My mother recently called me with a request: One of the moms at the elementary school she works at was newly diagnosed with breast cancer. Could I give her a call?
I immediately phoned Susan, a sweet, smart lady in her early 40s. She was weighing her options about surgery and doctors, and gathering information about her course of treatment. She was also terrified. I reassured her about the success of current cancer therapy, but what she really wanted to know were the little things, like does it hurt when your hair falls out? (No, but your scalp feels tingly, like someone pulled your ponytail too tight.) These are the questions that fall under "What you always wanted to know about having breast cancer but were too afraid to ask," a category that is still too relevant.
This October marks the 20th anniversary of National Breast Cancer Awareness Month. According to the American Cancer Society, an estimated 217,440 people in the United States, almost all women, will be diagnosed with breast cancer in 2004. Despite growing awareness and funding for this disease, the incidence of breast cancer has continue to rise since the 1980s, and while detection methods have improved, there is still no foolproof prevention method.
So, for all those out there who are or will be new members of the Breast Cancer Sisterhood -- the sorority no one chooses to join but is, especially in the Jewish community, very popular -- here is a list of what to expect during treatment:
There are many choices when it comes to breast cancer surgery: lumpectomy, simple mastectomy, bilateral mastectomy. If you decide to opt for the "extreme makeover," take comfort in the fact that, at least, both sides will match.
The reconstruction process can be uncomfortable and it takes a long time. Be patient.
There are advantages to not having nipples. Clothes look better on you, it's harder to tell if your breasts are uneven and no one knows when you are cold.
The best hair substitute for nighttime: ski caps.
The good news, for those of us who have had a close relationship with Gillette since the seventh grade: by the time your hair returns, you will actually miss shaving.
Be prepared for people, especially kids, wanting to touch your bald head.
Wigs are itchy, but if you buy one that fits your appearance, you will look and feel more normal.
Scarves and hats are a lot more comfortable, but they tend to draw attention to you, especially if you are young. However, I've noticed on the days when I am wearing a scarf, more people go out of their way to be nice to me -- which is a big boost when you're feeling unwell.
Although it might be tempting to eat your favorite meal the evening before or the day of chemo, don't. The associations between food and nausea are so strong you might never want that meal to cross your palate again.
Along those lines, the best advice from my nutritionist, Rachel Beller, was to avoid eating good-for-you foods, like fish, around chemo days. Spicy foods and anything too hot or too cold should also be off the list.
Chemotherapy tends to make people anemic, so think Atkins.
You will crave strange things, or only be able to eat a certain food after one chemo session and a different one after the next. (For me, it was the Caesar salad from Sharky's, alternated with, of all things, pea soup.) If it's legal and you can eat it, go for it.
Speaking of legal: not only is it a bad idea to fast on the designated holidays when you are undergoing cancer treatment, several rabbis advised me you are not allowed to do so. God will understand.
PMS has nothing on cancer. You will be moody. Forgive yourself for it.
It may sound cliche, but cancer really does give you the opportunity to examine your life and your relationships and make the changes you have been putting off for years.
At least one friend will not be able to handle what you are going through.
Unexpected people will come out of the woodwork to support you. Outside of my family, my two best friends through this whole process have been Ronette K., who teaches at my mom's school, and Linda C., my brother's girlfriend's mother. Ronette sent me funny get-well cards after every chemo (I had 10 courses) and kept me in mystery books during my recovery from surgery; Linda ended her chemotherapy the day I got my diagnosis and was my mentor through the whole treatment process. I wouldn't have made it without either one of them.
All in the Family
Husbands/significant others are the greatest unsung heroes in this battle. Remind people to check on them instead of you every once in a while.
As with friends, some family members will handle your situation better than others.
Kids can be your greatest allies. For little ones, you don't have to tell them much, just what they might need to know. Like that Mommy will be living in the bathroom for the next three days.
Beam Me Up, Scotty
Compared to chemo, radiation seems like a cakewalk. Some people do get exhausted from it, so while you may be feeling better, this is not the time to take up lacrosse.
Yes, you will be asked to get tattooed. If this freaks you out, there are alternatives, but a tattoo provides the best record for any possible future radiation. The tattoos are tiny, not the big, rosy "Mother" ones found on certain bikers. Your doctor can give you a note for the chevra kadisha (burial society) if you feel the need.
Know that, even if you do get the tattoos, the radiology staff will draw on you. With a big marker. In dark, purple ink. As if you needed one more thing to make you look strange.
Words to remember: body lotion. Some people swear by aloe vera; I like Aveeno with the colloidal oatmeal (which, by the way, doesn't mean any kind of special oatmeal -- it's just minced up really fine so they can get it in the lotion).
The machinery used during radiation emits a loud, annoying whine that makes it difficult to lie still. Find a "theme song" you can run through your head to distract you. (Mine is the overture from "Star Wars.")
Just when you start getting good at dealing with the chemo and radiation, it's over. Thank God.
Wendy J. Madnick was diagnosed with breast cancer in December 2003. She awaits the return of her hair with growing anticipation.