Rowman & Littlefield

From the book "Breast Cancer Surgery and Reconstruction: What is Right for You" by Patricia Anstett; Copyright 2016 by Rowman & Littlefield; Used by permission of Rowman & Littlefield

Author’s note: The spotlight isn’t my happy place. I’m very private. Or was. My modesty went out the window after months of treatment for breast cancer at Henry Ford West Bloomfield Hospital where most of the exceptional human beings in the oncology, surgery, and radiology departments wouldn’t recognize me with a shirt on. I agreed to do this chapter in part under duress. I think there may have been wine or anesthesia involved. But my real motivation came when I discovered an unexpected risk factor I could not, in good conscience, be silent about. I also looked at the women in the other chapters and thought it an honor to be counted among them.

Call it the Luck of the Irish, Murphy’s Law, whatever you like. The timing was ironic. Five months into photographing women for a book about breast cancer — Wouldn’t you bloody know it? — I was diagnosed with the same damned thing.

There had been no signs of a problem. No symptoms. No lumps. Nothing. Cheryl Perkins, the gorgeous nurse from Detroit I photographed for chapter 1, made me promise to schedule a slightly overdue mammogram. It seemed routine.

And then the call. Breast cancer. Me. My family specializes in lung cancer, depression, and the national pastime of the Irish. We are not breast cancer people. Other people get that. And now I was part of that Other.

My odds of having breast cancer weren’t as low as it seemed. The average American woman has a one in eight chance of getting it in her lifetime. But I’m also a veteran, a former army medic, and according to a 2009 study, doctors at Walter Reed Army Medical Center found that breast cancer rates among military women are 20 to 40 percent higher than their civilian counterparts.1 And while more than 800 women were wounded in Iraq and Afghanistan from 2000 to 2011, 874 were diagnosed with breast cancer, according to the Armed Forces Health Surveillance Center. That blows my mind.

Before I hung up my fatigues in 1987, I spent two-and-a-half years at Fort Devens. The base may not have the notoriety of Camp Lejeune, where breast cancer was found in eighty male marines. And it isn’t Fort McClellan with thousands of sick veterans calling themselves “toxic soldiers.” All the same, it contained a stew of carcinogens: arsenic, mercury, cadmium, toluene, and trichloroethylene. Poison circulated above and below the water table. It was added to the EPA’s National Priorities List in 1989, and cleanup continues to this day. Lovely. I’d been living on a toxic Superfund site. Maybe the irony is that I didn’t get cancer sooner. I’m proud that I served. My dog tags are dearer to me than any piece of jewelry could ever be. But I’m angry that the U.S. Department of Defense, one of the world’s greatest polluters, poisons its own. If you are one of us, keep up on yearly exams.

Napoleon once said, “A soldier will fight long and hard for a bit of colored ribbon.” No one expected that ribbon to be pink.

I never was the pink type. My friend Stella, who’s covered conflict from Chechnya to Mogadishu, said, “If I were cancer I wouldn’t want to meet you in a dark alley.” It was a vote of confidence I needed. The possibility of a mastectomy didn’t scare me. I just wanted to get rid of cancer — the faster the better. My surgeon was a wonderful man, Dr. Robert Elkus, who wore running shoes everyday while he worked from dawn until dusk and spoke to me like I was family. He advised against mastectomy because survival rates were no better in my case and lumpectomy involved far less surgery and trauma. My decision came down to test results, the advice of a surgeon I trust, and damned good luck.

Following that advice, a few days later I was prepping for surgery. A lot of people compare cancer to a roller coaster ride. It’s more like a joyride with a drunken driver. Mine started early on a Wednesday, and I was less than enthusiastic about the switch from producing the book to being featured in it. I felt less anxious about the actual surgery that morning than the entourage of family and bystanders around me. I’d agreed to allow my surgery to become part of the book. I was delighted to meet the anesthesiologist. When I woke, the cancerous tissue and three lymph nodes had already been sent to the lab. Then I waited for test results. There was a lot of waiting involved. Dr. Elkus was kind enough to call late that Friday evening so my weekend wasn’t spent worrying about my top concern. “I have some good news,” he said. The lymph nodes were clear. The cancer hadn’t spread, and I was riding a high.

As the other tests came back, I learned that I had estrogen-positive early-stage invasive ductal carcinoma. It’s really not as impressive as it sounds. As cancer goes, it’s pretty uninspired, but I’d need a second surgery to catch the rebellious cells that eluded us. Dr. Elkus took that bit of news much harder than I did. I was given a few weeks to heal before the next surgery — just in time for cancer awareness month. Believe me when I say I was aware. While other people enjoyed the fall colors last year, I saw nothing but pink.

They put me on the estrogen blocker Tamoxifen to prevent recurrence, and I went back to work. The week I began taking it, I was staked out in front of the federal courthouse in downtown Detroit with other news media. I hadn’t been there since I covered a prominent oncologist who was convicted of poisoning his patients for money. As we say in the business, you can’t make this shit up. A wave of nausea hit, and I scanned a nearby parking lot for a semiprivate trash can to hurl in. For weeks it continued.

I dreaded the possibility of chemo. Burn me, cut me. But please keep the poison away. At one time they blasted everyone with it. Now there’s a test, called oncotyping, that gives a recurrence score between 1 and 100. If the score is low, the benefits don’t outweigh the side effects. I was shooting for a big fat zero. A bit of my cancer was shipped to a lab for an eternity of waiting on that number to come in. Life stands still for lab results, and sister, the lab ain’t open on the weekend. I tried to resign myself to the possibility of chemo and losing my hair, my eyebrows, and eyelashes. That seemed worse than mastectomy somehow. I could handle being sick. I hated the thought of looking the part. I bought a Conehead wig figuring if it had to happen, I might as well go big.

Fortunately, my odds of recurrence turned out to be very low. I was spared from chemo, mastectomy, and reconstruction. A couple of surgeries and a season of radiation — that’s like winning the cancer lottery.

Although the second surgery went well, Tamoxifen made me feel like holy hell. The nausea was somewhat manageable, but I was beginning to get very depressed. Something wasn’t right. I decided to laugh about my situation to keep from losing my mind. My coworkers at the Detroit Free Press had organized a campaign to bring meals to my home after I returned from both surgeries. I loved their visits. My little house was filled with life. “Hell,” I joked, “had I known it would be this much fun, I’d have done it years ago.” Friends I hadn’t heard from in years reached out to me. People brought candy, books, movies, candles, and wine. It was overwhelming. At one point, there were so many flowers I ran out of vases and bottles and mason jars. I was often moved to tears by their kindness. I still am, and I will never forget it.

Maybe it’s the soldier in me, but I’m not in the habit of reaching out for help so all the unsolicited spoiling was wonderful. Denial works for me. Although I made sure to get the best care I could, for the most part I lived like the cancer didn’t exist. I was actually doing things for other people because I was “OK.” I started to repaint rooms at my (then) boyfriend’s house. And I got busy fund-raising for this book as I watched the leaves pile up, the snow pile up, and the bills pile up.

From the time I was diagnosed, cancer felt like a twisted publicity stunt for this book. I promise it wasn’t. I had just enough cancer cred to be legit, but compared to what other women experience, it felt like cheating. I referred to it as “my candy-ass cancer.” I fooled myself into thinking I was invincible. I’m a veteran dammit. I’m a photojournalist. I’m a strong woman.

Bullshit.

I’m human.

Friends said, “If you need anything, I’m here.” Did I ask for help? Hell no. I’m a trooper. And a fool. I raked leaves and shoveled snow between coats of paint, and I continued the march right through a ministroke somewhere between surgery two and surgery three. Just before Christmas while talking to a friend, my words became garbled midsentence. My whole right side went limp for about five minutes. They called it a TIA or "ministroke."

I called it the worst five minutes of the past year. It was terrifying. It was the drug. They took me off of it immediately.

But my breed of breast cancer is estrogen positive. In other words, it feeds on estrogen. Loves the hell out of it. Estrogen was an enemy, and mine had to go. Without Tamoxifen to block it, we scheduled another surgery to remove my ovaries. I didn’t realize how much I liked my estrogen. I miss it so.

Good-bye, ovaries. So long, estrogen. Hello, instant menopause on steroids.

Still, menopause was not going to affect me in the slightest. Not this girl. No sir, not me. My grandma once told me the seventeen-year-old in you never dies. It stuck. I’m a fifty-one-year-old grandma now, but menopause was completely out of sync with my happy teenage delusions.

Before this menopause business I slept like a baby. Now a typical night is interrupted with a dozen hot flashes. No sooner do I get back to sleep than I’m shivering on damp sheets wide awake with a pile of blankets kicked to the floor. Rinse. Wash. Repeat. I feel dehydrated. I walk around in a loopy fog.

Memory and focus left with my hormones and ability to sleep. I get dumber by the day, I swear. I don’t recall the name of the person I met two seconds ago. I can’t remember where I left my keys. My coworkers tease me about my little white desk fan, but I’m telling you, it’s my new

best friend. I’m glad they’re amused. I may have escaped chemo brain; I’m afraid, however, that I’ve lost my mind to menopause.

Radiation? A breeze for me. I absolutely loved the radiation team and was in awe of the technology. In keeping with the denial theme, radiation involves invisible subatomic particles. I never saw what hit me. On the first round, I took my place on the linear accelerator table like some halfnaked astronaut and waited for the laser show. The radiation therapist didn’t get my reference to the film 2001: A Space Odyssey. (Am I really that old?) But when he went into the control room, he found the theme song on his iPhone and played it over the sound system. I looked up to see a calming photo of a wooded country road. The staff hid a Where’s Waldo figure among the trees in it and moved him around from week to week for our entertainment. They took away any fear. I joked with them that they actually made cancer fun. I miss my Tuesday talks with my favorite doctor, Dr. Levin. And I have to add that the parking was fabulous and the radiation side effects were nothing worse than sunburn and a few small blisters. The unexpected fatigue, on the other hand, absolutely hammered me. I still feel it six months later.

During the fall, winter, and spring I was focused on the mission. Time stood still. I went from one appointment or treatment to the next, and there were always more tests. I couldn’t wait to get my life back and feel like me again. I put on makeup and a smile to give the illusion of having my act together. You’d think I’d smarten up and admit I needed reinforcements once in a while. My brother tried. He wanted me to come stay with him from the beginning. He doesn’t say things like, “I love you,” but he was by my side for every surgery. Rather than ask if I wanted his help, he said he’d be doing the driving. I love him for that.

Then it all just stopped. The fight was over. No more surgery or radiation or miserable medications. I went back to real time, and I found myself alone wondering, “Now what?”

Maybe it’s natural to expect to just pick up where you left off before cancer invades your breast and your life. But the transition is unfamiliar

territory. Other survivors have told me the same thing. We will never be the same. There’s all this talk about a “new normal” after cancer. I’m not there yet. I decided to make a few changes to my old normal. During a road trip for this book, my friend Michelle, her fiancé, Balam, and I had just pulled into a drugstore to get water and stretch. My son Zack called. He wanted to know if I was mad at him because I hadn’t visited him or my granddaughters in a while. I lost it. I was doing such a good job of downplaying cancer that he thought I was avoiding him. He took it personally. The truth is, I was exhausted and didn’t want either my family or friends to see it or waste energy worrying. I bit my lip as I fought back tears. By the time I hung up, they were running down my face.



Michelle saw the tears. When she came back to the car she had three red clown noses in the bag. We took a ridiculous photo with the noses and uploaded it to Facebook. Within minutes, Marjorie Hacker, who we had photographed for chapter 8, saw it, photoshopped herself into the shot, and reposted it. I love these women.



I finally got it through my thick skull that I was hurting people I loved most by putting up a false front of strength. I missed my family, and I needed to be with them. I was missing the best parts of my own life. It’s not strength to go it alone. Vulnerability takes courage. This is no revelation to any well-adjusted person, but I’ve been especially gutless about it. We all have our own forms of crazy — this is one of mine. I’m still not great at saying, “Hey, I could use a hand here,” but I’m at least to the point where I can say, “Give me a break just for now. This is scary shit and I feel lost.”

Cancer’s been good to me. It was a swift kick in the ass gift-wrapped in a few mutant cells. The crazy thing is I’m happier than ever. I’m aware of how fortunate I am. My lazy, unambitious cancer was caught before it gained momentum. I’m alive. I don’t mind the changes, and I don’t mind the scar tissue that feels like a rock in my boob. I’m grateful I still have two. Perfection is overrated. I’m more comfortable in my skin now than I’ve ever been. Maybe I just appreciate how much of it I still have.



I’ve heard scars are tattoos with a better story. Is it possible I even feel affection for my scars? It is. I love them. My scars are a permanent reminder of my latest adventure, a time where I felt more love than ever before. They connect me to millions of others who share the experience. My scars give me permission to be vulnerable. They remind me of the countless times people went out of their way to show me kindness. They don’t make me feel less of a woman. They make me feel more of a human being. I’ve got people. There’s no medal or ribbon for any of them, but I cherish every last cut, burn, and dent. They are my proof. I’m one of the lucky ones.

And I’m still standin’.

BREAST CANCER SURGERY AND RECONSTRUCTION PROGRAMS

Patricia Anstett will moderate two upcoming programs about breast cancer surgery and reconstruction in metro Detroit, on Aug. 10 at the Barbara Ann Karmanos Cancer Center and another Sept. 29 at the St. John Van Eslander Cancer Center, Detroit. For more information, go to http://bcsurgerystories.com