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Reach to Recovery

Reach to Recovery is a program from the American Cancer Society which matches up breast cancer survivors with women who are newly diagnosed or undergoing treatment.  I'm a volunteer and I've worked with a few women.  Tonight, I had an especially moving and emotional phone call. 

The woman lives in my town, is 62 and just lost her husband recently.  She had a mastectomy this past February and is debating whether to undergo chemotherapy. 

Her will to live was lost with her husband. She could barely talk about him - they'd had a long and happy marriage. She felt alone and lost.

What could I do?  What could I say?  How could I help?

In her case, chemo will give her a 5-7% improvement in odds of not having a recurrence.  I said everything I could think of to convince her to do it.   I could really understand how she felt, but as I told her, one day she will wake up and it will be spring and the sun will be out, the flowers will be blooming, and she will be glad to be alive and glad she gave herself a better chance for a long life.  She has 2 children, one grandchild and another on the way. I shamelessly told her to do it for her children, and that she shouldn't deprive her grandchildren of their grandmother.

She said she has friends who have offered to help, but she hated the thought of asking them for anything.  I suggested that instead of thinking she was asking for help, she was instead providing an opportunity for others to feel needed and good about themselves. That people like to help others and they would especially like to be able to help a friend. And of course I told her she could call me.

I suggested that she consider thinking about trying one dose, and seeing how it goes.  People react in different ways - maybe she would be one who got through it more easily. She said she hadn't thought of that, that maybe she would try it. 

I'll call her back in a few days to see what she decides.

FYI: Breast Cancer Facts 2007

From the National Breast Cancer Coalition (NBCC), a grassroots organization dedicated to ending breast cancer through action and advocacy:

• The National Cancer Institute estimates that a woman in the United States has a 1 in 8 chance of developing invasive breast cancer during her lifetime. This risk was about 1 in 11 in 1975.
• More women in the United States are living with breast cancer than any other cancer (excluding skin cancer). Approximately 3 million women in the U.S. are living with breast cancer: about 2.3 million have been diagnosed with the disease and an estimated 1 million do not yet know they have the disease.
• Breast cancer is the most commonly diagnosed cancer among women in the United States and worldwide (excluding skin cancer). In 2007, it is estimated that 240,510 new cases of breast cancer will be diagnosed among women in the United States: 178,480 invasive breast cancers and 62,030 cases of in situ breast cancer (of which, 85% will be ductal carcinoma in situ (DCIS)).¹ 
• Breast cancer is the second leading cause of cancer death for women in the U.S, after lung cancer. Approximately 40,460 women in the U.S. will die from the disease in 2007. Breast cancer is the leading cause of cancer death for U.S. women between the ages of 20 and 59, and the leading cause of cancer death for women worldwide.
• Approximately 11% of women diagnosed with invasive breast cancer die from the disease within five years; at ten years, 20% will have died. The most recent available statistics show that 40% of all women diagnosed with invasive breast cancer died from the disease within 20 years.² 
• Older women are much more likely to get breast cancer than younger women. Most breast cancers (about 80%) occur in women ages 50 and older. About 5% of all breast cancer cases occur in women under the age of 40. However, younger women who get breast cancer have a lower survival rate than older women who get breast cancer.
• Combining all age groups, white (non-Hispanic) women are more likely to develop breast cancer than black women. However, black women are more likely to die of breast cancer than white women.
• Black women have a higher breast cancer mortality rate at every age, and a lower survival rate than white women.³ The five-year survival rate for white women diagnosed with invasive breast cancer is 90% while the five-year survival rate for black women diagnosed with invasive breast cancer is only 77%.
• Between 1994 and 2003, the mortality rate for women of all races combined declined by 2.4% annually. In white women, breast cancer mortality declined by 2.5% annually. In black women, mortality declined by 1.4% annually during the same period.⁴ 
• Mortality has declined faster for women under the age of 50 (by 3.3% annually), regardless of race/ethnicity.
• The current methods of treatment in use in the United States are surgery (mastectomy and lumpectomy), radiation, chemotherapy, hormonal therapy, and biologic therapy (e.g. monoclonal antibody therapy).
• Mammography screening does not prevent or cure breast cancer. However, it may detect the disease before symptoms occur. Breast cancer tumors can exist for six to ten years before they grow large enough to be detected by mammography.
• Mammography is less effective in younger women. In the overall population, digital mammography does not perform better than traditional film mammography. However, among younger women, digital mammography has been reported to detect more breast cancers than film mammography. There are no studies to establish whether screening with digital mammography decreases breast cancer mortality.
• All women are at risk for breast cancer. About 90-95% of women who develop breast cancer do not have a family history of the disease.
• Factors that increase a woman's risk of breast cancer include older age, genetic factors, family history of breast or ovarian cancer, long menstrual history, nulliparity (having no children), older than 30 years of age at first full-term pregnancy, daily alcohol consumption, use of combined postmenopausal hormone therapy (PHT), postmenopausal obesity, and ionizing radiation. Factors that decrease a woman's risk of breast cancer include breast-feeding and physical activity (exercise).
• Recently, higher breast density has been show to be strongly associated with the risk of breast cancer. It was found that breast cancer rate was almost four times greater in those with extremely dense breast tissue as opposed to those with fatty breast tissue. It is important to remember that since mammography is less sensitive in detecting breast cancer for dense breasts, the effect of breast density may be somewhat underestimated.
• Although scientists have discovered some risk factors for breast cancer, the known risk factors account for only a small percentage (~30%) of breast cancer cases. There are few interventions with limited value that reduce risk, and none of them prevent breast cancer.

Link

Three Strikes

...and you might be out:

Women with what is referred to as "triple-negative" breast cancer are more likely than other women with breast cancer to experience a relapse, a new study by Canadian researchers shows.

Triple-negative breast cancers are estrogen receptor-negative, progesterone receptor-negative, and HER2-negative.

The study shows women with triple-negative breast cancer were almost twice as likely to develop distant relapse even after accounting for other factors related to relapse such as tumour size and involvement of lymph nodes.

"To confirm both the aggressive nature of triple-negative breast cancers regardless of other tumour features, and the distinct pattern of relapse will help identify those patients who need aggressive treatment up front," said Dr. Rebecca Dent, a medical oncologist at Sunnybrook's Odette Cancer Centre.

Dent collaborated on the study with Dr. Steven Narod at Women's College Hospital. 

Their study found that the pattern of relapse had a rapidly rising rate in the first two years following diagnosis and a peak at two to three years followed by a decline over the next five.

Link

My CA was triple negative. But I am almost 6 years out from diagnosis.   

Chemobrain

Yeah. I know it well. This writer describes it just as I experience it:

First, I became aware of gaps in my memory. People would mention an event or conversation that I had been party to and I would have absolutely no memory of it. I was reminded of the movie "Memento," in which the main character has lost the ability to store anything in short-term memory. When he met someone new he would take a photo of them and write their name on it because he knew that by the next day he would have no recollection of having ever met them.

I have no way of predicting what I will remember and what I will forget. It isn't really the same as ordinary memory lapses -- forgetting one thing from a long list or forgetting something because you were distracted and not really paying attention when it happened. I think I am paying attention, but ... poof! No memory of whatever I was supposed to do, no recollection of a conversation or event. And it is usually so completely erased that I am initially incredulous. "I already told you? Are you sure?"

So, if I repeat myself or if I have forgotten something you've told me, this is why. I don't dislike you, you are not boring to me, you do make an impression - my mind has simply become a sieve and things sometimes slip through the holes. 

Oops, I almost forgot this.

Am I upset over it?  I've learned to accept it.  I don't like it, but what choice do I have? Life is a challenge - never boring.  One more stumbling block in the "whatever doesn't kill you makes you stronger" path to...to...where am I going again?

When Cancer Strikes

I read of the passing of Cathy Seipp and the recurrence of Elizabeth Edward's cancer with great sadness.  I'd read Seipp's blog from time to time.  She was a great writer and a beloved member of the blogosphere and there has been a tremendous outpouring of grief at her passing.

In a matter of moments, Elizabeth Edwards discovered that a killer has spread to her bones.  I sincerely hope she is one of the fortunate few who survive stage 4 cancer and go on to live for many years.

Lately I've been feeling very much like a regular person instead of a cancer survivor, but I feel a bit brought up short and unnerved by this news - particularly Edward's recurrence.