Mens Health Blog. Medical Blog

Most, if not all of us, have confronted serious challenges and threats in our lives before being diagnosed with cancer. We did our best to address these situations, work through them, and then put them behind us as we moved on with our lives. In fact, this strategy is fully applicable to many kinds of cancer, since once the patient has passed the five-year mark, she can usually be pronounced cured. Unfortunately, the same cannot be said with certainty about breast cancer. While it is true that with every year that passes, it is more likely that breast cancer will be a part of our past, this is not always the case. The disease has been known to recur five, ten, fifteen, and even twenty years later. Thus, living with breast cancer becomes a particularly stressful challenge. Hester described the challenge well in a letter she wrote to the editor of our local newspaper. “All of life must be viewed through a double lens, that of possible future good health and that of possible future disaster.

Learning to live well after breast cancer is a lesson in hope.”

Once you get through this ordeal, each of you will find your own way of beginning the next part of your life, choosing your own path, marking your own priorities. One thing is certain, whatever decisions you may choose: You will make changes in your life. Having cancer forces you to assess and reassess what you want to do with the rest of your life. If there are projects-you have fantasized about but have pushed out of your consciousness, you may well decide to take the plunge and go ahead. This book is one of our projects.

The challenge is to learn how to live well, whatever that means to you personally. Although the terror you feel now, at the time of diagnosis, will subside and lose its intensity, it will remain a lifelong companion. Your awareness of it will, of course, fluctuate, and some days you will struggle not to be overwhelmed by it, while other days you will feel calmer and more in control. The overarching goal is to keep trying to achieve a balance in our lives between fear and hope. Whether healthy and well, or ill and unwell, we struggle to find level ground—a safe place where we feel the various competing attentions in our lives are in equilibrium.

*73\109\8*

Several kinds of chemotherapy are frequently used to treat breast cancer. Your oncologist will speak to you about which drugs are most appropriate for your situation. Some of the common chemotherapy agents which have been used for years include Cytoxan, Adriamycin, Methotrexate, and 5-Fluorouracil (5-Fu). Others are being studied and used all the time, and it is likely that, over the next few years, standard chemotherapy combinations will be somewhat different than they are today. For example, Taxol or Taxotere are now sometimes added to adjuvant chemotherapy treatment. Usually the drugs are administered through an IV tube in your arm/hand and are not painful. It can be unsettling to realize that there is no standard treatment that is best for everyone, but you can be sure that your doctor is recommending what is best for you. Feel free to ask questions, and, if you wish, to get a second opinion.

*58\109\8*

Occasionally, tissue expanders (temporary fillers to prepare your breast) are indicated; these are inserted during a series of procedures over several months. You will experience three stages of treatment. The first step will be the implanting of a tissue-expanding device that your surgeon will insert into your chest wall following the mastectomy itself. When you wake up from surgery, the device will already be in place. As the plastic surgeon will explain to you, s/he will expand your remaining tissue gradually over the next several months so as to accommodate an implant large enough to match the other side. This is accomplished by injecting saline solution through a porthole left exposed at the mastectomy site. After these expanding treatments are completed, s/he will schedule a time to both remove the expanding device and insert your permanent implant; this procedure will require that you return to the hospital.

Each of these reconstructive procedures involving tissue transfer is essentially a graft. You can expect to heal fairly rapidly after the first couple of days. The first twenty-four hours you will feel lousy; you have just had major surgery lasting several hours. You need time to recover from the effects of anesthesia as well as from the surgery itself. Try to cooperate with your nurse, who will urge you to turn, cough, and deep-breathe regularly, even though doing these things will hurt. Be aware that you will have odd-looking tubes hanging from your incisions; the tubes accumulate fluid (a mixture of blood and other body fluids) and will need to be emptied on a regular basis. When your surgeon determines that the drainage has slowed to an acceptable trickle, s/he will remove the tubes by exerting a steady, firm pressure at the site; the opening in the skin through which the tubes had been inserted will seal quickly (within one to two days).

You can expect to have some postoperative pain; however, you may be surprised that the mastectomy site itself is not the major source of discomfort. This is because the area is numb, following the severing of many nerves. The chest area will remain numb for weeks or months OR POSSIBLY FOREVER.

*44\109\8*

Mothers may find it disturbing to discover that their children have told all their friends and classmates about the illness or its side effects. Children do not have the same sense of what is private that you do, and your calm management of the situation may enable them to share the news with everyone in a matter-of-fact way. The positive effect of this is likely to be that many people, even some whom you do not know well, will offer to help. Many elementary school classrooms organize dinners for a student’s mother undergoing chemotherapy. If you are lucky enough to have this come your way, say yes. Make sure your own child’s teacher and classmates know how much you appreciate their help and the efforts of their parents. Write (or draw, depending on the age of the children) a communal note that your child can help you create and might want to read out loud (if s/he feels comfortable doing this), or ask the teacher to do it on your behalf. Alternatively, you might ask your child’s teacher to pin your note of thanks up in the classroom or to transcribe it onto the blackboard.

*31\109\8*

Many women facing cancer treatment are interested in complementary or alternative therapies. Traditional or Western treatments for breast cancer include surgery, radiation, chemotherapy, hormone therapy, and biologic therapy. All other treatments can be considered complementary. Since we feel strongly that there is far-reaching and impressive data to support the value of traditional medical treatments for breast cancer and no comparable set of data exists for complementary therapies, we implore you to use these other modalities in addition to, rather than in lieu of, standard medical care. This is the reason that we are referring to them as complementary rather than alternative treatments. Having said that, we recognize that many women are motivated to do everything possible to help themselves, and that some believe that non-Western health traditions have much to offer.

Frequently, this is also an area where friends may give advice. You may find yourself the recipient of many articles and books espousing one or another treatment, diet, or program to cure cancer. Of course you may find all this interesting “and welcome. If you do not, one strategy can be to ask someone to screen-your mail, setting aside all such literature. You can then look at it later if you wish.

There is often controversy about the value of these treatments. This is because alternative, or complementary, therapies often have not been subjected to carefully designed clinical trials. A clinical trial is a research study designed to evaluate the effectiveness or value of a particular treatment. In the context of treatment for early breast cancer, any option offered under a clinical trial would be considered to be at least as effective as the prevailing standard treatment for the same condition. On the other hand, most standard treatments for breast cancer have been subjected to such clinical trials and have therefore accrued substantial scientific data to support their value.

*16\109\8*