Finding her strength

October is Breast Cancer Awareness Month. "In Jerusalem" shares how one woman battled the disease – and came out on the other side.

By AS TOLD TO NOREEN SADIK
Breast cancer ribbon (photo credit: INGIMAGE)
Breast cancer ribbon
(photo credit: INGIMAGE)
Cancer. It’s such a harsh word. Everything about it is harsh, cold and cruel. As I said the word over and over in my mind, I wondered how the doctor could be associating this dreaded disease with me.
A sharp pain and three hard lumps in my left breast. I tried to wish them away. A mammogram, an ultrasound and a biopsy. I knew I had cancer even before the doctor told me on that sunny November morning two years ago.
Stage 2 breast cancer. My eyes went back and forth between the doctor, the nurse and the social worker as I watched their reaction to my lack of reaction.
Why did they bring the social worker? Did they think I would collapse in an uncontrollable emotional state? Shirly Alon, head of Kfar Saba’s Meir Medical Center’s Psychology Department, later told me that although everyone responds differently to the news that they have cancer, some women do “fall apart.”
But I was determined not to be one of them. I was going to be stronger than the cancer.
Aside from my immediate family, I told only a select few friends. I didn’t want to be pitied. Maybe it was a mistake, for my secret consumed part of my energy, often leaving me with the feeling that I was alone in this battle.
But the fact is that I am not.
According to the Susan G. Komen organization, breast cancer is the most common cancer in women worldwide. Approximately 1.7 million new cases occurred in 2012.
Statistics from the Israel Cancer Association (ICA) show that one in eight Israeli women will develop breast cancer. In Israel in 2012, 4,396 new female patients were diagnosed with invasive breast cancer, and 571 new female patients were diagnosed with breast cancer in situ. That same year, 994 Israeli women lost their battle with it.
CANCER CONJURES up dark thoughts and fears. But I believe, as the saying goes, that knowledge is power.
I began building my educational army, gathering as much information as I could about diet, exercise, alternative treatments, chemotherapy, radiation and medications.
However, the hours I spent educating myself did not prepare me for the time-consuming, overwhelming and physically and emotionally exhausting series of doctors’ appointments and tests that awaited me. CT, MRI, bone scan, blood tests, oncologist, surgeon, plastic surgeon... paperwork, so many papers from doctors.
The surgeon said the lumps should be removed.
The plastic surgeon said it would be cosmetically unappealing. They agreed that a mastectomy was the best solution, and with reconstruction, my breast would look just as it should. I never believed that my femininity was in my breasts. Without hesitation, I told them, “Take it out. Do whatever you have to do.”
Surgery was scheduled a couple of months after the initial diagnosis. The removal of three lymph nodes, two of which carried cancer cells, caused pain and stiffness in my left arm. I knew that the physical scars would eventually fade, in time the pain would disappear, and my breast would be reconstructed and life would return to normal.
Or so I thought! Reality hit when the bandage came off and I looked in the mirror. Reflected back was a woman with an amputated body. Half of her chest was that of an undeveloped girl, and the other half with a breast intact. Unsightly scars covered my skin, which now covered a tissue expander instead of breast tissue.
My face twisted as tears flowed from my eyes. I did not want to see what was before me. How could life return to normal when I couldn’t even recognize the person in the mirror? Visits to the doctors continued while they decided the best way to rid my body of any cells that might have been left behind.
The meeting with the oncologist was on my birthday.
As if it made a difference to his decision, I said, “Today is my birthday, and I want nothing but good news!” He spoke of chemotherapy, and I immediately raised my hands as if I were pushing him, his thoughts, his words and his treatment as far away as possible. Was this some sort of sick joke, I wondered.
“I’m not doing chemotherapy!” I said defiantly.
He wrote “psychological counseling” at the top of the paper in my file.
The nurse talked to me about loss of hair, wigs and nausea during the prescribed four months of chemotherapy.
More tears – lots of tears. How could this be happening to me? But I was lucky. A little over a month later, another doctor, my angel, gave me the good news: Further tests of my tumors determined that chemotherapy would not help. Radiation and Tamoxifen, a breast cancer medication, were recommended instead. I was overjoyed. I could keep my hair! Radiation took me back and forth to the hospital – 45 minutes each way, every morning for five weeks.
With each treatment, the radiated area became a dark-red, peeling mass of very thin skin.
And then my tissue expander ruptured. Another operation to replace it. Even an unasked-for liposuction was part of the deal this time! Just last week, following a series of inflations, I was told that the radiation had thinned my skin, and it could be stretched only so much. An alternative type of reconstruction had to be found.
My select few loving friends and family who know have offered fat from their bodies, suggested tattooing the area, stuffing bras and a couple of friends told me to do nothing, just accept how I am.
My body image has been compromised in these two years. I try to hide what is no longer there. I don’t feel feminine. If one does not feel comfortable in their body, then they won’t feel comfortable in their mind or in their soul.
Sometimes I feel that the treatment did more damage than the actual cancer.
“Almost all women face problems with body image following chemotherapy, radiation and even Tamoxifen,” Alon reassured me. “Some women compensate their losses by improving their looks in other ways.”
ICA offers a program called Look Good... Feel Better. Brought to Israel from the US by Francine Robinson, makeup artists give women suffering from cancer makeovers and facials at a time when they most need attention.
A few days after my second operation, I paid them a visit during a workshop at the Meir Medical Center. I watched as Yifat Katzir, a software marketer, combined her two loves – making people happy and makeup – and put delicate colors on the beautiful faces of my fellow survivors (I hate that word!). They smiled with approval when they saw themselves in the mirror.
“When women have cancer, they lose control. A way of regaining it is to put on makeup and feel better. You feel as if you can meet the world in an optimistic way,” said Robinson. “It is important for self-image, and it helps women begin to take control of other things.”
Katzir gave 10 women makeovers that morning. Ten brave women.
Even though I had begun to hate my body, my limited, drab body, I did not participate. Having a makeover was public admittance about my cancer. My confidence weakened as I felt that I was losing control of everything.
I DON’T KNOW how many times I was told that “it could have been worse,” “It’s a good thing that it was caught before it spread,” “You’re small, so it’s not noticeable” and “It’s time to put it behind you.” These statements had no meaning.
You see, cancer is not just about the physical impact. It is also about the emotional impact. About fear of recurrence. About mental exhaustion. About taking in so much information and still not knowing what is right and what to discard. It is about confusion.
Constant confusion about something that never really goes away.
And it is about control – will it control me or will I control it? It does not matter the stage or the location of the tumor; cancer is cancer, and again, is cancer. It is an enemy not only to the body but to the mind.
Alon says that each woman reacts differently to cancer. Some learn that nothing should be taken for granted. Some women find safety in returning to their routines as a source of stability. And some use the opportunity to make positive changes in their lives.
Some women decide that now it is time for them to devote more time for themselves; to take better care of themselves because if they don’t, no one else will; and they wonder if they are not here, who will take care of their families? Other women become more assertive to do things that they always wanted to do. And sometimes there are family members who don’t accept the changes in the woman.
I laughed at the familiarity of Alon’s words.
I wanted to change my lifestyle, but I did not know how. I didn’t predict the loss of purpose in life, the loss of self. I was empty. I had no focus and could not concentrate. I did not know how to find myself or know what was important anymore. I spent many hours just sitting and staring at nothing, incapable of doing much more.
Alon reassured me that a major problem for women is when they finish their treatment. They are on their own, taking care of themselves, and people expect them to return to their pre-cancer life.
The process of getting back to life can be slow. But no one told me that.
“Just get on with your life as before,” I was told. But the thing is that cancer comes as a slap in the face. It’s a wake-up call, a chance for a new beginning, a fresh start in life, an opportunity to decide exactly what is important and how one wants to live. And if you don’t know what direction you want to take, you drown in emptiness until you figure it out.
In spite of the many bad days that I faced, I am improving. A part of me thanks cancer. I don’t thank it for invading my body or for disrupting my life or for taking so much of my time. I thank it for giving me a new perspective on life, for allowing me to know what is truly important and valuable, for confirming my belief that beauty lies in simplicity.
The hurt that this happened remains. On the surface, I am often nervous. But in spite of that, deep inside me I feel a sense of calm. I have a better understanding of life. I lack patience for people who have not yet realized that life is about so much more than money, getting ahead and possessions. Life is about finding happiness in the simple things, it is about love and about being human.
I accepted that cancer will always be a part of my life. And in that acceptance, I found my strength.