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Journey through the labyrinth -- My breast cancer treatment choices
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A breast cancer diagnosis touches off an intensely emotional, difficult period of a woman's life at the same time that it demands dozens of life-and-death decisions. Cynthia Brouse tells the story of her path and her choices.
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By Cynthia Brouse
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Radiation treatment options
By now I feel as though I have two full-time jobs. All of this research has taken a great deal of time, and I still haven't sorted out radiation treatment.
Yes, there are options there, too: instead of the traditional five to six weeks of daily radiation treatments, I could go to Montreal to be part of a trial of something called brachytherapy, in which tiny beads are inserted at the site of the excised tumour and radiated from within during just five days (in fact, a new method will soon be in trials that gets radiation over with on the day of surgery). I make arrangements to take this shorter treatment, then change my mind; since I had two tumours, I decide I'll be better off having my entire breast irradiated.
The PICC catheter
I take a nine-month disability leave from work and book my first chemo treatment -- and find out only the night before (in my addled state, I didn't notice some of the pamphlets stacked in the clinic waiting room) that I'll be getting something called a PICC catheter inserted in my body so that I can have frequent intravenous infusions without repeatedly having my veins poked by a needle.
It's a long tube that will be inserted in my arm and pushed through to a spot very close to my heart. The line will remain there, hanging out of my arm, for six months, and will need to be flushed with a syringe of saline solution every single day by a visiting nurse, unless I learn to do it myself.
Why didn't anybody explain this earlier? In tears, I nearly cancel the entire deal. Then I remember my godfather, who is going into his fifth year with Lou Gehrig's disease, and tell myself to buck up and take my medicine.
Side effects from breast cancer treatment
Three years have passed since I finished chemo. Did I "sail through"? I've never been on a sailboat in my life; maybe that should have told me something. Mind you, on some days I feel like a fraud; there are far worse things than breast cancer treatment (see godfather, above).
Compared with the stories I've heard of other cancer patients' experiences, my actual treatment, though time-consuming (I could never have done it if I hadn't taken a leave), wasn't so bad. I didn't lose my hair, and I threw up only once, though my stomach was constantly misbehaving. The PICC line was a nuisance that got infected near the end -- I learned to flush it myself, which, for a wuss like me, was an accomplishment. Radiation exhausted me, and I got a nasty burn that cleared up in a week or two.
But there are other days when I wish I had sprung for the pricey DNA testing; maybe I could have avoided ingesting those powerful chemicals. To tell the truth, I don't remember a lot of the experience -- and that's the problem. I now see that Dr. Lee purposely avoided telling me about some of the long-term effects of chemo for fear they'd become self-fulfilling prophecies. They happened anyway.
Ill-prepared for menopause
I thought I was prepared for the sudden plunge into menopause that the chemo would cause, but I wasn't (hot flashes every 45 minutes, 24-7 -- you can almost set your watch by them -- a creaky libido and a matronly 25 pounds that arrived seemingly overnight). I really wasn't prepared for what's known as "chemo brain": not just memory loss, but an inability to concentrate, which -- fingers crossed -- seems to be diminishing. And my arthritis and sciatic pain, which were tolerable, are now much worse, particularly since I switched from tamoxifen to Arimidex.
The bottom line is I feel old and tired, which makes getting back in shape tough. Would my experience of menopause have been the same whether or not it had been induced? I'll never know.
Treatment choices
I do know that I'm still alive. There's little point in asking whether I'd make the same choices knowing what I know now, since the knowing only comes after the choice-making. I feel fortunate to live at a time when so many new treatment options are available; on the other hand, sometimes they resemble nothing more than a slightly sophisticated form of voodoo, as mysterious as herbal tinctures or applying leeches. Becoming an informed patient means confronting a lot of contradictory evidence without the background to comprehend it, and the array of remedies makes one's head hurt.
In his book The Paradox of Choice, psychologist Barry Schwartz explains that just as having no choices can be damaging to our emotional well-being, having too many choices can lead to stress and depression. (On the other hand, a Danish study found that highly stressed women were less likely to get breast cancer than their easygoing sisters. Are we getting into grain-of-salt territory here?) Schwartz quotes research showing that while 65 per cent of people surveyed said they would prefer to choose their own treatment if they were to be diagnosed with cancer, only 12 per cent of people who really had cancer wanted to make treatment choices.
When the hypothetical becomes real, we miss the days when the doctor was always right. Sometimes I envy women I've met who did no research after they were diagnosed, preferring to follow their physicians' lead -- as well as the ones who eschewed conventional science altogether and went the natural route.
Minding the medical studies
In the meantime, I've been taking a low-dose Aspirin every day because I read a single 2004 newspaper headline connecting daily Aspirin to a reduction in the incidence of breast cancer (until, while writing this article, I found a 2005 story reporting that daily Aspirin has been associated with an increase in the incidence of breast cancer). I take a tablespoon of ground flaxseed every day because of Dr. Muffin. In response to other recent headlines, I take vitamin D and, when I think of it, wear an eye mask in bed and stumble to the bathroom at night without turning on any lights (reportedly there's a connection between nighttime light exposure, melatonin production and breast cancer).
I eat a lot of organic fruits and vegetables, along with mountains of cheese popcorn and Oreo cookies, and I don't drink -- much. I shop for paraben-free lotion and shampoo and (occasionally) use a glass water bottle instead of a plastic one. And I'm trying to bring back the daintily waved hand fan as a boomer fashion accessory rather than take some powerful drugs that are thought to prevent hot flashes.
Those may or may not be the best choices -- but they're mine.
Page 3 of 3
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| 1. Breast cancer essay: Doctors, patients, a lumpectomy, lymphedema, research |
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| 2. Breast cancer essay: Chemotherapy, cancer stages, tamoxifen, flaxseed |
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| 3. Breast cancer essay: Radiation, side effects, menopause, medical studies |
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 more articles |
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