I've linked before to columns by Dr. Amy Tuteur, who blogs at salon.com. Today, salon has front-paged an excellent piece of hers, in which she describes a devastating experience from her medical internship, when she did not speak up against an oncologist who recommended chemo to a clearly-terminal patient.
I'm sure that many of us who have, or have had, cancer can relate to the oncologist's desire to pursue any chance of recovery, no matter how remote. But many of us who have had chemo can also relate to the patient's conviction that the end of life should not be a time of over-medicalization, but rather of sitting on a beach somewhere and saying goodbye peacefully (even if, still, painfully) to a lovely world.
The article is food for thought. It is very easy to be swayed by the signals we get from our doctors. One doctor who offers a strong opinion can change the entire rest of our lives--and they are not always right. To me, the moral of the story is: independent second opinions!!
Tuesday, March 17, 2009
Friday, February 20, 2009
Three years, all clear!
Three years ago today, I'm pretty sure I was skiing at Copper Mountain in Colorado. Three years minus 7 days ago today, I was standing in the shower saying "Oh, shit" as I felt a subcutaneous golf ball on my right breast.
Today, I drove 26 miles north to Norris Cancer Center. I had my blood drawn by my favorite "stick," Dean (he said my arm-crook veins are hardened by the chemo, and he took the blood from a vein that crosses the back of my thumb--but he got it painlessly, and on the first try). I waited for a long time in the mammogram waiting area, with about a dozen other women, some with the short crew-cutty hair that marked them as recently completing treatment; some looking frightened, with husbands' hands clutched in theirs; others playing it cool, telling anyone who starts the briefest conversation that they're "just there for my yearly!" I wore my new t-shirt: "I already kicked Cancer's ass. Wanna be next?"; only one nurse commented on it (positively), but it garnered a lot of furtive looks. I wondered if the "ass" was shocking people, or if I looked too young and healthy to be a cancer survivor (I like that one!), or if maybe they secretly liked it.
Anyway, I was called late for my mammogram, by a cute little radiographer who did a fine job of mushing, smashing, and subjecting me to excruciating pain. I also think mammograms must have been invented, by the way, by someone with no concern for breast perkiness. Those underside ligaments must age about 6 years with each image.
All was going fine; she went off to consult the radiologist and I relaxed with my iPhone to wait to go see the doctor. But then she came back and said that the radiologist wanted "a few more views," to look at something she wasn't happy about. I barely blinked; we've been keeping a close eye on the left side (the one not previously involved) because it's fibrous and sometimes achy.
But they didn't want to look at the left. They wanted to look at the right.
And for the next 5 minutes or so, I experienced real terror. I've already had surgery and radiation on the right. If there were a new tumor there, the whole thing would have to go. And I've sat through enough support group meetings to know there are worst things than losing a breast, and there is life after a mastectomy, and reconstructed boobies actually look pretty real and cute--but still. While she mashed me into new, contorted positions, and used a compression plate whose effect was like having a stiletto heel pierce a nipple, I just kept thinking, "I don't want to lose it after all of this." It's funny; I didn't even think about chemo or radiation or months of illness. I've thought about that before, but even my nightmares of getting cancer again--somehow they just never involve it happening on the same side.
It was super scary, but when the tech went back to consult again, she returned saying that it was all clear, that the extra mashing had given a better view and I was fine. I couldn't quite relax and believe it until I saw Christy, my oncologist, but her exam and the bloodwork and the images were all telling one happy story, she said, and finally I did believe.
Still, not until I was driving away did I get the moment of full realization that I've now reached the third year of survivorship. With my cancer profile, this is really huge. Two years was huge, but three years is huger. My risk curve drops off precipitously at two and then three years. Not like I'm ever "home free," but at this point I can really relax much more about the prospect of recurrence.
In the car, I felt the grin spread across my face like someone was stretching it with their fingers--and it stayed there until the third time a slow driver cut me off in the left lane. Then I was back to reality, which is what life is, after all, and I must say I'm pretty glad to be here.
Today, I drove 26 miles north to Norris Cancer Center. I had my blood drawn by my favorite "stick," Dean (he said my arm-crook veins are hardened by the chemo, and he took the blood from a vein that crosses the back of my thumb--but he got it painlessly, and on the first try). I waited for a long time in the mammogram waiting area, with about a dozen other women, some with the short crew-cutty hair that marked them as recently completing treatment; some looking frightened, with husbands' hands clutched in theirs; others playing it cool, telling anyone who starts the briefest conversation that they're "just there for my yearly!" I wore my new t-shirt: "I already kicked Cancer's ass. Wanna be next?"; only one nurse commented on it (positively), but it garnered a lot of furtive looks. I wondered if the "ass" was shocking people, or if I looked too young and healthy to be a cancer survivor (I like that one!), or if maybe they secretly liked it.
Anyway, I was called late for my mammogram, by a cute little radiographer who did a fine job of mushing, smashing, and subjecting me to excruciating pain. I also think mammograms must have been invented, by the way, by someone with no concern for breast perkiness. Those underside ligaments must age about 6 years with each image.
All was going fine; she went off to consult the radiologist and I relaxed with my iPhone to wait to go see the doctor. But then she came back and said that the radiologist wanted "a few more views," to look at something she wasn't happy about. I barely blinked; we've been keeping a close eye on the left side (the one not previously involved) because it's fibrous and sometimes achy.
But they didn't want to look at the left. They wanted to look at the right.
And for the next 5 minutes or so, I experienced real terror. I've already had surgery and radiation on the right. If there were a new tumor there, the whole thing would have to go. And I've sat through enough support group meetings to know there are worst things than losing a breast, and there is life after a mastectomy, and reconstructed boobies actually look pretty real and cute--but still. While she mashed me into new, contorted positions, and used a compression plate whose effect was like having a stiletto heel pierce a nipple, I just kept thinking, "I don't want to lose it after all of this." It's funny; I didn't even think about chemo or radiation or months of illness. I've thought about that before, but even my nightmares of getting cancer again--somehow they just never involve it happening on the same side.
It was super scary, but when the tech went back to consult again, she returned saying that it was all clear, that the extra mashing had given a better view and I was fine. I couldn't quite relax and believe it until I saw Christy, my oncologist, but her exam and the bloodwork and the images were all telling one happy story, she said, and finally I did believe.
Still, not until I was driving away did I get the moment of full realization that I've now reached the third year of survivorship. With my cancer profile, this is really huge. Two years was huge, but three years is huger. My risk curve drops off precipitously at two and then three years. Not like I'm ever "home free," but at this point I can really relax much more about the prospect of recurrence.
In the car, I felt the grin spread across my face like someone was stretching it with their fingers--and it stayed there until the third time a slow driver cut me off in the left lane. Then I was back to reality, which is what life is, after all, and I must say I'm pretty glad to be here.
Tuesday, February 10, 2009
Monday, February 09, 2009
Birthdays
I caught myself in some insanity this week.
Friday was my 42nd birthday. Around Friday, you could have found me gazing into a mirror, looking at the lines and wrinkles around my eyes and mouth that weren't there before chemo. You could, if you could see into my mind, have watched swirling thoughts of sadness and loss about getting older, losing skin elasticity...and resentment toward cancer, for how its treatment has hastened and deepened my "inevitable decline."
I'm not sure how this craziness took hold of me, but when I went out to the beach yesterday, on a tenuously lovely day sandwiched between days of rain, and ran and hit a ball and enjoyed playful banter with friends, the world righted. I remembered that I don't mind aging at all. I am thrilled to be aging, thrilled to be getting older. I'm especially thrilled to age, for as long as I can, in a strong and healthy body.
It sure beats the alternatives.
Friday was my 42nd birthday. Around Friday, you could have found me gazing into a mirror, looking at the lines and wrinkles around my eyes and mouth that weren't there before chemo. You could, if you could see into my mind, have watched swirling thoughts of sadness and loss about getting older, losing skin elasticity...and resentment toward cancer, for how its treatment has hastened and deepened my "inevitable decline."
I'm not sure how this craziness took hold of me, but when I went out to the beach yesterday, on a tenuously lovely day sandwiched between days of rain, and ran and hit a ball and enjoyed playful banter with friends, the world righted. I remembered that I don't mind aging at all. I am thrilled to be aging, thrilled to be getting older. I'm especially thrilled to age, for as long as I can, in a strong and healthy body.
It sure beats the alternatives.
Thursday, February 05, 2009
It's not too late
It's not cancer-related, per se, but I just read an incredibly moving article about a man who, during the civil rights era, beat a young black activist bloody. The activist survived, and grew up to be Congressman John Lewis; his assailant lived for years without realizing who his victim had been, but plagued by guilt over his own actions. When he did come to understand the link between his behavior and this member of Congress, he contacted Lewis to try to offer an apology. The two men met, Wilson (the attacker) apologized, and Lewis forgave him.
I find this moving for so many reasons. First and foremost, it's never too late. These guys waited over 45 years--waited to make amends, or to accept them. Wilson is the first person involved in that attack to come forward to Lewis. They are both humbled and profoundly changed by their new bond of understanding, which grew out of shared violence. People can address their regrets, even if it takes too long; other people can forgive, and experience the wholeness that comes through forgiveness. And from a Buddhist perspective, it is wonderful to have the additional compassion and healing in the world, that didn't exist before these two men met, and that now extend benefits to all of us.
I find this moving for so many reasons. First and foremost, it's never too late. These guys waited over 45 years--waited to make amends, or to accept them. Wilson is the first person involved in that attack to come forward to Lewis. They are both humbled and profoundly changed by their new bond of understanding, which grew out of shared violence. People can address their regrets, even if it takes too long; other people can forgive, and experience the wholeness that comes through forgiveness. And from a Buddhist perspective, it is wonderful to have the additional compassion and healing in the world, that didn't exist before these two men met, and that now extend benefits to all of us.
Wednesday, February 04, 2009
The LA Times today mentions a study by USC researchers that found green tea to block the effects of a specific kind of chemo agent used on multiple myeloma and a couple of other cancers--not breast cancer, though. Green tea is an antioxidant (perhaps it would be more precise to say it contains antioxidants) that are effective at preventing breast cancer, and it may even aid in the treatment of breast cancer. Although some very conservative oncologists, such as the local practice near where I live, don't want their patients using green tea or other antioxidants during chemo, I found a substantial amount of research showing that green tea actually aided the effects of chemo. It may help chemotherapy target cancer cells better, while protecting non-cancer cells and thus easing the damaging effects on the body. (Note that I am linking to a layperson-friendly page, not to one of the studies, but a quick Google search will get you the real research.)
I'm very happy to say that I was treated at USC, which--this study notwithstanding--seems more open to green tea; I wasn't treated at the local practice.
Just wanted to share!
I'm very happy to say that I was treated at USC, which--this study notwithstanding--seems more open to green tea; I wasn't treated at the local practice.
Just wanted to share!
Thursday, January 22, 2009
And now for something a little bit different
I've been quiet again! Nothing bad. In fact, I've been writing plenty, only it's all been book chapters and reviews of journal articles and other scintillating fare. Work is back in full swing and if I'm not cleaning up the remains of my fall course, I'm writing or doing tedious administrative stuff, or if it's a great day, playing some volleyball. But I keep meaning to write this post, and last week's season premiere of Big Love (on HBO) finally gave me the kick in the pants I need.
I want to talk about arts and literature. Surely we've all noticed by now that cancer is a popular plot device in books, movies, TV... Sometimes it's infuriating, sometimes it's downright terrifying. There are quite a few artistic works that have been important to me during my treatment and post-cancer life, and I wanted to share them.
I'll start with the things I don't recommend so highly. You may remember that Nancy on thirtysomething got breast cancer (she got better), as did a character--Dana, maybe??--on The L Word (she died). And Samantha of Sex in the City, of course. In fact, Samantha's oncologist's name was taken from a real oncologist here in LA, the one from whom I got my second opinion. Anyway, these portrayals were fine, but they all made me cynical and annoyed just the way that Pink October does. I couldn't decide whether Dr. Susan Love's appearance on The L Word was a nice bit of public service and education, or a cringe-inducing turn by a non-actor. In either case, the Art was definitely taking a back seat to Being Important Through Breast Cancer.
While all these portrayals were just pedestrian, there is one movie that I would absolutely, positively tell anyone with cancer to fling far from them. Torch it, burn it, or if necessary run in the opposite direction. It's the movie (or play) Wit, starring Emma Thompson. Sure, an acting tour de force, but perhaps the most dire, depressing, hell-on-earth depiction of cancer (ovarian) and chemo (brutal) that I've ever seen. And nothing good ever happens, except she gets a popsicle. Seriously! This is NOT a movie for a cancer patient.
OK, now on to better things. These are still not happy, necessarily. But they are works that gave me hope and comfort and a sense of larger importance in life--even if they sometimes left me sobbing, too.
One of the books I read during my winter break was Jhumpa Lahiri's Unaccustomed Earth. I've loved this author for a while now, and didn't even realize until I started the book that it was also on many year-end top-10 lists--but I can affirm that it deserves to be there. The latter half of the book consists of three connected short stories, collectively titled Hema and Kaushik, about two people whose lives touch briefly at a couple of points in time. I might not recommend these stories to someone currently being treated for breast cancer, or to anyone out of treatment but plagued by fears of recurrence: Without spoiling any surprises, there is a plot point involving breast cancer that isn't a happy tale. But the writing is beautiful and the stories are deeply engaging. (And by the way, ALL of her books are fantastic.)
I've mentioned, before, the TV show Battlestar Galactica (the current version, not the cheesy 70s incarnation). It's not geekdom sci-fi; it's intelligent, challenging drama. In the very first episode (a 3-hr movie, really), one of the main characters, Laura Roslin, is diagnosed with breast cancer. She's the secretary of education in her world's government, and she has to attend a ceremonial event just hours after the devastating news that her cancer is inoperable and incurable. While she is at the event (which takes place in orbit around her planet--there IS a sci-fi element), the planet is nuked to oblivion and everyone in orbit must flee the hostile attackers. When her aide finds her crying in the lavatory, she tells him about her diagnosis and says something like this: "The human race may be completely destroyed, and all I can think about is, I have cancer and I'm gonna die." Mary McDonnell, the actress, just nails it. In any case, it's not only Roslin's cancer, but the whole theme of dealing with terror and loss and existential crisis that has made this show a touchstone for me throughout cancer and survivorship.
I want to mention two shows that aren't about cancer, per se, but were also enormously important to me during treatment and shortly thereafter. The HBO miniseries Angels in America, based on the Tony Kushner play, is one of the most beautiful works of art--it's a visual poem, or symphony, not just a drama--I've ever experienced. It's full of darkness and dread, but then hope and life and determination. "But still. Bless me anyway. I want more life." These 6 hours say more profound things about living and loving than I've seen anywhere else.
The last one--HBO again; I wonder if they'll ever get back to this level of excellence?--is the show Six Feet Under. It's off the air now, but the DVD boxed set is excellent. The show deals with a family in Los Angeles (holla!) who runs a funeral home. Each week features the "DGDJ," as the folks at Television Without Pity used to say ("dead guy du jour"). The episode opens with someone's death. They run the gamut, from someone slipping in the shower; to a dogsitter racing down a hill on rollerblades, pulled by the two dogs she was sitting, and running smack into a car; to a "Jesus freak" listening to a religious broadcast, seeing a bunch of blow-up porn dolls escaping into the air from the back of a truck, thinking they were angels here to announce the Rapture, and then running out into the middle of traffic to be taken up by them. And, of course, cancer: the woman who looked pregnant with the tumor that had grown for months, that was now untreatable and killed her in a few days.
It might seem macabre or depressing to watch deaths occur every week, but I found Six Feet Under hugely reassuring. It reminded me of just how many ways there are to die, of how delicate and fragile our lives are, how vulnerable to the slightest vibrations in fate and positioning. And that reminded me of the futility of sitting and worrying about whether cancer would kill me, since there are a billion other things that could do it, too, and meanwhile I have a life to live and I need to embrace it. Just as the characters on this show did, with all their messy and dysfunctional fumblings.
Oh, and I should explain my reference to Big Love! One of the characters may be having a recurrence of ovarian cancer--which nearly killed her 7 years ago. :-( That's sad and spooky, but it was interesting to watch her immediate response, which was to sit down and tell the cancer that she was not going to let it win, and then to seize control of her own life, determined not to be a passive victim of fate or other people's whims. You go, girl!
I know this isn't a very comment-oriented blog, but I would really like to invite readers to share the stories, books, music, artwork, movies, TV shows, etc., that are meaningful to your own sense of life or to your cancer journey. I'd love to learn about more things to check out!
I want to talk about arts and literature. Surely we've all noticed by now that cancer is a popular plot device in books, movies, TV... Sometimes it's infuriating, sometimes it's downright terrifying. There are quite a few artistic works that have been important to me during my treatment and post-cancer life, and I wanted to share them.
I'll start with the things I don't recommend so highly. You may remember that Nancy on thirtysomething got breast cancer (she got better), as did a character--Dana, maybe??--on The L Word (she died). And Samantha of Sex in the City, of course. In fact, Samantha's oncologist's name was taken from a real oncologist here in LA, the one from whom I got my second opinion. Anyway, these portrayals were fine, but they all made me cynical and annoyed just the way that Pink October does. I couldn't decide whether Dr. Susan Love's appearance on The L Word was a nice bit of public service and education, or a cringe-inducing turn by a non-actor. In either case, the Art was definitely taking a back seat to Being Important Through Breast Cancer.
While all these portrayals were just pedestrian, there is one movie that I would absolutely, positively tell anyone with cancer to fling far from them. Torch it, burn it, or if necessary run in the opposite direction. It's the movie (or play) Wit, starring Emma Thompson. Sure, an acting tour de force, but perhaps the most dire, depressing, hell-on-earth depiction of cancer (ovarian) and chemo (brutal) that I've ever seen. And nothing good ever happens, except she gets a popsicle. Seriously! This is NOT a movie for a cancer patient.
OK, now on to better things. These are still not happy, necessarily. But they are works that gave me hope and comfort and a sense of larger importance in life--even if they sometimes left me sobbing, too.
One of the books I read during my winter break was Jhumpa Lahiri's Unaccustomed Earth. I've loved this author for a while now, and didn't even realize until I started the book that it was also on many year-end top-10 lists--but I can affirm that it deserves to be there. The latter half of the book consists of three connected short stories, collectively titled Hema and Kaushik, about two people whose lives touch briefly at a couple of points in time. I might not recommend these stories to someone currently being treated for breast cancer, or to anyone out of treatment but plagued by fears of recurrence: Without spoiling any surprises, there is a plot point involving breast cancer that isn't a happy tale. But the writing is beautiful and the stories are deeply engaging. (And by the way, ALL of her books are fantastic.)
I've mentioned, before, the TV show Battlestar Galactica (the current version, not the cheesy 70s incarnation). It's not geekdom sci-fi; it's intelligent, challenging drama. In the very first episode (a 3-hr movie, really), one of the main characters, Laura Roslin, is diagnosed with breast cancer. She's the secretary of education in her world's government, and she has to attend a ceremonial event just hours after the devastating news that her cancer is inoperable and incurable. While she is at the event (which takes place in orbit around her planet--there IS a sci-fi element), the planet is nuked to oblivion and everyone in orbit must flee the hostile attackers. When her aide finds her crying in the lavatory, she tells him about her diagnosis and says something like this: "The human race may be completely destroyed, and all I can think about is, I have cancer and I'm gonna die." Mary McDonnell, the actress, just nails it. In any case, it's not only Roslin's cancer, but the whole theme of dealing with terror and loss and existential crisis that has made this show a touchstone for me throughout cancer and survivorship.
I want to mention two shows that aren't about cancer, per se, but were also enormously important to me during treatment and shortly thereafter. The HBO miniseries Angels in America, based on the Tony Kushner play, is one of the most beautiful works of art--it's a visual poem, or symphony, not just a drama--I've ever experienced. It's full of darkness and dread, but then hope and life and determination. "But still. Bless me anyway. I want more life." These 6 hours say more profound things about living and loving than I've seen anywhere else.
The last one--HBO again; I wonder if they'll ever get back to this level of excellence?--is the show Six Feet Under. It's off the air now, but the DVD boxed set is excellent. The show deals with a family in Los Angeles (holla!) who runs a funeral home. Each week features the "DGDJ," as the folks at Television Without Pity used to say ("dead guy du jour"). The episode opens with someone's death. They run the gamut, from someone slipping in the shower; to a dogsitter racing down a hill on rollerblades, pulled by the two dogs she was sitting, and running smack into a car; to a "Jesus freak" listening to a religious broadcast, seeing a bunch of blow-up porn dolls escaping into the air from the back of a truck, thinking they were angels here to announce the Rapture, and then running out into the middle of traffic to be taken up by them. And, of course, cancer: the woman who looked pregnant with the tumor that had grown for months, that was now untreatable and killed her in a few days.
It might seem macabre or depressing to watch deaths occur every week, but I found Six Feet Under hugely reassuring. It reminded me of just how many ways there are to die, of how delicate and fragile our lives are, how vulnerable to the slightest vibrations in fate and positioning. And that reminded me of the futility of sitting and worrying about whether cancer would kill me, since there are a billion other things that could do it, too, and meanwhile I have a life to live and I need to embrace it. Just as the characters on this show did, with all their messy and dysfunctional fumblings.
Oh, and I should explain my reference to Big Love! One of the characters may be having a recurrence of ovarian cancer--which nearly killed her 7 years ago. :-( That's sad and spooky, but it was interesting to watch her immediate response, which was to sit down and tell the cancer that she was not going to let it win, and then to seize control of her own life, determined not to be a passive victim of fate or other people's whims. You go, girl!
I know this isn't a very comment-oriented blog, but I would really like to invite readers to share the stories, books, music, artwork, movies, TV shows, etc., that are meaningful to your own sense of life or to your cancer journey. I'd love to learn about more things to check out!
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.
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.
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!
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.
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.
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):
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):
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