Wearing an oversized floral top, you sit on an exam table, swinging your legs off the end when the doctor enters the room. She greets you and then probes your left breast. Her two fingers stop at what would be eight o’clock if your breast was a clock face. This visit is a routine follow up after having a breast biopsy. A family history of breast cancer combined with your dense, lumpy breasts have made doctors vigilant. Frequent ultrasounds, mammograms, and biopsies—always negative—have lulled you into a sense of invincibility. Most people would be anxious about the results, but not you.
“It’s cancer,” she says, “Right here.”
“Is that the correct test result?” you ask. I can’t have cancer. There is no way I have cancer.
The doctor removes her hand. Her lips pucker, one eye crinkles as she grabs the report and tilts the paper towards you to confirm your name and birthdate. “It is the good kind,” she says. You are not sure what that means, but you hang on to those words. She writes ‘good’ on the test report next to the tumor description. You dress and stash the paper into your purse.
While driving home, the words ‘the good kind’ loop in your mind like a catchy song on the radio. Pulling into the driveway, you see your husband’s car parked in the garage. Knowing Matt is home and not still on a business trip relaxes your muscles from your shoulders down to your pinky toes. “I have breast cancer, but it is the good kind,” you say to him without greeting, trying to mimic the doctor’s optimism. His eyes tear up, and his strong arms open, pulling you to him.
At dinner that same night, you tell your only child, a fifteen-year-old son, that you have breast cancer. In your matter-of-fact mom voice, as if you are going over the week’s schedule of events, you say, “So, I got some bad news today. Last week I had a test. Well, it came back positive. I have breast cancer.”
His face is blank. His silence keeps you talking. “Grandma had breast cancer when she was just a bit older than me, and she has never had cancer again. She is in perfect health.” Still no response. “You know she drags Grandpa to the mall to walk with her every morning.”
Finally, a reaction, a half-smile and simultaneous grunt as he acknowledges his grandparents’ routine.
“I will need surgery and have lots of doctor appointments, but I will be okay. Our family will be just fine.”
He nods his head, and his blue eyes meet yours, but his expression remains unreadable. His emerging manliness both comforts and jolts you. He cleans up the dishes without being asked.
Researching ‘the good kind’ of breast cancer, you learn about the different types of tumors. Your kind, HER2 negative, may grow more slowly and is less likely to come back or spread to other parts of the body compared to the other tumor types. If there is such a thing as ‘the good kind,’ perhaps this is it. But you don’t believe any cancer is good.
A full team of specialists is assigned to manage your care. Matt, having taken the day off from work, accompanies you to the appointment. The towering glass building advertises state-of-the-art treatment. Views of the Columbia River surround the seventh floor waiting room. Looking out, all you see are shades of gray—gray sky, gray water, gray sidewalks, and tiny gray pedestrians. It is a typical dishwater February day, matching your state-of-mind.
“It is nice to put a face to the name,” says a smiling nurse whose friendly demeanor and soft body reminds you of a teddy bear. You had exchanged a few emails with her before this appointment. In the email, she had you fill out a get-to-know-you type questionnaire. It asked questions like, What are your fears?
Answer: Dying and disfigurement. Plus, losing my hair.
Is there anything we should know about you?
I climbed Mount St. Helens two months ago. I am in good shape and eat healthily. How can I get cancer? I’ve never smoked, not even weed.
As you received no response, you wonder if she, or anyone, looked at it.
Her outstretched arms indicate she expects a hug from you, so maybe she did read it and your answers suggested you are the huggable type? But you recoil, not in any mood to be touched by strangers. As the patient coordinator nurse, her job is to be compassionate, helpful, and guide patients through the cancer treatment process—the warm-up act for the white coats.
Matt sticks out his hand, “Nice to meet you. Lots of road construction made it hard to find the parking garage,” he says.
Grabbing his hand and shaking it, she says, “Yeah, we’ll all be glad when the construction is done. We’re hoping the new building will be finished early next year.” She smiles at you and says, “Our cancer team is ready to meet you.” As she walks, she turns her head to look at you. “The breast surgeon, radiologist, and plastic surgeon will meet with you one at a time. We have them set at twenty-minute intervals, but you can take as long as you need,” she explains.
You and Matt follow her to the exam room where you sit, listen, and drink bottled water as each of the specialists filter in at their scheduled times. The breast surgeon arrives first. Her eyes zero in on the necklace you are wearing as she enters the room. It was a birthday gift. You turned forty-nine eleven days before you got the cancer news. The pendant says, ‘Believe.’ All business, she delves into the nitty-gritty regarding the surgery options—either a lumpectomy to remove the tumor and preserve the remaining breast or a mastectomy, complete removal of the breast. “The lumpectomy followed by radiation is equally as effective as the mastectomy. It is your choice as to which treatment you would like to do,” she says.
“How long does the surgery for a mastectomy take?” you ask.
“Six to eight-hour surgery for a double mastectomy—removal of both breasts with reconstruction.”
“That’s a long time under the knife,” you say.
She nods and says, “Not all women choose reconstruction.”
“A lot to think about. Thank you.”
The breast surgeon exits, and the radiologist enters, trailed by an entourage of people, crowding the room. Dressed in white jackets, their youthful faces remind you of trick-or-treaters coming to your door on Halloween. The radiologist introduces them as residents, “Mostly, here to observe and learn,” she says, “Doctor Garcia, a second-year resident, will explain the process and answer any questions.” He steps forward and begins speaking.
Glancing out the floor-to-ceiling window, you spy window washers on scaffolding scaling the building you are in, a floor or two down, close enough to wave. They are a distraction from the grave conversation happening in the room. “Adding radiation after a lumpectomy lowers the risk of cancer recurrence in the affected breast,” says Dr. Garcia. You can see the other residents mentally taking notes, as he continues to explain.
“What are the side effects?” asks Matt.
“Weakened chest bones,” he says and then adds with a laugh, “So if you ski, this might be a concern.”
You do ski, but don’t say anything. Why is he laughing? Do women with breast cancer, not ski?
“Heart problems later in life and possible skin rashes during treatment are a few more adverse effects,” he says.
You mull over the risks and watch the window washers.
“Our technology can pin-point the area precisely,” he assures you.
The mustached plastic surgeon whose forehead doesn’t move arrives with samples. The inserts remind you of the Ziploc bags you filled with water as a kid to pretend your Barbie dolls slept on waterbeds.
With the informational sessions complete, the exam portion begins. A nurse gives you an extra-large wrap-around top to put on, even though your size is extra-small. The surgeon returns and feels your breast. Then the plastic surgeon comes back with a camera. He is apologetic that he must photograph you topless. He closes the drapes shutting out the view of the window washers. Working quickly and professionally, he instructs you, “Face front. Turn right and look at the corner. Turn left now.” It reminds you of mug shots on a police TV show. You imagine your breasts put in a book where victims of crime try to identify them as perpetrators. A few awkward giggles escape.
The final appointment is with the geneticist. You aren’t on her schedule, but she makes time. You go to her office, where she asks about your family history. To answer, you ‘phone a friend,’ or rather, text your mom.
“What kind of cancer did Uncle Jim die of? Did anyone have ovarian cancer?” you text. She texts you back right away with the information.
You had told her a few nights ago about the diagnosis over the telephone because she lives out of town. Her response was, “Well, SHIT!” She then told the rest of the family, saving you the burden. None of them live close. Your older sister called about five minutes after you hung up with your mom. “Wow, when Mom had it, I never thought we would actually get cancer,” she says.
“I guess your odds have just increased,” you say. I always knew I would get it, just not today—maybe someday.
Once the geneticist completes the family history interview, she sends you to the third floor. A nurse draws a dozen or so tubes of blood from your arm. The genetic testing will take six to eight weeks. You wish you could skip the commercials in this drama like you do when you stream a show or just fast-forward to the happy ending. Will there be a happy ending?
By the end of the day, the fact that you have cancer has sunk in. A treatment decision weighs heavily—either a bite to remove the tumor followed by baking the surrounding tissue or completely carving off your breast. On impulse, you agree to the lumpectomy because it seems less invasive with quicker recovery time. But you have nagging questions: What if cancer comes back? Will I have to repeat this process? For peace-of-mind, would it be better to get rid of them both? Will people think I just want a boob job?
You spend hours on the computer researching the tumor, obsessing about whether the mastectomy is the better choice. You feel like you are a leaf at the mercy of a violent wind riding its current through a fierce storm. Tossing and turning all night, you watch the clock, counting down the hours until dawn. By the end of the week, you are sleep deprived and in a heightened state of anxiety, muddling through daily routines.
While pureeing a mushy avocado for salad dressing one night, you slice through your pointer finger with an immersion blender. “Shit, you didn’t just do what I think you did?” asks Matt, having heard the crash of the blender hitting the floor and your swearing as you grabbed the towel next to the sink.
“I did. You need to take me to the emergency room.”
“Are you okay? Is it bad?”
“Um, my finger feels still attached, but I don’t want to look at it. I feel queasy.”
In the ER waiting room, you fill out paperwork about your health with your uninjured right hand. You check the ‘excellent’ health box but then think again. Maybe cancer puts you in the ‘good’ health category or perhaps just ‘okay’? You don’t know what box to check, so leave it blank. The hospital sends you on your way with seven stitches, a splint for the broken bone tip, and a prescription for an antibiotic. You leave, feeling stupid for making such a careless mistake that caused more fuss about your health.
Even though you committed to the lumpectomy, you continue to grapple with your choice as the surgery date draws closer. The options remind you of a Choose Your Own Adventure book from childhood. The characters in the books come to a crossroads in their perilous journey. The reader decides their fate by choosing the next move. To continue with the lumpectomy, turn to page four. To change your mind and choose the mastectomy, turn to page six. Will it be a happy ending or horrifying fate? Only now, you can’t flip back through the pages and try again if you don’t like the result.
The doctor calls and wants you to have an ultrasound. “They want another look at something they saw on the MRI you took a couple weeks ago,” she says. After the ultrasound, the radiologist explains, “There are some spots on your other breast. According to protocol, we should schedule a follow up in six months to see if there is a change.” You don’t want to repeat cancer treatment in six months on the other breast. So, you change your mind and flip to page six, the double mastectomy surgery, hoping it is a happy ending. “Are you sure you want to do both, even though just one has the tumor?” asks the surgeon.
“Yes, I want them both gone. I can’t repeat this.” Besides, your boobs are like a sweater set. You can’t fathom wearing one without the other.
Sleep finally comes after choosing to remove both breasts. A few days later, a test result comes back saying there is a gene mutation, meaning a higher chance for recurrence and possible risks for other cancers. This new information gives you more confidence in your decision.
While golfing, you tell your friend, Robin, that you have cancer. Her grandmother was a famous actress during the 1920s when silent films were popular, and Robin has her grandmother’s movie-star looks. Now divorced, Robin emerged from her abusive marriage with grace, wisdom, kindness, and an optimistic spirit. All traits you admire and want to emulate. You hope a bolt of lightning will transfer her superpowers to you when you tell her.
You wait until you walk off the green on the last hole and say, “I have breast cancer, but it was caught early. I will be fine.” She stops walking, and her blue eyes meet yours. There is no superpower shift, but you feel peace with her gesture, a light touch on your shoulder, more than any words spoken as you walk up the hill towards the clubhouse.
Most other acquaintances you tell by email, text, or phone. You also post on Facebook. Matt is a retired Air Force officer. Having moved every two to four years for twenty years, you have friends around the world that you think of fondly but only keep in touch with via social media and Christmas cards. If they were going through this, you would want to know.
It is a relief to tell people. You text Robin to let her know the news is no longer secret squirrel: “I told a bunch of people today. I feel optimistic. I know God has this. If anyone asks, just say I need prayers.”
The most common response to your news is, “Can I do anything for you?” Not prepared how to answer this question, other than requesting prayers, you smile and say, “Thank you.” Admitting you need help feels weak, and makes you think you are disappointing people. You prefer to do the giving in relationships, rather than be the receiver. Being perceived as strong is important but acting like you have it handled makes you feel isolated because people get the impression you want to be left alone. You give some thought to how best you can be supported and ask for meals. Even your friends who don’t like to cook sign up to bring dinner.
Your mind is a ping-pong ball the week before surgery. You are desperate to refocus your energy on something other than the thunder rumbling towards you, so you ask your friend, Tammy, for help. As an extrovert-wanna-be, you enjoy riding her fun bubble at social events where she does all the talking.
In a text message to Tammy, you ask: “Will you host a boobie wake for me?” you go on to explain, “When I laugh, I feel like I am stopping cancer from growing.” You also need her help inviting people because it seems pathetic to plan your own wake.
“I would love to help,” Tammy replies, but guilt for asking creeps up your spine. Will people come? What if they think I am just seeking attention? Despite these worries, you move ahead with the wake because you crave the chance to release your pent-up fears and anger like a prizefighter going into the boxing ring.
You look for confirmation from Tammy. “Do you think it is weird that I want a boobie wake?”
“Not at all,” she texts back. “I think it shows amazing strength and courage. It also provides you the opportunity to be surrounded by people who love and care about you. In a way, it seems to make it easier for others.” As always, she knows just what to say.
On the night of the wake, you audibly exhale greeting the first invitees who show as they trickle in the alehouse. An affectionate buzz circulates through the air. There is a need to bond and support each other, not just you, that lingers—hope billowing instead of cigarette smoke puffs. Friends keep buying Matt many drinks. He needs to forget too. Your best pal, who lives an hour away when the traffic is good, brings sugar cookies frosted to look like boobs. The bar owner, a breast cancer survivor sympathetic to your plight but exhausted from her long day, kicks everyone out at midnight. Not wanting the night to end, you, Matt, and some of the guests walk across the street to a saloon to karaoke.
The next day, the words a party goer whispered come to mind, “Cancer can be absolutely terrifying, but there is also joy and beauty that can be found in the darkest of places.” She has lived with a brain tumor for the last eight years. Posting photos of the party on your Facebook page, you write, “My boobs had one hell of a send-off. I was truly shown joy and beauty last night. Thank you.”
On the morning of the surgery, you wake before dawn and pray: “This is the day the Lord has made; rejoice and be glad in it.” You look at your breasts in the mirror. The breasts that made you popular in middle school, the ones your husband has cupped in his hands while spooning every night since your diagnosis, the ones that fed and comforted your infant son. You wear your pink ‘fuck cancer’ shirt to the hospital.
In the pre-op room, the nurse takes your vitals, and the plastic surgeon marks your body with a pen. Before you leave for surgery, your minister says a healing prayer while laying her hands on your shoulder, and your husband kisses you. A small wooden cross is clenched in your hand until they roll you into the surgical suite.
You wake after surgery and look down at your chest and see an old-lady style white bra. The bra creates the illusion that you still have boobs, but you know the breast surgeon scooped them out like ice cream, and the plastic surgeon filled the space with balloons. Drainage tubes dangle out the sides of your body.
In the future, one of the balloons will leak. The plastic surgeon’s nurse will pump the broken expander up like a floaty pool toy. It will deflate a little each day. By the end of the week, it will be flat and need pumping up again. Almost every Friday for five weeks, you will go to have your boob inflated.
In the future, ‘the girls’ will look centerfold worthy. Still, they will feel like skin-and-nipple-covered life rafts drifting out at sea, separate from your ocean body.
A couple of weeks after your operation, the breast surgeon will call and ask, “Did you have a ‘premonition’ to remove the other breast? The lab report indicates there were two more tumors in what we thought was a healthy breast.”
“Hmm,” is all you will say, biting your bottom lip and thinking back to the ultrasound protocol to wait six months. Thank you, God, for the right decision.
“We found micro metastases in the lymph node I removed. The hope is cancer has not spread, but there is no way to know for sure.”
“Well, that sucks,” you will say. Did my indecisiveness, which prolonged scheduling the surgery, put me at greater risk?
But on that day—the day you wake from surgery—you are naive about what lies ahead. The eye of the storm is directly above you. You feel calm, peaceful, and free from worry. It is glorious to be alive. Soon, you will experience the eyewall where the winds are the most potent, and the thunderstorms are their most intense, but at the moment you wake from surgery, you do not know you are in the middle of a hurricane. You breathe in the fresh air and think your cancer journey has ended, but it is still spinning.
You will need three more surgeries; two will involve breast reconstruction. The other will remove your ovaries—more girlie parts vanishing.
A test on your tumor will reveal that chemo doesn’t work on it. You will be relieved you will not lose your hair, a rainbow amid the tempest.
The oncologist will prescribe an aromatase inhibitor to decrease the amount of estrogen your body makes, since your tumor thrived on estrogen. This little pill’s job is to prevent cancer from returning. You will take it daily as instructed, but you will experience what you believe to be a rare side effect of the medicine. Over time, the drug will slowly take over your thoughts like a snake displaced from a flooding river. It settles in your mind, slithering around your brain, squeezing it, suffocating your ability to think, and choking out pleasure and happiness. A day will come when your nostrils will smell the stench of despair, and your ears will hear the gnashing of teeth.
That day will happen when you are hiking with a girlfriend along a river swelled with snowmelt, chatting affably about nothing in particular. While you climb the trail, you will stare into the river’s swirling eddies and long to join the gushing anger floating down the hillside. Your accidental slip on the muddy banks, followed by a cold moment of panic and sinking into darkness, will be a relief from your zombie-like state. Through the clouds, the sun will break the serpent’s constriction, preventing you from taking that fatal step. Was that God’s saving hand or a guardian angel?
You will go home after the hike and cook dinner for your family. You will continue to walk through each day’s motions but resemble a robot mom, an automated wife. Your husband will notice you are short-tempered and pessimistic, but he will give you space. The snake will warn you to keep your gloomy thoughts secret.
Visions of your body dangling from a white sheet tied to a powerline tower will play on repeat with the words, “You suck,” singing continuously as the soundtrack—day after day for months. Love for your husband and son will stop you from acting on these depraved fantasies. You will not want to leave your family with the anguish and stigma of suicide. But it will become harder not to submit. When you are alone, you will cry for no reason or just stare at the ceiling. You will not trust yourself to be alone, so you will continue to seek out friends, but you will focus on perceived slights done or negative comments said, capturing them like mice to feed to the creature in your head. The stench of self-pity will start to repel people. You will no longer pray.
You will see an acupuncturist weekly to help relieve the hot flashes, back and joint pains caused by the same pill. One day, when she asks you to describe your symptoms, you will blurt out, “My thoughts are dark. I want to hide and disappear from the world.” She will get you an emergency appointment with your oncologist. He will ask, “Have you ever had those thoughts before?”
“This drug is not known to cause those thoughts but stop taking it and see if you are better,” he will say.
“Will the cancer return if I stop taking the pill?” As you ask the question, the irony of not wanting cancer to kill you while you are battling suicidal thoughts will slap you in the face. Within twenty-four hours of discontinuing the drug, the fog will begin to lift. By the end of the week, the winds will calm, and the sun will shine. The snake will be silent.
You will function better in the good weather, but you will grieve for your life before cancer. You will not know what to do with your time now that you no longer have several doctor appointments scheduled each week. Your son will be driving, not needing you to chauffeur him around anymore. I survived the storm, but for what reason? Like a cellar door opening in your mind, it will be easy to return to suicidal thoughts when you feel anxiety about your future.
Finding yourself again at a turning point, you will be reminded of the Choose Your Own Adventure books. Maybe you will meditate and pray to find purpose? If so, turn to page five. Perhaps you will seek professional help, a counselor? If so, turn to page eight.
Before you choose the way forward, you flip back through the pages of your breast cancer story. Family and friends and even strangers showed you love and kindness. Friends cooked and delivered meals. Hundreds said prayers on your behalf and offered encouraging words. At your boobie wake, hope flowed like beer at an Octoberfest celebration, not just for you, but for all who attended. You pause in the climax of your story when the eye of the storm is directly above—a moment when you felt no worry, no fear, no anxiety—only the joy to be alive. You now choose your next steps forward, knowing there’s no wrong or right route, no perfect way to proceed. Amid the next storm, you’ll look for the sun breaking the clouds, act to reflect its warmth, and rest in the eye knowing new adventures are ahead.
Author’s Note: This is a work of nonfiction. It relies heavily upon my memory. With the help of research, emails, texts, my medical charts, and fact-checking, I have attempted to tell the story of my cancer journey as honestly as I remember. Some names and small details have been changed to protect the people in these pages.
Wendy A. Miller has recently rediscovered her passion for writing now that her son is almost grown. Once upon a time, she worked for a public relations firm and holds an M.S. in Communications. Her essays have been published in Grown and Flown and Quail Bell Magazine. www.wendyamiller.com