The Miami Herald

Taking control of the fear with breast cancer

Narcotics detectives hunt addicts and traffickers for the sort of painkillers that are prescribed to breast cancer patients after a bilateral mastectomy. Oxycodone can destroy a life.

I decided to stay away from it on the fifth day after the surgery. That was a big mistake. It was torture. I felt like there were little creatures with sharp objects poking and tearing me from within. The pain was so excruciating it made me weep.

“Why are you crying? That’s not going to solve anything,” said my mom. “That’s enough. Just take it.”

She is a believer in homeopathic remedies, and taught me how to use prana yoga and breathing exercises to deal with headaches when I was 8. She is the person least likely to push pharmaceuticals, yet she was standing in front of me with a glass of water and a container full of white pills. I laughed and swallowed one. Within 40 minutes, I found peace.

The pills couldn’t vanish the gray cloud floating over my head. The body image I had been used to seeing in the mirror after showering was no longer there. I felt deformed, and still I had to find the courage to be topless in front of two men at the University of Miami’s Sylvester Comprehensive Cancer Center.

After careful examination, Dr. Marc Lippman, chairman of the University of Miami’s department of medicine, said the outcome of the surgery was “great.” I told him I disagreed. My doctors had done an amazing job, and I had not had any complications while healing. All was well. I just didn’t like the “under construction” sign that was hanging over my chest.

“You could have come out of this surgery a lot worse,” he said. “You are not going to have the breasts you used to have but it will come close.”

He was right. Vanity twists perspective and makes one ungrateful.

“We are still aiming for a cure? Aren’t we?” he asked.

“Yes, absolutely,” I said.

I wasn’t as enthusiastic. The surgery had added the risk of developing lymphedema, which causes painful and chronic swelling of the arm due to fluid retention.

The medical director of the Baptist Health Breast Center, Dr. Robert DerHagopian, said the pain in my left arm was going to subside.

“Damage to the intercostobrachial nerve causes numbness on the upper inner arm,” said DerHagopian, while pointing to the back of my arm.

The damage happened during the axillary lymph node dissection. This procedure and another one — the sentinel lymph node biopsy — were done to examine whether the pea-sized filters under the arm had collected cancer cells that may have spread. The pathology report said DerHagopian had removed “one sentinel lymph node and 16 random lymph nodes” and that doctors had found two with “macrometastases.” The good news was that doctors did not believe the cancer cells had spread to other parts.

“Your prognosis is good, but there is no guarantee that a recurrence won’t happen,” DerHagopian said.

To reduce the risk of a recurrence, both DerHagopian and Lippman recommended that I undergo radiation and referred me to UM Sylvester Comprehensive Cancer Center’s radiation oncologist, Dr. Cristiane Takita. During my meeting with Takita, who specializes in using radiation to kill or shrink cancer cells, I learned that the therapy would reduce the risk of recurrence from about 30 to 10 percent. Although when used on children, Takita said, radiation can become a cancer risk.

“We are going to use radiation as a preventive measure,” said Takita. “That means that we are going to radiate the clavicular area.”

The chest wall was also a very common area of recurrence, Takita said. She recommended I undergo six weeks of treatment Monday through Friday.

“The treatment is painless when administered, but your skin becomes more sensitive. It will feel like you had a sunburn,” said Takita. “Some patients experience tiredness  … lowered white cell counts and inflammation.”

I had fears. What if the radiation damaged my tissue so severely that it would cause my body to reject the implant? “I am concerned about it affecting my reconstruction,” I said.

Fear has taken different forms through my experience with breast cancer treatment. The steps the doctors have recommended are simple, and I’m going to continue them despite Lady Terror’s creative mirage.




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