One Year and Counting

Well, the one-year anniversary of my breast cancer diagnosis came and went last week with little hullaballoo. Part of me was braced for an emotional tidal wave that never manifested. As it turned out, January 29th, 2010, was just another day. And, more than anything, I felt/feel lucky. Lucky that I’m on the other side of cancer (knock wood). Lucky that mine was the type that could be sliced out—I have a good friend with lymph cancer who will never have the luxury of another cancer-free day. Lucky that I’m back to worrying about the little stuff, like freelance work. Lucky that I get to move on with my life. Speaking of moving on, friends sometimes ask me what nuts-and-bolts lifestyle changes I made in the past 12 months, so I thought I’d make a little list. Of course, this is not meant to be health advice, I’m just offering a little window into what I did after my cancer diagnosis (aside from freak the hell out). So, here it goes:

• Stopped drinking Diet Coke
• Started drinking green tea
• Started juicing in the mornings
• Stopped eating sugar, wheat, soy and dairy
• Went vegan at home
• Traded anti-perspirant for natural deodorant (yeah, it sucks)
• Got serious about buying only paraben-free soaps and shampoos
• Bought chemical-free laundry detergent and dryer sheets
• Traded soy milk for rice milk (I’ve eased up on the soy)
• Reduced my use of canned beans
• Replaced most of the tupperware in my kitchen with glass containers
• Cut back on wine
• Yoga, yoga and more yoga

None of these rules are written in stone. In fact, they fluctuate depending on the day. But, more days than not, I follow them, and my plan is to keep it up for a long, long time. I’m not naive. It would be silly to think any one of the actions above might ward off cancer. But it would be equally foolish to stick my head in the sand. I figure that the least I can do is to cut back on the number of cancer-causing, hormone-disrupting substances I invite into my home and body. After that it’s anyone’s game. This time around, maybe I’ll get lucky.

Homebody

Standing on the cusp of my first cancer-versary, I’m surprised (but not) to note how much I’ve changed during the past 12 months. The most obvious and painful souvenirs of my trip to cancerland are also the most permanent—the two neat scars, like dash marks, running across my chest. The psychological shifts are harder to see.

Some days I feel like a completely different person, as if my body was hollowed out and re-stuffed. Other days I feel as though I’ve simply settled more deeply into myself, as if my psyche moved from the second floor to the basement apartment.

As cliche as it sounds, I’m less likely to sweat the small stuff (a parking ticket, a hole in my sweater, cat litter on the furniture–eww) and more likely to do annoyingly upbeat things (like hum in the shower). One of the most notable shifts is both physical and mental: a profound need to stay put.

I’ve always been a homebody. I like routine. I relish the simple stuff  like cooking, walking the dog, and practicing yoga. At night I love cuddling on the couch with Mary to watch a movie or laugh at bad reality shows. I love sleeping in my own bed. Since I need a lot of alone time and dislike crowds, confined spaces, and flying, travel has always presented a challenge. But I bite the bullet because I know I’ll be happy once I’m there.

So, last summer, after I’d physically healed, I thought I was ready to hit the road. Nothing crazy, just a few trips to visit friends and family. Oy, big mistake. Somewhere along the way, my travel angst blossomed into a full-blown aversion. Departing for each trip felt like walking off the gangplank into a churning sea of chaos and confusion. Mary deserves a medal of honor for traveling with me because I was a mess. In DC, I burst into tears when we got lost leaving the rental car facility. In San Francisco, my favorite city in the world, I felt physically pummeled by the city’s vibrancy and spent most of the trip in our hotel room, dodging maid service and crying. Fun times.

Unbeknownst to me at the time, I was mired in a bog of depression and traveling exacerbated my sense of helplessness. (I’m doing much better now, thanks.) Finally, at the end of my last trip, I had a complete and utter meltdown and realized that what I really needed was to stay home, so that’s what I’ve done. For the past four months I’ve stayed home and the world feels right again.

Shortly after my epiphany, Dana Jennings, a writer for The New York Times who blogs about his experience with prostate cancer, posted an entry about his sudden desire to stay home. He writes, “More than ever these days, I want to shrink the world to the couple of rooms in my house where I’m most comfortable…I’m still reinterpreting myself in the face of cancer, and that takes time and quiet.”

I couldn’t have said it better myself.

Coming Full Circle

I’ve never liked January. Between the cold, the gray, and the post-holiday blues, the slog to February feels like an annual chore. But, as the one-year anniversary of my diagnosis draws near, I am in a surprisingly good mood. In fact, I’m positively upbeat. That’s because, compared to last January, this one feels light, airy, and carefree. Who cares about gloomy skies and frigid temperatures? Heck, at least I don’t have cancer! So what if it’s -10 degrees out with the wind chill? At least I don’t have to crawl out of my warm bed at 6am for a doctor’s appointment in Indy. More snow? Bring it on. Last year, the only significant snow accumulation fell on the day of my diagnosis. That was doubly depressing because, typically, Mary and I celebrate snow by breaking out the cross-country skis, putting the dog in the car, and heading for the University’s golf course where I scoot, she skis, and the dog runs cabin-fever-fueled laps around us. We laugh and putter around the snow-covered greens until our cheeks are frozen and the dog runs out of gas. It’s the best thing about winter. Last winter, the skis stayed in the basement. The dog sulked. Not so this year. So far this month, I’ve been skiing three times. The snow is gone now, but I’m hoping for more because, after all, it’s January.

Whine

Science giveth and science taketh away. Just when I was starting to feel downright giddy about my diet, another study comes along and rains on my parade. I’d be a hypocrite if I only raved about the good news, so here’s my bad news for the week.

Researchers at Kaiser Permanente in California found that drinking alcohol may increase the risk of cancer recurrence in breast cancer survivors. More specifically, women who drank 3 to 4 servings of alcohol a week—roughly 3 to 4 glasses of wine—were 34 percent more likely to have another bout of breast cancer than women who drank little to no alcohol. My personal silver-lining is that the greatest risk was among post-menopausal, overweight women; neither one of which describes me (yet). But I feel as though I’d be tempting fate not to take this news seriously.

To be honest, this finding is less than shocking. Drinking has long been known to increase a woman’s risk of breast cancer because alcohol is estrogenic, meaning it increases the circulating levels of estrogen in the body, and estrogen—as we’ve discussed—is to breast cancer cells what Miracle Gro is to anemic backyard tomatoes. But the gap between knowing this information and its practical application is Grand Canyon-esque.

I’ve known about the link between breast cancer and alcohol for years but, at least before my diagnosis, I chose to look the other way. Like any self-respecting health writer I focused on research that supported my favorite indulgences, such as the stack of studies showing that wine is good for the heart. Since my family history is riddled with heart disease but has (had) nary a wisp of breast cancer, I easily rationalized a few glasses of wine a week. Heck, wine was practically a health food in my book.

That said, I was hardly a heavy drinker. I’d sip a glass of wine while I cooked, which was a couple of nights a week, plus drink a glass or two with friends on weekends. Although my weekly wine tally didn’t seem like much, it easily added up to 3 or 4 glasses a week—the same amount that showed negative consequences in the study above.

I swore off wine after being diagnosed with breast cancer. But, after six months of depriving myself of all of my favorite foods and food rituals (like drinking a little wine while cooking), I realized that living in fear of my favorite foods and beverages is downright depressing. So, in the past month or two, I’ve eased up a bit. Part of that has meant a return to wine, albeit less than I drank before. Although I’m not one to shift dietary course on the winds of a single study, this news does make me rethink my relationship with alcohol. While I don’t want to be a teetotaler, I might need to make wine more of a special-occasion treat. Sigh.

Soy Reprieve?

In the wake of my breast cancer diagnosis, I took a long, hard look at my diet. I stared down the contents of my refrigerator the way a crime victim glares at a line-up of possible perps. I wanted justice. I wanted revenge. I wanted to guarantee this wouldn’t happen to me again. (All the time knowing there are no guarantees.) Still, out went cheese, yogurt, and wheat (mostly). In came raw nuts, rice milk, and a staggering amount of fruits and vegetables. But one of the hardest transitions was saying goodbye to soy. I hung on with desperation, like a child hanging on to the last threads of her favorite blankie.

Eating soy meant I could still order a latte at Starbucks and—somehow—feel like I still had a toehold in the land of “foods normal people eat.” Saying yes to soy meant I could still indulge in things like eggless-egg salad and stir-fried tofu. But, after looking at the scientific research, I wasn’t convinced the natural phytoestrogens in soy wouldn’t ratchet up my body’s estrogen load. And, since I was going to the trouble of taking Tamoxifen to block the estrogen in my body, why possibly add to it?

My oncologist was no help, but, at least, he was honest. “We really don’t know if soy is helpful or harmful for breast cancer patients,” he said. Then he followed up with the mantra “in moderation it’s probably fine.” But “probably” was a far cry from the certainty I craved and when another health care professional questioned my continued intake of soy (saying something along the lines of “why play with fire?”) I decided he had a point. Maybe it was fine but what if it wasn’t? So, I said sayonara to soy foods.

But today I saw some news that made my shriveled taste buds perk up in hopes they may once again know the joys of soy. A study published in this week’s issue of the Journal of the American Medical Association found a higher intake of soy foods was associated with a lower risk of death and breast cancer recurrence among breast cancer patients in China. Researchers enrolled more than 5,000 breast cancer survivors (a nice big number) and followed them for nearly four years (not a decade or more, which would have been nice, but a solid length of time). Interviewers asked them detailed questions about their diet and closely tracked the amount of tofu, soy milk, and other soy foods the women ate. In the end, they found that soy intake was inversely associated with mortality and recurrences in the group. Meaning, the more soy the women ate (up to 11 grams a day), the lower their odds of dying or having a breast cancer relapse.

So, what about those plant estrogens? The scientists are placing their bets on the anti-estrogenic theory of soy. In other words, that plant estrogens directly compete with the body’s own estrogens for cellular parking spaces. When a plant estrogen glides into a parking space, other estrogens are forced to keep circling. Eventually, the game of musical chairs ends and the estrogen (now dizzy from driving in circles) is booted from the body. As far as we know, beyond being parking-space hogs, plant estrogens don’t continue to impersonate “real” estrogen and, therefore, they subtract rather than add to the body’s estrogen load. At least, that’s the theory this group is espousing. While this notion isn’t new to me, it’s nice to see some new scientific oomph behind it.

Of course I would be remiss in my duties as a medical writer if I ever suggested one should make a dietary change based on a single study. And, no, you won’t find me bingeing on tofu and washing it down with great gulps of soy milk. But I may just indulge in the occasional soy latte. (After all, who can afford them more than occasionally?) So, thank you to scientists who keep exploring the hinderlands of breast cancer research, and Starbucks here I come…

Finally…Connecting the Dots

Well, my stint as a professional blogger for Time Magazine is ancient history. Ironically, instead of giving me a burning desire to blog,  it turned me off of blogging for awhile. Not in any theoretical sense, I was just bone tired of cranking out words. Even last month’s mammogram mayhem wasn’t enough to draw me out of my anti-blogging funk. (Maybe because I had so much to say…I just couldn’t begin to distill it down.)

But today is different. Today I want to shout from the rooftops about a recently published article in the New York Times. An article that made me want to jump up and say “Hallelujah!” The op-ed, titled “Cancer from the Kitchen” and written by Nicholas Kristof, is about the connection between chemicals in the environment and breast cancer. Long before I was diagnosed with breast cancer I was frustrated by the lack of attention given to environmental toxins and their role in cancer. Since my diagnosis, my low-grade irritation transformed into a red-hot annoyance. So I was thrilled to see someone at the NYT discussing the subject.

In a nutshell: it’s the estrogen stupid. Scientists have long known that a woman’s lifetime exposure to estrogen is directly linked to her risk of breast cancer. The more estrogen percolating through her bloodstream, the higher her risk of breast cancer creeps. That’s because estrogen fuels rapid cell division in breast tissue and cancer is a disease of rapid cell production.

But what scientists are only now beginning to understand (insert sound of forehead smacking here) is just how much environmental estrogen is contributing to breast cancer rates. More than 80,000 new chemicals have been developed since World War II, states Kristof, but “even of the major chemicals, fewer than 20 percent have been tested for toxicity.” And, since 1975, a woman’s risk of breast cancer has gone from 1 in 100 to 12 in 100.

Many of these chemicals act like estrogen in the human body, meaning they are estrogenic. These substances aren’t esoteric agents handled by people in biohazard gear, these chemicals are in our homes, more specifically they are in our pantries and in our medicine cabinets. They hide in plain sight in our detergents, our perfumes, our make-up, and our plastics. Estrogen swims in the food we eat and the lotion we slather onto our skin. Over the years I’ve written about this topic at length for Health Magazine, Yoga Journal, and others. In doing so, I’ve interviewed some of the top endocrinologists in the country. They’ve been sounding the alarm bells but no one seems to be listening.

Earlier this year a 10-year-old girl in California was diagnosed with breast cancer. (Here’s a link to her blog.) Makes you wonder how bad things will need to get before more people get red hot and insist on a change.

My Radio Debut

An abbreviated version of last month’s blog entry “Pinked” aired on my local NPR station (WFIU) last Thursday, October 29th. (Thank you to all of the Bloomingtonians who tuned in!) The spoken-word version of my essay is a mere 300 words (2 min), but I think I got my point across.

If you’re interested in listening, here’s the podcast.

Warning: clicking on the link will take you straight to the recording, meaning my voice will immediately leap out of your computer. So, brace yourself, adjust the volume, close your office door, whatever you need to do…I found it a little startling myself ; )

PS. Still blogging for Time Magazine (insert sound of panting here…) but sharing the load with another writer, so I’m a wee bit less stressed. Just one more week to go!

What is it About Prayer?

My friend Bruce emailed last week and told me that his partner of 19.5 years has leukemia and is having a bone marrow transplant in a few days. Why is it that my first instinct was to tell him I’d pray for them? My confusion stemming from the fact that I tossed conventional prayer out the window long ago (right along with my Catholicism). So, instead I told him “I’m not the praying type,” but that I’d be holding them both near and dear to my heart in the coming weeks. That’s the absolute truth, but it still doesn’t sound as solid, as comforting, as results-oriented as “I’ll pray for you.”

In his reply, I was reminded of the many people who prayed for me and how grateful I felt for the good energy these folks (many of them strangers) pointed in my direction. He wrote, “it’s been really interesting to see in my circle of friends, near and extended, how many people either say that ‘you may be surprised, but I pray, and I’d like to pray for you.’” Then he told me this story that (with his permission) I’m posting here because I found it really touching. For context’s sake, Bruce and his partner, Stan, live in New York City with Terry, their adopted rescue Greyhound.

A Thai hairdresser who works near here would always stop to admire our dog, saying every time, “Beautiful. Like tiger.” Our dog leaned his head against her a few weeks ago , she looked at his soulful eyes, and said, sort of out of nowhere, “Is he okay? You know, I pray for people healing.” She said she often offers prayers to Buddha for her clients–she sends a donation to the temple in New Jersey she goes to. So I told her a bit about Stan, asked if she would pray for him, wrote his name on a piece of paper and wrapped it in a couple of dollars. (You know, even in cynical New York, this seems reasonable–we’ve seen this woman for well over a year, and she clearly has no interest in hitting people up for money.) so now I’ve got her enlisted too. When I got home, Stan smiled and said, “It can’t hurt.”

My thoughts exactly—it can’t hurt.

Thinking of you Stan and Bruce… And, to all of those who prayed for me, thank you.

Blogging for the Man

As of last Monday I am the temp blogger for Time Magazine’s Wellness blog. (I would have posted sooner, but I’ve been blogging my brains out.) So far, the 3-week assignment is fun but a helluvalotta work. I’m supposed to post 4 to 6 times a day—a far cry from the 1 to 2 posts a month I squeeze out here. Not to mention I’m spending (on average) 2 hours writing each post so my work schedule is U.G.L.Y. My editor swears that once my “writing metabolism” revs up, I’ll be whipping out posts faster than you can say, “embargo, what embargo?” But, alas, by the time that happens, the gig’ll be up and I’ll be back to navel gazing. The upside? I’ll be posting here more often to ward off blog withdraw.

Pinked

Yesterday, I spoke with a reporter from the Detroit News. She is writing a story about breast cancer awareness month and was interested in talking to folks who are less than tickled pink by the proliferation of pink ribbons. (Who, moi?) I thought I’d blogged forward and backward about this topic, but I was caught a bit off guard by what seems to be the most obvious question of all.

“So, why is pink NOT your color?” she asked.

(Insert forehead-smacking moment here.)

How could I have not written at length about why (exactly) pink is not my color! Okay, loyal readers (all 3 of you) know that I am not a card-carrying member of the rah-rah, breast cancer sisterhood. Hence, maybe the name of my blog is self-explanatory. But I welcomed the chance to answer her question and thought I’d do so here as well. Because, believe it or not, until I was tarred and feathered in pink last February, I thought pink was a swell color.

Let me explain. In those awful two weeks after the “C-bomb” dropped, Mary and I schlepped around shopping for a breast cancer surgeon. My first inkling that  pink was no longer my innocent, cherry, childhood friend was when I entered the first breast surgeon’s waiting room. It was as if a flamingo had just vomited on the place. My eyes stung at the pink upholstery on the chairs, the pink wall-to-wall carpet, and the pink window treatments. The staffs’ outfits matched their surroundings, like lizards that evolve to look like rocks or leaves. Every nurse was peppered with pink-ribbons from her lapel pin to her pink shoelaces. And the pink suffocation didn’t end when you escaped the office, it followed you home, like a virus.

Every time I consulted a breast cancer surgeon, I left with a bag of pink SWAG. I felt as though I’d just attended the breast cancer Oscars–or a birthday party for 5-year-olds. I kid you not, I have a box of breast cancer tchotchies in my linen closet. (Seems like hubris to recycle that breast cancer business—never know when you’re going to need a brochure on metastasis.) Each goody bag revealed various assorted breast cancer bric-a-brac including a pink water bottle to quench my thirst after sitting in the waiting room for hours, pink binders to hold my important medical papers, a pink day planner to help me remember my radiation and chemotherapy appointments, a pink pen to write them down with, and a pink journal in which to record my pinkest of pink thoughts. (Just so you know…I am not making this up.)

Now, just for kicks, imagine a man newly diagnosed with prostate cancer. Picture his doctors and nurses showering him with baby-blue baubles. Maybe his gift bag includes a blue beer cozy, blue-ribbon-bedazzled sweat socks, and a blue notebook to keep track of his deep man-thoughts about how it feels to lose a part of his masculinity. Imagine the man slinging his blue tote over his shoulder on his way out the door. Let’s stop and ask ourselves: Is this supposed to make the man feel better? Does his possession of a blue-ribbon festooned notebook make him feel welcomed into the “sacred brotherhood” of prostate cancer patients? Did a chipper “survivor” pop into the examination room to hold his hand and shoot him knowing looks while the doctor outlined his surgical options? (Again, I’m not making this up.)

This scenario sounds insane when you put a man in the picture, but this is exactly what happened to me last February, and I’m guessing it happens to thousands of women every year. Granted, some breast cancer patients undoubtedly eat pink ribbons for breakfast, lunch, and dinner and that’s fine, but let’s make some room for those of us who aren’t hungry.

This pink-coating of breast cancer makes me want to scream until I’m pink in the face. What would I yell? Oh, here are a few jewels that come to mind: For starters, I’m an adult, not a fairy princess. I don’t want to join your pink sorority. I have a deadly disease, not a boo-boo you can cover up with a giant pink Band-aid. I don’t want a fucking pink day planner. What I need is a surgeon who will treat me like an intelligent person, a person who needs accurate, concise, no-bullshit information much more than she needs a linen closet overflowing with pink gewgaws.

And while I’m on my pink soapbox, I would add: Don’t use your pinkest, most upbeat voice to tell me that radiation will give me a “virtual breast lift” by tightening the skin around my breast or that reconstruction will give me the “breasts I’ve always wanted”—all expenses paid! And stop waving your pink wand, like I’m 8 instead of 38. Pink is cute. Pink is frilly. Pink is for little girls. But there is nothing cute or frilly about having your breasts carved off and your estrogen levels chemically decimated to the point that your libido is a distant memory and your genitals turn to sandpaper.

Do I want to shroud myself in black? No.

Am I a negative, angry person who wants to simmer about her disease, her brush with mortality, her troubles on Tamoxifen? No.

What I am is a smart, curious, thoughtful person who needs a little pink-free space to wrestle with her breast cancer demons. Because no amount of forced pink smiles, pink walks, and pink banners will undo what cancer has done to my body and my psyche. The hardest part is that I know there are other women out there who feel the same, but I can’t see them or hear them because we are all drowning in an ocean of pink.