I was diagnosed with Stage 0 non-invasive DCIS (ductal carcinoma in situ) in my right breast on August 29, 2013. My cancer surgeon explained what those words meant and the treatment options, but shock erased my ability to process her words that day. The only thing that reverberated through my brain was the word “cancer.” I soon started to feel like I was sinking underwater and I couldn’t breathe as waves of fear and panic crashed over me, muffling out all the sound and squeezing all the oxygen out of the room.
I’d been dreading the possibility of that day for several weeks having been through a battery of inconclusive tests over several weeks, including two mammograms, two sonograms, and an MRI. Two radiologists had not seen anything threatening in the images and had advised me to come back in six months for another round of tests when the malignancy would have finally appeared on the screen. However, the symptoms continued to plague me so my doctor ordered an MRI core needle biopsy, which revealed tiny cancerous growths stretching along five centimeters within a milk duct, barely visible but doubling their numbers every 100-120 days. I was lucky to have gotten the “good kind of cancer” – completely treatable because the cancer cells hadn’t yet invaded the surrounding tissue, and I wouldn’t die and I wouldn’t need chemotherapy or even the weird hormone therapy drug called Tamoxifen, the side effects of which resembled menopause. No, all I had to do was choose between three grim options: lumpectomy, unilateral mastectomy, or bilateral mastectomy. Lucky me!
A lumpectomy preserved breast tissue, but the procedure would mangle the breast into a misshapen blob and the accompanying radiation treatment would scar what remained and damage the skin around it. This procedure required a lifetime of careful monitoring because breast tissue remained in which cancer could reoccur and then require more surgery, more mutilation. A unilateral mastectomy meant removing all the breast tissue in the cancerous breast, effectively removing any possibility of a re-occurrence, but the procedure could not guarantee that breast cancer would not attack the healthy side. It also meant sporting one perky fake boob and one natural boob that would eventually sag and require occasional surgical “lifts” to maintain a semblance of symmetry. I studied pictures of women who’d undergone a unilateral mastectomy and it looked okay, but the blatant disparity between the two breasts seemed like it would be a depressing reminder of what I once had. A bilateral mastectomy meant removing healthy tissue in the unaffected breast, which seemed like a ghastly choice, but it also meant never worrying about getting breast cancer ever again, and enjoying symmetrical breasts, which was not a small consideration.
Another major downside to both mastectomy options: the plastic surgeon would remove the nipple. He assured me that he could reconstruct the protuberance in an additional procedure down the road and a tattoo artist in Baltimore renowned for his 3-D nipple tattoo skills would ink in a shade of brown that would replicate my former nipple. I would have frankenboobs! The possibility of losing the nipples, symbols of sexuality and womanhood that were also points of pleasure, motivated me to seek several opinions on the viability of the lumpectomy, though in my gut I knew that I needed peace of mind. I didn’t want to roll the dice and always wonder when the cancer would return so I chose the bilateral mastectomy. The nipple situation resolved itself two days before surgery when my original plastic surgeon suffered his own health crisis and took an immediate leave of absence, and the replacement surgeon performed a nipple-sparing mastectomy. Huzzah! And therein lay one of many moments during the last seven months when I felt “lucky” despite having been afflicted with cancer.
I know that I am lucky in so many ways. However, anyone other than my doctor or another breast cancer survivor telling me so grates on my nerves and causes my eyes to roll to the back of my head and my teeth to grit behind a polite frozen smile. Survival is more complicated than simply being alive. Survival forced me to face death and the reality of my impending mortality, though I was grateful for the opportunity to see how little time any of us has in this life and to make the most of what little any of us has left. Survival meant always wondering what I could have done differently to avoid getting cancer, blaming myself for drinking too much alcohol or taking birth control pills for too many years or eating too much tofu. Survival meant that my life would be irreversibly changed by an involuntary predicament that required making preposterous decisions for which I had neither prepared nor felt equipped to make in such a short period before plunging forth. Making big changes in your life (job, husband, home, etc.) when you have free will to make those choices is scary enough as it is. However, my Wonder Woman powers activated and I felt like I could do anything if I could do that. Survival meant that my body would be mutilated and scarred, and fake objects would be placed inside me as constant reminders of my former self, and the perpetual perkiness and symmetry of my new rack was tiny consolation. Survival meant leaving behind my former self and everything I thought I knew about myself, but it also meant leaving behind the parts of me that ever gave a fuck about being “cool” or what anyone thought of me and gaining the capacity to accept love and to love more.