Block Margaret - Straight talk about breast cancer: from diagnosis to recovery

An Addicus Nonfiction Book

Copyright 2015 by Suzanne Braddock, M.D., Jane Kercher, M.D., John Edney, M.D., Margaret Block, M.D., and Melanie Morrissey Clark. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopied, recorded, or otherwise, without the prior written permission of the publisher. For information, write Addicus Books, Inc., P.O. Box 45327, Omaha, Nebraska 68145.

ISBN: 978-1-940495-70-5

Cover design by Peri Poloni-Gabriel

Typography and illustrations by Jack Kusler

This book is not intended to serve as a substitute for a physician. Nor is it the authors intent to give medical advice contrary to that of an attending physician.

All proceeds from the sale of this book are donated to the Straight Talk about Breast Cancer Charitable Trust and are used to assist breast cancer patients and their families.

Library of Congress Cataloging-in-Publication Data

Braddock, Suzanne W., 1942

Straight talk about breast cancer : from diagnosis to recovery / Suzanne W. Braddock [and four others]. Fifth edition.

pages cm

Previous ed.: Straight talk about breast cancer / Suzanne W. Braddock [et al.]. 2010.

Includes bibliographical references and index.

ISBN 978-1-940495-70-5 (paperback)

1. BreastCancerPopular works. I. Title.

RC280.B8S748 2015

616.99449dc23

2014033745

Addicus Books, Inc.

P.O. Box 45327

Omaha, Nebraska 68145

www.AddicusBooks.com

Printed in the United States of America

10 9 8 7 6 5 4 3 2 1

To all the women with breast cancer,
their families, and their loved ones

P lease read this book imagining that a very good friend is sitting close to you, giving you this introduction to the rest of your life with love and understanding. Imagine your friendwho has indeed walked in your shoestaking you by the hand and guiding you through the next few weeks.

Your friend wants to help you understand what is happening, and help you cope with the decisions and treatments ahead. She also wants to help your family and friends, for they are suffering with you.

Know there will come a time when youll go entire minutes without thinking of breast cancerthen hours, and even days. Of course, your life will never be the same. In fact, it will probably be better in many ways you would not have chosen but will be delighted to discover.

The authors of this book reach out to you as dear friends and offer you the hope of a complete recovery, along with the certainty that the journey from here will be one of growth, challenge, and change. That is, after all, what life is about.

W e, the authors, would like to thank those who helped make this book possible. We are grateful to physicians Robert Langdon Jr., M.D., Patrick McKenna, M.D., Janalyn Prows, M.D., Henry Lynch, M.D., Ramon Fusaro, M.D., John J. Heieck, M.D., Richard Bruneteau, M.D., and Carol Kornhehl, M.D., author of The Best News about Radiation Therapy.

We thank Mollie Foster, Ph.D., for her contributions and Judy Dierkhising, Ph.D., for her insights into the emotional needs of breast cancer patients. Our appreciation goes to the Nebraska Methodist Hospital Breast Cancer Support Group for their comments, wit, and strength. And with gratitude, we remember Sue Kocsis, a real spark, whose encouragement meant so much during the early stages of this book.

We are also deeply grateful to the women who shared their personal stories in order to help others. A special thanks to the women who shared their surgery and reconstruction photos. We acknowledge photographers Larry Ferguson and Paula Friedland for their creativity and sensitivity in portraying these women as real, living people, rather than medical subjects. We thank Jack Kusler, who provided illustrations and designed the layout of the book.

S omeone you love or someone you know will get breast canceryour friend, your aunt, your mother, your father, your daughter, yourself. The fact is, if you are an American woman, your chance of getting breast cancer is especially highabout one in eight over your lifetime. The chance of dying from breast cancer is one in thirty-six. Each year in the United States, more than 200,000 women are diagnosed with breast cancer.

Heres the good news: Thanks to early detection and better ways to treat breast cancer, more and more women with breast cancer are surviving. The percentage has climbed steadily since 1989not just five-year disease-free survival, either, but real, lasting, bounce-the-grandkids-on-your-knee survival.

The rest of my life started April 1, 1992, with a phone call from my friend and doctor, who informed me that the lump in my breast was malignant. I reacted, as do most women, with the irrational certainty that I was going to die, and soon. I was forty-nine.

Although I am a physiciana dermatologistI knew little more about breast cancer than what I had learned in medical school in the late 1970s. Back then, I saw several patients who died from the disease, and I was afraid. So I started doing the right things. I dutifully saw my physician every year for an exam (right). I had a baseline mammogram between ages thirty-five and forty (right) and a mammogram every other year between forty and fifty (right). I began planning for annual mammograms when I was about to turn fifty (rightthough experts now recommend annual mammograms after forty). I also practiced breast self-examination on a regularly sporadic basis (wrong). Like many women, I had lumpy breasts, making self-examination difficult to interpret. I relied on my physicians and mammograms to keep me safe (very wrong).

When I learned that I had breast cancer, I was disappointed that three doctors who had examined me many times had failed to recommend a biopsya test that takes a tissue sample and analyzes it for cancer. I was disheartened that mammograms had failed to detect my cancer. But more than anything, I was amazed at myselfthat I had been so cavalier about the very precautions that could have diagnosed my tumor sooner: doing monthly breast self-exams without fail, and insisting on further tests on a lump that worried me. Denial is a powerful emotion.

Fortunately, my cancer had not yet spread when it was diagnosed, at least not that the existing technology could determine. The tumor was medium-size2.2 centimeters, a little under an inch, in diameter.

Surgery is almost always recommended for breast cancer. I chose to have a mastectomysurgery to remove the breastfollowed by chemotherapy. Women with breast cancer are offered chemotherapy when their tumors are of a certain size or they are in a high-risk category for recurrence. Adjuvant treatments such as chemotherapy and drugs such as Herceptin can prevent or postpone a recurrence of the cancer and improve the chance of long-term survival.

The usual chemotherapy for early-stage breast cancer, while no picnic, is no longer the ordeal it used to be. Now there are drugs to help with nausea and fatigue, and to stimulate blood-cell production in the bone marrowthereby helping to prevent infection and possibly detrimental treatment delays.

Of course, chemotherapy has turned wig-making into a real growth industry. Your bad-hair day lasts about nine months. My daughter, Gail, had a lot of fun playing with my wigor, as we called it, the muskrat. Actually, I learned to appreciate the ease with which I could wash my hairswish it in a bowl of suds, rinse it, and hang it to dry. I also enjoyed snatching it off at stoplights on the hot drive home from work and chuckling at other drivers startled expressions.