Wednesday, January 23, 2019

Progress, Semantics, and Optimism with DCIS

Is history doomed to repeat itself?

It appears my blog has taken an unfortunate turn to have a repeating theme that involves Stage 0 cancer for me. As they say, third time's a charm. 

Stage 0 cancer? Let's review the positives:
  1. Don't worry, that shit won't kill you. 
  2. Don't worry, it is just cancer by name (maybe it needs a new name then?)
  3. Don't worry, you are going to live a long and beautiful life (with a statistically higher chance of you eventually succumbing to cancer somewhere in the next 10-50 years).
On the flip side: 
  1. Seriously, we have to treat this like cancer. 
  2. Seriously, it can definitely get worse. 
  3. Seriously, IT COMES BACK
  4. Seriously, get ready for a bunch of surgery and possibly radiation. 
Let's be honest - I have spent a lot of time researching Ductal Carcinoma in Situ. A LOT. While I am no doctor, I feel like I could practically write a thesis on this particular diagnosis. More importantly, I have even seen and lived the changes in available research in a short three years. I am very happy to  say that new protocols that have been instituted since my first and second mastectomy have greatly improved even in a short three years. The reduction of opioid use following the surgery made my recovery astronomically faster. The allowance of a giant glass of apple juice in the hours before surgery was also an amazing change that gave me a head clear of headaches and veins that could be found by nurses thanks to just a bit of additional hydration. These were minor changes that made a big difference in the way I felt going in and coming out of the hospital. 

I have participated in multiple studies and honestly, I feel like the number of people who have seen my breasts in the last 3 years number well in the 300s. I am not broaching on stripper status, and no one has offered me money yet, but I have heard people (doctors) say - "Oh yeah, I have seen your pictures." I have a (medical) reputation. And to be clear, these doctors mean my various MRIs, ultrasounds and other scans - not a weird peep show image. 

While I am writing this post almost 4 months after my re-recurrence, I would be remiss to not mention the real battle that should be affiliated with DCIS, and that is the psychological battle. I have already alluded to the attitude towards DCIS in the cancer community and I have struggled with it myself each and every time this damn diagnosis gets applied to my medical history. It is cancer by name; it is cancer by pathology; but it is "good" cancer. How confusing is that? I mean, should I be talking about this more like a knee replacement? Or should I just drop the C word and let people use their imaginations.

"Hey, it turns out I need a breast replacement."
vs.
"Hey, it turns out I have a form of breast cancer."
vs.
"Hey, it turns out I have an early stage breast cancer that can turn into way worse stage cancer (at any time, and we don't know when or why)"

The truth is, mentioning that you have cancer in a casual conversation can really throw people off. I have done it many times and it really just never works for anyone. And since my treatment is mostly "invisible" to others, it doesn't feel like I am qualified to add any gravitas to my situation. I don't lose my hair, I don't have that pallor of a cancer patient, and really, I have a significantly better chance of dying in a car crash on my way to a medical appointment than I ever did with this diagnosis.

For anyone who knows me personally, I am not a "woe is me" kind of person. Don't get me wrong, dealing with even an early stage breast cancer certainly knocked me for a loop and wreaked temporary havoc on my ability to manage all the day to day stressors in life with this added element of dread. This has been 3.5 years of uncertainty around something that could have/should have/would have been a done deal for nearly 75-99% of cases. Nevertheless, I truly remain very optimistic that this time is truly the charm - and if for some reason it isn't... well, I will simply accept it as another challenge in life in which I will be forced to find the silver lining. If you remember to find the joy and grace in the everyday, the practice will be easier when the challenging times arise.

This is the source of optimism. 

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