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Photograph by Anna Symonds Myers If It Happens To You A woman living with breast cancer talks about what she's learned--so far By Julia Cecelia Smith T HE INITIAL DIAGNOSIS of malignant breast cancer is a horrible moment; it isn't a scene from a movie, it's not a joke, and it puts you immediately in the driver's seat of a runaway train. Nothing--and I mean nothing, not divorce, not the death of a loved one, not owning your own copy of Terms of Endearment--prepares you for what is to come. This is true for several reasons: no one knows why you developed the disease, no one knows yet what treatments you are going to choose and no one knows the ultimate outcome. Certain doctors hate to hear that. Certain doctors will tell you that you have a fixed percent chance of survival, or that you won't survive, or that a particular treatment will work better than another. Certain doctors are full of baloney. My personal experience with oncologists in three countries--France, England and the United States--has brought me to this informed conclusion: oncology (that is, the study of cancers) is a crapshoot at worst, a leap of faith with a boost from science at best. What works for one person can fail another. Some people who were told to get ready to die 20 years ago are still alive, and some who were told they had beaten the disease died from it long ago. As all of this is true--and it is--the most important advice of all is that you trust your instincts when it comes to your treatment, and that you work with a doctor you adore. There are cancer patients who know their diagnosis, pathology report, prognosis and treatment history like the backs of their hands, probably better. Others choose to remain blissfully ignorant of the polysyllabic words and mystifying numbers that quantify their existence in a medical file. Neither is right, neither is wrong. Yes, I've gone and gotten all Zen on you: it just is. If giving up dairy, caffeine, alcohol and hair color make you feel better about fighting advancing disease, go for it. My friend Jan Bacco, who died of metastatic disease two years ago in the village in England where we both lived, enjoyed what she called "retail therapy." That's when you buy whatever you want whenever you want because it makes you feel better. In six years of treatment, I've swallowed about a billion prescription pills, vitamins, minerals, organic supplements and seriously nasty tasting Chinese herbal teas, plus water from Lourdes, dirt from Chimayo, cleansing tonics and homeopathic perles. I've also undergone eight or nine chemotherapies, hormone therapies, a mastectomy (don't get me started on that one), a collapsed vertebra, three rounds of radiation, deep vein thrombosis, compromised heart function, and even whooping cough, thanks to having my immune system knocked out by chemotherapy and taking my small daughter for a live-virus vaccination. And I love my life. It's been almost three years since I abandoned the formidable cancer-treatment factory at Stanford Medical Center because it wasn't good enough for me. My doctor there was an iced cod who actually seemed disappointed that I wasn't following his vision for my future; specifically, that I didn't have one. When I weaned myself off Vicodin and morphine following the vertebra collapse and then walked my first Race for the Cure to raise money for breast cancer research, I asked him for some encouragement. These were his exact words. "It is neither my style nor my practice to give my patients false hope." False hope. Those two words sum up the difference between us. I think there is no such thing as false hope. It's an oxymoron, like jumbo shrimp. I don't know when I'm going to die, but then, neither do you. How and when I die is between me and God, and not by the grim word of some cold fish in a lab coat. Being a cancer patient isn't anything I'd recommend to anyone, but I'm being the best damn cancer patient I can be, for myself, for my husband and for my three young daughters. I have a severe case of transference toward my current oncologist, Dr. Alan Newman of San Francisco. Thanks to him and his remarkable staff, I look forward to treatment days as much as is humanly possible. And another thing: I look forward to tomorrow. Julia Cecelia Smith worked as an assistant editor and writer for Metro from 1985 to 1991. Send a letter to the editor about this story . [ Silicon Valley | Metroactive Home | Archives ]