100%

There is no 100% when it comes to cancer. There just isn’t. No doctor will ever tell you 100%: you won’t get cancer, or 100%: cancer won’t come back, or 100%: surgery and chemotherapy and radiation will save a life. This is why actress Christina Applegate’s recent comment about her breast cancer battle bothers me.

“I’m clear,” Applegate, 36, told Good Morning America the other day. “Absolutely 100 percent clear and clean. They got everything out so I’m definitely not going to die from breast cancer.”

Now, I’m all for hope. Gosh, I I’d love to say I’m definitely not going to die from breast cancer. But I just can’t say that with complete conviction. No one can. Applegate’s own mom has had breast cancer—twice. And the actress herself has tested positive for the genetic mutation BRCA-1, a big risk factor for breast cancer diagnosis and recurrence—and for ovarian cancer too. There is simply no lifetime guarantee on breast cancer survival.

I know it’s only been a few weeks since Applegate had her double mastectomy and perhaps the girl is just elated that she caught her cancer early and feels in her gut it will not return. I understand—my instinct tells me mine won’t come back either. But to broadcast to the masses, most of who may know nothing about breast cancer and its implications, that beating the disease is as simple as removing breasts and moving on, seems a little simplistic. When explaining why she opted for a prophylactic mastectomy when her cancer was early stage and had not spread, Applegate said: “I didn’t want to go back to the doctors every four months for testing and squishing and everything. I just wanted to kind of be rid of this whole thing for me.”

OK, so she won’t need mammograms anymore—there’s nothing to squish and squash anymore—but breast tissue remains. And cancer cells sometimes get away—my friend Amy had both breasts removed and then discovered cancer in her lungs and brain. She died 15 months after her initial diagnosis.

My bottom line is this: There is no 100% when it comes to cancer. I wish there was. But there just isn’t.

Photo courtesy of tanakawho on flickr

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See my boobs

dsc_0195.JPGSee these boobs? Protruding outward in all their glory. Pushed up in a fancy bra, positioned under a tight pink shirt, pointing right at you as you read this post. These are the very boobs that threatened to take my life almost four years ago. Well, the cancer inside the boob—just the left one, to be exact—is what made the threat. The boob was simply the packaging for the tumor that presented itself underneath my fingertips on that horrible November day, in that hot, steamy shower where I thought I would merely wash my body, not find a cancerous mass.

A mass I did find—a mass a surgeon removed, an oncologist poisoned, another oncologist radiated, and the first oncologist targeted with the glorious drug Herceptin. Thanks to these two men and one woman, the mass I found is gone. So are all traces of cancer that could have started pouring through my system but for now, have not.

Yes, the mass is gone. My boobs, they are not. And this is such great news that I just have to share—my joy, my relief, my pride over having two very healthy and hearty boobs that will be featured in published form in September when they hit the newsstands inside Family Circle magazine.

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My story

I don’t often tell my entire breast cancer story all at once. I usually share just bits and pieces of it. This afternoon, I talked about a few chapters with a fellow mommy while waiting in a doctor’s office. It turns out while I was being diagnosed with cancer three years ago, this woman found herself in a serious car accident. We talked about physical therapy, our long lists of doctors, our respective survivals. Our chat was short and sweet—and powerful.

This morning, I told my whole story. I talked about diagnosis, surgery, chemotherapy, hair loss, radiation, drug therapy, counseling, anti-depressants, hospitalizations, and doctor relationships. I talked about my hopes, my fears, my attitude, and my state of mind every step of the way. It took more then one hour of phone time to pour out every last detail for the researcher who will somehow use my information to help better the business of cancer. Our chat was long and involved—and powerful.

Talking about cancer is emotional. It forces me to revisit my travels with a life-threatening disease. It also helps me appreciate how far I’ve come, how well I’m surviving, how important it is to talk.

I told my researcher guy today that I’m willing to talk about anything related to cancer. Sure, I could be private about it all. I could keep my information inside. But I figure that doesn’t do anyone any good. Talking—and writing—about cancer is what helps. It helps me. I hope it helps others.

If you want to know something about cancer, especially breast cancer, ask me. My information is yours for the taking.

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The big deal

Tomorrow is the day I report for a visit with my radiation oncologist, the woman who designed and delivered my radiation therapy, those 30 some daily sessions that blasted the site of my tumor in order to prevent a local recurrence of breast cancer. So far, its doing its job. My cancer has not returned.

I return for radiation follow-ups every six months. I get weighed, my arms get measured to check for swelling caused by lymphedema, my breasts get manipulated by several sets of hands, and I get a chance to report any new symptoms, to ask any pressing questions. I don’t have either at this time.

This appointment is not really a big deal anymore. Except that when I really think about it, it actually is. There’s a lot at stake as I present myself before the medical students, residents, fellows, and doctors who will study me. There’s a chance they may find something suspicious, after all. And if they do, the could-it-be-cancer? wheels will start in motion. The prospect of that stings a bit.

My gut tells me that I am fine, that my cancer is long gone, that I’ll walk away from my appointment as confident and happy as I’ll be when I arrive for it. My gut has served me well throughout my cancer years. If it’s on target as usual, then I will be well. And I won’t have to worry about this high-stakes visit for another six months. Well, not exactly.

I also see my medical oncologist—also known as my chemo doctor—every six months. The same basic scenario occurs—substitute blood work for arm measurements—on a different time schedule and in a different office. Also not a huge deal anymore.

Except that when I really think about it, it is.

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Goodbye cancer, hello fitness

My days writing for The Cancer Blog have come to an end. The site is being retired, effective September 14, and so my thoughts will no longer be consumed with the disease that came barreling at me three years ago. Blogging about cancer for a year and four months was a great gig, and I truly believe I’ve somehow contributed to the world by informing readers about all sorts of cancer-related tidbits, both informational and personal. Still, I’m happy to move on.

I’m still blogging for pay, this time for a blog called That’s Fit. It’s about fitness, health, nutrition, and overall well-being. It’s right up my alley. Since May, I’ve been overhauling my own approach to diet and exercise (no sweets, no soda, low sugar, low fat, no red meat, and lots of fruits, veggies, and exercise) and so this career path suits me well. Plus, the content at That’s Fit is positive, light, happy, and has very little to do with cancer. It’s a refreshing change.

Come visit me when you can. That link above will take you directly to my posts. And keep stopping back here at my personal site. I intend to update it from time to time. Promise.

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The long and short of it

Two years ago, I wanted another baby. Instead, I got breast cancer.

It was the day before Thanksgiving when the surgeon who performed my biopsy called me at home with the news. And for the entire Thanksgiving holiday — that seemed to last an eternity — I grappled with the fear and confusion and uncertainty that accompanies the discovery of a life-threatening illness.

It’s been a long road — complete with surgery, chemotherapy, hair loss, two hospitalizations, one blood transfusion, radiation, a year-long drug therapy, physical therapy, counseling, and more. But it also seems like a short trip. And today — two years after I learned the tiny, hard lump in my left breast was in fact cancer — it’s hard to believe so much time has passed. But it has. And the passing of time is marked by the scars under my armpits, a scar where my port once lived, hair that has grown so much it almost reaches my chin, and the growth of my two little boys who two years ago were 18 months and almost four years old. Now three and a half and almost six, it’s clear time has stormed right by.

Two boys are all I have. Cancer took the place of a third child. And while I still want another baby, I don’t know if I will have one. Because I am still grappling with the fear and confusion and uncertainty that accompanies life after cancer.

If I never have another child, I will be okay. Because I have my life. And I am thankful to simply be alive.

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Normalizing

I am returning to my old self. My hair is growing back — and on most days, I actually like my dark, short, wavy hair. My skin is back to normal which means the effects of radiation are gone — no redness or irritation or pain. Just a regular armpit with a few scars. My menstrual cycle has returned — so I will not enter menopause at my young age and I now have back the option of getting pregnant. There are many issues to consider, and it’s recommended that I wait one year before making a decision, but the choice is mine and that is enough to make me happy for now.

My energy is normal again too. Joey and I were on my bed the other afternoon, watching TV. It was the first time in a long time that I let my body rest without fighting sleep. I was wide awake, not tired at all. There were times in the past months when fatigue surrounded me. One day I feel asleep in a living room chair and woke to Joey saying, “mommy, did you have a nice rest?” I am no longer desperate for sleep during the day. I like that.

Today I saw my surgeon again — seven months after he removed my lump and four lymph nodes — and he looked at my breast for a possible infection. He determined it is not infected. He said I am well. He told me I’m good for another 10,000 miles. I hope I exceed 10,000 miles.

Jacki Donaldson

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Peace of mind

Today I learned that my CA 125 test was negative. That means that there is no indication that I have ovarian cancer. But because I have breast cancer and the two are cancers are linked, I will continue to be screened for both. I also learned that Friday will be my last day of radiation. It was scheduled to end on Tuesday, May 31st but my radiation oncologist thought I could end on Friday and not come back after the Memorial Day holiday. She will adjust my treatment doses so that I get what I need this week. Four more days.

My real peace of mind came today from a discussion I had with my radiation oncologist. She is a well-respected doctor and has been highly recommended by many. So I have been interested in her opinion about my chemotherapy treatment but have been afraid to ask her. Since I’ve had two different opinions (one to continue with chemo and one to stop), I was scared she would say I should continue. I do not want to continue and do not think my body could even tolerate the treatment. But I still second-guess myself and have had some dark moments contemplating whether or not I cut myself short on treatment. This oncologist said I did not. She agreed that I should not have received Taxol, the drug I refused. Like others, she said the benefit would be so small and the toxicity could be so great. She said she would not have done it herself. And she said if I do have a recurrence of cancer, it will not be because I didn’t receive Taxol. This brings me great peace.

I hope to gain more peace of mind with my therapy — which begins tomorrow.

Jacki Donaldson

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Countdown

I have seven more radiation treatments — the end is near. My remaining treatments are “boosts” and are quicker than my previous treatments. I do not have to use the breathing device and this time, a machine moves very close to the tumor site and zaps the area for about 30 seconds. Then I’m done. For this entire radiation process, it has taken me longer to drive to and from the hospital than to receive the treatment. The treatments have been very short — and I rarely have to wait. It’s a smooth system. With the boosts, it’s even quicker. Today I dropped my boys with my mom at 9:45 AM. After radiation and a quick stop at the grocery store, I was back for them at 11:00 AM. And what followed was the best part of the day — we visited the preschool that Joey will attend beginning June 6th (he got to meet his teacher, play on the playground, and see his classroom). Then we went strawberry picking. On the ride home, Joey said, “Don’t you love that we got to pick strawberries?” I told him, “yes, I do” and realized that soon my life will be back to normal — free of treatment and fatigue and full of family fun and one day — a head full of hair.

Jacki Donaldson

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Boost

Today I had another radiation simulation. This time the therapists readjusted my set-up to prepare me for my “boost” treatments which will begin on Thursday. I have green markings on my body which will line me up with the radiation machine in a new and different way. The boost treatments will only treat my “tumor bed” — the location of my tumor. Currently, my tumor bed and entire breast and surrounding tissue are being treated. But the tumor bed is where a recurrence is likely to occur (if it occurs) so this area gets an extra dose of radiation.

So Thursday begins the boost treatment and the last boost will be given on May 31st. This will be my last day of radiation and will mark the end of my treatment. I won’t be finished with medical stuff, though. I will see my oncologist every three months for the next year and I will have my port flushed every month (it will stay in for one year in the event of a recurrence that would require additional chemo). I will attend therapy sessions and physical therapy sessions too. And I have an infection in my affected breast right now that may send me back to the surgeon once radiation is complete. Apparently, infection sometimes occurs and is related to the surgery. I have been taking an antibiotic for one week but there is no improvement yet. But depsite my occasional medical appointments, I am almost free of the burden of regular and on-going treatment.

My treatment will end exactly six months (and a few days ) after I discovered my lump. It will also end one day after Danny turns two years old. There are odd coincidences in this journey. On Joey’s fourth birthday, I met with my oncologist and learned about my treatment plan. On Danny’s birthday, I will be one day away from completing the treatment plan. The journey usually somehow takes me back to my kids — the two little ones who give me perspective.

Jacki Donaldson

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Breathless

I have been having trouble holding my breath during radiation. In order to activate each dose of radiation, I take a deep breath through a tube in my mouth (and with a plugged nose). This breath triggers a “click” sound and then I hear a “beep” that lasts up to 15 seconds. I have about six total doses each day and at least twice I have to hold my breath for 15 seconds. On the other doses, it’s less. It’s gotten harder and harder to last for 15 seconds and it’s not clear why this is happening. I’ve reported it to the doctor but since I am not having a shortness of breath in my everyday life, it doesn’t seem to point to a problem. Yesterday and today, the issue became more complicated. Yesterday I could hardly breath deep enough to trigger the “click.” With extra effort and every ounce of energy in my body, I finally did it. But today I could not do it at all. I thought maybe my lungs were failing me. Fortunately, before concluding that it was me with the problem, my radiation therapists called in their physicists who made some changes on my machine and with my tubing. With a new tube, I could breath! The problem may have been just a leak in the tube where my breath was escaping before I could “click” the machine on. A relief.

So my mind runs wild. I have trouble breathing for radiation and I think it’s a problem with my lungs. Headaches — something serious in my brain. Pressure in my stomach — ovarian cancer. A lump on my leg — a tumor. None of these are likely but it’s the first step in my thought process. I am able to dismiss these worries with time but not without an irrational venture in my mind. Which is one of the reasons I will soon begin therapy.

I met with a psychologist and two psychology student/interns today. Shands is a teaching hospital so there is always a team of doctors who see me. One of the students did an intake session with me. I told her my whole story and answered her questions while the doctor and other student observed from another room. After my intake, the three met and developed recommendations for me. Then the presented them to me. They recommend I take the anti-depressant medication (Zoloft) prescribed by my oncologist and begin therapy to last for 6-10 sessions. The therapy will be structured and will include some relaxation techniques. The doctor believes this will help me greatly — especially since I have a perfectionist personality. It seems perfectionists are prone to anxiety under normal circumstances. With a cancer diagnosis on top of my propensity for anxiety, it’s not a shock that I am anxious, worried, and somewhat depressed.

I will begin therapy in the next week or so and will go once per week until I feel more at ease with life. That’s my goal — to live and breath easily.

Jacki Donaldson

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A little hair & a little sunburn

My hair is growing back. It’s a little longer than stubble now — and it’s dark! I can see traces of blond hair in the mix but I don’t know if it will be enough to overpower the dark. I’m not sure when I will be comfortable enough with my short hair to show it in public. I think I’m waiting for a time when people will not look and stare. I don’t know why this bothers me — I’m comfortable in my own home with my baldish head — but I guess I don’t want to appear like a victim of chemo. Which I am. So maybe I should be proud and bold with my head. But I’m not.

I am also a victim of radiation. My skin is starting to look sunburned. It’s very mild but it’s there. It looks a bit like my skin looks after a hot shower — pinkish in color.

I’ve completed four weeks of radiation treatment and have a few more weeks to go. With each day that my breast tissue and skin is attacked, my hair grows in more and more. Part of my body is weakened but part is strong. An interesting balance.

Jacki Donaldson

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Physical therapy & more

Yesterday I went for a physical therapy consultation. My therapist specializes in lymphedema which is a swelling of the arm that results from the removal of lymph nodes during a lumpectomy. I had four lymph nodes removed so I am risk for this condition. It can be a mild swelling or it can be quite obvious. It is usually permanent so therapists try to address the condition before it happens. There is no real prevention for it but awareness is still important. And radiation therapy can contribute to the swelling because it damages the effectiveness of the lymph nodes — which work to drain fluid from the body. When some are missing and others are damaged, fluid can build up and cause swelling.

I have a low risk of getting lymphedema — four missing lymph nodes is not so bad — but I will still be monitored. So yesterday I had my arm measured. My affected arm (left) was a tiny bit larger than my right arm but this is not significant right now. I was given some exercises to do at home to maintain good range of motion — I feel some tightening in my armpit — and I need to purchase a compression sleeve to wear on my arm if I experience swelling or if I ever fly on a plane. It is not recommended that I lift more than 15 pounds with my left arm (Danny weighs 30+) and I cannot ever have my blood pressure checked on this arm — or have a needle stick or any other procedure that could affect the flow of blood and fluids.

I will go back to physical therapy in two weeks and will be monitored throughout radiation — which is 1/3 of the way done now.

I just completed my 10th radiation session and have 23 to go. It is making me very tired but I have not experienced any skin irritation yet. I am prepared for something to happen in the next week or so. I am applying aloe vera gel and calendula (an ointment made from a flower) to treat my skin. When the burning occurs (which is expected), these will soothe my skin. I was told not to wear a bra throughout the whole radiation phase — or to at least wear something that is not tight or restricting on the skin that is being treated. Today I am wearing a bikini top because I have not found anything else that works. Since I can tie the string that goes around my back, I am able to adjust the tightness and pull it low enough that it doesn’t touch my affected skin. I tried jog bras and tight camisole shirts and wearing nothing at all. I am not comfortable without any support so I hope the bikini works out.

So now I am struggling to find the best bra and the best support — exactly what I was doing up until 1996 when I had a reduction surgery. And I thought then I was forever free of this problem. You never can tell what lies ahead.

Jacki Donaldson

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Zapped

I’ve been zapped. Today was my first radiation treatment — one down and about 32 more to go. It was a pretty uneventful treatment, really. I was in my reclined position with no shirt or bra and just a pillow case resting on my chest. The pillow case was positioned so that my left breast was exposed. My head rested on my very own personal mold, and I had to breathe using an assisted breathing device (a plastic tube). Clips were placed on my nose so that I could only breathe out of my mouth and into the tube. Two therapists got me set up and then left the room. Then a voice came over a speaker and said, “When you are ready, take a deep breath and hold it.” I have to hold my breath for about 15 seconds while the treatment machine delivers the radiation. Then the voice says, “You may breathe.” The reason I have to hold my breath is because my heart is located behind my left breast. To minimize the exposure to my heart, I hold my breath which moves my heart out of the way while the radiation occurs. After about four different zaps (I hold my breath for each one), I was done. Besides a machine moving around me, I could not tell anything was happening. I didn’t hear anything or see anything or feel anything. It was less invasive than a tanning bed. I may see some effects with time — apparently most people experience burning or blistering skin and some people report fatigue as a side effect.

I do have a few more markings on my skin — blue ones this time. Eventually, I will not have marker all over my skin. But during the first few treatments this is necessary for lining me up correctly with the machine.

Blue must be the color of the day. I got a blue card at my appointment which I will use to automatically check in for radiation each day. I slide the bar code of my blue card under a machine and then wait. Then I hear my name announced over a speaker. Then I walk to waiting area “C” until my designated therapists come for me. I will see the same four therapists until my treatment is complete.

Until my treatment is complete, I also see my radiation oncologist once per week so she can check on me — mainly to see how my skin fares through the ordeal. I saw her today and all is well so far. And I learned from her that about 90% of breast cancer recurrences happen in the same general area as the first cancer — so the purpose of radiation is to attack the local area, while the chemo attacks cells that may have gotten away from the breast and landed somewhere else.

I go back again tomorrow — and the next day and the next day and the next day, until the end of May rolls around. I hear that I have to look at this phase of treatment as a job in order to not burn out completely. Fortunately, this job only lasts for 6 1/2 weeks. And then I can get back to my other job — full-time mom — without this distraction.

Jacki Donaldson

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Simulation

Preparing for radiation.
Ready for radiation

Today I had a simulation for radiation — which begins Monday and goes on for 6.5 weeks, 5 days per week. The simulation is kind of like practice for the actual radiation treatments. The key to radiation is delivering the same exact treatment in the same exact manner each day. So each time, I will rest on my back and my head will sit in a mold (made just for me). I have tiny little permanent tattoos (dots that look like moles or freckles) that serve as guides so the treatment machine lines up correctly each time. A therapist pulls and pushes me around on the table to get me in the right position. And in preparation for my very first treatment on Monday, I now have black and red markings all over my body. When Danny saw the writing all over my body, he said, “paper” because we tell him all the time that he can only write on paper (and not on walls, floors, furniture). He must be very confused.

Before today’s appointment, I had my blood checked again. It’s normal — and my white blood cells have dropped from 58,000 to 34,00. It appears that I will return the normal range of 4,000-10,000. And I appear to be healthy enough to begin radiation on Monday.

I feel pretty well — and my headache is mostly gone.

I am truly taking one day at a time now. Today I feel well and that’s great. But there is no predicting what tomorrow will bring — it could be a good day; it could be a bad day. I’m taking small steps.

My next step involves dinner!

Jacki Donaldson

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Radiation

I had a consultation today with my radiation oncologist. I will begin radiation soon — maybe next week — and then if my genetic test comes back positive and I opt to have a bilateral mastectomy, I will just stop the radiation (without breasts, there is no need for radiation).

I am not so worried about radiation, although there are still side effects. I may feel tired. And I may experience skin redness, burning, itching, and irritation. Since I tend to burn in the sun, I am likely to burn from the radiation. Long-term side effects include damage to the heart, lungs, and ribs since they all are located near my breast and will be exposed to radiation. So I’m learning over and over again that to survive cancer, I must accept other potential health issues in the future. One author wrote about cancer patients that we should all be so lucky to live 20 years to have a heart condition.

There is a possibility of an arm condition as a result of having lymph nodes removed (I had four removed during my lumpectomy). This condition is called lymphedema — a swelling of the arm that can be permanent. My arm is not swelling, but I am being referred to a physical therapist who will work with me on exercises to help prevent the swelling. Doctors are trying to be more proactive about preventing it and not just addressing it once it occurs.

So radiation and physical therapy are on the horizon. And my blood test results should be back in 2-3 weeks. Then I will know if a genetic mutation is to blame for this journey.

What a crazy journey it is.

Jacki Donaldson

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The beginning

My breasts have been a problem for a long time. For years, they were too big. I was a 34 DDD and hid them with tight fitting bras and under big shirts. So I had them reduced and lost 4 pounds of tissue. I am now a 34 C, which is much more manageable. But the surgery left me with scars, loss of sensitivity, and an inability to breastfeed my babies. This has not been a big deal to me, just life circumstances and I’ve adjusted to them. And now I’m on to another life circumstance with these problem breasts. I have breast cancer.

On November 16, 2004, I felt a lump in my left breast while taking a shower. I have always been aware of what my breasts feel like. I have a lot of dense tissue, so dense that the surgeon who performed my breast reduction had trouble separating the tissue to take some out and leave some in. My breasts always seem lumpy to me and I never knew if I’d be able to tell the difference between normal and abnormal tissue. Four years ago I had a mammogram because of something I felt. It all turned out fine. It was just the dense tissue. All of my annual GYN visits have revealed nothing abnormal. But I’ve always been aware and curious which is why I found something in the shower. I knew it was not normal. It was hard and felt like a small green pea. It moved around and for the first few days, I had a hard time locating it. Once I became obsessed with it, I could find it immediately.

I went to my OB/GYN on November 18. My doctor felt the lump but was confident it was nothing to worry about. It moved around easily, there was no discharge from my nipple, I did not feel any pain: all signs that it was benign. But it’s routine to get a mammogram for any mass so I got one the next day.

I was the youngest person waiting to get my mammogram, another sign that this lump was nothing serious because it is not common for young women to have breast cancer. Mammograms are not even recommended for women under the age of 40. I am 34.

The mammogram films looked OK, and the technician told me the doctor would talk to me but that she was not worried about anything. This was true but she did an ultrasound anyway to look further at the lump. She determined it was not a cyst, which is fairly common, and nothing serious. It could be a fibroma (a common growth that can be removed or left in place without harm) or it could be cancer. She said she wanted me to have the lump removed. She wanted it out and in a jar, she said. I asked her if it could be cancer and she said it could be.

On November 23, I had a biopsy. A large needle was placed in my breast and a piece of the lump was pulled out. The surgeon had a hard time getting a piece, however, because it moved around so much. He said this was a good sign, the movement. He sent the tissue to pathology and told me to call his office the next afternoon for the results.

The next day, November 24 and the day before Thanksgiving, my phone rang at 10:00 AM and the doctor who did the biopsy said the pathology report was back already. He said that unfortunately, cancer cells were found. He said I would need a lumpectomy (surgery to remove the lump), radiation, and possibly chemotherapy. He told me to buy a book called Dr. Susan Love’s Breast Book. I got the book that day.

Somehow, I made it though the Thanksgiving weekend, with my thoughts jumping from the hope that this would turn out OK to the fear that I would not see my boys grow up. My mind wandered and worried about surgery and what treatments I would have. I wondered if I could have more kids and whether or not I would lose my hair. I cried and lost sleep and was hopeful too. I learned a lot from reading my new book. I learned that many women do go on to have kids after cancer but I also learned that chemotherapy in young women could cause early menopause. I learned that I have an 85% survival rate and also that I will get tiny little tattoos surrounding my breast to aid in the proper delivery of radiation. These permanent tattoos will also alert any future doctors that my breast has had radiation because I can never have it again in that same area. The book helped me feel positive about this journey but it also helped me face reality.

On November 29, I met with a surgeon at Shands who prepared me for my first step: surgery. He said he would remove the lump and would determine whether or not my lymph nodes were cancerous. He would check all the margins around my breast to see if any surrounding tissue was affected and would identify all the defining factors of my cancer. If he found extensive cancer, he would have to remove my breast. I had to sign a form stating that my surgery was to be a lumpectomy but could turn into a mastectomy. My surgery was scheduled for Friday of this same week.

On Thursday, December 2, I had a radioactive dye injected into my breast. The dye slowly collected in my main lymph node, the sentinel node. During surgery, this lymph node would be blue so the doctor could easily find it and biopsy it. The biopsy would give him clues about my other lymph nodes. For the rest of this day, I was very anxious about surgery. I didn’t know what kind of prognosis I would wake up to hear and whether or not I would still have my breast.

lumpectomyI do have my breast. And I have a fairly good prognosis. My lump was removed and measured 1.1 cm, which is small. My lymph nodes were negative for cancer, although four were removed for biopsy purposes. My margins were clear, and there was no apparent spread of cancer. My cancer is considered stage 1. And that is good. I have two incisions, one in my armpit where lymph nodes were taken and one underneath it, on the side of my breast. They are both about 3.5 inches long. Besides a bad skin reaction to the tape I was bandaged with, everything went well. There are minor inconveniences right now. As my incisions heal and my skin tightens, it’s harder to lift my arm. So I have exercises I must do each day. Because of the missing lymph nodes, I may have trouble with swelling in my arm so I have to watch for that. I have not been able to shave my armpit since my surgery on December 3.

And now I await the next step in this battle. I will begin receiving chemotherapy in mid-January. This will last for three months. I will go for treatment four times, once every three weeks and will have a combination of drugs sent through my body via IV. The purpose of chemo is to kill rapidly growing cells, and cancer cells are rapidly growing. Unfortunately, all rapidly growing cells are killed, like hair cells and bone marrow cells. The chemo should kill any cancer cells that floated away from my breast, if any did. I don’t know how I will react to this process, as each person responds differently. At the very least, I hear I will be tired at times during each three-week time frame. I may also be tired from the radiation. This will begin three weeks after chemo ends.

I will receive radiation every day for 6 weeks. The purpose of radiation is to zap the actual area where the cancer was found to prevent it from recurring. Many women take a drug after chemo and radiation to prevent recurrences. The drug (usually tamoxifen) is taken for five years. My body will not respond to this type of drug due to negative estrogen receptors (if they are positive, the drug can be taken) so chemo and radiation will be my only two real treatments.

For now, I am trying to keep life simple. Joey and Danny help me do that. Joey knows I am frequently going to the doctor for a “boo-boo” I had in my “booby” and he has been very attentive. One day after a doctor appointment, he said, “Mommy, you need to go home and rest. I’ll bring you a banana.” He is almost four years old. Danny, at 19 months, does not seem to know anything is going on and it’s my hope that he never has any recollection of this path our lives are taking. I will never forget it, though, and that’s OK. I will take this experience and make it matter. A friend sent me a breast cancer bracelet inscribed with trust your journey. I do. I trust that I will be fine in the end. And I trust that I was given this fight so I can help others. That is why I have written this. I hope everyone who reads about my journey is affected in some way. Perhaps it will increase the amount of women who do self-exams. Maybe it will arm others with information to help loved ones who are affected by this common disease (about 1 in 8 women will get breast cancer at some time in their lives). Maybe it will spread hope. At the very least, writing helps me. And for now, that is enough.

Jacki Donaldson

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