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Today, I am grateful

The following post is one of a series of posts appearing Monday through Friday on The Cancer Blog. This feature -- Today, I am grateful -- allows me to share with readers my appreciation for all the treasures in my life, both big and small. In my post-cancer world, I find It healing for my soul to be mindful of the good in my life. It is my pleasure to share my gratitude with you.

The night before my lumpectomy, way back in December 2005, I was consumed with fear, worry, and panic. Since I'd found it, the lump in my left breast had been sitting untouched for nearly two weeks. I imagined the mass spreading with each day and believed I could detect its growth each time I felt for it. A doctor told me if it was growing like I thought it was, my tiny pea-sized tumor would be the size of an apple within days.

My fears were unfounded and irrational. I know that now. But during the moments of uncertainty that filled my days between diagnosis and prognosis, I had no direction. I had only my wandering mind for company. The waiting really is the hardest part. Once faced with the specifics of our diseases, we can take action.

Continue reading Today, I am grateful

Thought for the Day: Cloudy juice clearly healthier

I'm not a fan of juice and have never been one to offer it to my little boys. There's just too much sugar swirling around in the beverage to make it an appealing choice for me.

Despite its sugar content, however, there are certain health benefits one might gain from drinking juice -- especially a specific type of apple juice.

Think about this:

Next time you're in the market for apple juice, try the cloudy, unclarified variety. Recent research indicates it has four times the concentration of anti-cancer polyphenols as the clear juice most people drink.

Source: Family Circle, April 2007

Kindergartner has all the write stuff

I'm wearing a pretty pink sticky note on my shirt. It was taped on me just recently by my six-year-old Joey who's been busy in kindergarten learning to spell words. He's in the sounding-out stage and as long as he gets his consonants right, we're happy. Joey's teacher says he doesn't need to master the vowels just yet, and with that in mind, Joey is doing a pretty impressive job of crafting real words -- although sometimes he misses.

Tonight, Joey had a hit and a miss. But the sentiment buried in his written message -- cryptic as it was -- is enough to warm my heart.

Joey always links me with breast cancer -- no surprise, since he's been a key player in my match with cancer since it began two years ago -- and so tonight, he wrote on the pink sticky note, Bube skawos. He tells me it reads, Boobie cancer. Not so sure about the cancer part. But the boobie part speaks loud and clear. And even more clear is the breast cancer ribbon he drew on the same sticky note, just before he pinned me with his powerful work of art.

Joey's smile spanned from ear to ear as he presented me with my special badge. And I'm smiling just the same as I look at the little pink piece of paper given to me by my loving little boy.

Mind games help clear fog left from chemotherapy

As evidence mounts, it's becoming more and more clear that chemo brain, a mental fogginess that can result from chemotherapy, is a real concern and not just a convenient excuse cancer patients use to explain away their flighty and forgetful tendencies. It seems the brain really can suffer cognitive damage from the poisonous drugs that fight off deadly cancer cells. And sometimes, this damage is present years after treatment.

Add to chemo brain the normal aging process as well as brain conditions such as mild cognitive impairment and even schizophrenia and the brain might not stand a chance of ever remembering anything. Unless we buy into the new concept of mental training -- somewhat like physical fitness training -- in which case we may be able to bring back a level of sharpness to our lives.

Research suggests this type of training may delay mental decline. And Betty Hall, 85, who is taking a brain fitness class at her senior living complex in Illinois, says brain-enhancing activities are definitely helping her.

Hall is participating in an eight-week program where she spends one hour per day, five days per week using a computer to match words and listen for details in stories. She says it's helping her remember where she places her keys and her grocery lists -- and it's even helping her in her bridge club.

"I've won four times out of the last five at bridge club, and I think the players are going to shoot me because I keep remembering the cards people have," she said. "It's much easier for me to concentrate . . . and I brag about it everywhere I go."

One clinical professor of neurology says brain health programs will explode over the next few years because of the stunning findings on this front. One study shows relatively short training regimens, lasting just five or six weeks, improve functioning for as long as five years. And booster sessions help advance these gains. Study participants says their everyday tasks, like managing finances, are much easier after mental workouts. Another study of the computer software Hall uses shows the program shaves an average 10 years off the mental age of users.

Not all mental training is alike, and different cognitive difficulties may call for different training protocols. But the simple fact that I can work out my brain like I can work out my body gives me hope that I can possibly reverse the effects of chemotherapy on my own foggy brain, that I can one day not worry anymore that I might find my check book in the refrigerator and my cell phone in my sock drawer. Bring on the workouts!


Thanks to Bev, my brainy friend, for this story tip!

One step closer to uncertain survival

It's an unsettling journey -- the pursuit of the five-year cancer survival mark. Some say each year of cancer survival makes the future more of a sure thing. And so surviving five years -- the traditional landmark of real remission -- is a big accomplishment. But then there's the perspective of numbers that for me say I have a 93 percent chance of surviving breast cancer for five years. After that, though, there's no telling what will happen. So I am eagerly awaiting the moment when I cross the five-year finish line as I anxiously realize this very same moment may also signal a more dismal outlook.

The paradox hit me straight in the face yesterday as I was waiting for my radiation oncologist to give me another six-month all clear announcement. I was reading the January/February 2007 issue of Coping magazine while I waited. And as I flipped through the pages, I landed right at these words:

Studies show that half of all breast cancer recurrences occur after completion of five years of standard tamoxifen therapy. Additionally, a third of women with estrogen receptor-positive early breast cancer experience a recurrence, and more of half of these recurrences occur more than five years after surgery.

Now this doesn't apply directly to me. My breast cancer was estrogen receptor-negative which makes me a non-candidate for tamoxifen. And this is what scares me. My tumor was aggressive and while my treatment was also aggressive, I don't get the extra five-year protection from hormone therapy. If women taking this drug can have recurrences after completing the therapy, I wonder what's in store for me having not had it.

Maybe I'm making comparisons that don't amount to any real conclusions. Perhaps my type of disease allows for a more secure future. Or perhaps it places me on shaky ground. I don't know for sure. And I don't think I'll dive any deeper into research than I already have. Instead, I will live for today -- while enjoying the announcement my oncologist shared with me yesterday. All clear!

All clear

The doctor who recently read my mammogram films and maneuvered her ultrasound wand over every inch of my breasts could not find one darn thing wrong with anything in her view. I wasn't worried that she would -- but it's still a relief to know that for now, I am fine.

It was two years ago, November 19, when this exact doctor sent me for a biopsy of a mass her same ultrasound wand detected. She did not know at the time the mass was a cancerous tumor, but she did know it was suspicious enough for further investigation. And so she sent me on my worried way, and the result of my biopsy -- cancer -- cemented our life-long relationship as doctor and patient.

Every six months I see this doctor for a mammogram and ultrasound. And when I find myself freaking out about something breast-related, I call her and she fits me into her busy schedule. I know she is there for me when I need her. And she knows I will always be there for her -- every six months and sometimes in between.

While I really like my doctor, I do hope I don't see her until May 15 when I report for my next mammogram appointment -- because with our kind of relationship, less is truly more.

Lumpectomy technique saves patients from repeat surgery

On Sunday, for the very first time, I read a magazine article about the hospital where I received treatment for breast cancer. I had never before seen mention of my hospital, my doctors, my city in anything other than local and regional newspapers and on area television stations. I figured news about Shands Hospital at The University of Florida was out there -- in more areas than my own -- because it's a well-known facility. People travel from all over to receive treatment here. So I know it's a good place. But to see in the October 2006 issue of Good Housekeeping an actual blurb about a new kind of lumpectomy -- pioneered right here in Gainesville, Florida -- is exciting.

I am the happy recipient of this new kind of lumpectomy -- which really is not new at all. It was developed 20 years ago by the surgeon who performed my own lumpectomy, and it allows women who undergo lumpectomy the chance to avoid return trips to the operating room.

The method is called frozen section analysis, and it was first used by Dr. Edward Copland III, first director of the UF Shands Cancer Center, who was tired of waiting for pathology reports and tired of operating on patients two and three times to ensure clear tumor margins.

It all happens like this -- a surgeon removes the breast cancer tumor, takes tissue samples, freezes them in an embedding compound, and sends them to a pathologist for immediate analysis. In a typical case, this frozen section process adds just 15 minutes to the operating time. If pathology reveals more tissue must be removed, the surgeon returns to the patient, still under anesthesia, and continues surgery. The patient does not need to return for more surgery.

Surgeons at most institutions rely on a method called permanent section analysis to determine whether or not cancerous cells remain along the margins of a tumor. The technique is labor-intensive, takes days to complete, and requires patients to return for additional surgery if margins are not clear. Surgeons using the frozen section method still consult permanent sections to confirm margins are clear -- but they are mostly certain of their findings during frozen section.

Studies show frozen section analysis to be safe and effective -- and it adds just $851 to the cost of surgery, a savings considering the cost of returning for surgery as a result of permanent analysis.

There are many advantages -- but the procedure is tricky and on occasion can fail to detect some cancerous margins, indicating frozen section should continue to be used in conjunction with permanent section. Opponents of the practice say false positives could result in unnecessary mastectomy. But Copeland says this has never happened at UF -- and he would never remove a woman's breasts until permanent section confirmed it was necessary.

Despite the promise of this method, only a handful of institutions make practice of this surgery-sparing technique. Shands at UF is the only hospital in North Florida where breast surgeons perform frozen section analysis on a regular basis.

The procedure -- which is not risky, is not harmful, and clearly saves patients from returning for surgery -- is the exact procedure I received almost two years ago. Dr. Copeland removed my tumor, froze tissue samples, sent them to pathology, and 15 minutes later knew my tumor had clear margins and had not spread to my lymph nodes. He visited my family in the hospital waiting room just after surgery and told them the good news -- clear margins, no spread, a 1.1 cm. tumor, stage I. And while other tumor criteria, such as ER/PR status and HER2 status, did not come my way immediately, I at least knew the basics when I woke from surgery. No waiting. No worrying. No complaints.

Jingles and jangles brighton third year of survival

I am jingling and jangling with charms around my wrist once again. Ever since I was diagnosed with breast cancer, my friend Nicole has sent me a Brighton breast cancer bracelet. My very first bracelet arrived in 2004, and I wore it proudly. My second bracelet arrived in 2005 and took the place of the first. And now, as I enter my third year of survival, my 2006 Power of Pink bracelet dangles from my arm.

This year's bracelet features a heart-shaped locket. Other charms -- designed to represent stepping stones to recovery -- feature key survival terms. Brighton tells it like this -- "When we accept, we open the door to trust and find love that will heal. Along the way, we learn to be the inspiration." And there are still more charms -- a breast cancer awareness ribbon signifying a fight for the cure, a four leaf clover to assure luck is on our side, silver beads for richness, clear crystals for truth and purity. And still, there are more.

Brighton recommends we all make a difference in the breast cancer crusade. Some may choose to chip in by contributing financially. Some may volunteer. Some may lend a sympathetic ear to others in need. Some may purchase and wear the 2006 Power of Pink bracelet -- proceeds benefit breast cancer research -- and this one simple act will send an empowering message to women everywhere.

Survivor Spotlight: Jennifer Matherly inspires with grace

Jennifer Matherly is a 27-year-old wife, mother, daughter, sister, insurance broker, student, and friend. She is also a breast cancer survivor. Jennifer, who lives in Columbus, Ohio, enjoys golfing, watching football, and spending time with friends and family. She doesn't have much free time lately -- but when she finds moments all to herself, she tends to her hobbies which include cross-stitching and working on her blog.

Jennifer's blog began as a story about her journey to motherhood. It turned into a story about her journey with breast cancer. It's an inspiring read, full of trials and triumphs. It's a testament to her strength and courage and sheer determination. It's a story of survivorship -- a little something like what follows.

Continue reading Survivor Spotlight: Jennifer Matherly inspires with grace

Song says it best: I hope you had the time of your life

I ran on my treadmill today while listening to a song by the band Green Day. I have always liked the song -- Good Riddance (Time Of Your Life) -- but I like it more at this moment in my life than ever before because it speaks about looking back on the past in light of unexpected journeys -- and because my unexpected journey with breast cancer makes me look at everything differently. And when I look back at my life one day, I want to say that I had the time of my life. And that's why I like this song. And that's why I share it here today. Because I hope that in the end, we all can look back with the crystal clear knowledge that we had the time of our lives.

Another turning point, a fork stuck in the road
Time grabs you by the wrist, directs you where to go
So make the best of this test, and don't ask why
It's not a question, but a lesson learned in time

It's something unpredictable, but in the end it's right.
I hope you had the time of your life.

So take the photographs, and still frames in your mind
Hang it on a shelf in good health and good time
Tattoos of memories and dead skin on trial
For what it's worth it was worth all the while

It's something unpredictable, but in the end it's right.
I hope you had the time of your life.

It's something unpredictable, but in the end it's right.
I hope you had the time of your life.

It's something unpredictable, but in the end it's right.
I hope you had the time of your life.

Sunday Seven: Seven subjects of breast cancer pathology

When I first looked at my pathology report more than 18 months ago, it made little sense. Terms like Bloom Richardson Score and margins and Her2Neu were as foreign to me as the breast cancer that somehow invaded my body. So I read it over and over again and was eventually able to identify the basic meaning hidden within the four pages that detailed my disease. As it turned out, this report was my map. It led me in various directions for various treatments. It contained some roadblocks. It was sometimes confusing. And sometimes I got lost. There were some good and not-so-good stops along the way. And in the end, I reached my final destination -- in the land survival. And this is where I hope to stay. For a long time.

My map is not necessary anymore -- although I still look back at it. I've found that it makes more sense now that time has passed. I can interpret it more objectively, with more perspective and less emotion and fear. I am still learning about the disease that was removed from my breast. And I am realizing there was a lot I never really knew -- like these seven subjects -- when breast cancer was new and fresh and debilitating.

Continue reading Sunday Seven: Seven subjects of breast cancer pathology

One woman with gallbladder cancer blogs new journey

Lynne began her blog on August 6 -- one week ago and two months after she endured surgery to clear a clogged bile duct and received the grim and frightening diagnosis of gallbladder cancer. Her cancer is stage IV -- not an uncommon staging for a hard-to-detect disease that many will only survive for two to six months. So Lynne is scared but still strong and hopeful and full of faith. Her goal is to live -- not die -- with cancer, even though her days may be numbered. So Lynne blogs her thoughts and fears and all the bits and pieces of information she gathers about a disease that is rare and resources that are scare. It helps her. And it will surely help others. And here is a glimpse into what she shared in her first post.

If you had only six months or a year to live, would you want to know? What would you do with the information? Would it make a difference in how you lived your life? These are questions I have been asking for the past two months. In asking them, I have also noticed how little guidance there is for this process. Who have I known personally who was able to anticipate their death? I can think of only two individuals, and I never asked them whether or not they were living differently in their awareness of their mortality.

So, those are the themes in this blog. I look forward to a dialog with those I know, and those I don't about this strange, life changing journey.

To Lynne -- and to all others who are faced with the disease -- may you find peace and comfort and strength in every step you take, every direction you follow, every path that becomes your road to recovery.

Spreading the word helps educate, raise awareness

I will share anything and everything about my own experience with breast cancer -- how I found it, how it was removed, how it was treated, how I fared through the whole ordeal, how I'm surviving now. I figure that if I spread the word about what happened to me, that others will become more aware and some -- especially those with a new diagnosis -- will benefit from whatever wisdom I have to impart. So I am an open book. I talk about breast cancer, answer questions about breast cancer, and probably insert my opinion about the topic to some who don't really care. But I will continue talking and sharing -- and writing -- because the alternative would be a disservice to the few I may be able to help.

So a card stuck in the middle of a magazine caught my eye the other day. The slogan on it reads, Tell Someone and the illustrations on this card -- that functions as a postcard -- show women reaching out to other women. There are women talking on the phone and a woman tapping another on the shoulder. The message they appear to be spreading is highlighted in the text below the graphic representation of this campaign to raise awareness of cervical cancer. The message is about HPV -- human papillomavirus -- and about how millions of women already have it and how some don't even know they have it. I learned from reading this card that for some, HPV will clear on its own. But for some, cervical cancer may develop. This is why Pap tests are critical. And so what all women should be telling other women is this -- ask your doctor about the importance of Pap tests. And be active in your own health. And follow all recommendations for detecting health concerns early. I learned from reading this card that I should tell someone about this. And so now I have.

Port saves veins, eases discomfort of chemotherapy

This is my port. It looks to me like a bottle cap sewn under the skin on my chest. My son Joey -- he is five years old --  calls it my stone and his brother Danny -- he just turned three -- at one time thought everyone must have this same boo-boo. He would look for it, feel for it, hunt for it. But mine is the only port he could actually locate and now that he's getting older, he is not so concerned with it anymore.

My concern about the port is that everyone who needs chemotherapy should have one. It's the alternative to receiving IV sticks in the arms and hands and except for one quick stick that can sting -- I use a 5% lidocaine numbing cream prior to my infusion and with this miracle lotion, I don't feel a thing -- it is quick and painless. My port is a one-stop shop. Once accessed, blood can be drawn, drugs and fluids can be infused, shots can be injected, and at the end of treatment, an injection of blood thinner keeps the line clear and clean. The line attached to the port underneath my skin travels into large veins in a direct and efficient manner. While hospitalized for chemo-induced fever and low blood counts, I received antibiotics and a blood transfusion through this method. There was one stick when I was admitted and for my five-day stay, I never had to be poked again.

My port, called Infuse-a-Port®, was implanted during a minor outpatient surgery with use of a local anesthesia and it was ready for use immediately after the procedure.

My port has been used for 16 months now and will no longer be necessary at the end of July -- this is when the last drops of Herceptin will sail through my veins. Then I get to decide whether to keep my port or have it removed. It can stay for many years as long as it is flushed once each month. The superstitious part of me thinks I should keep it for future use -- if necessary -- and the rational part of me thinks I need to get rid of this bottle cap because I may never need it again. Regardless, I love my port. It has eased the discomfort of chemotherapy and for that, I am grateful.

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