By Pam CNM, APN
Last week I sat in the lobby of my oncologist's office (which still sounds really strange to me since I don’t have a cancer diagnosis). However, breast cancer was up front and center in my mind. Usually it's not a focus of my life day-to-day, not at all. Well, except for a brief pause that happens right before I take my Tamoxifen every evening. I've been on Tamoxifen for over two years now, as a way to prevent breast cancer. Originally I had no interest in starting this medication, but after talking it through with a buddy whose wife was going through breast cancer treatment, I realized I needed to do a paradigm shift. I began thinking of these little white pills as my “new friend.”
It was 2 1/2 years ago that I underwent my second series of breast biopsies, following a routine mammogram. That's when they diagnosed LCIS--Lobular Carcinoma In Situ. Although it sure sounds like cancer--it is not. Rather, it is an indicator that puts me at an increased risk of developing breast cancer in the future. However, Tamoxifen reduces that risk. I remember the surgeon sharing with me what the pathologist told him--"There's a lot of activity going on with the cells.” That was a reality check. At that time, I was in no place to even think about a mastectomy. However my surgeon shared with me how some of his patients were so very afraid of LCIS and breast cancer that they chose to have a mastectomy as their next step.
For me, the next step was seeing my new oncologist and hearing her out about Tamoxifen. She convinced me to go for it and try this medication. I have an MRI every December, and a mammogram every spring. I see my oncologist every 6 months. And the plan seems to be working.
Back to sitting in the lobby...One thing about these appointments is that it makes me stop and pause and think about it all. The mix of emotions comes on kind of strong sometimes. There's feeling happy and relieved I have dodged this bullet multiple times. And feelings of guilt that so many women around me are dealing with or have dealt with breast cancer. About 14 years ago I had my first biopsy which was found to be fibrocystic. The following year, five friends were diagnosed with breast cancer. Four of the five were in there late 30's to early 40's. One of them had a recurrence last Thanksgiving and passed away right after Christmas. Since then, more women around me have been diagnosed. I think about them all....Kathy, Roberta, Barb, Jane, Cathy, Joyce, Kim...and others.
Then there's feeling scared this might be "the time" they find something, alternating with confidence in the plan. I wish I had a crystal ball for the boob question--should I consider a preventive mastectomy? I may not be "well-endowed" but hey, I like my boobs. I discussed mastectomy with my oncologist and know I am not ready to make a decision about this now. Then there's feeling slightly ticked that I have to even be in this position dealing with all this....and back to grateful because I'm pretty damn lucky. So there's a snapshot picture of it. I'll go back to breast cancer not being the focus of my day, but the 6 month visits and testing leads to a definite pause.
So what am I clear on right now? That I love life. That I have a good plan which I'm comfortable with. That I have a great oncologist who answers all my questions and helps me understand the relative risk of all my options. That everyone seems to be touched by breast cancer in one way or another, some more directly than others. That there's more to this journey and more to understand. That each person with this diagnosis will have to make decisions that are right for them, considering all the options before them. That all is well right now.
VIDEO: Pam, Planned Parenthood Nurse Practitioner, discusses breast cancer awareness month and breast health