Close to Home: A doctor shares lessons she learned as a breast cancer patient
My diagnosis of breast cancer was a shock, as it is for most women. I found the small hard lump doing my self-exam. I had false alarms in the past, but I was due for a mammogram and scheduled one. From there, the shock snowballed.
I always peek at my mammogram before I leave. This time what I saw looked bad, even to a dermatologist. On the follow-up visit, my surgeon, Charles Elboim, said I had small suspicious tumors in each breast. In denial, I said, “I just returned from my 25th wedding anniversary trip to Italy and bought the most beautiful bras - I can’t have breast cancer.” I’m pretty sure I saw a tear in his eye as he processed how far from reality I was at that moment.
It turned out that I had the most aggressive type of breast cancer, with a small deadly tumor in each breast. When Elboim said that I needed chemo, my denial spoke again: “I’m from west county and can’t possibly have chemo; I eat organic.” Denial finally let go when he said, “This is an aggressive cancer, and you only have one shot - it’s chemo. We take your breasts off after to prognosticate, not to treat.” Translated, this means that if the cancer is gone after chemo, I live; if not, I won’t. Along the way, I learned that I carry the BRCA gene mutation for breast and ovarian cancer, meaning I had that to contend with, too. I couldn’t wiggle out of this, and I was scared.
My life changed, and not all for the worse.
I made survival my singular goal, and I mastered the skill of being a highly effective patient. My familiarity with medical care helped me understand how to get what I needed in the way of information and care. My husband, a business attorney, and I used our skills to collect information and make decisions. In the end, it paid off. What we learned may help anyone facing breast cancer or another serious illness. It also helped me evolve from a cancer victim to a survivor and on to what’s called a “thriver.”
It started with a complete shift of perspective. This diagnosis was war against my body, and I needed to marshal, mobilize and focus. To do this I had to stop working - for the first time in my life.
Next, I shopped doctors. I knew I needed to trust my team. I brought an “active listener” to each visit, and we came prepared with my questions. I asked each physician if I could record the visit on my phone. All agreed, though some were uncomfortable. The recordings helped because I needed to reference those visits many times, especially when I was catastrophizing. My doctors were never as negative as my imagination was. Along with the recordings, we filed all medical paperwork where I could find it. The filing system was helpful when I panicked or my memory failed me.
I also sought out mentors by joining positive online and local support groups. I collected tips and referrals from people who knew the landscape, and I followed my gut regarding the choices I made. For example, one highly recommended surgeon set off so many red flags for me that I knew I could never trust them and let go. In the end, it was a good choice.
I set up my lifestyle to be a survivor. As a physician, I know that there are things a sick person can do to either help or hurt their chances of a good outcome. I wanted the math in my favor, and I took that project seriously.
I exercised daily because a cancer survivorship doctor said I would get a 20% bump in my survival statistics if I did 40 minutes of gentle exercise almost every day. I needed help because I was weak, so my daughter set up a Caring Bridge site for me that included a calendar where people could sign up to help. These walk-and-talk visits anchored my day with conversation and friendship - which is also known to boost survival. They also prevented me from isolating myself.
I stacked my diet in favor of beating cancer. I ate a plant-slant diet of veggies, fruit, lean animal protein and whole foods. This has been shown to help bodies fight cancer.
Other important lifestyle choices that boost survival include rest and minimizing stress.
Taking care of my mental health was a priority, too. I needed a plan for melancholy because I could get depressed researching medical articles about my illness. I had to limit that. I sought therapy to help me grieve and cope with the possibility of impending death, illness and this huge change in my life. I set up visits with friends, spent time outdoors, meditated and prayed. I also avoided negative TV or people, both of which can stress me. Why did it take cancer to boost my self-care?
I set up treats to help me get through a gauntlet of medical care. We spent a few nights at a spa in Napa after I finished chemo. Between the double mastectomy and the hysterectomy, we stayed up the coast for a week. Sometimes we would just drive out to Bodega and sit on a beach for a few hours. It helped.
I also stepped out of my comfort zone and let people help me. I was terrified of the double mastectomy surgery. As a doctor, I knew exactly what was going to happen, and I didn’t want it. Beautiful west county came to my aid; friends in my yoga class offered to hold a healing circle for me. The result was nothing short of miraculous. I went into that surgery focused on coming out a survivor, instead of going in terrified. Who knew? I didn’t even know what to ask for, and yet what I received was miraculous.
I’ve hit the six-year mark, which for me means I survived this cancer. I have side effects from treatment, and my life is much different than before cancer. But I’ve also changed in a good way. I’m kinder to myself and grateful to be here.
Cynthia Bailey is a dermatologist in Sebastopol.