My Summer With Cancer

The doctors didn’t find it. The mammograms didn’t either. I did. One in every eight women gets breast cancer. I’m learning to live with the odds.

June 6, 2005
I hear a voice. It’s loud and clear, and it interrupts my evening shower like a special report breaking through regularly scheduled programming.

“Check your breast,” it says. Literally, I hear this. Or think I do. I glance around the bathroom. “Check your left breast first,” the voice says.

People who hear voices wear tinfoil hats and communicate with aliens. I wonder if I’ve lost my mind but then realize I lost it years ago, so it’s a moot point. My brain flips through imaginary calendar pages as far back as a year ago in May—the last time I had a breast exam by a doctor. It flips forward to December, to a mammogram that was normal. But have I done a physical exam myself? Hmmm. No. A lump that was removed several years ago was just a benign growth, and the chances of more forming were small. Still, to appease the voice that seems to be waiting, I reach for my left breast and immediately feel a small, hard, immovable lump. Could it be my breastbone? I quickly check my right breast. It has small lumps that move, but not in the same place as the other. I decide to keep the discovery to myself and sleep on it. Maybe I’ll wake up and it will be gone.

June 13, 2005
“You hate to give someone bad news, but I’m afraid I have some,” my doctor says on the phone. My stomach feels ice cold.

June 15, 2005
As I pass strangers’ homes, I start counting. One, two … For every eight houses, there could be another breast cancer statistic inside.

Even with the extreme heat, the skies haven’t a trace of haze—an amazing feat of Texas. Thank goodness for the optimism it inspires.

I remember God but don’t always understand him. When God isn’t playing himself, there are scientists who try to play him. Or make up for him, or perhaps do the work he inspires us to do. My brother is a scientist in California. And now he’s the constant voice in my ear. Sometimes I have no idea what he’s saying. How did we come from the same parents? Part of me would love to go where he is and have the surgery done, but it’s important for me to be close to home, to my sons, to try to maintain as much of a routine as possible. Except for vacuuming. I’m thinking of slipping the surgeon a few bucks to say I can never do that again. I’ve also decided that if I lose my hair and need a wig, I want to be a blonde. I’ve always wondered if their lives are more sublime.

Tonight, I’m keenly aware of what I have not accomplished in my life.

Everything I touch triggers a visual flash-forward. A nightgown is set against a hospital bed, shampoo becomes falling hair, a bra becomes a bandaged chest, and my bed becomes a place where I have to lay, instead of where I want to.

My husband Steven reminds me that the survival rate is as high as 99 percent and tells me I’ll be fine. He’s moved on from his grief and says I should, too. He’s practical to keep himself from being too emotional. I’m emotional to keep myself from becoming too practical.

June 16, 2005
The adrenaline has rushed up and down and all around, and now I want to stop thinking. I do want to eat cookies, though. My goal for the day is to find a good snickerdoodle to relight my fire. I can’t believe it took 45 years for me to discover them.

People keep telling me stories about others they’ve known with breast cancer and how ultimately  they’re fine. This is supposed to be reassuring to me. “Ultimately,” for the record, is a long, long time away for someone just diagnosed with cancer. The journey itself is never fine.

June 18, 2005
I snapped at the woman who wouldn’t give me a refund for my son’s summer camp. “I have cancer and I can’t get him there,” I said meanly. The previous me, the last-week me—before my news—would never have blurted that out. “Can you get me a doctor’s excuse?” she asked. “No,” I answered flatly, surprising myself. “That’s way too personal. You’ll just have to believe me.” “I’ll talk to my supervisor,” she said quietly.

My mom is having fun in New York. I’m glad for her. If she were a TV mom, she would be here with me now. But she has little flexibility to react to the unpredictability of life. I know that. I also know that, like many women of her generation, she’s not comfortable being intimate, and perhaps it’s for the best. I’ve known that since I was a teenager and had questions about love and sex and respect and how they’re intertwined. I hoped she would sit down with me, guide me, tell me what she knew. But she never came, and I never asked.

I miss my grandmother. Or perhaps I just miss being little when the world seemed less complicated. If I close my eyes I can feel her large, tender arms around me. She’s a woman of ample bosom, like me. We are bosom buddies. I want to press my nose into her soft neck, smell that clean, plain smell of Ivory soap mixed with chicken soup that seemed to magically permeate her perfectly pressed blouses. If she were here, she would smell me back and say it was me who smelled so good, so clean, and so familiar. We have done this for as long as I can remember.

I press my nose into my children’s soft necks. Nicky, my younger son, has skin like hers. His hair feels like rose petals and soft cotton. He looks inside my eyes and I see his little soul. I think he sees mine. We share a love of storytelling, of magic and mystery, and of triumph over evil. Alex, my older son, sneaks his hugs. He moves slowly, sideways, backing into my arms, longing for closeness but self-conscious of his need. His body is lanky and strong. He doesn’t like to sit still. We can both instinctively read people in an instant, a gift and a curse depending on how you use the information you glean. We sense moods like barometric changes. I sneak a sniff when he is finally settled. One breath reminds me of the day he was born—when I was young and happy, and life seemed eternal. His soulful brown eyes are full of questions. Mine lack luster and have no answers these days. I turn away and hope he does not notice. But I know he does.

June 19, 2005
Yesterday was sad. All-day sad. The tears came and would not leave. I ran around in search of material things. They mean nothing yet offer everything. A distraction. In the end, I spent $9.60 on a bird cage I truly dislike. Not only do I not own a bird, but the cage has hearts. I don’t like hearts on decorative objects. I saw them and bought it anyway. I don’t know why.

Today is Father’s Day. I wonder if I’ll be here next year to celebrate. Maybe the surgeons will find this thing has spread. Maybe they will assure me it hasn’t. It’s time to get the cancer out of me so I have answers and can plot my course. I’ll return the cage and cook a feast for my husband to celebrate his special day. The aroma will hang in the air and fill my soul.

June 21, 2005
I took a crash course in cancer today, meeting with surgeons. I’m a C student at best. Where has my brain gone? I can’t wait to shower, as I have been “felt up” all day.

I get more wishes for the best. Most include notes about praying for me. Do they say this to make me feel better or so that they feel better? All prayers are welcome, but when you hear so many offering them, you have to wonder if you’re already dead.

June 22, 2005
Shopping for a surgeon is a bit like shopping for a big appliance with an extended warranty. I’ll have to trust its performance and study its reputation, then want to live with it for a long time since I’ll have to go back every three months for years to come.

It’s funny how you lose what you thought were your natural investigative abilities when you get news that punches you in the stomach. The research is not coming together. Maybe it’s because most of me wants to build a fort with my comforter and hide inside with chocolate and reruns of Groucho Marx’s You Bet Your Life.

I had an out-of-body experience yesterday. I left my husband in a room talking to the doctor, and I went grocery shopping.

June 23, 2005
The pressure is making me anxious. I’m still trying to decide between two surgeons. There are differences in technique as it relates to pathology during surgery and bedside manner. One is very feminine and nurturing; the other is male, easygoing with no frills. One office is mauve and full of ladies in cream-colored pumps; the other is barren trees in winter wallpapered from north to south, east to west, serving as an icy backdrop to women in navy scrubs. It’s funny, though, now that I think about it. I felt like a number, rather than a name, and slightly masculine amid the mauve. I felt like an individual and feminine among the barren trees.

June 24, 2005
Surprising even myself, I choose the mauve package. It feels like a soft place to land. Soft is good. Hard is bad. My lump is hard. These days are hard. My faith has hardened. Once the decision is made, relief floods my body. As if on cue, I’m hungry again.

July 7, 2005
My entries are growing further apart. Maybe I’m feeling less, or maybe I’m just sick of my own thoughts. After reaching a new low last week, with a crushing migraine where I was tended to by doctors who appeared to be 12 years old, I’ve decided the issue is one of control. Who has it? The cancer. How can that be? It has no face, no voice.

I’ll have to let myself lose control when I go under on Monday. Really, I can’t be president all the time. “Let myself” are key words. That means I’m in control, ultimately. I can still make choices and still say no. True, I did not choose this diagnosis. Who would? Yet I can choose to let people do their job—which is to make me better.

July 8, 2005
At the pre-op visit to the hospital, they lay out every detail of every possible thing that can go wrong, and I sign countless waivers. Is there a form that outlines the good things that can happen?

My sister and I have talked a few times this week. She’s been absent and missed for so long. The conversations were at first terribly awkward, then just awkward. We are former childhood roommates, looking for the link—some 30 years later.

My mother is coming. That makes me quite happy. Soon her trademark trail of poppy seeds, sesame seeds, and coffee grinds will be sprinkled about my kitchen.

I want to tell her everything will be okay. I suppose I don’t know that. It must be hard to be a parent and watch your child face cancer. I feel her pain. But there I go again—feeling for two. Sometimes I feel for four when I crawl into my children’s and husband’s hearts and poke around. No wonder I get migraines.

July 13, 2005
It’s done. The cancer has been cut out and then some. The last thing I remember was meeting the nurse with the beautiful blue eyes, kissing my husband goodbye, and saying to the doctors, “Hey, did you put something in my IV because … .”

Apparently, I spent quite a bit of time talking about where to find the best milkshake but recall none of it. I ask a nurse if I said anything (else) I shouldn’t have and the nurse tells me unfortunately (for their own entertainment), they don’t use sodium pentothal anymore. I laugh. It feels good.

I have to call my boys. But first I have to go to the bathroom. Someone shoves a bedpan under my bottom. “I can’t,” I say, feeling anxiety trumping the drugs designed to keep me calm. “You just got into recovery, and it is too soon,” I am told. “But I have to go to the bathroom,” I plead. “My bladder is the size of a pea.” From that moment on, I am known as the patient who pleads that she has to pee because she has a pea-sized bladder. I am reminded of this as I check out. “Oh, you were the woman who had to pee.”

Invasive cancer cells are sneaky and can pop up anywhere, anytime. Though the tumor has been removed, more treatment will be needed. The results of pathology tests in a couple days will tell me the tumor’s size and type and how aggressive the cancer is. The results of further tests, in around two weeks, will tell me whether the cells are receptive to estrogen or progesterone and something about a Her2 that I still don’t understand.

Cancer, I’m learning, is a game of wait and see.

As the bandages come off in the shower, I see my breasts for the first time since surgery. There are incisions around 2 to 3 inches on each, plus several more under my left armpit where two nodes were removed. I am shocked.

I have taken their existence for granted. They were one of my better features, and now they look as if they have been through a lightening storm or marked by Zorro. As I watch the water trickle over them, I’m overcome by the memory of nursing my children—how much life I felt then, how much loss I feel now. I close my eyes. My husband helps me regain my composure, overcoming his own thoughts, I’m sure. Without saying a word, he gently washes away the blood and stench I cannot seem to get off of my body and out of my head.

My brother came yesterday for several hours. He was on his way back from a meeting in Washington, D.C. He told me his meeting, ironically, was with some of the leading breast cancer researchers in the country. We played Scrabble with our mom and my sons. It was the first time we’d played a game together since we were kids. It seems like an eternity since we were a family.

The phone rings with round one of pathology news. My cancer is in an early stage, slow growing, and small. “Small,” however, is a relative term. Each tumor is made up of millions of cells. If even one escapes, that renegade cell can take up residence in pretty much any part of my body. Radiation will kill cancer in the area being treated. Chemotherapy is designed to kill it anywhere it may have drifted. My tumor size, 1.1 centimeter, puts me into chemo territory by one-tenth of a centimeter. Seems I’ll have to wait and discuss options with the oncologist in a few weeks, when the rest of my test results are in.

I ask my mother to stay another day, knowing how hard it is for her but not wanting to be alone yet. The physical part of me is healing. The emotional part has a long way to go. She tries to reschedule her flight, but there are no seats available for the next day and her work is waiting for her. I go back to self-soothing, as I have done for much of my life.

The phone continues to ring with calls from friends old and new, and I am reminded again when I hear their voices that family is not just who you are related to.

July 14, 2005
Sitting on my closet floor, I look up, survey my wardrobe, and sigh. What’s a girl to wear on a hot, sweaty, summer day in Texas when she has difficulty lifting her left arm and is not allowed to shave her left armpit or use deodorant? Whatever it is, it must fit over a zipper contraption the doctors call a bra. I’ll wear it day and night for around 10 days. It could keep a large suitcase closed. I glance at my husband’s closet. He has little volume but great quality. Why didn’t I get cancer in the winter? A sweatshirt sounds pretty good.

During the 17 years we’ve lived together, I’ve never asked Steven to shop for me. Today’s his lucky day. I ask, “Would you mind picking up a couple of blouses, something really inexpensive that I don’t have to look at again when this is all over?”

The days of my designer dressing for the office are long over. Finding a bargain that can handle dog poo, children, and marinara sauce is more my speed. Steven shops infrequently but gets the good stuff—Neiman’s good. Now I’m sending him to do something that goes against everything he knows. He calls me twice from the store. “Would you be a size medium?” he inquires politely. “I would be,” I say. “But I’m looking for something big, so go ahead and get a large.” He says, “Do you care if it’s polyester? I found something in linen.” Of course he did. He probably found the only linen blouse at Wal-Mart.

He returns with two surprisingly pretty blouses. One is actually a good color for me. And they fit. Now I have clothes, but I still don’t want to leave the house.

July 15, 2005
It’s my first time out in several days. After dropping off my older son at a music lesson, Nicky and I head for a drive-thru. Not healthy, I know, but what’s it going to do? Kill me? I wonder how long this little joke will work before it offends someone. Or me. I feel compelled to let my child know we are not eating responsibly. Then equally compelled to dig in.

July 19, 2005
Today is my post-surgery visit to the doctor. I explain I’m feeling pretty good, if you don’t count the sensation that I have a pizza under my arm. A sonogram reveals mild fluid build up, quite common after nodes are removed, and the surgeon, whom I’m seriously impressed with, offers to drain the beast.

I’m informed that round two test results show that the cancer is estrogen and progesterone receptive, Her2 negative, and this is, ironically, positive news. I’m a candidate for hormonal therapy, which has been shown to increase survival in breast cancer patients. The chemo question, however, still needs to be addressed with an oncologist, and an appointment will be set up for me soon.

Lying on the exam table while the fluid is drained, I scan the room and focus on a poster of a ballet dancer. She is arched backward, like a swan. The woman has no breasts. She is so flat that it looks as if her chest is concave. I wanted to be a ballet dancer when I was a girl. Then I grew breasts. I was the only one in ballet class who did. I still feel self-conscious about them, only now it’s for a different reason.

July 21, 2005
I’ve walked for almost eight years now, two to three miles a day. It’s my religion of sorts. I used to walk alone. That’s when we lived in the country. Save for the birds overhead, I was the only living thing in sight. Now I have walking friends and we share our thoughts.

This morning I’m going to a mall to walk for the first time since surgery. I swore I’d never go to a mall for exercise (like I swore I would never buy a minivan).

Inside, before the stores open, herds of young mothers push babies in strollers. Watching curiously from level three, I see them stretch, each beautifully clothed in matching stretchy outfits, then walk, en masse, throughout level two. The thought of being among them, breast feeders no doubt, makes me sad, so I stay a level above, walking past the same shops over and over, smelling stale mall air, and recalling wistfully the flight of the birds and the serenity of the country.

Back at home, my couch calls to me. Two hours later, I wake up, grumpy at my own lethargy.

July 22, 2005
It’s 80 degrees at 7 a.m. I decide to tough it out and walk anyway. Lunch is a milkshake. Cures anything. I don’t even hear the couch call till late afternoon. Breast cancer patients should get milkshakes free. Envision that sign: FREE (Pink) MILKSHAKES FOR BREAST CANCER PATIENTS. TUESDAYS.

July 23, 2005
I slept without a bra for the first time in almost two weeks. If my back could reach around and kiss me to say thanks, it would. My dreams were so vivid that I woke up feeling as if I’m still living them. I knew I shouldn’t have walked in that mall. I dreamt that my husband left me for a 20-year-old in a bikini. She worked at “the mall.” I saw her in the store window. She had lily-white skin and no hair but he loved her more than me.

This morning I tell my sons what their father did. They find it quite amusing. Then I tell Steven. “Oh by the way,” I begin, “I’m mad at you.” He looks at me unsure of whether to laugh or run.

July 26, 2005
I learn there’s another test I should consider. Oncotype. It can tell me what the chances are that my cancer will return and help determine what post-operative therapies will be most effective. Not all insurance companies will pay for it, though, and it’s very expensive. I’ll have more homework to do. Certainly, the cost of unnecessary treatments is horrendously higher for companies to pay.

July 28, 2005
I’m baking biscuits. Joni Mitchell, Chaka Khan, and Norah Jones alternately croon while I knead the luscious dough, blending crushed dill and basil between the tiny dots of butter. The kitchen is humming along, happy to have me back. So, too, is the dog, living in hope, as my father used to say, that I will drop a morsel of the finished product on the floor. Nothing good has fallen from the countertops in weeks.

July 29, 2005
The oncologist’s office is in a building that has the word “CANCER” advertised in big letters across its façade. I prepare myself for what I envision will be hell—with a sliding glass door.

Once inside, though, sunlight streams through angled windows, and a handwritten sign instructs radiation patients to sign in. There are snacks neatly organized on a cheerful party platter. Tucked away on a narrow bookcase in the ladies’ room are wigs, all perfectly perched on Styrofoam heads. Brochures and business cards from wig suppliers detail their services.

People here have cancer, yes, but nobody looks sad, nobody is talking about being sick, and Hell is nowhere in sight. Only kind doctors and nurses.
I will need radiation. It will be five days a week for six and half weeks, each session around 10 minutes. Beyond the physical cost, I learn of the monetary cost and am thankful that we have insurance to help.

The hormone therapy will be with the drug Tamoxifen—taken for five years. It should help increase my chances of survival by around 6 percent. Six percent sounds like a lot when you’re paying taxes, but it sounds like nothing when you’re applying it to your longevity.

The decision about chemotherapy, as it turns out, falls to me. If my tumor had been slightly larger, there would be no question about chemo. We’d have to do it, and things would be easier. In my case, the chemo could increase my chances of survival from 1 to 3 percent.

I try to process all the data and put it into perspective.

I’ve learned that the odds of a woman developing breast cancer for the first time are around 1 in 8. That’s 12.5 percent of women. One doctor told me that number is too high, that it’s more like 8 percent, and the higher number is merely a scare tactic by breast cancer activists. But we need to be scared. That’s a lot of breast cancer, either way. Most don’t find it as early as I did—though “early” seems like the wrong word. My cancer grew for around seven years before it became palpable. Four mammograms over five years missed it. Five annual breast exams over five years missed it. And yet it was there the whole time.

The odds of my developing breast cancer a second time are around 1 in 6.

August 3, 2005
How does anyone move forward with the same sense of wonder about life’s infinite possibilities knowing it’s really just a matter of probability?

I head for the shower and listen for a voice to guide me in my decision-making. After recalling dozens of conversations, I lean toward not having chemotherapy and decide to go for the Oncotype test before I make a final choice. It means waiting for more results, but at least if the cancer returns, I won’t kick myself for not having been thorough.

August 15, 2005
Today I talk with our dog groomer. His wife was recently diagnosed with myeloma, a cancer of the plasma cell. In the process of finding it, he tells me, she had a mastectomy she did not need. As he speaks, his eyes fill with tears. Her cancer is late stage and her prognosis is poor.

All along, I’ve been fretting about the tiny odds that my cancer will return and about making the right treatment choices. This woman’s treatment choices are limited to a hope and a prayer.

I’m filled with guilt for having a good cancer. An oxymoron I hope I can live with.

Freelance writer Melissa Shultz is a former weekly newspaper columnist who regaled her readers with observations, confessions, and tales of life.

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