Confessions of a Breast Cancer Survivor

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Sunday, January 27, 2013


“Courage is what it takes to stand up and speak; courage is also what it takes to sit down and listen.” - Winston Churchill

A breast cancer survivor tells her tale
Zobel R. Epler

The first inkling I got that something was terribly wrong was when my doctor gave me a book titled "The Little Book of Breast Cancer" which was written by Dr. Michael Andrew Hunter. It was Sept. 2, 2011 more than a year to date. To say that I was shocked beyond comprehension would be an understatement as I have no idea that something was horribly wrong with me. How long was one of the first questions asked. Am I dying? What is next? What about my children? I went by myself to my surgeon that morning thinking it was nothing to worry about. It was just a kernel-sized mass at 1.5 cm X 1.2 cm. I was wrong; I could have brought with me a family to cry on. A month before this devastating announcement, Aug. 24 to be exact, my friends and colleagues were having a bite of santol, that sweetish sourish fruit, much loved by Filipinos. We were having our usual chit-chat when I suddenly felt a mild, painless and very short palpitation on my left breast.

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The palpitation was very brief say four to six seconds that before I could call the attention of my co-teacher about the palpitation, it is over.

Immediately upon reaching home, although I felt no pain, I did a self-check on my left breast and to my surprise I felt a small growth on the underside. I compared the right breast and there was no feel of a mass. Panicking, I then called my sister-in-law to tell her what I found and asked her to do a check for confirmation being in the medical field. Readily, she recommended that I go see a doctor the soonest possible time.

But prior to my visit to the doctor, I tried putting warm compresses several times on the affected area, an effort to reduce the swelling. On the third day, I decided to visit a specialist who ordered a "sonomammogram” to be undertaken on the lump.

A "sonomammogram" is a special sonographic exam- using sound, like all other sonograms you hear about, most known for taking for taking a peek at a baby still it in mother's womb. "Mammograms" are useful as first line screening as they can detect microcalcifications that could indicate some kinds of breast cancer, sonograms can't do that. On the other hand, "sonograms" can tell you if you are likely looking at a tumor or a fluid filled cyst, which can be hard to do with the "mammogram".

So I had sonmammogram the result was “… tumor with malignant characteristics….” and that the impression was excision biopsy required.

The Internet’s Wikipedia, breastcancer.org and several medical websites were my consultant for quite some time. What are malignant characteristics? What is excision biopsy? What is the size of a tumor to be cancer? What is cancer? I remembered Typhoon Mina successfully stopped me from seeing a surgeon to do excision biopsy. A biopsy is a medical test commonly performed by a surgeon or an interventional radiologist involving sampling of cells or tissues for examination. It is the medical removal of tissue from a living subject to determine the presence or extent of a disease. The tissue is generally examined under a microscope by a pathologist and can also be analyzed chemically. When an entire lump or suspicious area is removed, the procedure is called excisional biopsy.

I had excision biopsy when Mina weakened to a tropical storm on Aug. 29, 2011.

The morning of that eventful day, my feet seemed heavy as I came closer and closer to the pathology room. Upon seeing the pathology results, I had a violent gasp for air. It says infiltrating ductal carcinoma- moderately differentiated. This is one of several recognized specific patterns of breast cancer that begins in the cells that form the ducts of the breast.

It is also called invasive ductal carcinoma. Invasive means that the cancer has “invaded” or spread to the surrounding breast tissue. Ductal means that the cancer began in the milk ducts, which are the “pipes” that carry milk from the milk-producing lobulestothenipple.

The most common form of breast cancer, it may appear as a smooth-edged lump in the breast. On physical examination, this lump usually feels much harder or firmer than benign lumps in the breast. This time my pace was faster and handed results to my surgeon. Upon seeing the results she handed me the book earlier mentioned above.

Tears fell profusely, then sobs and eventually a deep sigh. Only my sleeves wiped them dry until I composed myself and asked, “How many days, months to live? What stage?” Medical terminologies I did not understand whirled, flashed in my mind. The only terminology registered was mastectomy. The removal of all breast tissue, from just under the collarbone to the abdomen, including the chest wall muscles and the axillary lymph nodes in the armpit. Modified radical mastectomy is usually recommended if the tumor is large and cancer has already spread to the lymph nodes.

I had it set on Marian Day, Sept. 8, 2011. I availed of Magna Carta for women or Republic Act 9710. Chapter IV SEC. 18. Special Leave Benefits for Women. – A woman employee having rendered continuous aggregate employment service of at least six months for the last twelve months shall be entitled to a special leave benefit of two months with full pay based on her gross monthly compensation following surgery caused by gynaecological disorders. I know and I feel very healthy except for this stupid cancer on the left breast. Unbelievably, I stayed only overnight in the hospital for the Modified Radical Mastectomy. I was not able to entertain visitors because before they came to pay visit, I was discharged from the hospital.

I brought home with me two plastic tubes attached to my breast area to draw off fluid from the surgery. I was instructed to care and to monitor the drainage of the fluids until they are removed in a week or more after the surgery. A feel of a ruler under the armpits was so unnatural and painful. Only then did I feel, I was sick and thought I was dying when I was referred to an oncologist. Immediately, I sought medical attention. I was on denial, this is nothing, I comforted myself but after a week I was diagnosed a having Stage 3A. There were six out of twenty two lymph nodes that are positive for tumor and one out of four lymph nodes (axillary) is positive of tumor.

I underwent several test – blood chem., 2-d echo, ultra sound and x-ray. These may sound very simple but I was wrong the tests were very rigid. Only then again did I start to be closer to our greatest healer, God. He is not only the greatest doctor but also a great provider. I would now say that I am a living epitome of His greatness.

God knows and gives our needs. I felt the love, care and concern of my family and my friends. I had six cycles of adjuvant chemotherapy from October to March 2012 and concurrent radiation therapy for thirty three sessions on April to May 2012 at Saint Louis University Sacred Heart Hospital, Baguio City and Villaflor Hospital in Dagupan City, respectively. The latter is not available in the City of Baguio.

A local newspaper said that a radiation therapy machine will soon be available in the city. This is good news for the sick especially the Cordillerans and those from Region I because travelling daily to Dagupan and Baguio makes cancer patients sicker and is worsened with the hot weather of the province. Having breast cancer is one big problem, paying for medication is double jeopardy.

Unexpectedly, prayers, financial assistance and moral support poured in.

My finances being a public school teacher with four children were very meager but being with the public school system pays off. Allow me to extend my gratitude to the following - Baguio City National High School family, Association of Master Teacher (BCNHS); English Department, TLE Department, SPA, SPS, Rizal Annex, Roxas National High School, BCNHSTEA Multipurpose Cooperative, BCTEA Cooperative, BCNHS faculty club. More importantly and surprisingly, my students in the 80s, my family and my friends during my college years and early teaching years came to my rescue for financial, spiritual and moral support.

God is the greatest Provider. He provides even before I ask for it. His deeds are very miraculous. I remember visiting and praying at San Carlos Basilica in Pangasinan and as soon as I stepped out of the church text messages were received informing me of financial help. To date Tamoxifen is my maintenance hormone treatment for five years. God is really good, all the time.

Published in the Sun.Star Baguio newspaper on January 28, 2013.

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