Fear of cancer

A by product of raising cancer awareness can be increasing people's fear of getting the disease. I think that often in the back of people's minds as they donate or pinkify in someways is "I really hope I don't get it". With Angelina Jolie's decision to have a prophylactic bilateral mastectomy because of the BRCA gene and the ensuing publicity, more and more women are concerned about their risk of getting breast cancer.

While breast cancer eventually impacts one in eight women by the age of 80, it is much less common in younger women. Most cancers are also discovered at the early treatable stages.

The BRCA gene, which Ms. Jolie has, is only responsible for about 5-10% of breast cancers. If you have relatives who died of ovarian or breast cancer at a young age, you probably should speak to your doctor about being tested for its presence.

If you do have the gene or have a strong family history of breast cancer there are still options available to you instead of a bilateral mastectomy. You can take Tamoxifen. You can skip surgery and medicine and opt for an aggressive screening schedule - particularly if you have not yet had children and plan to do so.

You can still get breast cancer even if you don't have any risk factors (I didn't) at a young age (mid-40s) - anything under 50 is considered young for breast cancer. You can eat right, get exercise, blah, blah, blah.

There is no reason to fear breast cancer or any other cancer or medical ailment. If you spend your life in fear of getting sick, you are not living, you are hiding.

My body is in such bad shape right now. My doctors are amazed at the amount of osteoarthritis I have in my knees and I tell them I worked hard for many years to get into this shape - snap, crackle, and pop every time I bend my left knee from years of skating, skiing, roller blading, hiking, and much  more. I had fun for a long time. Now I still have fun and don't hide from what might happen but I just move at a slower pace.

Taking back my life

Over the past few years, my life has shrunk. There are many things I can no longer do - hiking, biking, camping, skiing, vacuuming. I have decided it is time to take back my life.

I used to go for a daily walk, rarely skipping a day. A habit started years ago. I would walk in the rain and snow and heat and cold.

In the spring of 2007, I was working at a small company near home. I started walking at lunch with a co-worker once or twice a week. I left the job but kept walking weekly with her, through cancer treatment. We would walk the steep hills to keep in shape. We kept going. Some weeks would skip because one of us was traveling or busy, or my back hurt too much.


Two winters ago, she and her husband started spending two months in Utah to ski so we stopped for the time. Last winter she went for her two months in Utah, we walked once after she came back in the spring. Then my back started hurting more, and my hip (bursitis). We haven't walked since.

I have gone for a few walks since then but nothing as regular as I used to. I do go to the gym and do an hour of cardio three times a week as well as weights and stretching. But long walks result in bad effects - including hobbling home and spending a few hours or a day in bed. I find I don't have the stamina for it. My muscles aren't used to walking any more.

I am determined to start going for regular walks again. I do need a day of rest after working out. But I have a plan. A dastardly plan. My husband has no idea what he is in for.

We are going to go for a walk every weekend. We have started already. We went for a walk at a nearby wildlife refuge last weekend. And on Saturday we went for a walk in the wind and cold on the hills around our neighborhood. This coming weekend we will go for another walk.

I want to walk enough so that we can go on hikes again, something we really liked to do. One of our first dates was a hike along the edge of a cliff on western MA where we got hit by a thunderstorm and literally soaked to the skin. I would love to be able to hike like that again. It may take a while but I do want to hike again. I enjoy being out in the woods. Its part of taking back my life.

I am tired of watching things I enjoy slip away. I'm taking back my life. And maybe I'll lose some weight too.

Participating in the post cancer life without criticism

Yes we must participate in our lives post cancer. We need to do the right things in order to stay healthy and help reduce the chance of recurrence. The best things we can do are the things that all adults should do - they simply become more important:

• eat right
• maintain a healthy weight
• exercise
• reduce/avoid alcohol consumption

But as an additional stressor, we tie in the emotional impact of our cancer diagnosis.

Dr Bechold, here, writes about life post cancer as not a passive sport. I agree with her points but disagree with her tone. First of all, clearly although she has been a doctor for 30 years, she clearly has never been diagnosed with cancer herself. Back to if you haven't walked the walk, you can't talk the talk.

Second of all, she seems to blame the patients for their non compliance with recommendations for exercise, healthy lifestyle, and recurrence risk reduction.

"You can’t see that breast cancer survivor every 3 to 6 months, watch her weight balloon up, and not ask her what is causing this to happen. We must take time to talk to people and ask about their lives and how they are living each day with an eye on remaining cancer free. I had one patient who was clearly having some anxiety issues. As we talked, I found out that she was self-medicating every evening with a bottle of wine. While she graded papers! After I picked my chin up off the floor, I advised her that this was not an acceptable coping mechanism."

Hmm... so back to the patient whose weight was ballooning up. Did she ask about weight gain caused by Tamoxifen or aromatase inhibitors or chemotherapy or just plain emotional stress? Maybe what we used to eat and maintain a healthy weight, now makes us gain weight? I know I have tried to eat healthy and my weight has definitely increased. I go to the gym regularly but my medications cause weight gain and my other ailments have reduced my ability to move around. I know many other cancer patients who deal with similar issues.

And to the patient who self medicates with a bottle of wine - clearly a destructive behavior - but why was she so astonished? If the patient had anxiety issues, why hadn't other interventions been taken previously such as therapy?

Finally, I am somewhat appalled by this closing paragraph:

"No more excuses. No more “I don’t have time,” or “It’s too cold out,” or “I know I should, but…” It has to be done. Just like getting up every morning and going to your job—no-shows are fired! If you don’t buy gas for your car, it will not run. If you do not buy food, you will be hungry. There are just things you have to do. Compliance is required for a pill or a lifestyle and failure to comply will compromise the outcome. No matter how many tests we order."

From the point of view of a relatively healthy, active doctor, who looks fairly thin in her picture, without a cancer diagnosis under her belt, I am sure she thinks its easy. But she needs to walk a mile in hour shoes before she can criticize us. I am just glad she is not my doctor.