The Gift of Cancer


My journey with cancer began in July, 2008. It was just a few weeks after returning from NY, saying goodbye to my dearest Aunt who died of Alzheimer's disease.

Before my trip I had a mammogram, my first in 5 years, which came back "suspicious" when compared to the last one. My primary care physician ordered a biopsy that I was sure was a waste of time, assuming any differences were due to recent changes in imaging technology.

The Biopsies
On arriving at the Breast Cancer Center, my husband and I learned there were two different procedures for the distinct types of potential cancer that had been spotted. The mammogram found 2 small lumps and 4 starbursts (what they look like), mainly in the right breast. Lumps were scheduled in the morning, starbursts in the afternoon.

They also informed me that they would be biopsying only three of the six areas, as they could infer the results onto other spots that were of similar type "with great accuracy".

Now, I'm a trained statistician. I really understand sampling theory and was not about to allow full surgical removal of what could be substantial breast tissue based a small sample projection -- I wanted a 100% census on the biopsies, even if these procedures were long and potentially painful.

Adamant for biopsies of all sites, I was advised I would have to come back another day to finish, since no one was scheduled for the additional work. Through my tears, I demanded someone get scheduled as I wasn't going anywhere until this was done in one visit. I had all day.

After the morning session, I was informed that my surgeon had approved my request and that a doctor be scheduled or rescheduled to accommodate me. Thank you both my surgeon and the doctor who stepped in at the last minute.

The biopsies were performed on a Thursday and I was told to expect the results sometime next week. Over the weekend, I spent a lot of time in our backyard with my dogs. We wandered over to our pool waterfall and they did not leave my side.

The Diagnosis
First thing Monday morning I got a call from my primary care's office. She wanted me to come in that afternoon and they couldn't say why. Did this have to do with my biopsy results? I was panicked.

My husband held me tightly as we walked into the office that afternoon. The doctor had us sit down in an examination room and proceeded to explain the stages of cancer. One of the biopsies had come back showing carcinoma. What an ugly word.

All I heard was "Stage 1 blah, blah, blah"; then "Stage 2 blah, blah, blah" ; then "Stage 3 blah, blah, blah" . My spouse was taking copious notes; I stopped my doctor at Stage 3.

"What the (expletive) do I have, Stage 4?" I shrieked, now in shock. Thankfully, she stopped drawing pictures to educate us and calmly informed us it was most likely Stage 1.

I melted back into my chair, bawling. I was relieved and scared at the same time. What do I do now? She outlined a general course of treatment, which I did not hear, as my husband continued to take notes.

When we got home, I headed straight for the waterfalls with my Doodles, Razz and Rosie. Razz is a miniature, red LabraDoodle (lab/poodle mix) and Rosie is a miniature GoldenDoodle (goldie/poodle mix), each about 30 lbs. They knew something was wrong and stuck to me like glue.
The following week, I went back to the Breast Cancer Center, escorted by my husband. I had an appointment first with my surgeon and then with my radiation oncologist.

Their knowledge and confidence reassured us and answered the questions we had at that point, particularly about the dreaded mastectomy I was sure to be my fate. Proven just as effective was a lumpectomy followed by six weeks of daily radiation. They were positive my cancer was of a non-aggressive form, so we could even push the surgery out a month and go ahead with hosting our family reunion in August.

While this was a good idea in theory, the reality was another matter. I was in a fog and not present in many ways throughout the reunion weekend and spent most of it isolating myself near our waterfalls. I was terrified beyond reason and obsessing on my upcoming surgery. What would they find come September?

The Surgeries
As she did for my wedding three years earlier, my high school buddy (and one of my two bridesmaids) came out for the week of surgery to help unglue me from the ceiling. Our conversations and cocktails by the waterfalls were a great comfort.

My lumpectomy with sentinel node biopsy to discern if the cancer had reached my lymph nodes was textbook. My husband was even given the "thumbs up" that the nodes were clear. I went home and slept well for the first time in months. We awaited the Stage 1 confirmation and set the date for my radiation treatment to begin.

A week later, the official pathology came in. It turned out that of the two sentinel nodes, one was healthy but the other had cancer. This meant that I was in Stage 2 and would have to have a second surgery to remove some or all of my lymph nodes. It was then that chemotherapy reared its ugly head and the roller coaster ride began once again.

While recuperating from surgery #2, I developed a seroma in my armpit (fluid pocket, not lymphedema) that was literally the size of a baseball. This would delay radiation treatment from weeks to months until the fluid was reabsorbed. My waterfall was starting to feel like a fire hose and I was drowning.

Throughout my adult life when there have been dark times, either personal or professional, I always had a plan to bounce back. For the first time, there was nothing and I had more than I could handle. This complete loss of control was overwhelming as I now had to rely on others, meaning I was at their mercy.

Then, the Universe miraculously intervened on my behalf. An oncological genotype profile determined that statistically, chemotherapy would only add 2-3% treatment value over radiation alone and my doctors would support my decision if I opted out of chemo. This was data I could live with, literally, and decided not to take it.

The Radiation
The standard approach for radiation is full breast , daily for 6-8 weeks on a low level dose. An alternative approach was a targetted "pellet" at the lumpectomy site for 3 weeks with significantly higher radiation level, still considered experimental at the time. My doctors were recommending the standard 6 week treatment of the entire breast.

I feared radiation even more than surgery. Since my tumor had been very small, why would the whole breast need to be irradiated? I talked extensively with my radiation oncologist regarding the requirements for a treatment that was both localized AND lower level intensity .

My good doctor knew how terrified I was and we also connected around the statistical research. It turned out I was an ideal candidate under the criteria for partial breast irradiation at a lower dosage over a longer time period.

I couldn't have been more grateful for his flexibility and willingness to work with me. He carefully plotted measurements with the nuclear physicist and marked the topography of the treatment area. By November, we were ready to start treatment since the seroma had now reduced and stabilized to the size of a golfball.

Every weekday throughout the holiday season, from Thanksgiving through New Years, I drove 20 min. down and back to the Breast Cancer Center for treatment. Each session required setup to position the beams precisely from 3 different angles; the actual "zap" time was only 30 seconds total. Twice the seroma had to be drained so it would fall within painstaking measurements that had been taken for the entire area.

My technicians were outstanding, both professional and empathetic. One holiday Sunday, they even let me bring my Doodles to meet them in the waiting area. On my last day of treatment, I noticed the background music was not our usual rock/blues selections but rather "pomp and circumstance" for my Graduation. On leaving, they handed me a diploma which I cherish to this day…

The Aftermath
The experience of cancer forced me to step back and surrender in order to not just save but honor my life. I had never thanked my body for serving me so well over the years and throughout this process. I realized (as many Survivors do) that my cancer was actually a gift.

It took 18 months after completing radiation for my seroma to dissipate. I still haven't hit my 5-year Survivor mark but can't wait that long. When the Waterfalls was established as a metaphor of my personal journey in giving back to organizations like the Breast Cancer Center, who support those passing through life-altering milestones.

Women have different needs throughout our lives' transitions, whether it be cancer, aging or coming-of-age. Education of women benefits our entire society, much less our world. The ground-breaking work performed by researchers, caregivers and educators who uphold women in transition can't be thanked enough. They must be recognized and supported.

Programs like the Buck Institute's research on aging and breast cancer or the investigation of partial breast irradiation as a viable alternative for cancer patients (meeting the criteria) are examples of advocacy for women in life transitions.

Our mission is to serve through illuminating such opportunities that might otherwise go unnoticed. Won't you help? Many thanks for your support.

Elaine Black, Founder and Resource Advocate
When the Waterfalls: Spotlight on Women in Transition

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