I never believed I would live past the age of 39,” she said describing a place of acceptance she’d reached early in life.
Sandra was born with a dangerous form of hereditary hypertension. It is the same form of hypertension that cut short the life of her maternal grandmother at the age of 39, and like a nightmare scenario that repeats itself, this same deadly affliction which stole the life of Sandra’s mother. Like the grandmother, her own mother passed far too soon, also at the age of 39.
Although she passed this same hypertension on to her son, advances in medication and treatment has made a difference in their lives. It wasn’t until she turned fifty years-old that she allowed herself to believe she had truly beaten the odds, released a life-long anxiety and embraced the potential gift of longevity both her mother and grandmother were denied.
Such optimism however would be tested and rigorously shaken a few years later by a telephone call she received on the eve of Thanksgiving 2012. “I had just sat down to relax after a rigorous day at work, a rush home and furious preparation of my holiday dish for the next day’s family feast when the telephone rang.”
“Hello, Sandra? I recognized the voice of my primary care doctor. ‘I’m so sorry,’ she began… My heart beat accelerated, I sank back in my chair and my mind returned momentarily to the place of uncertainty I’d abandoned years ago when I thought I had beaten the odds of a shortened life.”
At the same time, her doctor’s voice droned on in the background walking her through the results of the biopsy and charting a path forward regarding the next steps in what was now a battle to beat the odds associated with breast cancer.
This breast cancer journey actually began weeks earlier when a trained technician reviewed her mammogram, identified calcification in the right breast and advised her primary physician of the need for further testing.
The next step was a diagnostic mammogram which differs from a regular screening mammogram because additional views of the breast are taken. After the diagnostic exam, Sandra was scheduled for a biopsy. It was the biopsy results that led her doctor to call that fateful evening.
“Never be ashamed of a scar. It simply means you were stronger than whatever tried to hurt you.”
Calcifications, like those in her right breast, look like grains of salt on a breast x-ray and are very common and can be found in the breast of nearly half of women over the age of 50 and in at least one in ten women under the age of 50. Because they are too small to be felt during physical examinations of the breasts, they are usually detected during routine mammograms. Breast calcifications can result from normal aging, inflammation, and/or past trauma to the area—it does not result from calcium in one’s diet.
More than 98 percent of the time when calcifications are found during routine mammograms—they are ultimately determined to be non-cancerous. Sadly, Sandra fell among the two percent of women whose breast calcifications were cancerous.
“My first reaction when I heard the news was fear,” Sandra explained, “Fear of the unknown, and confusion. I was confused as to why someone like myself, who went for a breast exam every year like I was supposed to, and given there was no history of breast cancer in my family, how this could happen?”
She continued, “I think it is human nature to go to the worst place first and begin to wonder if this was what was going to end my life, so to speak.”
One of the first things she did after getting the news was to research. “I wanted to find out why and how [I got it]? Was there anything that I did to bring it on? And, I wanted to find out what the possibilities were regarding treatment, medication, etc. Would I lose my breasts? Would I lose my hair? I wanted to know everything associated with breast cancer.”
She also thought about the impact this would have on her only child. “My son and I are very close. I wanted to tell him in person. “When I told my son, I wanted to talk to him, I could tell he suspected right away that something was up.”
She was right. Her son knew right away something was wrong, “I raised him as a single mother and we can read each other very well,” she explained. “His first reaction was very emotional—he cried. He later told me he cried because he knew what it could mean. I think because cancer usually has such a negative connotation. He said it was the stark reality of not knowing how ill I was and whether or not my death could be imminent.”
Buoyed by the support of her partner, son and other loved ones, Sandra met with an oncologist and surgeon to discuss her treatment options. “The cancerous calcifications were grouped in two sections on opposite sides of my right breast. If I opted for a lumpectomy the surgeon would have had to carve out two large sections on either side of it and there was no guarantee they would get it all or that it would not return. I chose a mastectomy,” she said because it offered the best odds that all the cancer would be removed.
Sandra went on to explain how she might have made a different decision had she been younger. “I’ve learned over the years that I am more than my body parts, that the loss of one or both breasts would not make me less of a woman.”
She further explained how her support network was instrumental in helping her through the shock of the initial diagnosis and making the hard decision to have a mastectomy. “I never felt pushed,” she confided. “I was able to speak my feeling about what I was going through, and I was listened to without judgement or others imposing their beliefs on me. My partner allowed me to express how I felt. I was never told what to do. This made it easier for me to make decisions. There was truly a partnership that I felt was in my best interest.”
Dealing with cancer can be catastrophic. “It is a blessing to have people that embrace you and take your experience to heart without the ‘if I were you’ so to speak.”
After deciding to have a mastectomy Sandra was faced with the additional choice of whether to have reconstructive surgery. “I weighed the pros and cons, but ultimately decided against it.”
This was the one part of her cancer journey where she expressed disappointment with the medical community. Although she had made it abundantly clear to the surgeon she did not want and would never consider reconstructive surgery, the surgeon took it upon herself to leave additional skin when the breast was removed just in case Sandra changed her mind.
The doctor later explained she left the extra skin because—based on her surgical experience—so many women do change their minds about reconstructive surgery and without additional skin that can be stretched to accommodate it, there is no way to do reconstruction. “It was not her place to override my decision,” Sandra said with a tinge of anger and frustration. Removing the extra skin would now require another surgical procedure, something she did not want to undergo.
Sandra encouraged other women to document their preferences to protect themselves from other physicians who may take similar liberties. “I didn’t like the fact she [the surgeon] took that privilege. I was offended by that,” she adamantly declared. Beyond this issue, she has no regrets about the course of treatment.
From a different perspective, Sandra stressed the valuable role of caretakers and spoke with praise of how important the caretaker was in her own recovery. “I was the person with the cancer. I was the person who had the ‘C’ word, but I think the caretaker, caregiver was the real hero. I think the person who cleared my drainage tubes, who looked at and washed my scar before I found courage to see it for myself, the person who steadied me when I found the courage to look at it for the first time and nearly fainted—that’s the real hero.” She continued, “I always felt blessed. My faith is strong, and I knew God would take care of me, but having that support person, the unsung hero called ‘caregiver’ helps cancer survivors like myself make it through.”
Fortunately, her cancer was caught before it spread to her lymph system and she did not require chemo therapy or radiation; however, she was prescribed hormone therapy for five years following the surgery to reduce the chance of the cancer reoccurring. She also went for diagnostic mammograms every six months.
Sandra completed her five years of hormone therapy almost two years ago. “There was a certain security I had while taking the medication,” she said along with what she described as the self-imposed belief that as long as she took it, the cancer would not come back. “When I came off it, I felt insecure and afraid. Every little feeling that came up I was questioning the doctor, ‘Is it coming back?’”
The oncologist reassured her there would continue to be check-ups every three months and a diagnostic mammogram annually or sooner if warranted. “The fact I would be closely monitored made me feel more secure. Although I continue to have what I describe as ‘electric charges’ from the nerve endings left when my breast was removed, I am in a good place right now. I don’t worry about it anymore. With ongoing support and my faith, it is not something I constantly think about—I know whatever the future holds, I will get through it . . . my faith keeps me rooted in the fact that I can make it through anything.”
Sandra encourages women not to assume that because no one in their family has ever had breast cancer that they are exempt. “I am ‘now’ my family’s history,” she noted. “Value yourself. Be proactive. Get your mammograms as recommended. Don’t assume because you can’t feel a lump in your breast(s) that you are safe—I never had a lump.” She also noted how sons, as well as daughters, of women with breast cancer may be at risk and should consult with their doctor about scheduling a breast examination.
In conclusion Sandra said, “I know I have a lot more to offer this world—maybe this conversation for example—sharing my journey, encouraging others to be proactive is this regard is, maybe it is all part of the reason I’m still here.”