The CT scan showed that the tumor is shrinking. It’s gone down by about 1 cm.
This should be good news, and it is, but the rise of the celebratory music is dampered by the ongoing knowledge of cancer’s continued presence. I am talking about a lack of trust, a lack of belief in the body’s full capabilities. This lack is not pessimism, but rather the realization that this body can and has betrayed me. Faith in a long future is a vertebrae that’s been removed. One slight hunch is now always impacting movement, tilting each tentative step. It’s a little harder to look up.
“Continue the treatment until it shrinks further.” Then surgery, then recovery.
My old life feels like a harbor from which I drift further away each day.
I do not want to sound sad. There is always coffee, or sunlight.
A friend or a flower.
A note or a text message, laughter, friendship, good books, food, family, naps. You, they, these things:
are all the antidote.
are all I need.
And the truth is? We are always pending, are always, like the pendulum,
It’s the CT, PET, or MRI. The acronyms don’t matter as much as the fear, because what if? What if there’s a blip, a lighting up, a growth, a recurrence, an expansion, a concern? And what if there isn’t? What then?
(“Clear,” calls the Emergency Medical Technician before shocking the heart.)
Cancer is an abusive lover. I’ve learned not to celebrate too much when things go well, because the trust in a long-term, healthy future is gone. Even if the scans show nothing, trust in the world has failed. The sure sense in an ongoing future has failed. Planning a year or five years ahead with certainty? Failed. This “lover” – cancer – is always lurking, its revenge always a possibility. It hides its power, it lures you into comfort. It charms you back into living. It leads you back into your body, the ease of each day’s choreographies: movements through the front door, work, friends, gestures here and there, family, food.
Oh hello, hair, hello travel plans — let us begin again. Let us pretend with the ease of the healthy-bodied living that we are ever ongoing, that we will not, in our careful financial records and remodeling plans, ever perish. Tahiti? Paris? A mani-pedi scheduled for Friday. Oh, and the workout.
Scans jolt me out of this trance. There is the word we are all trying so hard to avoid: death. Dying. A finite closure, that the body and mind and this life as we know it will end. Will.
And so, I have a scan today. A CT scan to see if this current treatment of Xeloda and Taxotere are working to shrink this recurrence. If the tumor has shrunk, we continue, proceed with later surgery, and keep cancer at bay for awhile longer. I’ll take it.
If it’s not working, then we don’t know. Clinical trials, hope for the best.
It’s a rarer type – 15-20% of breast cancers are triple negative.
It’s more common in African-American and Latina women. Diagnosis and treatment equity are a real need.
It has a “worse prognosis,” but if you are a newly diagnosed TNBC (triple negative breast cancer) sister reading this, know that it is a hotbed of research, and new treatments are coming out all the time. Old statistics are not your friend. There is hope.
It is aggressive and tends to spread/grow more quickly than the other types.
It tends to be higher grade (more quickly and aggressively proliferative) and is also discovered at later stages.
Due to its high recurrence rate, most treatments tend to include chemotherapy. Good news: Chemotherapy tends to work very well for TNBC.
Like all other cancers, it stinks.
What Triple Negative Breast Cancer is Not:
A death sentence.
A slow moving, hormone-receptor positive breast cancer for which targeted treatments like Tamoxifen are available. (Although: some TNBC tumors have slight estrogen-receptor positivity, and so at times TNBC patients are prescribed Tamoxifen.)
In talking about this type of breast cancer in my support group and in the world at large, I often find myself having to place TNBC on a hierarchy of ease-of-treatability types. This is understandable. The world of treatment changes constantly, and clinical trials and subtypes and genomic testing are – happily – complicating and more specifically targeting treatments to every woman’s benefit. Yet: TNBC almost always comes out the worst, is still, in some circles, considered the diagnosis to deliver with a sigh and a pause, and Google/goggle/ogle/oogle aka do not Google will only offer doom. Don’t do it.
So, if you have it, I welcome you with open arms to this most unexpected club. We’re a rarer sort, part of the “danger” side of breast cancer. I think of us as the Austin Powers version:
There’s a dairy company in the Bay Area called Berkeley Farms, and one of their milk carton slogans is, “Farms? In Berkeley?”
I will now co-opt it. Joy? With Cancer?
The answer, sisters and brothers, is hell yeah. Because fuck cancer and its thievery. If you’re in treatment, there can come a level of exhaustion like low tide before a tsunami that is so deeply and utterly draining that you cannot see any shore. The dry and distant ocean floor, broken sea shells, rotting kelp, driftwood, spaced between long distances of drying sand–the metaphorical and barren landscape for even getting water becomes a distance so far and difficult that rest and floating in a haze of whowhatwhere is the only option. And that’s just the first few days.
But I digress.
We are talking about joy. I am talking about the resurgence of fresh water, when the tide returns, when some semblance of normalcy comes back to the body.
It is summer vacation, and I’m so grateful to have this time with my daughter. She’s entering high school next year, which means that the needs and tendings of little-kid childhood are receding. They will always be there, as they are all of us, but there is a shift. A shift outward, as in looking out to sea. In this spirit, the two of us went to the Fitzgerald Marine Reserve yesterday. This is in Moss Beach, CA, south of San Francisco. The reserve is not well known, but it has some of the best tide pools I’ve ever seen. Such was yesterday that we saw harbor seals, anemones, European green crabs, and one native red rock crab that snatched another small hermit as it attempted to scuttle free.
The day was grey, overcast, perfect.
The rocks were slippery but the pools beckoned.
And afterwards, we took a hike along the bluff. Always I slip back into metaphor – I can’t help it. The small gaze, the larger. The bluff and the pool. But as we walked along the edge I couldn’t help feeling grateful for all of it – the water, the land, even the dark cloud cover that offered a kind of comfort against being too brightly lit. Who can take constant light, after all? The risk is of burning.
Show of hands if cancer has made you re-think your relationship to food?
Me, too. Not that I was ever an unhealthy eater. Au contraire. For the last two decades, I’ve prioritized fruits and vegetables, whole grains, healthy proteins (mostly fish, chicken, eggs), and lots of exercise. I was running 5 and 10k races, lifting weights, and I kept my weight healthy. In talking to others, I hear this story frequently: “I did everything right, yoga, ate vegetarian, meditated – and I still got cancer.” I stand 100% with you, and am truly sorry.
We do so much to bat back mortality. Skin creams, reps at the gym, another helping of kale. Green tea and running. We “beat on, boats against the current, borne back ceaselessly into the past.” Like Gatsby in F. Scott Fitzgerald’s famous novel, we’re looking for Daisy’s green light across the water, the one that says you’ll stay young and healthy forever. It’s as if we’re under some collective delusion that we alone will avoid the final drop off and if only we find the right combination, the right cream, the right treatment — well, we’ll be all right then. And we keep on, going on, butting against the inevitable.
Cancer mocks that. Cancer is a skeleton who knocks on the door and refuses to leave. Cancer says, “Whatever,” shrugs and smirks at the next helping of broccoli. But I do it anyway, eat better anyway. It’s the one thing I can control, one of the few parts of the radar blip where I can say: “I’m here. I’m going there.” The shadow side of this is that some people, and I’ve met a few – who become so obsessed with food and unproven cancer cures that it borders on an eating disorder. (Steve Jobs’ decision to follow elements of the Gonzales regimen, to include coffee enemas and taking an enzyme from pigs, may have contributed to his shorter life span.) But there is one, emerging practice that seems to be supported by scientific research, and it’s a big reason why I’m writing this post today. It’s about fasting.
I’ve decided to do a modified, 24-hour fast prior to chemotherapy, and a 12-hour fast after my infusion. Fasting for 48 hours prior – the recommendation for chemo – is too much of a stretch for me, and even now, heading into 20 hours of no food, I am beginning to dream of cakes, pasta piles, cream cheese frosting, sushi, and banana splits. My body is screaming for carbs. I’ve been poring through recipe magazines and books and staring at the butter sauces, pancakes, battered fried prawns.
And cake. Did I say cake?
I am going to bake this cake tomorrow. And eat it.
And oh my God I miss bacon.
I miss bacon and fries and burgers and pizza and candy. I miss chocolate shakes. I miss a cool mojito – alcoholic thank you very much- with cussing and dirty-joke telling friends around a table in suburbia. I miss steak, I miss fried chicken, I miss Coke – my cans of Coke and Diet Coke – and I miss Swedish fish. I never ate much of these – always in moderation – but the casual nonchalance – the not-fretting – is what I miss the most. Always there is a second guess now with my meal, always more pressure. It is another price to pay for this disease.
And so, this Friday, it’s 22 hours of fasting now and an infusion in a few hours. After the Taxotere, I’ll go home and probably nap, read a bit, wander and not get much done. But it’s ok, it’s ok. Food is coming.
And I’m here. You’re here. Thank you. And love out.