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MAKING THE BREAST DECISION
It’s been 4 months since a core biopsy revealed I have invasive breast cancer. Since then, my days have been chock-full of research and reflection, so I’ve had plenty of time to think about the upcoming July 24th surgery that will theoretically save my life.
Originally published on RebelleSociety.com
July 23rd, 2013
It’s been 4 months since a core biopsy revealed I have invasive breast cancer. Since then, my days have been chock-full of research and reflection, so I’ve had plenty of time to think about the upcoming July 24th surgery that will theoretically save my life.
In the past 4 months I’ve had 14 infusions of chemotherapy and 16 weeks toweigh the options: single mastectomy, double mastectomy, reconstruction, no reconstruction, nipple tattoo, artistic tattoo, no tattoo. I’ve grappled with whether the path of least resistance would be to peel myself back to the bone, bravely staying flat chested forever, or to move gracefully forward with the replication of what I am about to loose.
Photographer: Joey "Islandboi" Rosado / Make-up artist & Art direction: Moshoodat
Each option has its pros and cons. Of course they are all preferable to have no options at all.
With all the decisions that needed to be made, I’ve researched all my available choices (there are many) and prepared myself for the various possible outcomes of resection (there are a few). I’ve asked everyone I knew who’s gone before me all the relevant (and delicate) questions: Are you happy with your choices? Would you do things differently? Do you like the way you look?
Some of my fellow breast cancer warriors elected to remove only the breast affected by cancer, and haven’t sought to reconstruct. Some of these women use an external prosthetic in their bras and bathing suits, some don’t.
Many women I’ve spoken to have removed both the diseased breast and the healthy one prophylactically, and have reconstructed both. Some of these women were candidates for nipple-sparing mastectomies, which left their original areola and nipples intact; some were not and could not.
For those for whom saving the nipple and surrounding skin isn’t an option artistic tattooing can be healing. These women are empowered by reclaiming this part of their body with stunning tattoos where nipples or whole breasts used to be. Each woman’s options are affected by her case, diagnosis and genetic background. The possibilities are many. The choices can feel overwhelming…
I’ve taken a winding, sometimes bumpy road to arrive at my own decision.
In the beginning I researched various autologous reconstruction procedures, all of which create new breasts using some fat, muscle, skin and blood vessels harvested from another area of one’s own body. But I came to the conclusion that this option could leave me physically weakened in the donor area of my body, and might seriously interfere with my yoga practice and my love of competitive athletics.
Then I asked myself if I’d be okay using cadaver or bovine (yes, cow) tissue to hold a silicon or saline implant in place. As an aspiring vegan, this presented me with a bit of an ethical dilemma, and I wasn’t sure if I could introduce any kind of foreign body into my own; whether it came from a four-legged friend or a chemical manufacturer.
David Jay Photography via TheScarProject.org
Down to the bone.
In May, I came to the momentary conclusion that I would choose mastectomy without reconstruction. I started compulsively feeling my ribcage, imagining a smooth hillside slope from my collarbones down to my bellybutton. I’d press my fingers into the divots between my ribs and try to picture myself with a full set of 12 impressions instead of the breast tissue that presently occludes the spaces between my fifth, sixth and seventh intercostal muscles.
For hours and hours I Googled images of women without reconstruction to see how I would feel when trying on a more Balanchine ballet dancer version of femininity: flat chested and boy-like. What I found were hundreds, maybe thousands of brave women who have documented their journey through breast cancer and proudly displayed photographed themselves or posed for others.
Coffee table books and websites, like The Scar Project, celebrate these women and beautifully illustrate the process of survival and recovery. The photographs I unearthed revealed incredible courage and strength, and touched places deep inside my feminine soul.
But after sitting with this decision for several weeks, I realized that my reasoning was flawed.
My decision making process no longer felt personal. It felt political, forced and academic. I realized that the pressure of what I thought I was supposed to choose was strangling what I wanted to do.
Through meditation and self-inquiry, I realized how reactionary my initial decision had been. I had judged myself harshly in April for wanting “fake breasts,” and I had labeled myself vain. What I needed to do was get out of my head and into my heart.
When I finally did, I realized that choosing not to reconstruct out of fear of being judged for having implants is no more authentic than choosing reconstruction for fear of being flat chested. To reconstruct or not to reconstruct are both honorable choices. Navigating breast cancer is brave, period. Ultimately not only are other people’s opinions none of our business, they are certainly not worthy of influencing such an important and personal decision.
David Jay Photography via TheScarProject.org
Beauty takes many forms.
I have unending admiration for the women who have lost their breasts to cancer and have chosen not to reconstruct. I think they are just as beautiful as women with breasts; reconstructed or natural. But after much debate with myself, I have chosen another path.
Tomorrow, June 24th, I am having a bilateral mastectomy and hopefully, reconstruction.
I have chosen to remove both the breast that has cancer and the one that does not. If single stage reconstruction is possible, it will happen shortly after my breast tissue and cancer is removed. If my cancer is still too invasive to save the majority of my skin and nipple, my plastic surgeon will put in tissue expanders that will stretch my skin until it is able to hold a pair of implants.
Either way, I am excited to have a new pair.
This decision has brought with it great freedom. I feel released now from the pressure I had put on myself to practice the asceticism I had applauded as part of renouncing of this process. With my mind settled now on rebuilding what cancer has taken from me, I’ve been able to return my focus to healing.
Spending time in quiet meditation and holding myself with greater tenderness, I’ve been mourning the imminent loss of the breasts I used to feed my son, and pleasure my partner.
In honoring our time together I’ve been directing thoughts of loving kindness towards my breasts and letting go of any negative feelings I’ve had about them in the past. I’ve come to realize that for me saying good-bye to my breasts has also been about letting go of any shame, blame or animosity I’ve felt about them in the past.
I’ve forgiven their colossal and early development in my pre-teens, the shrinking they did when I lost weight in my 20s, the tear-jerking mastitis I had during the first few months of breast feeding, and their abrupt deflation after I weaned my son. I’ve reached back into the distant past and forgiven the right one for being smaller than the left. I’ve forgiven this sweet hijacked tissue from being compromised by cancer and failing to stand up to what I can only surmise is an attack of environmental causation. On the brink of momentous change, I think I’ve finally made peace with my bosom, and let go of old gripes and insecurities.
Pre-Mastectomy {Photo: Larisa Forman / Caitlin Marcoux}
I’ve put my hands over my chest and thanked my breasts for all the amazing things they’ve brought into my world: thousands of hours of enjoyment, the pleasure of a satisfied partner, the discovery of a deeply maternal sensibility, and a strapping, well-nourished toddler.
I’m ready now; ready to make space in my heart to welcome myself home again: perhaps a little modified, but healthy, cancer-free and damn it, just as much a woman as before.
“Think of all the beauty still left around you and be happy.” ~ Anne Frank
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HOW TO TALK TO SOMEONE WITH CANCER
{Originally published on RebelleSociety.com May 15th, 2013}
Bummer. Sounds like you have to talk to someone with cancer. I’m so sorry – for you both! After all, it’s no easy task for either party. Going through this very thing myself, I’d like to help you out with a little cancer context, so that we can put your inevitable dialogue into your loved one’s perspective.
Originally published on RebelleSociety.com
May 15th, 2013
Bummer. Sounds like you have to talk to someone with cancer.
I’m so sorry – for you both! After all, it’s no easy task for either party. Going through this very thing myself, I’d like to help you out with a little cancer context, so that we can put your inevitable dialogue into your loved one’s perspective.
The thing about people living with cancer, is that we are a complicated bunch.
Our senses have been rubbed raw by diagnostic testing and medical evaluations. We’ve been graded, staged and given projected survival rates. We’ve seen the fragility of our lives held up before our own faces, and we come away from our treatments feeling vulnerable in a way we’ve never felt before. We cling to our independence, but know we’re dependent on others for healing and help.
We are emotionally taxed and psychically drained.
The very nature of our dis-ease has thrown us into a world off-balance. Not only are our bodies working over-time to halt the production of alien-like rapidly mutating cells, they are struggling to process the toxic poisons we voluntarily ingest to cure ourselves. The very treatments we implement to make us healthy, make us sick. We walk a fine, contradictory line on a daily, weekly or monthly basis.
Cancer survivors know better than most how fleeting life can be.
We live with a foreboding and heavy awareness of risk. We are almost painfully aware that each day we have is precious.While certainly there are many silver linings, we remember wistfully what our lives were like Before Cancer, before the silver linings needed to be pointed out. We navigate the remainder of our days knowing that we will never again feel the pre-cancerous freedom we may have taken for granted.
“Toleration is the greatest gift of the mind; it requires the same effort of the brain that takes to balance oneself on a bicycle.” ~ Helen Keller
We know it’s a tall order, and that our needs are inconsistent, but we really appreciate your patience as we figure out exactly what we need. We want you to be sympathetic, but we don’t want your pity. We want you to look us in the eye, but please don’t stare. We’d like it if you could meet us where we are, not judge us for where you think we should be. We want you to reassure us that we are capable and brave, but don’t blow smoke up our asses; being the authority on ourselves, we know we’ve looked better, felt better, or seemed more grounded.
We’d like it if you lent us a compliment or even two, but for heaven’s sake, please don’t go over board. Sure, Bald is Beautiful, but given the choice, most of us liked ourselves just fine with hair.
Love us.
We still want to be loved, and by that I mean made love to. Those of us withbreast cancer and facing mastectomy could be on the brink of loosing the very largest symbols of our sexuality and femininity. If in the face of buzz-kill cancer, we can muster up enough energy to jump in the sack, please do whatever you can to rise to the occasion.
We might complain all day long about not feeling pretty but at night we’d like to be pursued as if we were the most beautiful women you’ve ever seen. We might ask you to turn off the light, just go with the flow.
Shower us with empathy.
Compassion is a prized commodity amongst our kind. It’s better that chocolate, red wine, or our anti-nausea medication. A single empathetic commiseration that indeed things can suck may be more appreciated than any other grand gesture of affection you can bestow us. It’ll certainly go over better than the knee-jerk condolences you might be tempted to offer up.
The truth is, no matter how above it we may project ourselves to be, we are embarrassed by our vanity. Even those of us who walk a path spiritually devoted to cultivating an awareness deeper than the skin, know real and intense discomfort when our physical identity starts to fall apart.
We may attempt to take control of our hair loss by cutting it short, or shaving it off. We may throw ourselves a Boobvoyage party before a mastectomy or parade around with our newly bald head held high. BUT we are actively engaged in the most difficult task of accepting that we are completely and utterly out of control.
This week I’m grappling with something I find simply humiliating. As if it weren’t bad enough that my hair has fallen out only in patches, to add insult to injury I now have something called folliculitis, a bacterial infection of the hair follicles, not only on my scalp, but also in the soft downy follicles on my neck and all the way down the small of my back. It is nearly impossible to feel sexy when touching your own head gives you the heebie-jeebies.
For all the cancer patients out there who have experience this particular itchy, hot, and unflattering torture, I bow to you. It takes a formidable person to rock this particular look without tears. And to those of you, who like me, have wanted to hide far from society in the seclusion of your own homes, or in the very least under a hat, I feel you. I know the last thing in the world you want to hear is how beautiful you look, when you feel like shit.
Get real.
We know that you know we are strong, but don’t you know we don’t always feel that way? Do you know how hard it is for us to be brave when our hair is falling out and our bones are itching? Do you know there are days we don’t feel graceful, moments we don’t act graceful and times we fail to live up to our own graceful expectations? It is hard for us to feel empowered with an icepack on our head and a heating pad on our knees, dry red eyes and a rashes lashed across our skin.
Sometimes we feel bad.
We don’t envy you: those of you who run into us at the grocery store, or the coffee shop on one of our bad days. We know it’s awkward to hear us panicking on our cells phones with our mothers, or crying to our husbands. But please don’t walk away and pretend that you didn’t hear. Chances are in a moment like that, we need your help and we might be too proud to ask.
Forget attempting to offer up some gratitude platitude (we are more grateful for the chance to keep living than most), just give us a silent squeeze. One hand on the shoulder is worth a million well crafted aphorisms. Most likely, we will hug you back with all our strength; perceived or projected.
We want you to see us. To see our strength and our vulnerability. To feel our pain and to know the depths of our gratitude. Ask us sincerely how it is, and we will tell you the truth.
“There is no difficulty that enough love will not conquer; no disease that enough love will not heal; no door that enough love will not open; no gulf that enough love will not bridge; no wall that enough love will not throw down; no sin that enough love will not redeem…” ~ Emmet Fox
Here are a few more things to keep in mind when you talk to someone with cancer:
1. If you know about our disease, address it immediately. Chances are we already know you had dinner with a friend of a friend the night before last and they told you all about it, so get it off your chest. Waiting for us to tell you how we are puts us in the awkward role of feeling like we’re complaining; usually things could be better, but if you’re curious about how we feel, just ask.
2. If you’re not prepared for some detailed response to your inquiry, just don’t ask. We may need to vent about some gnarly side-effect, and most of them are kind of yuckie. Be prepared to listen. Your shoulder to cry on might be the biggest boon we get all day.
3. Please refrain, if possible, from telling us a story about your friends and relatives who died of cancer. Just like a pregnant women gearing up to deliver her baby, it’s important that we surround ourselves with stories of success not fatality. If you haven’t experienced cancer first hand it is normal to want to relate in any way possible, but for our sake think twice before sharing a story with a bad ending.
4. Unsolicited advice might be great, but it’s still unsolicited. You might just have the most miraculous outside-the-box alternative therapy that you’re dying to put to the test, but please, unless we’ve asked, soften your enthusiasm. No one takes their diagnosis more seriously than the patent themselves. Most cancer survivors I know have thought long and hard about their treatment plans. They’ve often consulted their nearest and dearest and have gotten a second and third opinion. And by the time we are in active treatment we have a pretty solid plan of attack in place.
5. Empathy, empathy, empathy. Plain and simple, cancer sucks. If anyone wants to talk about how it’s a gift, leave that to the patient to offer up.
6. Shower us with love. According to the mother of Western yoga, Judith Lasater, all emotions stem from the two most basic: Fear and Love. We, cancer patients, are confronting our fears in a full frontal attack. Showering us with love is like helping us stock up our arsenals and helps us prepare for battle.
7. Lighten Up. The more you can make us laugh, the better. This is not to say we don’t appreciate you taking our challenges seriously, but let’s face it, laughter is the best medicine. If you can find a way to make us giggle we will love you forever.
I am lucky enough to have some of the best and silliest girlfriends in the world. When three of them came to visit me last month we took over the infusion room at the Nantucket Cottage Hospital. When Gretchen, my infusion nurse, slipped out to go to the lab, the girls promptly took over and we turned Cancerland into Clubland.
9. Touch us. Cancer is not contagious. We can’t give it to you. What we can give you is the chance to heal our aching hearts. Most of us just want to be held.
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