence, huge lymphedema issues.  We can all remember the massive arms many of these unfortunate women had to endure for the rest of their lives.  But I have to admit they were survivors. They had no option for a lumpectomy in those days, the breast and lymph were gone.  I believe chemotherapy was very one size fits all and radiation was radical to say the least.  Those poor women probably glowed in the dark. Today, an uneventful mastectomy surgery is an overnight stay.   

The good news is the survival rate is improving in Canada. They attribute it to early diagnosis and better treatment plans. Although 1 in 8 women are diagnosed, 1 in 39 will die from the disease. The statistics say in Canada 83% of breast cancers are diagnosed in women over 50.  About 9% of breast cancers are found in women younger than 45, probably due to a hereditary factor.  The cancer is often found at a later stage is usually aggressive and difficult to treat.  Men are diagnosed with breast cancer 1% of the time. For some reason breast cancer is typically more often found in the left breast with no reason why.   

One of the most rewarding experiences I have had in my life was when I walked along with my dearest friend on her breast cancer journey. When she told me she had breast cancer, I replied with "how do you know that"? I soon realized that what I knew was strictly medical, yes, I know the right thing to say the majority of the time and how to provide any type of treatment but take the uniform and nametag off and it was different, very different.  It amazes me how knowledgeable people with cancer become and I was now the student.  They not only have done many a google search, but they are taught by their team of specialists everything they need to know about their Cancer and the treatment plan.  Especially, in chemotherapy, I can't even pronounce the names of the drugs and every person at chemo is a pharmacist in their own right. In other words, they are empowered.  Even though my friend was up against triple negative breast cancer, I never for one moment thought she wouldn't beat it.  I wasn't just being naive or hopeful I truly believed it.  There were so many people that she called her team, that prayed and supported her why wouldn't it be okay.  And it is over seven years since that experience, it turned out okay. 

Some of the lessons I learned from that experience was the power of prayer.  I am like Julia Roberts on "Eat, Pray, Love" when she is trying to pray and says to God, "I'm not very good at this".  Well, that is me and praying, not very good at it.  I was once told if you think about a person that means you are praying for them.  That suited me perfectly and praying became thinking. I also, learned how cancer is a family disease.  Some families seem to fight a lot, some put their heads down and just do it, some don't talk about it, but in the end, they love each other through it.  Not just every family can manage cancer and I think that is one of the reasons that certain people are chosen.  I learned how desperate people want to help.  In small communities you never have to worry about a thing.  Food, money, gas cards you name it show up when they are needed.  Being sick is expensive, so any help is appreciated.  Small communities have the power to raise tens of thousands of dollars in one evening.  It takes that much to get through the expense of being sick. Lastly, I learned if you are "the friend", that is one of the biggest honors you will ever have.  Don't be afraid to step up to the plate and be honest, talk the hard talk, wipe the tears but be strong.  You just may be the only person that can help at this time to make sense of the craziness.  The fight against cancer is more than a full-time job and you are there to help in any way you can.  

When I sat down to write this, I decided I was just going to let my fingers do the talking.  If you are the one in eight, I feel you lead your life differently now than before you got your diagnosis.  You are here to teach others how to embrace the worst news you have heard, to accept "why not me" as opposed to "why me".  To be warriors against breast cancer and to wear pink with pride. 💗

When I started my career in 1976, 1 in every 35 people were diagnosed with Cancer, today's incidence is 2 in 5 Canadians.   

Light a candle in Remembrance