Walking into my cancer center waiting room is one of my most sobering experiences. I enter this room -- jam-packed full of men, women, and children -- every three months for a breast cancer follow-up. It never gets easier. It always startles me, stirs my emotions, makes me realize how so many people are touched by such a treacherous and all-consuming disease. The fact that I sit in this room, that I am one of these many people, still doesn't seem real.

It's been almost three years since I got a phone call from a surgeon declaring, "You have cancer." I didn't believe it then. Even after all I've been through -- surgery, chemotherapy, radiation, and more -- I hardly believe it now. But it's real. I have scars and new hair and a whole new set of worries to prove it.

Walking into that waiting room proves it's real. There's nothing like it. There's also nothing like walking out, with a clean bill of health and the promise of three more months.

I'm in another hospital lobby -- this time waiting while my three-year-old son has surgery to repair a hernia.

So I'm back to reading a magazine. This time I brought my own not-so-outdated publication -- The Oprah Magazine, April 2007. And as I sit here flipping and turning the pages, there is so much I want to tell you.

I'll be back with more. But for now, think about this:

"...see how the flesh grows back
across a wound, with a great vehemence,
more strong
than the simple, untested surface before.
There's a name for it on horses,
when it comes back darker and raised: proud flesh.
as all flesh
is proud of its wounds, wears them
as honors given out after battle,
small triumphs pinned to the chest."

Jane Hirshfield, From What Binds Us

I have a few small triumphs pinned to my chest -- they show in the form of surgery scars and radiation tattoos and puckered skin where a port once lived. Proud flesh. Stronger than the once untested surface. My honors for having survived a battle.

While sitting in the lobby of my hospital's MRI center on Friday -- time for the annual breast MRI -- I found myself a bit irritated by an appointment mix-up that kept me waiting much too long for a procedure that in and of itself is no real treat.

As I waited to bare my breasts and dangle them through square cut-outs on an MRI table, I flipped through a few ancient magazines -- why are lobby offerings so old? -- and as is usually the case when I read just about any publication, out jumped some cancer news.

So maybe the wait was worth it. Without it, I wouldn't have found this enlightening bit of information, this thought for today.

Now I warn you -- this item I am about to share comes from an October 2005 issue of Parenting magazine, so it's a bit outdated. But it still holds some truth. And if you remember nothing else from this message, I hope you'll take to heart this one lesson -- women tend to overestimate their chances of developing breast cancer.

Think about this:

• 46%: What women estimate is their lifetime risk of getting breast cancer
• 13%: Their actual risk

Health care provider Dr. Anthony Vendryes wrote Monday in the Jamaica Gleaner that he is distressed at the growing number of young women developing cancer -- especially breast cancer. He believes women are not working very hard at preventing the disease. He thinks we are just waiting for the problem to surface and then treating it with "painful and often ineffective" efforts.

According to Vendryes, research indicates a woman's risk of developing breast cancer is under her own control. If we live a lifestyle that promotes cancer, we are apparently likely to get the disease. Such a lifestyle would include gaining more than 11 pounds after the age of 18, exercising less than one time per week, eating less than five servings of fruits and vegetables per day, eating more than three ounces of red meat per day, ingesting too much fat and salt, consuming more than one alcoholic drink per day, and smoking cigarettes.

I am all for healthy living. And I believe achieving good health is under our control. I would personally recommend every woman take charge of her life in a healthful manner. But I do not believe as Vendryes states, "most women actually give themselves cancer by making poor choices in life." I think it's the word most that bothers me.

Obviously, there is a connection between lifestyle choices and chronic disease. And of course our level of health is under our control -- to some extent. But I don't believe it's fair to claim most women ask for breast cancer. I know I didn't.

I did not choose cancer. It chose me. Vendryes might say I am one of the disillusioned people who think cancer is entirely a matter of chance or entirely a matter of genetics. Actually, I suspect it's a combination of all factors. All I know for sure, however, is that my own lifestyle choices were pretty darn healthy prior to my diagnosis.

My weight has always been in a normal range -- and while I did gain more than 11 pounds twice in my life, it was due both times to the more-than-ten-pound babies I delivered into the world. I have always eaten a fairly healthy diet. I consume sweets, salt, and fats in moderation. I have never smoked and have consumed alcohol only minimally. And I have always consistently exercised.

I admit I have eaten red meat, although never daily. And I'm sure I fall short on the recommended intake of fruits and vegetables. But really, I cannot even begin to imagine that my lifestyle was an invitation for cancer. And it makes me sad that most other young women, shocked by a diagnosis of breast cancer like me, might think they asked for such a horrible disease.

It's been two years since my breast cancer diagnosis and subsequent "painful and often ineffective" treatments. And although I have made some lifestyle changes -- I never drink alcohol now, I exercise a little more, and I don't choose to eat red meat if other options are available -- my life is much the same as it was prior to cancer. And I am certain that if cancer makes a return visit to my body, it will not be because I asked for it.

I once waited to see my oncologist -- in a room with nothing more than outdated magazines and my own wandering mind -- for four hours. I offered up 20 hours of my time for chemotherapy treatments and then spent five days -- two times, for a total of ten days -- waiting in the hospital for doctors to determine how to raise my blood counts and decrease my fever after the completion of a dose-dense chemotherapy attack. I traveled to and from radiation appointments for 35 days, spending an average of 90 minutes on each of these round-trip excursions. I reclined in an infusion chair every three weeks for 12 months so that a new breast cancer wonder drug could sail through my veins. I spent 52 hours in that chair. And I spent countless hours pouring out my emotions to a counselor, in an attempt to clear my mind of all that cancer took from me -- including my time.

These are just seven memories I have of time lost to cancer. There are others -- countless others -- but this should suffice as proof that among all the potential side effects that accompany cancer, loss of time is a guarantee.

According to the first study to put a price tag on the time patients spend battling cancer, it seems the disease steals at least $2.3 billion worth of time for patients in the first year of treatment alone.

Eleven of the most common cancers were included in the study. And it was determined that 368 hours are lost during the first year of treatment for ovarian cancer. For lung cancer, 272 hours are lost. For kidney cancer, 193 hours go down the drain. These hours don't take into account time spent in bed recovering from surgery or chemotherapy treatments. It accounts only for time engaged in actively receiving care -- it counts chemotherapy, radiation, blood tests, scans, surgery, check-ups, waiting to see doctors, and driving to and from appointments.

The study, published in the Journal of the National Cancer Institute, sheds new light on the burden of commitment -- the human cost of cancer.

"Cancer is more than the just the dollars and cents for the medicines and the treatments and the doctors. It's also the lost opportunities for the patients," said the American Cancer Society's Dr. Len Lichtenfeld, of this overlooked reality.

Lichtenfeld says this study demonstrates the need for early detection. The earlier cancer is caught, the less time patients spend in the system. It also shows the need for more targeted therapies that spare patients physical side effects and allow them opportunities for taking pills at home instead of receiving treatment in clinics.

I would love to have back the time I spent treating and recovering from cancer. But I'm not heartbroken over my lost time. Because it bought me something in the end -- more time.

I will visit my oncologist on Monday for my every-three-month check-up. It's the recurring appointment that will appear on my calendar until I hit the five-year-survival milestone. I am three years away.

It's the appointment that consumes at least half of my day due to endless waiting -- waiting for a parking spot, waiting in the lobby, waiting in the exam room, waiting to pay. It's the appointment that officially begins with the drawing of my blood for lab work, continues with a check of my vitals, proceeds with a history review and physical exam with a medical student. It's the appointment that brings me face to face with the man who prescribed my treatment, the man who offers me strategies for living beyond treatment, the man who helps keep me alive. My oncologist.

And so I am preparing for this visit in the same exact way as I always do. I set aside a large chunk of time for this time-consuming extravaganza. I think a lot about the lab work and wonder if something suspicious will surface. I think a lot about the physical exam and wonder if an enlarged lymph node or mass in my breast will be discovered. And I think a lot about what I want to ask -- because this is my only very own allotted time for unraveling the mysteries of cancer with the man who knows the topic like no one else I know.

On Monday, I will ask a few questions. I will ask about tumor markers, about why I am not tested for these indicators of tumor growth, a standard option for my co-writer and co-cancer survivor Kristina Collins. I will ask about Zoloft, about how long I should continue taking this anti-depressant and how to best wean myself from this drug when the time comes. I will ask about the flu shot, about whether or not I can get one during this same appointment.

And that's all. For now. Until three more months pass and my calendar tells me it's time to return for this recurring appointment that takes me closer to the five-year mark.

Not only did I get the tumor markers to check for breast cancer recurrence but I figured I would really go nuts and have them do the ovarian cancer tumor marker too. I figured if I'm going to be worrying anyhow I might as well worry about everything. Of course I'm also thinking about the other blood tests they will be doing, especially the liver enzymes.

Yesterday I showed up at my oncologist's office without an appointment. I knew that I wouldn't need to see my oncologist to get a port flush and blood taken, however when he saw that I was there he wanted to see me. He immediately thought I had some sort of pain somewhere for me to be all of a sudden wanting tumor markers that I usually refuse to get. I do not have any pain or reason for getting these tests other than the fact that mentally I need to do this for myself.

This is hard, very hard. I'm scared that something is going to show up. I keep telling myself that knowledge is power and that if they do find something wrong that I will be getting on top of the problem before it gets worse. At this point I'm not sure if I will be calling my doctors office all day in a panic on Tuesday or if I'll just wait and see if my oncologist calls me.

Breathe in breathe out, breathe in breathe out...

A few days ago, notification of an e-mail arrived in my inbox. It popped up right in front of me, with the sender's name -- Amy Wilson -- glaring in black print right before my eyes. Amy is my friend who was diagnosed with breast cancer just after my own diagnosis. We e-mailed frequently about our cancer hopes and fears and so it was never before odd that a message would travel from her computer in Ohio to mine in Florida. But on the day this one e-mail arrived, it was odd -- because Amy died two weeks ago, after a 15-month battle with the disease we both vowed to conquer.

The e-mail was not from Amy. It was from her husband, Paul. And it was as comforting to hear from him as it was odd to see Amy's name flash in front of me. You see, I have wanted to call Paul, e-mail Paul, send a card to Paul -- something. I have wanted to reach out in some way, even though I have never met the man who thought he would spend the rest of his life raising his two children with Amy. But I never could figure out what I would write or say or send. I have been afraid that it would be hard for him to talk about Amy's death. I've been afraid that it would be hard for me to talk about her death. So I have waited, hoping the passage of time would help prepare me for some sort of action. And in the end, time was not necessary. Because Paul reached out to me. And this is what he wrote in the e-mail he sent from Amy's mailbox.


And now I can contact Paul, because he has opened the door. He -- the one suffering the greatest loss -- has comforted me. And now I need to thank him.

I know that after my surgery for breast cancer I wanted to start chemotherapy immediately, so much so that I had my first dose of Adriamycin and Cytoxan before my port was put in. I didn't want to have to wait for another surgery and more healing time before getting started with fighting the cancer that may be in my body.

A new study shows that it is safe to wait up until twelve weeks after surgery to start chemotherapy. This is important because it can give the patient time to recuperate after surgery and also can help them to have more time to make decisions about treatment options.

The women in the study received chemotherapy after surgery for Stage I and Stage II disease. The study showed that among the women who started chemotherapy within four to twelve weeks after surgery had an average survival rate of 86 percent at five years. It also showed however that waiting longer than the twelve weeks to receive chemotherapy can cause the patient to have a higher risk of recurrence and also lower survival rates.

"Our findings can reassure women with early-stage breast cancer that it is okay to take time before they start chemotherapy to gather information and be actively involved in treatment decision making. These steps have been shown to reduce anxiety and depression associated with breast cancer. However, to achieve the full benefit of chemotherapy, patients should not delay further, and should ensure that they start treatment within three months of surgery." said the lead author of the study, Dr. Caroline Lohrisch, a medical oncologist with the BC cancer agency.

I was in the emergency room the other night with my three-year-old who was experiencing a mysterious leg pain that resulted from a bad case of strep throat. It wasn't serious enough to warrant swift movement from the waiting room to an actual room and we sat in a holding pattern with a crowd of other patients, some of whom were still waiting after Danny had been treated and released. I was told patients are served in the order in which they arrive but also according to the seriousness of their complaints -- which takes me back to the night I was in the ER with a fever, headache, sore throat, and sore gums. The night I was given a mask and was immediately escorted from the waiting room to a private room where doctors and nurses treated me for neutropenia -- a condition caused by chemotherapy and marked by a drop in neutrophil levels, a condition that puts chemotherapy patients at great risk for infection. This was the second time I went to the hospital for neutropenia. Both times I was admitted and treated for five days.

And so sitting in the ER reminded me about how serious chemotherapy side effects can be. And it makes me want to caution all chemotherapy patients to never dismiss the signs that the body is suffering -- to never tough it out with the hope that a good night's sleep or a few days rest will straighten everything out. Because it may not -- and the end result may be tragic.

All chemotherapy patients should be briefed by their medical teams about when to call for medical assistance. For me, a temperature of 100.4 was the magic call-for-help signal. And twice, I called for help -- once in the middle of the night. But any symptoms , and definitely a combination of symptoms, are cause enough for a simple phone call. So don't delay. Don't excuse warning signs that your body is struggling. Don't second-guess your decision to notify a medical professional about your symptoms. Just call. It could save your life.

Researchers are suggesting not all men diagnosed with early stage prostate cancer need aggressive treatment, but may do just as well with a watchful waiting approach of periodic monitoring of the progression of their prostate cancer before medical action is taken.

When the records of 71,602 men diagnosed with localized or regional prostate cancer were evaluated, University of Michigan in Ann Arbor researchers concluded that over half of the men considered in the lower risk category who might have qualified for watchful waiting underwent immediate treatment instead.

The lower risk group would be men of any age at diagnosis with well-differentiated tumors or men 70 years or older at diagnosis with moderately differentiated tumors.

Roy Thayers has experienced death up close, as he was caregiver for his first wife as she battled cancer -- he knows what it is like to watch someone fight for their life -- and he was there when she lost her life to cancer.

Thayers, who at the age of 77 lives alone, was recently told by his doctors that he was at risk for a fatal heart attack and might lose his life if he didn't undergo heart surgery to unblock the heart valves immediately.

The problem of avoiding death and living longer became a matter of time and money. When the NHS put Thayers on a nine-month waiting list for heart surgery, he worried he might not have that long to wait -- considering the urgency with which the doctors had impressed upon him concerning the imminent threat of a fatal heart attack without surgery. He was told he could have the surgery immediately if he paid for it himself.