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The last words I ever thought I'd hear about myself were "You have breast cancer." It was as though someone had dropped a load of lead on my head. I felt stunned. This is something that happens to other people, I thought. Not me. I figured, I am healthy, I eat right, I have exercised all my life. My sister being diagnosed with breast cancer four years earlier was just a fluke. I mean, other than her, there is no history of breast cancer in my family, I reasoned. How could this be happening?
Every year since I turned forty I have been going to the USC/ Norris Comprehensive Cancer Center and Hospital in Los Angeles. I always looked forward to seeing my doctor, Mel Silverstein, who created the concept of the breast centers in this country. He is a nice guy and has committed his life to the care of women's breasts. My husband always jokingly tells him he is the luckiest guy around because he spends his days feeling women's bosoms.
It was time for my yearly mammogram, and I had been religious about having annual checkups since I turned forty. Because I had been so diligent, I cockily assumed that I was immune to the disease. After all, keeping such a vigilant check on my breasts would ensure that even if there was a problem, we would find it before it ever had a chance to take hold. The nurse pulled and squeezed, flattened, and pressed my poor aching breasts into positions no breast was meant to endure. But it was for a good cause, and all women know that the discomfort and humiliation are worth it in the long run, because this examination is about life, health, and prevention.
"Well, I don't see anything to worry about," Dr. Silverstein announced cheerily after looking at my mammogram.
I felt relieved, even though I hadn't even considered the possibility. Now I could go on with my life for another year knowing I had beaten the statistics once again.
I went into the changing room and hurriedly put my clothes back on. I had a busy day ahead of me--meetings with the various vendors for my jewelry business, the skin care line, updates on the fitness business, costume fittings, and a band rehearsal to get ready for an upcoming date in Las Vegas the following week. I was filled with energy and vitality.
"Suzanne?" I heard Dr. Silverstein call through the changing room door.
"Yes," I answered.
"You know, you've got such cystic breasts--lumps and bumps everywhere. How about having an ultrasound for good measure?"
I opened the door, wondering why this would be necessary. "Wasn't everything okay with my mammography?" I asked.
"Sure," Dr. Silverstein said good-naturedly. "It's just that we have this new state-of-the-art ultrasound machine. I just paid half a million dollars for it; and what the heck, let's take a look for good measure."
Why not, I reasoned. I was there, and it would only take another half hour. Surely I could fit this into my busy schedule. My health was more important than anything.
I lay down on a stationary bed in the ultrasound room, feeling no alarm, since this was just for "good measure." The technician rubbed on some cold, gooey liquid (a conductive fluid) and then began a gentle movement on my breasts with a wand about the size of a curling iron. She kept rubbing back and forth for some time in one particular area on my upper right breast. Then she excused herself and said she would be back in a couple of moments. I still felt no alarm. I had been through these exams before. Often we found cysts that were filled with fluid, which were then drained with a needle. Not the most pleasant experience, but part of the routine. I wasn't worried. Even when the technician returned with the radiologist to further probe my now rather sore and overworked breast, I heard myself telling them, "Not to worry. I always have these cysts; they're just filled with fluid."
The tone in the room turned noticeably serious, and I was at a loss as to why everyone seemed so intense.
"We see something here we don't like, so we're going to stick a needle into it to see what we come up with."
Frankly, I felt relieved. It's the same old thing, I thought. "I've had needles before," I told her cheerfully.
"Well, this is going to be a bit more uncomfortable than what you are used to. We are using a bigger needle, and I will try my best not to hurt you."
The doctor inserted the needle, and this was indeed different. It felt like a carving knife being plunged into my flesh.
"Yeow!" I said, trying to stifle the fact that this hurt like hell.
"You're going to feel a little pop, like a cap gun going off inside of you," she told me. "This way we can gather a piece of tissue for biopsy. Okay, ready?" she asked.
Pop! Wow! It hurt . . . a lot! It felt more like a real gun going off in my breast. Then I felt the needle ripping through my breast while the doctor pulled with all her strength to get the needle out.
"Oh, my God!" I blurted out. "That is painful."
"I know; I'm sorry," she said. "Unfortunately, we are going to have to do this several more times."
Several insertions later we were finished.
The pain was unbelievable. My breasts felt like punching bags. Okay, at least now we've done it, and I can get on with my day, I thought. As I dressed, I decided to tell Dr. Silverstein that he should have prepared me for the pain a little better. In fact, after all the pulling and probing, I wasn't feeling very cheery; and in thinking about it, I felt a little angry that Dr. Silverstein had downplayed the hurt quotient. Carefully I pulled on my jacket, which was no easy feat because of the pain in my breast, and then opened the door of the changing room. Standing in the hallway just outside were Dr. Silverstein, the radiologist, and the nurse, all with serious looks on their faces.
Dr. Silverstein took my hand sensitively and said, "We hope you will be okay."
"What?" I asked, bewildered.
"It doesn't look good," Dr. Silverstein said.
"What do you mean?" I asked. I could feel my heart pounding.
"Of course, we're waiting for the pathology report to come back in a few hours," Dr. Silverstein explained, "but from what I can see, I think we should make plans for surgery."
I experienced the next hours as though I were under water. I heard and saw everything, but it was filtered, distant. I was in shock. So many decisions had to be made. They had found a malignant tumor, 2.4 centimeters in size. It was lodged deep in my chest and had not been detected. The doctors thought it had been growing for approximately ten years. How could the mammogram have missed something so large? I kept asking myself.
Cancer is lonely. The decisions to be made are too serious and too monumental to be passed on to anyone. These were decisions I had to make. It was unfair of me even to ask Alan, my husband, what he thought I should do. Luckily, we had caught it soon enough so it didn't look as though they would have to perform a mastectomy. They would remove the tumor and some lymph nodes from under my arm. If the margins were clean, they would not have to remove the breast. I never thought that I would have my own cancer doctor; but now I had an oncologist, Dr. Waisman. I liked him. He was wise, sensitive, and smart.
I was still in a daze. Only this morning I had been getting ready to go to Las Vegas in a week with my show, and now it all seemed insignificant and unimportant. Alan and I sat in the waiting room, not knowing how to feel. I kept thinking, One day life is perfect; the next day it's as if all the balls have been thrown into the air, and you have no idea where they will land. I'd never given dying any thought. It's what happens somewhere down the line a long time from now. For the first time in my life, I was faced with the possibility of my own mortality.
We drove home in a stunned silence. Alan and I walked on the beach for a long time. Our arms were wrapped around each other, giving support. We were in this together. I couldn't think. I was being asked by so many what I wanted to do, but I couldn't give them any answers. I didn't know.
The following morning I awakened from what seemed to be a nightmare, and suddenly I knew I had to take charge. It was my body, and I wanted to be in charge. I called my endocrinologist and dear friend, Dr. Diana Schwarzbein, to fill her in on my condition. This was war. I began a visualization of my tumor. Inside the tumor I saw this cowardly, creepy person hiding. Every time I saw him even try to step out of the encapsulated tumor, I would yell in my mind with all the venom I could muster, Don't even try to leave this tumor, or I'll fucking kill you. Then I visualized the cowardly little cancer cells shrink with fear and step back inside the tumor. I know it sounds weird, but at that moment I didn't know how to keep the cancer at bay, and this was the only way I could feel that I had any control over it.
Next, I started making phone calls. My agent, Al Lowman, said, "You should talk to Selma Schimmel."
"Who's that?" I asked.
"She's one of my authors who has written a lot about breast cancer."
Selma told me about Dr. Avrum Bluming, who was doing research with women and breast cancer and hormone replacement therapy (HRT), albeit with synthetic hormones. I did not want to give up my hormones. As you will find out in the next few chapters I have expended a great deal of effort getting my chemicals balanced and learning about natural hormones; now, upon diagnosis, I was being told that hormones had to be stopped because of my breast cancer. I knew what that meant relative to the quality of my life, and I was not about to go back to feeling the way I had before I got my hormones balanced.
I started to gather doctors. Dr. Waisman came highly recommended, but I wanted other opinions. I told Dr. Waisman about Dr. Bluming, and he said that not only did he know him, but he was working with him on a study of the connection between women with breast cancer and hormone replacement therapy. Okay, this is good, I thought.
I was on the phone constantly. Cancer is like a job. The treatments are inexact. There is the "common course" of treatment, but so far everything I was being told about the common course was not appealing to me. I knew of too many people who were on the chemotherapy merry-go-round. Chemo seems to make people in treatment more ill; and frankly, it scared me to death. I was afraid of what it would do to the good cells; and I can't say that I wasn't more than a little afraid of the harshness of the treatment. First there's the hair loss and then the sickly color the complexion takes on; then there's the damage done to the parts of the body that until this time were functioning properly. The idea of ingesting potent chemicals was abhorrent and frightening to me. I am against putting chemicals into the body unless absolutely necessary, and I wanted to be sure that this was the only option before I took on something so radical.
Then it was suggested that after surgery I would take the drug tamoxifen for the next five years as a preventative. The only problem I found in doing my research was that this drug would probably make me depressed for much of the duration, plus there was a 40 percent increased risk of heart attack, stroke, and pulmonary embolism. All this for only a 10 percent greater chance that the cancer would not recur? Didn't sound like very good odds to me. I felt weary. So much information to gather, so much authority to weigh. It would be easier to just sit back and let all of "them" handle it for me. That is what I would have done in my younger years. I would have assumed that they knew better. I would have followed the common course. But things were different now. I was a grown-up, and the privilege that comes with having lived this long is the realization that no one knows better than I what I want to do with my body. I have worked too hard all my life to undo the damage of my childhood, to get out from under the grip of having been raised by an abusive alcoholic, to make something of my life, to raise a child on my own, to endure the pain of blending families, to see my career knocked out from under me in a war of egos, only to come out the loser in the whole deal. I could not have known that those earlier ordeals would give me the strength to fight this giant war now raging inside my body.
The big revelation that comes with maturity is that life is a series of highs and lows, and it's during the low points of life that you have breakthroughs. Through the negatives we are given the opportunities to have that "aha" moment where we figure out what we don't want in our lives. I didn't want to live my life as a victim; I didn't want to use the excuse that I coulda or shoulda or woulda had a great life, but I had some bad luck. It has always been the "bad luck" or the negatives in my life that have taught me and shaped me, and I wasn't going to lose this time around. Cancer was going to be my blessing. I was going to learn and grow and survive my way.
From the Hardcover edition.