I had my 6-month oncology check-up a week ago, but I've been putting off writing about it. I don't know why. But now I'm stuck at home on a snow day...A is sick and still in bed. I had to cancel my trapeze lesson due to pain/spasms in my lower back, but I can't even get to my chiropractor's office because that would mean shoveling the driveway, which my back can't handle. So here I am stuck at home, and I might as well write, right?
Last Thursday was my 6-month check-up, and it was with a new oncologist, since my previous one is no longer practicing in the cancer center I go to. It was also the 2-year anniversary of my lumpectomy. It would have been an emotional, stressful day for me just because of all of that, but in addition, someone I love (who I won't name, out of respect for their privacy) had an appointment elsewhere in the building at the same exact time, because they had 5 out of 7 symptoms of a scary kind of cancer. So my fear for my loved one's well-being pretty much eclipsed my fear for myself, and I was so distracted because of it. We made plans to meet in the main lobby when we were both done with our appointments.
My new oncologist, Dr. J, spent 45 minutes with me because it was our first visit - I was used to these appointments being only 15 or 20 minutes. We didn't hit it off too well, I'm sorry to say. Then again, I totally got off on the wrong foot with my first oncologist, too, and then our connection improved greatly...so perhaps I just need to be patient and give it a chance with Dr. J. What stressed me out was that Dr. J wanted me to have what felt like a gazillion tests and procedures, not because she was really worried about my health, was the impression I got, but simply because that's how she does it with all of her patients. I've been feeling really great for months, trying my best to eat well, sleep well, exercising (there's always room for improvement, but I've been walking fairly regularly), de-stressing, taking all of my anti-cancer supplements along with the Tamoxifen, and continuing to educate myself on/engage in activism against environmental toxins. I haven't been worried about the possibility of a recurrence. I felt like I was happily living far away from cancer-land. But these stupid cancer check-ups are a reminder that I will never get away from cancer-land... I will need regular check-ups of some kind for the rest of my life. Dr. J wanted me to schedule a bone density scan, a pelvic ultrasound (to assess the cause of my irregular/heavy menstrual bleeding - which I'm sure is a Tamoxifen side effect, not a third cancer, geez), and have more blood work, a flu shot, a mammogram, and consider genetic testing. I only agreed to half of that, declining the last 3 items. Dr. J is super bothered by my refusal of mammograms, telling me that mammograms really aren't optional. But it's my body, and I'm not willing to have that much radiation.*
The appointment dragged on and on, and ended with her telling me she wants to see me again in four months, because she's still getting to know me. I was dismayed, for I had been expecting to not need a check up with her for at least 6 months, maybe a year...considering I'm now over 2 years past diagnosis. Having my oncology appointments instead increase in frequency - along with the increase in tests and procedures - makes me feel cranky, too immersed in cancer-land once again.
Once I got my clothes back on, scheduled all of the stupid tests and procedures, and had my 3 vials of blood drawn, I practically ran to the main lobby to find my loved one. They were there, waiting to go into the lab for blood work and an X-ray. Within minutes, they were whisked into the lab, and I had to sit there for a full hour, so scared, waiting to hear whether or not it was cancer. Then, they came running out, gleefully telling me it was a virus, not cancer. Relief washed over me. Never before have I been so thrilled by someone being sick with a virus!
There are so many things I hate about cancer; I hate having the fear of it lurking about. My logical brain knew that it was very, very unlikely that that person I love had cancer... but that's what I had thought about myself, too, and twice now I've had the experience of being told, "Oh, it's probably nothing," and then finding out, BOOM, it's CANCER. That has skewed everything for me and it's a constant challenge to maintain perspective and logic and not let the fear win. Even young, healthy, fit people get cancer. Even cancer survivors who have been given an excellent prognosis and have a low risk of recurrence and feel certain that cancer is a thing of the past can end up dying from the cancer a year later (see my previous post). We really just never know and there are no certainties when it comes to cancer...or anything in life, really. Do I sound like a broken record when I say that all we can do is take life one day at a time? Sometimes it's one hour at a time, one minute at a time, one breath at a time. Inhale, exhale, repeat.
*By refusing annual mammograms, I'm not making a fear-based, uneducated decision. I have thought long and hard about it, and have read a lot about mammography and other breast cancer detection methods, and have talked with many people about it, including medical professionals. And I'm choosing annual breast MRIs. My surgeon, who is also the director of the Breast Care Program at a National Cancer Institute Designated Cancer Center, has approved that choice. She told me, "You know that if I felt strongly about your need for annual mammograms, I would beg you to do it, like I did with radiation therapy." And that right there is good enough for me! If something shows up on the MRI, of course I will get the recommended follow-up ultrasound, mammogram, biopsy, etc. And I'll continue having at least 3 Clinical Breast Exams (CBE) per year, from my oncologist, surgeon, and gynecologist, and possibly thermograms on occasion. I will consider having an occasional mammogram. I will consider having mammograms on a more regular basis when I'm older and my breast density has decreased. I have very dense breasts, like most young women, and I have a report from the radiologist who interpreted my mammogram a couple years ago that clearly says that my very dense breast tissue decreases the sensitivity of mammography. On mammograms/X-rays, dense breast tissue shows up as white, as does cancer, so it's like...what's that expression...trying to find a polar bear in a snowstorm. I see no point in annually exposing my breasts TO A CARCINOGEN (radiation) for the next SIXTY FIVE YEARS (ish), when A) it's really hard to detect cancer via mammogram, given my breast density; and B) the more mammograms I have, the more my risk of cancer increases. I've already had a shitload of radiation to my breasts (the radiation therapy, I mean). And we're all exposed to so many carcinogens on a daily basis, most of which we're not even aware of, and cannot avoid. Thus, if there are carcinogens I can avoid, I will avoid them.