it, and here, in the pages that follow, is your step-by-step guide to help you through the chaos, catastrophe, and turmoil of the entire breast cancer experience.
The book is organized into four sections of chronological progression, from that disbelieving moment of diagnosis to that anticlimactic, ever-elusive “finish” to the treatment, and that strange transition period back to real life. We will cover:
• The Diagnosis—Managing the News that you have cancer, including comprehending it yourself, and determining how and when to communicate it to the broader world; and Swinging into Action, which provides perspectives on gathering the information you need to make informed decisions, establishing your emotional support and coping mechanisms, and building the best health care team you can find to assist you in your journey.
• Surgery—Deciding on Surgery offers an explanation and factors to determine which surgical alternatives might be appropriate for you; Undergoing Surgery provides an overview of the surgical experience and what to expect from the hospital visit; and Recovering from Surgery sets forth what you can expect from your body, emotions, and the actual surgical results.
• Treatment—Deciphering Treatment Alternatives discusses the plethora of choices available, how they work, and why your health care team might recommend various options for you; Managing Treatments: Chemotherapy and Radiation delineates all the practical advice you need for getting through both the process of treatment and its impact on your life, as well as managing any physical side effects and balancing demands of the workplace.
• Getting Back to Life—Ending Treatment explores the often surprising issues you may face in your transition back to your “normal” life (although you will never quite be able to go back to where you came from); Maintaining a Healthy Lifestyle offers suggestions on how nutrition and the world of alternative medicine can optimize your strength and well-being.
Sprinkled throughout the text are portions written by Dr. Robert M. Gelfand entitled “A Note from the Doctor,” which explain some of the more clinical technical aspects of managing breast cancer. And at the end of each section, you’ll even find some “Rules of the Road” directed to family, friends, and others who will accompany you on your journey through breast cancer.
So before we get into the guts of this book, you’re probably wondering just who I am and why I am writing this book. What makes me the expert? Unfortunately for us both, I may be just like you. Nothing made me the expert until one day without any warning this ominous disease called breast cancer reared its ugly head and slapped me in the face. No family history, no other health issues, nothing. I’m just a fairly normal person with a normal life, who could be your friend, coworker, next-door neighbor, wife, sister, or daughter.
All in all, my life up to now has been good. No, it hasn’t been perfect, but in retrospect, it’s been pretty terrific, now that it’s been threatened to be taken away from me. I’ve been blessed with a close family, incredible friends, a never-ending array of interesting professional challenges and coworkers, and a wide variety of athletic, intellectual, and social interests and activities. I’ve seen a lot of the world and learned to appreciate what I have, and to be content to know that there will always be things that I might never have.
But perhaps most important to you, my diagnosis helped me realize that, if caught in its early stages, breast cancer is not a catastrophic disease, but merely a potentially catastrophic situation. My expertise comes from experience, from being able to offer real-world, in-the-trenches, been-there guidance on how to manage your way through—and thereby avert—physical, emotional, and even financial catastrophe.
And finally, just to be safe, I recruited Dr. Robert M. Gelfand, an oncologist whom I encountered when I visited him for a second opinion. After he spent more than two hours with me, objectively, but compassionately and patiently, answering each and every one of my questions—no question was too dumb to ask—I was convinced he was to be my co-author. He generously agreed to provide expertise regarding the more technical aspects of the book, and to ensure that nothing I discuss or suggest is harmful or improper.
In this newly updated edition, we have added the input of two esteemed breast surgeons: Drs. Faith Menken and Eugene Nowak. As the care of breast cancer patients has evolved both medically and surgically, input from experienced surgeons has surfaced as a clear need. Hopefully, you will find this addition to be of great value.
So, enter breast cancer.
PART I
THE DIAGNOSIS
1. Managing the News
2. Swinging into Action
Rules of the Road for Family, Friends, and Other Participants
CHAPTER 1
Managing the News
There is no good way to receive the news that’s the single fear beyond your worst dreams—that you have cancer. No, not somebody else, but you. This chapter will cover a few ways to handle this nightmare over the first few days, in terms of:
• Comprehending the news yourself, and communicating it to those few people who need to know as soon as possible, both for your sake, if only to be able to vocalize it, and theirs.
• Reacting to the news, and a few ideas for giving yourself a helpful perspective on the situation.
• Spreading the news, and determining how broadly and by what means to expose yourself to the “outside” world.
COMPREHENDING AND COMMUNICATING THE NEWS: AN UNEXPECTED TIDAL WAVE
Malignant Cells: Are Those the Good Ones or the Bad Ones?
It’s 4 P.M. on a Thursday afternoon, and I’m waiting for a meeting to begin in my office. The phone rings and I decide to answer it while I await my guest. I had been to see a “breast specialist” forty-eight hours earlier for a biopsy on a lump I had found on the side of my breast, but to be honest, I hadn’t thought twice about it since. He had reassured me, “It’s probably nothing. With women your age, most likely—80 percent chance—it’s just a fibrous knot.” I had no family history, knew nobody who had breast or any other cancer in my age group, so I had just put it out of my mind.
No more; actually, never again. When I answered the phone, he got straight to the point. “Hello, this is Gene Nowak. I’m sorry to tell you this, but the lab tests showed some malignant cells in your biopsy, which will require treatment.” Malignant? Are malignant cells the good ones or the bad ones? I could tell by the tone of his voice that malignancies didn’t exactly bring you the winnings of a lottery ticket, but what did he mean? Did he mean cancer? I had only known two people with cancer, and they were older relatives of mine, my grandfather and my uncle, more than ten years ago each. I knew that “lumps,” tumors, or cysts—whatever you call them—were classified as either malignant or benign, but I didn’t know which was okay and which meant cancer. It just wasn’t on my radar screen. It was irrelevant to my young, healthy, active life. Treatment? What does that mean? Is it surgery? Or does it mean lots of other medical “procedures” that are terrifying, so the doctors don’t tell you the potentially far-reaching implications of them now, because you have enough to swallow today? My head was spinning.
So, I queried, “Dr. Nowak, does this mean I have c-c-c-c-cancer?” And he responded, “Yes, unfortunately it does. Why don’t you come see me tomorrow morning when I have some time to sit with you and thoroughly discuss your alternatives.” Tomorrow morning? Can I wait until then? Will I still be alive!? I was in shock. I managed to get out, “Okay. What time?” Then I put the phone down. Now the entire room was spinning. I was shaking and my heart dropped to my stomach. I called my mother. “Mom, the biopsy is back and it shows some malignant cells.” “What???” she responded. “Mother, I have breast cancer,” I replied, deliberately pronouncing each word. And as I hung up the phone on her because those were the only words I could muster, my meeting guest was standing at my office door. I looked up and said, “I have to cancel our meeting and go home. My doctor just told me I have cancer.” And I picked up my coat to leave.