BY SUSAN MCCLURE | DECEMBER 8, 2011
In an educational session that kicked off this year's San Antonio Breast Cancer Symposium, Teresa Woodruff, PhD, noted that survivors experience depression and anxiety because of sterility. Adult survivors of childhood cancer are often afraid to begin dating because they don't want to have that conversation with someone at an early stage in the relationship but are uncertain as to when to initiate it. Young men and women have the same concerns, but these concerns are heightened among young breast cancer patients.
Fortunately for me, I was already married when I learned that I had cancer. I was also the mother of a wonderful two-year-old boy named Ryan, who remains the best and brightest light in my life. That said, at 35, I was devastated when my oncologist told me that I wasn't going to be able to have more children. I had always thought I would have two or three kids and the thought of Ryan being an only child, with no sibling to grow old with, made my heart ache. It still does.
Lance Armstrong announced publicly that he banked his sperm – that was one of the first public acknowledgements that cancer treatment can cause sterility and patients should do something to preserve their fertility before treatment.
In regards to the logistics of preserving one's fertility, men have an easier time, but not all men have been offered sperm banking. There needs to be better patient navigation in adequate time to ensure that men are able to father future generations. Options for women have been available for some time, but are not always used. Navigation is more difficult – Women have to go from cancer care to reproductive endocrinology and then back to cancer care again which is difficult, and quite honestly, scary and stressful.
Woodruff suggested that patients and doctors know that fertility conversations should happen, but she isn't convinced that all newly diagnosed patients are thinking about fertility, even if it is more widely known. What about you? Did your healthcare team bring it up? Were you given a chance to fully understand your options?
RELATED POSTSBY SUSAN MCCLURE | DECEMBER 12, 2010
Well, another great year of SABCS has come to a close. Almost 8,000 people attended the meeting, with 58 percent coming from other parts of the world. Citizens from 94 countries were counted.
This symposium has truly become one of the most significant international meetings for those interested in breast cancer.
I hope that our coverage of this year's symposium has made you feel that you had a "courtside" seat to all of the important data presented here. I also hope you got to know the CURE team a little better.
Now, I would appreciate hearing from you! What did you like, not like about this year's coverage? What can we do better next year? Is there something that really resonated with you? We want to hear it all so we can continue to be here for you at precisely the right time, the right place and in the right format.
RELATED POSTSBY SUSAN MCCLURE | DECEMBER 12, 2010
I have a confession to make.
While I've talked a great deal about my experience with breast cancer back in 1997, only close friends and family have been privy to the fact that I experienced a second diagnosis this year. I've often wondered why I was so comfortable talking about the first experience, but not the second. The first time was so different. So scary.
This time, I had DCIS (ductal carcinoma in situ), which was discovered during cosmetic surgery. I had decided that after 13 years of survivorship, I was tired of feeling lopsided. Surgery and radiation from my previous treatment left me a bit uneven, and I decided that I was going to do something for myself. I was going to "fix" something that only I really noticed or had a problem with. I was going to "even myself out."
The surgery went great. The very next day I could tell that I was going to be happy with the ultimate result. Well, actually, the very next day I was horrified by all of the incisions and tubes and condemned myself for voluntarily opting-in to cause such damage to a perfectly healthy body part. In fact, for a couple of weeks I referred to myself as "Frankenboob" and marveled at the notion that people called this "cosmetic" surgery.
In the midst of all of this self-criticizing, I got a call from my surgeon. It was Friday afternoon and I had just picked my son up from school.
"Susan, I'm afraid I have some bad news," my doc said. He went on to say that during the routine course of examining the tissue, the pathologist had discovered DCIS in my left--previously unaffected--breast.
I began asking very specific questions about next steps and assured the surgeon, who was very impressed by how well I was taking this news, that I knew a great deal about DCIS and that this in no way compared to my first bout.
"This is really baby cancer," I said. "This was nothing to freak out about." I hung up and glanced over at my 15-year-old son. He was crying.
How could this happen to us again? The first time was a fluke, right? She's been healthy for 13 years! Why now? All of these thoughts were whirling through his mind. I could see panic in his eyes and rushed to reassure him that this time in no way resembled the last. I told him that DCIS is the earliest stage of breast cancer and that many women have had it and it almost never progresses...meaning it just sits there, causing no harm.
In the months that followed, many tests were ordered, including an MRI, a biopsy, then a last-second canceled biopsy and a mammogram. I hade to wait for a couple of months for my breast to heal before further tests could be done. During that time, everyone privately worried.
When tests were finally ordered, a suspicious shadow presented itself, causing more worry and more tests. When the suspicious shadow disappeared and the biopsy was canceled, everyone rejoiced. The rollercoaster of emotion that my entire family endured from June through October was palpable.
The ups and downs, twists and turns in the diagnostic process this time were far more difficult than my first experience. The first experience was cut and dry. My health care team said, "You have an aggressive cancer. We need to remove it and will follow the surgery with chemo and radiation." This time I was told that I had three options, none holding greater promise or survival benefit than the next. I was told that I wasn't going to die from this and therefore, the options were broad, and I was the only one who could determine the best treatment option for me. I could remove my breasts, I could radiate the affected breast (not ideal because I remove that option should cancer present itself again) or I could watch and wait.
Guess which I chose? I am now being followed very closely by my health care team with frequent screenings.
What lesson can be learned from all of this? There's no such thing as "baby" cancer. A second diagnosis, no matter how early the stage, is just as emotionally draining as the first one. Maybe that's why it's so hard to talk about.
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