ENCORE #41 ! – David Breasterfield…

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry appeared in June of 2011.

I don’t know what it’s like, exactly for my wife, but there are long times now where the idea of breast cancer (and the accompanying metastasis possibility) disappears from my life as if by magic.

Between treatments, which she undergoes every three weeks, life returns to normal. Well, not “old normal”, rather the new normal (see “The World Didn’t Fall Off Its Axis”)…

But during this time, nothing seems to be “different” – we still chat, watch TV, go for walks with the dog, pay bills, see the grandchild, talk to people. Nothing seems to have changed. It’s almost like that magician – David Copperfield – worked his magic on breast cancer and made the whole thing disappear.

And maybe there’s something to be said for that – we’re NOT pretending. I don’t think I could ever do that. But we’re living in the promises of the doctors and the profound hopes of our friends and other women we know who are breast cancer survivors.

David Copperfield isn’t really a magician, he’s an illusionist, and while we harbor no mistaken belief that the cancer has “disappeared”, it’s sometimes helpful to live in the illusion that the cure is NOW. It’s something that allows us to go on day-by-day. I cannot imagine how terrifying these days just before a chemo session are. But I can help my wife entertain the illusion that she is done with chemo and she has been declared cancer-free.

Besides – that’s only going to be an illusion for a few more months. By Christmas, Liz will be a breast cancer survivor and THAT will be the real magic!

Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg

ENCORE #40! – Metastatic Breast Cancer: Lung Cancer

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry appeared in December of 2011.

Some [twenty] years ago, my wife’s mother passed away from lung cancer.

A child of her times, she smoked often and heavily for a number of years while raising four children, then quit – long before I met her.

Diagnose with lung cancer in 1994, she took chemotherapy, went into remission and finally succumbed to the disease in (I think – and my wife will correct me!) 1997.

Her disease was DIFFERENT than the type of lung cancer that can flare up after a woman (or rarely a man) is treated initially for breast cancer. Lung cancer after breast cancer is most often caused by BREAST CANCER cells that have invaded other organs and therefore are called metastatic breast cancer. The word “metastatic” was used in the 1570s and comes from the Greek metastasis which means "transference, removal, change.” The roots are meta which means "over, across" plus the word histanai which means "to place, cause to stand.” The medical use for "shift of disease from one part of the body to another" dates from 1660s in English.

“Metastatic cancer to the lungs is the spread of cancer from another region of the body to the lungs. The place where cancer begins is called the primary cancer. For example, if breast cancer spreads to the lungs, it would be called breast cancer with metastasis (spread) to the lungs. In this case, breast cancer would be considered the ‘primary’ cancer.”

Symptoms that would lead doctors to believe that the breast cancer had metastasized to the lungs are similar to those of “regular” lung cancer and would be warning signs that a person would need to see their doctor as soon as possible. They include: a cough that persists over time, or does not go away with treatment; coughing up blood, difficulty breathing (due to decreased airflow by a tumor obstructing the large airways or spread through the lungs); wheezing (caused by the interference of airflow through an airway obstructed by a tumor); pain in the chest, back, shoulder, or arm (when a lung tumor presses on nerves around the lungs); repeated lung infections such as pneumonia or bronchitis; hoarseness; and lastly, lung cancer CAN have no apparent symptoms and only appear  when a chest x-ray is done for another reason.

As well, “general symptoms” of lung cancer can sometimes present with vague concerns such as fatigue, weight loss, loss of appetite, and even depression can be a symptom of lung cancer as well as many other conditions.

Treatment for cancer metastatic to the lungs is usually determined by the primary cancer, or origin of the cancer. Systemic therapy (chemotherapy, biological therapy, targeted therapy, hormonal therapy), local therapy – which might include surgery or radiation therapy), or a combination of these treatments. The choice of treatment generally depends on the size, location, and number of metastatic tumors; the patient’s age and general health; and the types of treatment the patient has had in the past.

References: http://lungcancer.about.com/od/symptomsoflungcance1/a/symptomslungca.htm, http://www.cancer.gov/cancertopics/factsheet/Sites-Types/metastatic

Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg

GUY’S GOTTA TALK ABOUT #26…When Terror Mellows To Discomfort

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

I remember the first days, weeks, months, and maybe the first two years after the breast cancer diagnosis.
I remember a feeling that disaster hung over our heads every moment of every day, oppressive and heavy. It diminished slowly, and actually surely...

“The Oxford English Dictionary defines ‘oppression’ as ‘the state of being subject to unjust treatment or control.’ However, this does not mean that those so subject are aware of their unjust treatment or control. This is an aspect of oppression that is largely missed in popular culture when we consider whether we or others are being oppressed. Indeed, when living day to day in concert with the constraints of a given cultural milieu, we seldom consider whether we are actually being oppressed. Instead, we tend to think that one who wants to live according to the constraints of her culture is making a free choice.” (https://www.psychologytoday.com/blog/what-would-aristotle-do/201411/two-concepts-oppression)

The emphasis above is mine. Living with breast cancer day-to-day, whether as a victim or a caregiver, may lead to a sense that we are continuing to live in the shadow of the disease. But given the passage of years, the horror of breast cancer; the oppression of life under the disease, may fade to the sense that “it’s all over”.

I am living there now. My wife may not be. My friends may not be.

But I am there. I’ve forgotten the oppression. I write this blog, true. The subject of breast cancer is on my mind. I am “oppressed”.

I’m sure that there are those who will object to my use of cancer caregivers and victims being oppressed. They might say that “there’s a cure!” or that “it’s not a cultural oppression!”

 I would say: “Have you ever had someone move away from you when you say, ‘Yes, I have cancer’? Have you ever seen the look someone gives a woman who is bald because of chemotherapy? Have you ever seen the look someone gives a woman who has had a double mastectomy?” [Do I need to remind you of the outrage engendered by society when the photo of a tattooed, breastless woman, a breast cancer survivor, was deemed “pornography” by FACEBOOK of all megacorporations, who happily allows tittypix without a peep? (http://www.dailymail.co.uk/femail/article-2148029/Cancer-survivors-mastectomy-photos-BANNED-Facebook-pornographic.html)]

 Whether someone is oppressed or not is NOT for outsiders to decide. It is for those who ARE being oppressed. I am feeling oppressed.

 Image: http://wrex.images.worldnow.com/images/23784252_SA.jpg

ENCORE #39! – Lymph Node Excision, Mosquito Bites and “A Return To ‘Normal’”

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry appeared in July 2012 and is my most popular post!

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

Here again, just in time for the season!

After my wife came home from a lymphedema expert at the hospital, I asked her how it had gone. The answer was that the swelling is receding slowly and that the pressure sleeve would be here soon.

She asked how often she would have to wear it, the doctor replied, “Forever.” She added, “Oh, and don’t ever get a mosquito bite. That’s one of the worst things in the world.”

*blink in startlement*

I don’t know about where you all live, perhaps someone lives in Arizona or New Zealand or Hawaii where mosquitoes aren’t a big deal. But in Minnesota, we (somewhat facetiously; but only SOMEWHAT…) call the mosquito our “state bird”. They are everywhere.

Granted, susceptibility to mosquito bites ranges from, say, me to say, my wife…

I get bitten, make no mistake. But my wife? Let me illustrate: we went to a recent fireworks fest celebrating one or another of some small town’s heritages. Great times! We sat in camp chairs set up in the middle of the street. The next morning, she showed me a pair of fist-sized welts, one on each side of her back that had been “exposed” (even though they were covered by T-shirt material!) where NUMEROUS mosquitoes had bitten her!

Take this little tidbit and add it to the doctor’s admonition and you get a recipe for me *blinking in startlement*.

So what’s the problem with mosquito bites?

First of all, let’s review the lymph nodes, which I talked about in depth here: http://breastcancerreaper.blogspot.com/2012/02/lymphedema-another-for-rest-of-your.html.

Excision means to remove or cut out. When the breast cancer was initially diagnosed in my wife, the doctors were very, very interested in how far it had spread. If it remained only in the breast, it was “less dangerous”. But if it had spread to the lymph nodes in the armpit (usually), the diagnosis was more terrifying and led to identifying the stage of the cancer. For a complete explanation, try this site:  http://www.breastcancer.org/symptoms/diagnosis/staging.jsp They found cancer cells in the node and bumped the diagnosis from 0 to IIIB. This required them to removed lymph nodes – 21 in all and eventually the news that lymphedema would be a FOREVER concern.

Now to mosquito bites. Why are they such a concern? “...some insect bites probably are inevitable...treat them...to lessen the histamine effect, which can cause increased swelling in that area. Benadryl or hydrocortisone creams are two treatment options for insect bites. An ointment with aluminum sulfate as the active ingredient can also help decrease the effects of bites and stings...Treat an insect bite like any break in the skin on your limb at risk. Wash and dry the area completely and apply antibiotic cream to the area...take along a specialized first aid kit. The kit should include alcohol wipes to clean off any skin break, antibiotic cream for application on the skin, and bandages to protect the area…An insect repellent is a good idea...natural repellents, usually with citronella as the active ingredient, and these can be less detrimental to your skin...avoid putting insect repellent on your skin and then wearing a compression garment over it...”

Now you can be prepared for summer camping. As prepared as you can be!

Reference: http://www.lymphnet.org/lymphedemaFAQs/riskReduction/summerTips.htm

Image: http://voluume.fr/wp-content/uploads/2012/05/Encore-Sessions.jpg

ENCORE #38! – The Next Five Years

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry appeared in December of 2011.

All right – the mastectomy is done (not OVER, there are still deep emotions attached to that surgery that will never “disappear”). The chemotherapy is done (same thing there: deep emotions and memories that will be carved into my mind forever). While it’s never completely gone, the gut-wrenching worry has passed.

What now?

For the next FIVE years, in addition to some cosmetic surgery, checkups and maintenance, there are more DRUGS. Specific to breast cancer is the one I’ll talk about today: anastrazole.

Chemically, this is called 2,2'-[5-(1H-1,2,4-triazol-1-ylmethyl)-1,3-phenylene]bis(2-methylpropanenitrile).

But what’s it DO?

In a nutshell it slows down the production of estrogen in a human body (BTW – men make estrogen, too, just not as much as women do. Women make testosterone, just not as much as men do).

So?

Estrogen, which at puberty initiates the maturation of a woman, causes among other things, the increased growth of the cells in the breast. This estrogen comes from the ovaries and is a totally normal response to a person growing up. Estrogen levels in the blood increase during every menstrual cycle – which means it stimulates the growth of breast cells.

Estrogen doesn’t just stop affecting the woman after puberty. “…life-long exposure to estrogen…plays an important role in determining breast cancer risk…the number of menstrual cycles a woman has, and hence the length of exposure to estrogen during her lifetime, affects her risk for breast cancer.”

So every time a woman has her period, estrogen travels through the blood. The molecule of estrogen affects cells in the body – but only certain kinds of cells like the ones found in the breast and uterus. These cells have “keyholes” in their walls that are called estrogen receptors. The estrogen and the estrogen receptor hook together to make a single molecule that enters the nucleus of the cell. Once it locks on the cell’s DNA, it directs it to do many things. Among the things it tells the cell to do is GROW.

You know by now that cancer happens when cells grow totally out of control. So every time the breast cells get a message from the estrogen, they grow. Breast cancer is the out-of-control growth of breast cells stimulated by estrogen.

Anastrazole BLOCKS estrogen from giving its message to breast (and other) cells. On the website listed below, the author states: “…the medication is directed at preventing recurrence [of cancer] other than just in  breast tissue….The American Society of Clinical Oncologists stated recently: ‘To lengthen disease-free survival and lower risk for [cancer] recurrence in nearby tissues or distant tissues…’”

So in a single sentence – anastrazole blocks estrogen from giving its message to cells that like to take up estrogen and start growing wildly.

References: http://envirocancer.cornell.edu/factsheet/general/fs9.estrogen.cfm , http://www.medhelp.org/posts/Breast-Cancer/Why-Arimidex-Anastrozole-after-bilateral-mastectomy/show/1314813

Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg

BREAST CANCER RESEARCH RIGHT NOW! #46: Computer Targeting Cancer Cells

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

Every month, I’ll be highlighting breast cancer research that is going on RIGHT NOW! Harvested from different websites, journals and podcasts, I’ll translate them into understandable English and share them with you. Today: https://www.sciencedaily.com/releases/2016/06/160607120818.htm

Targeting breast cancer cells seems to be a major new thrust in the fight against breast cancer. I talked about it a couple of months ago here as well as some years ago: http://breastcancerreaper.blogspot.com/2012/09/breast-cancer-research-right-now-2.html and here: http://breastcancerreaper.blogspot.com/2016/04/breast-cancer-research-right-now.html

But how do you get from the IDEA of targeting cancer cells to trying drugs to do it? Apparently, you can do computer models.

Now don’t get me wrong, I am NOT a fan of computer models. The model is only as good as the person who inputs the raw data and the person who writes the program. Computer models are notorious for spitting out inaccurate predictions and drawing false conclusions – not the machine’s fault, of course. Like I said, programmers and data entry folks. Also, the assumptions of the researcher can find their way into the model as well; but that’s happened since forever, so it’s not a new factor.

Here we have the following: “Researchers have built a model to investigate the metastasis of cancer by examining the metabolism of breast epithelial cells and look at the role of signaling. This research may contribute to the development of cell specific anti-cancer interventions.”

 In English, then: researchers are looking at how the cells that typically erupt into breast cancer cells use the nutrients they get from the body and the waste materials they give off. With that kind of a trail, scientists can design drugs to follow the trail and destroy the cancer cells.

Sounds simple enough – sort of like the old story of Hansel and Gretel: going out into the forest, the smart little girl leaves an easily followed trail that her and her brother can follow back home.

In this case, the cancer cell leaves a trail that well-designed cancer drugs can follow. Then they can destroy the cancer cell. The way it’s done now, is that drugs like Taxotere (which interferes with cell division), Adriamycin (which inserts itself into the cancer cell’s DNA so the cells can’t make new cancer cells), and Cytoxan (which sneaks in as a harmless drug, then is converted by the cancer cell into a toxin) – but they aren’t perfectly targeted. They kill hair cells and T-cells that protect the body from infections.

The researchers, programmers, and data entry people are working to reduce the amount of damage current cancer drugs do while still maintaining the attack on cells.

So, while I won’t CHEER this new model on, I will certainly watch to see what kinds of effective results it produces!

Image: http://cache1.asset-cache.net/gc/548000043-breast-cancer-and-cancer-protein-molecule-gettyimages.jpg?v=1&c=IWSAsset&k=2&d=jXBfeL7HXTly94gsrbGffrZCbmlQQB7uQmafeFqCiLubsdmsUAoAsKA8v6SiNhIkVXJPsJ%2BcpkKQNWEVsiyBqfGNwCRu6VgXAjrN6d6JLmE%3D

ENCORE #37! – All Quiet On The Western Front…

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry appeared in January 2012.

Like most of you, I recognized this blog title as the name of an old book – maybe an old war movie.

I’d assumed it was about World War II, I suppose because that’s the war I’m “familiar” with.

It’s neither and it fits even better my current state of mind.

The main characters of the book are German boys sent to the Western Front – the leading edge of the German invasion into France and a place where the war essentially “stopped”. From its closest approach to Paris in September of 1914 to the position the Allies pushed them back to 1916 and where the war stagnated, little of import happened there. That is the thrust of the book. From the ground, when you are young and the horrors of war can’t possibly match anything you’ve ever seen, “nothing happens”.

The problem is that while nothing appears to change on the Front, nothing also changes back home. When you return home, while everyone is glad to see you and everything is just as you left it – you are no longer the same person who went to war. You have seen things you can’t even explain to those who remained behind.

 In the book, ALL QUIET ON THE WESTERN FRONT, the main character, Paul Bäumer is a soldier who—urged on by his school teacher—joined the German army shortly after the war began, and who is all of nineteen years old. Some time later, Paul visits on leave to his home which highlights the cost of the war on his psyche. The town has not changed since he went off to war; however, he finds that he does ‘not belong here anymore, it is a foreign world.’ He feels disconnected from most of the townspeople…not understanding ‘that a man cannot talk of such things.’”

I can understand something of that feeling.

While the breast cancer threat has disappeared, we no longer have to go to chemotherapy sessions and the imminence of the cancer has seemingly faded; it’s not gone from my mind. I am still worried. I still wonder. When I rub my wife’s head, touching the soft hairs that have grown back in the months since chemo ended, everything seems so peaceful.

Everything seems “over”.

But it’s not and I can’t explain that it’s NOT over to people who only ask occasionally now, “How’s your wife?” Some of it is that I don’t have the time to talk about my fears of MBC or the long-term effects of the estrogen-blocking drug she has to take. Some of it is that I don’t want people to think I’m whining and say, “Oh, get over it! She’s fine now! The drama’s over!”

Some of it is that while the drama isn’t on stage any more under the bright lights and makeup, it continues in the body. It continues in my mind. It makes me say things like, “Liz is three-and-a-half-months cancer-free!” and smile and high five people.

It makes me feel things like I do “not belong here anymore, it is a foreign world...a man cannot talk of such things.” I suppose I’m also afraid that I’m “weird” in that I’m not “over it”; or that someone might just look at me and say, “Man! Get over it!”

I’m pretty sure now, nearly a year after the initial diagnosis, that I will never “get over it.”

[Update: Four years later, and I’m still not “over it”, though all the hoopla has faded. We live in this New Normal life.]

Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg