1. “During 2002-2006, women aged 20-24 had the lowest incidence rate, 1.4 cases per 100,000 women.”
2. “The 5-year relative survival rate is slightly lower among women diagnosed with breast cancer before age 40 (83%) compared to women diagnosed at ages 40 or older (90%). This may be due to tumors diagnosed at younger ages being more aggressive and less responsive to treatment.”
3. “Women with breast cancer also are at risk for developing a second primary cancer. There is a strong relationship between younger age at diagnosis of the primary breast cancer and risk of subsequent cancer. Women diagnosed with early-onset breast cancer (age <40) have almost a 3-fold increased risk of any subsequent cancer, with a 4.5-fold increased risk of subsequent breast cancer.”
Source: American Cancer Society Breast Cancer Facts and Figures, 2009-2010.
The oncologist has spoken to the gynecologist re: me.
Oncologist: the gynecologist thinks you’re depressed. Are you?
Is it any wonder?
She writes me a prescription for an antidepressant that causes headaches and tremors and hands me a radiology requisition for a chest x-ray as I’ve been complaining of chest/rib pain. I walk down to Radiology, then turn and walk out of the hospital. I tucked the x-ray requisition, along with the antidepressant prescription, into a copy of Foucault’s The Birth of the Clinic, where both have remained since.
I’m tired of tests and drugs.
My problem, I told her, is not a seratonin imbalance or a residual, inexplicable melancholy. My problem is cancer.
I thought I’d be calmer for the second chemo treatment, which was obviously a gross miscalculation of my character. Upon arrival I was handed a sheet with a mammogram request on it; notes dated 26 March stated: ‘suspicious lesions on L. side.’ None of the nurses or reception staff were able to inform me what this document was and why I’d not been told about it. The first nurse directed me to Radiology rather than Breast Screening. Once at Breast Screening, the reception staff (the school-leaver and the imposing woman with painted eyebrows) tried to tell me I would not be allowed to have the test because I am under 34 — ie, “too young for mammograms.”
I’m too young for cancer. What do you think of that?
New staff every time. More waiting this time, and a new chemo nurse too, who–surpirse!–informed me that from now on, there would be no bed–and no guests. So I sat in the row of old women while she repeatedly failed to find a vein, eventually breaking into tears when the thing slipped began painfully swelling up my whole arm–then the nurse said “Oh shit” and left without explanation. K. was not at all surprised to fine me curtained off in the corner upon his return.
“They had to move me,” I told him groggily, by then under the influence of the anti-anxiety medication. “I made a scene.”
Despite the trauma of the Charing Cross East Bloc Hospital experience, I feel better this time in the aftermath. Not having vomited was even a bit of a disappointment. They gave me anti-emetics this time, and I’m sure my new living environment–green space, a bathtub, a bed I don’t need to climb into with a utility ladder–contributes.
I’m scared more and more. Reading the pamphets and the websites and the statistics terrifies me. “Younger Women and Breast Cancer”: cancer is more aggressive and tends to be less responsive to treatment. There is no “treating” this disease, this wrongness in my body. Even if and while I live, I will always be living with it. Somewhere. This terrifying thing, genetic hatefulness.
Jenni Murray recently discussed preventative mastectomy on Woman’s Hour; you can listen here to her interviews with a genetic medicine consultant and a BRCA+ woman who had prophylactic bilateral mastectomies and runs a helpline for hereditary breast cancer. Only 8 1/2 minutes, and well worth it.
I’ve not touched the subject of prophylactic mastectomy/oophorectomy/hysterectomy here yet (and to think that eight months ago I didn’t even know how to spell “mastectomy.” Now I’ve had one. Precocious, non?) — largely because I’m still not entirely sure how I feel yet. Maybe I never will be. Also, I know I have a readership of BRCA+ women who have had preventative surgeries without ever having had cancer, and it’s not my intention to offend by seemingly trivializing what is a serious personal decision. So I can only speak strictly subjectively.
And I will. Continue reading
Yesterday: last hospital appointment. Ok, not really (my back is still a f*ing battlefield), but the last one in England, at Charing Cross. I’ve got to admit, I love my surgeon. I have way more affection for her than I ever thought I’d have for anyone who cut my tit off. Now I have to deal with a whole new hospital…and a whole new shitty health care system. I’m a little uneasy about my lovely lovely doc having to pass the baton to some stranger for any further nip-tuck.
Today: first haircut. Ok, again, not really, but the dude who shaved my head six months ago cleaned up the curly scraggle around my neck and ears. Also, I am growing eyebrows and eyelashes. For no reason at all, I feel kind of proud of myself. As I imagine a 14-year old boy with his first “moustache” must.
And now, some stats.
The chance of developing breast cancer at 24 was: 1 in 19,000
The chance I will live to 30 is, supposedly: around 80%
Is that good? When I see percentages, all I can think is: that’s only a ‘C’.
For women with a BRCA mutation:
Chance of developing breast cancer: 85%
Chance of developing ovarian cancer: 40-60%
So, you may ask:
whaddya want, a cookie?
Yes please. Chocolate chip and orange, if possible.