Time is, at first glance, an impersonal entity. Time does not care about the milestones or events in our respective lives. The tendency to assign meaning to time is something that is a purely subjective event. Many of us are taught to assign meanings to holidays, weddings, births, and events that shape our lives and frame our respective outlooks. My parents remember the day that John F. Kennedy died, and I remember when John Lennon died. The big story of my daughter's childhood was the September 11th attack, which toppled the World Trade Center in New York City, while my late grandfather felt the impact of the Titanic's crashing into an iceberg.
The year 1985 marked my 18th birthday when I became eligible to participate in the democratic process known as voting. In 1991 I earned my bachelors degree from Illinois State University. Another pivotal event took place in 1992 with the birth of my one and only child. This year, my daughter registered to vote, and I earned my masters degree from Eastern Illinois University. As I consider the month of October where awareness of breast cancer is coming alive in advertisements, product endorsements, and commercials I look back on the year 2003. It was in the month of May that I received the diagnosis that would forever change my life. At the age of 35 I was told that I had breast cancer.
The year 2003, started out innocently enough. There were no serious signs that I would be diagnosed with cancer, and I went to a routinely scheduled appointment with a nurse practitioner who examined me and did a routine pap smear. She then suggested I go in for a baseline mammogram. She explained to me that I could get this mammogram taken and then wait until I was 40 before having regular checks. The idea behind the baseline mammogram was to have a way for future mammograms to be compared to detect any changes or abnormalities. At the time, the physical exam did not indicate any issues, and I had no reason to believe that anything could be wrong.
With this in mind I contacted my primary care physician and she scheduled the appointment for me. A couple of weeks later I showed up for my mammogram screening and the process was fairly short. The next week I received a call at work from the radiology department. The person on the phone told me that I had very dense tissue on my left breast and they wanted to do another screening to get a better look. No big deal, I just made another appointment to go over and have my left breast screened again.
At the appointment the attendant who did the screening asked me to wait while they developed the pictures to make sure that it came out clear. A few minutes later she came back and told me to follow her into another room. Wearing the hospital gown, which I had gathered at the front to cover myself, I followed her into a sonogram room where two women were waiting to scan my left breast. I was instructed to lie down on my side on the exam table. With my left breast exposed I felt the cool gel be smoothed on the delicate skin and over the nipple that had once given nourishment to an infant. The sonogram technician was chatting happily with the mammogram technician who brought me into the room as the probe was placed on my breast, and a picture appeared on her screen. I could not see the screen that she was looking at, but felt a chill in the air when the technicians stopped talking and grew silent.
One of the ladies excused herself from the room, meanwhile the sonogram technician kept the orb on my breast while watching the screen. The room was silent and I had a feeling that things were not all right. A moment later the technician returned with a physician who introduced himself as the radiologist. The orb on my breast moved around and the doctor directed them to stop, he instructed her to highlight a spot that looked suspicious. Later, I learned that the word "suspicious" is one that a woman does not want to hear in connection with a mammogram or sonogram. After the suspicious spot had been pinpointed and highlighted I was instructed to get dressed and sent along my way. I left with a sense of unease and not knowing what was going on. However, I had developed a terrible feeling that something was wrong, and the first thought that I might have breast cancer entered my mind.
A couple of days later I heard from my primary care doctors office, the nurse told me she wanted me to see a surgeon who could evaluate the results of the mammogram and determine if I would need a biopsy. I made an appointment to see the surgeon and, on the day of the appointment, spent much of that afternoon waiting for him to be finished with surgery. In the examining room I had the hospital gown opened at the front, while he and an intern examined me. The surgeon pointed out to the student that I had a spot that had showed up on my left breast mammogram. Additionally, he examined both breasts and commented that the skin on the left side was thicker than the right. I later learned that thickening skin can be an early sign of breast cancer. He recommended that I have an outpatient surgical procedure to remove the lump, so the tissue could be biopsied.
Two weeks later, I went to the hospital for an outpatient procedure. Since I was going to be put under anesthesia I had my mother drive me to and from the hospital. I don't remember much about the procedure or my mother taking me home so I could rest. However, my mother later told me that when she talked to the doctor that day she had a sinking feeling that something was not right. A few days later I was driving back to the office, after taking care of some business, and proceeded to make the call that confirmed my worst fears. The diagnosis was invasive ductal carcinoma which is the clinical term for breast cancer. When I saw the surgeon the next day, he told me I would need more surgery to remove some more healthy tissue from my breast to insure a "clear margin" and that my lymph nodes would need to undergo testing. In a fog I made the appointment, and I simply remember being in shock for the next couple of weeks.
The surgeon's office gave me some information regarding a local support group to attend. Before my next surgery I went to a meeting. One of the useful things I learned was the importance of obtaining a copy of my pathology report and learning how to read it using a brochure from breastcancer.org. Next thing I knew was I had undergone more surgery, had lymph nodes removed, and it was determined that my cancer was at stage one. The good news is that the cancer was still highly treatable, but at the age of 35 the treatments would be far more aggressive than what is prescribed for older women. I used the Internet to do as much research as possible, and learned that younger women often had more aggressive cancers, and ended up being diagnosed a later stages of the disease. All things considered I was incredibly lucky.
After my surgery I was referred to an oncologist, and the support group gave me the name of the doctor in my insurance network that had experience dealing with breast cancer patients. The oncologist told me that, due to my age, I would need to undergo four rounds of chemotherapy and radiation treatments. At the time I was in the mode of taking orders and directions because I simply wanted to live. I also continued to work full time as I went through this process, taking a minimal amount of time off for surgeries and chemotherapy. I handled all of my radiation appointments during my lunch hour, so I wouldn't lose a significant amount of vacation and sick time.
Going to the oncologist's office became a part of my routine for the next few months, and I learned to recognize when a pharmacy sales rep was in the waiting room. The suit and bag of free samples and other paraphernalia was the badge by which sales reps presented themselves. I also discovered, as I attended support groups, that often the monthly meetings involved presentations by researchers, social workers who handled end of life issues, and pharmaceutical representatives. Going through this process it struck me as odd that drug company reps would play such a huge role in the information chain for cancer patients. Later, when I walked in the local relay for life events I saw the presence of local hospitals, pharmaceutical companies, and other businesses that made a lot of money from cancer. One of the facilitators at the local support group wanted to know all about the drugs, and the innovations, because she was at an advanced stage of the disease. My own questions revolved around issues like raising a pre-teen daughter, working full time, and dating as a single parent.
At the time of my diagnosis I worked for the local cable company in the advertising division. Some of my responsibilities revolved around preparing promotions to air and ad insertion. Sales representatives during the month of October would sell Lifetime network promotions to local businesses to air. In exchange for purchasing a package the commercials from Lifetime would have the name and address of the companies placed at the end, and then put on the air. The month of October is a good time to spread both awareness and make a few bucks in the process. One of the sponsors of Breast Cancer Awareness happened to be a regional funeral home. It's kind of ironic that a business that profits from death would sponsor advertisements encouraging early detection of breast cancer. However, in the industry that I worked in, good taste often took a back seat to profits.
When we see advertisement of products and services that claim to reduce or eliminate carbon footprints it's often referred to as "greenwashing". In the case of Breast Cancer the term "pinkwashing" is used instead. As I was being treated for breast cancer one of my coworkers would eat Yoplait yogurt with the pink lids, and send them into the company so that money would be donated to the cause. However, I'm sure that she did not realize that for every lid that was sent in, only ten cents would be donated to support research. Considering that first class stamps are currently 44 cents it doesn't make that much sense to spend more money on postage than what would ultimately be diverted towards research for the cure.
An organization called Breast Cancer Action (BCA), also challenged Yoplait for including a hormone called rGBH in their yogurt products and managed to persuade the company to exclude the hormone from their products. This hormone is a known carcinogen, and it's an irony that any organization that contributes to research may also contribute some of the toxins that can cause cancer. BCA also notes with some irony that one of the biggest corporate sponsors for the Susan G. Komen For The Cure is none other than BMW. A car company that helps contribute toxins to the air also contributes to the pollution which can have an impact in the spread of cancer. It's about as ironic as Jack Daniels sending an alcoholic to a treatment program.
When I started undergoing chemotherapy I was given injections of a drug called Neulasta. The purpose was to enable my blood counts to stay high enough so I wouldn't be as vulnerable to infection. When I looked up the invoices that had been submitted to my insurance company I realized that the injections themselves cost around two thousand dollars and chemotherapy treatments cost a lot more. On the one hand the pharmaceutical industry has done much to develop drugs and research that have save many lives. However, it's naive to ignore the profits that these companies make from the illnesses that are being treated. Often a drug will spend several years on the market before becoming available in generic form.
When I was done with my radiation treatments my oncologist prescribed Tamoxifen for five years. Later it was a shock for me to learn that AstraZeneca, makers of Tamoxifen, also own a company called Syngenta. Syngenta is an agribusiness manufacturer of pesticides (www.sourcewatch.org) used in industrial agriculture. Pesticide usage is of particular interest to researchers who are concerned about how pesticide chemicals can mimic estrogen and cause mammary tumors in animals (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1242018/).
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