Monday, November 23, 2009

Risk

It's been interesting to me to see how a cancer diagnosis changes my life in many ways, both big and small, that I couldn't have predicted... for example, I get so many hugs now from people whom I barely know, and also people whom I've known for years but never were the hugging type!

And then there are ways in which this cancer diagnosis has not changed my life. I think many people, upon receiving a cancer diagnosis, feel compelled to make big changes to live a healthier lifestyle....whereas I feel glad to not have to make big changes, because I was doing so well pre-diagnosis anyway. I sleep well, eat well (mostly :)), exercise, avoid chemicals, laugh a lot. I've added a multivitamin (thanks, Mom!), and an immune-boosting 5-mushroom formula (thanks, Mom!), but really don't need to make huge lifestyle changes. Which is a relief. I just read the news aboug Sigg water bottles having contained BPA until 2008 - http://www.triplepundit.com/2009/09/surprise-sigg-bottles-did-contain-bpa-after-all/ - and while I'm pissed off that people who bought Siggs specifically to avoid the BPA in plastic bottles were cheated, I'm also glad I've been drinking out of my glass mason jars for years. It's a fairly common practice in the rural town of 12,000 people that I live in, but I do get strange looks when I'm drinking out of my mason jar anywhere but here... and yes, it's big and clunky and heavy, but I don't care.

On the other hand, I feel heavy with the knowledge that in many ways, it doesn't matter what I do or don't do in an attempt to take care of myself and stay healthy. Because even while doing everything "right," I was dignosed with BC. Of course the government won't admit that there's a correlation between environmental pollutants and cancer, but how can there not be? Humans have been treating the Earth like shit for decades and decades. The Earth is wounded, because of us - the air, soil, and water are contaminated. Thus, there is no way for any human to avoid contamination, either. When I was talking with a friend of mine about how angry I am to have cancer in my body despite "doing everything right," she said that a better question than why do I have cancer is why doesn't everyone have cancer? It's depressing but true.

I'm really trying not to go down the "WHY ME?" road, because that won't do any good right now. But receiving a cancer diagnosis despite being super healthy and consciously living a healthy lifestyle has made me think a lot about the concept of risk. When the doctor said the words, "They found something...they're calling it breast cancer," the first thing I blurted out was, "BUT I DON'T HAVE A SINGLE DAMN RISK FACTOR!" But you know, merely being alive means risking death. Not to get all melodramatic, but it's true. Life itself is a risk. Living is FULL of risks that we can never predict or understand, and we have to just keep on living anyway. It's so strange to me that we humans get scared of the unlikely dangers, such as dying in a plane crash, getting struck by lightning (or having cancer :P ), and then those rational people tell you, "Statistically, you're much more likely to get in a car accident than [insert unlikely danger here]!" Well, yeah. But I've been driving almost daily for about 15 years and have not been in a car accident, and I do have cancer. Go figure!

I've been trapezing for almost 4 years now, despite the inherent risk. It is a dangerous activity. I'm lucky to attend what's probably THE most safety-conscious circus arts school in existence, and I have learned how to trapeze as safely as possible, but still. There are big mats. You do fall. You do get hurt. But you trapeze anyway, because it's worth it. Because more often than not, you don't fall. My life would be SAD SAD SAD if I chose to forego the incredible joy that trapeze gives me, in order to avoid the potential dangers of it.

So why does part of me still want to have a prophylactic bilateral mastectomy?!?! It sounds crazy, even to myself, but I still sometimes think about it. I am already so scared of going through a lumpectomy and radiation only to have the BC return sometime down the road. Having BC once makes it more likely that you will have it again, but chopping off your breasts decreases your risk by about 90%. I do not plan on having a baby, and thus would not be breastfeeding... so my breasts are just aesthetic at this point. They are pretty awesome breasts and I love 'em, but I would SO much rather be HEALTHY than have nice breasts.
I have to go through genetic testing and find out if I test positive for mutations in the genes that increase the risk BC, and have long talks with my oncologist about how likely I am to get BC again, and weigh the risks and all of that. And probably I will not end up getting rid of my breasts. Probably that would be a ridiculously extreme measure, considering I only have a tiny Stage One tumor in ONE breast. But my partial-and-irrational desire to prophylactically get rid of my breasts is similar to the panic some people feel while flying in an airplane once a year, despite the fact that they're much more likely to get hurt in the car they drive every day.

Sometimes statistics of risks are just meaningless. Here's an interactive "Breast Cancer Risk Assessment Tool." - http://www.cancer.gov/bcrisktool/ I answered the questions as I would have answered them 2 weeks ago (i.e. before diagnosis), and the tool told me that the likelihood of me NOT getting BC in the next 5 years is 99.7%. WWWRRROONNNGGGG!!! AND, I had to lie and say I was 35, because they don't even calculate the risk for women younger than that. So if it had taken my actual age into account, it probably would have told me I had a 99.9% likelihood of not having BC.

At the very least, I am going to tell my surgeon straight up that my priority is my breast's health, not its appearance. With a lumpectomy, the surgeon doesn't just remove the tumor itself - she also has to remove a sizeable chunk of tissue surrounding the tumor, to make sure to remove all of the diseased tissue (well, as much as possible). That is called getting "clear margins." I have heard of some women having to have second lumpectomies because during the first one, the surgeon did not remove enough tissue to get clear margins. I want my surgeon to know that she is free to take as much of my breast tissue as she damn well pleases, to make sure all of the cancer is out of me. I will happily live with a lumpy, weird, dented, CANCER-FREE breast. Or one breast or no breasts. And I will still love my body and me.

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