Posts tagged with 'lumpectomy'

Intimate Details

  • Posted on August 4, 2010 at 9:01 pm

We’re now in the dog days of summer. Having lymphedema and enduring the heat so long, I am ready for the fall.

My topic this month is sex and intimacy. Not a subject I address much in my Mourning Has Broken book.  Nor do many other cancer survivor authors judging from the books I’ve read. The American Cancer Society put out a book addressing this issue that I found in my local cancer center library–a useful resource for those going through the trauma of surgery and reconstruction. It takes courage and moxie to write about painful intercourse. Nonetheless, it’s the elephant in the room for those of us with breast cancer.  My having a double mastectomy with no reconstruction challenged my self-image dramatically. On top of that, I went into early menopause due to chemo and took Arimidex for years, an anti-estrogen drug that thins out the vaginal lining. These factors led me to find ways to increase the pleasure of intimacy.

It’s no surprise then that I identified with and related to the advice in an article from WebMD on this topic:  http://www.webmd.com/breast-cancer/features/breast-cancer-sex-and-intimacy?ecd=wnl_brc_080310. To the boa idea I would add wearing a lacy camisole to add to the atmosphere.  And I’ve read in a recent blog post on vaginal dryness (http://www.breastcancersisterhood.com/_blog/Brenda%27s_Blog/post/Sex_and_Breast_Cancer/) that we who have estrogen-receptor positive breast cancer should look for vaginal moisturizers and personal lubricants with no parabens, which may possibly have some estrogen-promoting effect. Replens is an excellent estrogen-free brand that I recommend in my book.

May all you survivors out there be encouraged that you are not alone in this difficult and very private challenge.

Blessings,

Jan

Opting for breast reconstruction

  • Posted on May 15, 2010 at 4:33 pm

Exciting breast cancer news is blossoming as fast as May flowers.  It’s hard to choose a topic upon which to post. I decided to pick the recent study on the popularity of breast reconstruction.

One in three.  I was surprised by this number of women eligible for breast implant reconstruction surgery who opted for the procedure, at least in four California counties. This number is not representative of the U.S. according to doctors who responded to this study.  But it got attention from the medical community. The results showed that  older women, non-white women, women without insurance, and women not treated at a teaching facility where a plastic surgeon is more likely to be on hand are less likely to opt for reconstruction.

Limited to implants, the study did not address how many women decided to undergo flap reconstruction (using tissue from their own body) after mastectomy.  Flap reconstruction has some real advantages, but also some additional risks as compared to implant surgery. I was not eligible for an implant on my radiated side, so my reconstruction would have consisted of an implant on one side and flap reconstruction on the other. Not a pretty prospect. Especially when the implant doesn’t last as long as the flap breast mound.

Hence, I’m among those who rejected reconstruction after a bilateral mastectomy: a white women of 51 (at the time I was treated) in a rural area who had good insurance.

What to conclude?  I wish no one had to make this choice. Reconstruction is a highly personal–and wrenching–decision involving factors such as medical history, tolerance of risks, and marital and cultural as well as financial considerations. Prayer is key to getting through it. I know. I’ve been there.

Read more at http://www.webmd.com/breast-cancer/news/20100430/why-some-breast-cancer-patients-forgo-implants.

Blessings,

Jan

Cancer Patients Seek Honesty, Informality in Doctors

  • Posted on November 13, 2009 at 3:46 pm
Cancer patients want straight talk from their doctors, according to a written survey recently reported  in WebMD Health News (http://www.webmd.com/cancer/news/20091104/cancer-patients-want-honesty-from-doctors?ecd=wnl_brc_111009).  The survey reflected responses from over 500 survivors of breast, lung or prostate cancer.

A large majority of patients (95%) appreciated honesty in their doctor regarding their odds of survival and how long they might live.  Prostate cancer survivors were more likely than lung cancer patients to want their doctors to be upfront about survival chances: 97% vs. 91%.

In addition, the survey revealed that patients welcome informality in their doctors. Almost 75% preferred to be addressed only by their first name, and even more were fine with their doctor not wearing a white coat.  Most wouldn’t mind a hug after two months of radiotherapy, and a third of women cancer survivors indicated a desire to have their hands held by their oncologists during critical office visits.

Further survey findings reveal that most patients (84%) welcome a detailed explanation of their treatment plan, and an even higher percentage (95%)  said they want their physician to use laypersons’ terms when discussing the details.

As to spiritual matters, 40% of survey respondents indicated they would like to share their own beliefs with their doctor. The results indicated that patients don’t appreciate doctors imposing their own spiritual views, but would like doctors to affirm the individual patient’s own belief system.

I consider these findings refreshing. Patients long for an informal, straight-forward and detailed conversation with their oncologists, similar to what we had before doctors stopped making house calls. Anything the doctors can do to incorporate these findings into their practice would be very beneficial for cancer survivors struggling to understand their prognosis and treatment options. The personal touch is in.

Newly diagnosed with breast cancer?

  • Posted on October 17, 2009 at 1:50 pm

Wonder where I have been during October, Breast-Cancer Awareness Month?  Busy with book signings, Reach to Recovery training for the American Cancer Society, and my new job as church secretary.  But I am still very much engaged in the cause.

Here’s some interesting information for those who are newly diagnosed with breast cancer or know someone who is:

1. For aid in decision-making about breast-cancer treatment, visit  www.mytreatmentdecision.com.

2. An interesting study about surgical decisions was published recently in the Journal of the National Cancer Institute (www.cancerconsultants.com/surgical-decision-making-early-stage-breast-cancer).  Regardless of race or ethnicity, more women with early-stage breast cancer who were active in their own decision-making chose mastectomy than those who made a “shared or surgeon-based decision,” even though mastectomies and lumpectomies have been shown to be equivalent.  Women concerned about recurrence or the effects of radiation were more likely to opt for mastectomy than those who did not share those concerns. In contrast, women concerned about body image or their spouse’s opinion were more likely to undergo a lumpectomy than those who did not voice those concerns.

This finding rang true for me:  when I first had breast cancer at 43, I was concerned about body image and chose lumpectomy.  But when at 53 I was diagnosed with a recurrence in the same breast, body image went out the window, and I chose a bilateral mastectomy.  After my second bout with cancer I wished I had chosen a mastectomy the first time to avoid the recurrence and radiation effects.  God had His reasons, however (one of them being to tell my story), and I’m good with that.

Happy October!

Jan

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