Tag Archives: tests

In our time (at our age): Facts & Figures

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.

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cancer on my desk

When I got to work this morning there was an envelope on my desk. I opened it to find it full of literature on “young adults & living after cancer.” It might as well have been anthrax. I felt betrayed by it, strangely, and angered by the well-meaning email from my boss; a friend of hers had published these pamphlets on behalf of someone who’d died from the disease.

I don’t want my disease, its reality, to appear on a Monday morning as simply as a stack of filing. It’s as if every time I open a door, or an envelope or some part of myself, there is cancer in it.

I went to Michigan this weekend. “See you in the fall,” they said. It is such an easy thing to say. For everyone else, so easy to say that in six months, one year, two three four five six years I will do this and that thing.

And then these English Ph.D. people grinning flippantly: “I’m at the end of my first year, and I’m still alive.”

I thought: You really have no idea what that means to me, do you?

But how could you.

Saturday I have an MRI of the left side. Only after those results can I speak with any confidence about something as far away as fall. And I’m terrified of this awful always betrayal of my body. I feel so awfully encumbered by it.  And I’m trying not to be embittered by all these people who can read and drink and read and read and pursue their various happinesses, who can consider their deaths as abstract and distant, who can stockpile knowledge soundly in brains undestroyed by chemo.

I wonder if I will ever be a Ph.D. student more completely than I am a cancer patient. I don’t know.

Are you ever actually living “after” cancer?

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Knock knock. Mammogram.

This morning I had a mammogram.

I thought — the last time I did this, I had two breasts.

I had an ultrasound as well, which resulted in a pseudo-PTSD flashback of the first time I had to have a breast ultrasound, shortly before the needle biopsy left me bruised and and bleeding and crying, riding home alone on the Tube, shocked and dazed and terrified.

Today, the doctor opens with, “I don’t want to scare you, but…” 

and ends with, “I’m sorry. You’re too young for this.”

The recommended course of action, apparently, is a screening every six months, alternating mammograms with MRIs. These tests are so panic-inducing, I’m not really sure I’m down with that.

Remember that old Saturday Night Live Land Shark sketch? The Jaws spoof with the shark knocking on the door: “Candygram.”

That’s what I feel like whenever I hear the m-word. That something sinister is lurking on the other side of the door.

 Knock knock. Mammogram.

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Results are in

& I do NOT have a BRCA mutation.

Which is, yes, good news. Who wants to take me out for a martini? But my sense of emotional relief is tempered by the rational knowledge that this relief is largely artificial and unfounded, since I’ve already had f-ing cancer, and could die from it still.  And there’s no certain explanation for it now; cancer being genetic & all, not having the BRCA mutation likely means there’s some other genetic malfunction in me that hasn’t been discovered (and patented) yet.

I am taking the same course of action in light of these results as I promised myself I would if I tested positive: ie, doing nothing. But do feel blessedly exempt from that pressure of BRCA-scaremongering into preventative surgery.

I really wonder whether there is something defunct with my primal sense of self-preservation. I’d probably feel differently about preventative surgeries if I had children, or a life’s work, or anything else to live for. But I thought about it as I lay in bed this morning, hitting the snooze button over and over, and came to the same old conclusion: how presumptuous it seemed to act as if my life was really all that important–and how pointless it seemed to go through such great pains to prolong it.

Which is why I am dreading my upcoming mammogram, and why I have not called for the results of the CT scan I had six weeks ago. If I have cancer, still or again, I don’t want to know. I don’t want any more treatment. It’s terror and desperation, exhaustion and depression. But I can’t sustain myself on any of that, and I don’t want to.

(I am eligible to be tested for Li-Fraumeni syndrome, but would have to pay $3,000 for the privilege. And really, there’s not much point in knowing anyway, since there’s nothing anyone can do but wait for you to get brain tumors and leukemia and all the rest.)

I’m still obviously at risk for a new breast cancer on the left side, or for a recurrence/metastasis of the primary cancer. But I realized the full implication of the negative test result about twenty miles from the hospital, and burst into tears in the middle of traffic on I-79: as far as I know, I’m at no greater risk for ovarian cancer than the rest of the general population.

And I thought of all the women walking around with their ovaries inside of them, not even thinking about it, certainly not shedding tears of joy on the interstate over it, and felt strange–but strangely elated.  Even if I can never have children, there is something psychologically comforting about keeping those bits where they belong–and not having to defend to the death my decision to do so.

Then on NPR, an interview with Vic Chesnutt, & this rather incredible song:

Vic Chesnutt – Flirted With You All My Life

which he described as a “breakup” with death & the temptation of suicide.

Bizarre how Fate sometimes supplies a soundtrack.

Oh death, oh death
Really, I’m not ready

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19 March 2009: Pre-treatment

Three days of relative normalcy before I’m due to begin chemo. I know they’ll skip by almost thoughtlessly, and in the weeks and months to come I’ll long for that sense of health. Yesterday the NHS treated me to a battery of tests–bone scan, MRI, CT scan, mammogram–endured with surprisingly few complicaitons and refreshingly good humour. I was in near tears with laughter in the MRI waiting room as two armed guards led in a handcuffed inmate on a metal lead, clanking his chain while I considered the questionnaire: “Do you have anything metal on or about your person?”

I went to the gym this morning for possibly the last time. I left feeling light, unburdened, capable, and came home to a delivery of cardboard boxes in which to pack and deliver my books, my life–a more complicated undertaking than I originally surmised.

More and more today I’ve doubted my decision to stay here. I still have two days to call it all off, I suppose. I’m riddled with guilt; I don’t deserve the support and kindness they’re extending me, and yet I’m taking it all anyway.

I will be trapped wherever I go.

Tomorrow I’ll cut my hair short–become grotesque in stages.

I’ve been able to sleep lately, but am constantly exhausted anyway. It’s been a week. I’ve surprised myself by hardly crying, by making arrangements, or moving toward making them. But I can’t anticipate how it will be to have my body, mind and emotions ruled by drugs. To be so removed from life.

Though I wonder whether anyone will actually notice a difference in my absence.

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