The hardest decision I have ever made!

One morning this week, after returning from a run, I found myself staring in my bathroom mirror at my naked breasts. What I was staring at were not really my breasts themselves, but the large circles drawn around each of my areolas with a sharpie. In a consultation with my surgeon the day before she had marked on my breasts in order to show me the area where she would make an incision to remove my breast tissue and part of my breast (i.e. the nipple and areola) as part of mastectomy surgery on each of my breasts. As I starred at the marks on my breast, my mind swirled as I tried to make sense out of the many, many conversations with doctors over the past two weeks. As I have mentioned in previous blog entries, the original treatment plan for me was to complete 7 weeks of daily radiation treatments following chemotherapy. Happily I am now finished with 8 grueling months of chemotherapy, so it is now time for me to compete the radiation treatment. However, since I began treatment for breast cancer my younger sister was also diagnosed with breast cancer at the age of 31. So I decided that before I completed radiation that I should get some second opinions as to whether I should instead get a mastectomy. The standard treatment for breast cancer is either a lumpectomy with radiation or just a mastectomy. What I learned from talking to many, many doctors was that if I get a mastectomy now, I can forgo the radiation. So I have a decision to make. Do I now complete a mastectomy or just go forward and complete my original treatment plan by doing radiation? So over the past two weeks I have consulted with all of the top specialists in my area, and what I think I have learned is that if I were the only one in my family to have breast cancer then we could conclude that it was random and thus my original treatment plan would probably suffice. However, due to the fact that my sister also has breast cancer at a young age, to be safe we have to conclude that we have a genetic abnormality. We were both tested for the two known breast cancer genes and were negative. However, there are many other genes that are still unknown and there is also the possibility that we have a new genetic mutation. So the unanimous recommendation by every doctor that I consulted was that I be treated as if I do have a breast cancer gene. The standard treatment for women who develop breast cancer and test positive for the known breast cancer genes is a mastectomy of both breasts and removal of the ovaries. The ultimate decision is of course mine, but I am at a decision tree now. At this time I either have to do radiation or complete a bi-lateral mastectomy. As I stood there looking in the mirror at the marks where the surgeon would make her incision, I realized that I was terrified. Terrified of more pain, more surgery and of loosing my breast. But what I also realized was that what terrified me even more was not seeing my son grow-up. Although the numbers vary, my doctors informed me that by removing all of my breast tissue I decrease the odds of getting more breast cancer by 10-20%. They also told me that new studies were showing that when breast cancer comes back in young patients it is not good (i.e. mortality rates increase). So, looking in the mirror I knew what I had to do. Loosing both my breasts is such a small price to pay in order to increase the chance that I will see my son grow into a young man. Having made the decision; however, did not keep me from mourning my loss. I sat on my bathroom floor and cried for over an hour…..I was outraged at the unfairness of it all. But ultimately I feel good about the decision. The lesson in all this is to seek second opinions and realize that ultimately you have to drive your own treatment plan. I don’t think I would have gotten to this decision without persistently pointing out to all my caregivers that my medical records were not the end of my story. I insisted on providing my sister’s medical records to all my doctors and made sure they reviewed them. Once each doctor looked at the entire picture, they changed their treatment recommendation for me.

Strength from Friends and Family

Enough cannot be said about the strength that I have taken from my friends and family throughout this past year. My sister of course has been a constant cheerleader for me, and our daily conversations are so helpful since we are making this long journey through beast cancer together. I cannot say thanks enough to all those who have brought food for me, helped care for my son, said prayers on my behalf and driven many miles in order to just sit with me while I suffer through chemotherapy treatments. My husband has been my constant rock. He has been by my side for every surgery, doctors appointment, and chemotherapy treatment. Being a self reliant woman, at first it was very difficult for me to admit that I might need help. But once I let go and allowed my friends and family in, I realized that asking for help was not a weakness. In fact, I soon realized that surrounding myself with such kindness and generosity proved to be a wonderful source of strength. My advise to others is to reach out to your friends and family. Admit that you cannot do this alone, and just ask for help. The kindness of others, even complete strangers, never ceases to amaze me. So to all those that have helped me this past year, please accept my eternal thanks and gratitude. You help provide me with the strength and the determination that I need to make it through each day.