LLALALALLLALLLA (fingers in the ears?)

It’s my first #BreastCancerAwarenessMonth. It’s all suddenly got reeaaaally loooooud on the cancer front and I am feeling an overwhelming urge to stick my fingers in my ears and dive under the duvet. For a start, is it just me, or does it feel like one huge echo chamber of cancer people making each other even MORE terrifyingly aware than they already are? Are the non-cancer peeps even listening?!

I mentioned on the socials the other that it hasn’t been easy of late. I’m riding some pretty dramatic.. well.. I was going to say “highs and lows’ but it feels a bit more like ‘troughs and ravines’ at the mo where just reaching sea level represents high ground. I’m working through it and doing what I need to do. Constantly thinking about cancer (cancercancercancerCANCER!!!) is one of the things that needs to be managed. Steering clear of the ‘gram can help but paradoxically, it’s also where to go to find people on the same wave length that can make the inner terror feel, well, normal.

At the moment, though, it is REALLY CANCER LOUD with every Thomasina, Dick, and Harriet with Breast Cancer coming out to bang the Boob drum. Quite rightly. It is Breast Cancer Awareness Month after all. Out come the personal diagnosis stories, the tales of recurrence (eek), incurable spread (gut-drop), the scary facts and stats, the jubilant smiley posts about living a great life with incurable breast cancer (hmmmm), all of which is really important for the unworried well to hear, but unwittingly feeds my current Fear Modus Operandi.

It’s particularly loud at the mo of course because I follow a lot of people who happen to have cancer, breast or other. The cancer people I follow also follow, and are followed by a lot of other people with cancer. Lots of us follow each other. These people, the very-breast-cancer-aware, are sharing and commenting on each others’ posts, sharing awareness campaigns that they happen to be a part of, or their friends’, sharing breast cancer product promotions, blogs, campaigns, tweets, fundraising initiatives. I see the same content being recycled, daily. (As a brief aside, so enmeshed are the cancer aware in cancer awareness, that they opine on the nuances of cancer awareness. Mary Huckle, in life-long treatment for secondary breast cancer, wrote an apologetic instagram post today about ‘going pink’ this Friday because of the general outrage around the pinkification and pinkwashing of breast cancer.)

Anyway, back to this. The big question is, is this big Breast Cancer machine just feeding itself? Do the really important parts of Breast Cancer Awareness Month actually reach the people who don’t have breast cancer?How many non-cancer peeps have read a Breast Cancer Awareness post on social media and taken it in in some measure, shared or retweeted, checked their boobs, donated to cancer research, attended something that benefits a breast cancer organisation or charity? What difference will Breast Cancer Awareness Month make to them, or you, this October?

If that reads like an admonition, it’s not meant to. If I wasn’t being so lazy, I’d look up fundraising data and awareness stats and correlate with diagnosis rates. I’m pretty sure they’ll prove it’s all working. I am aware, as I write, I might be sounding a tad cynical in the face of this great force for good. Maybe it’s the medical menopause talking (it’s a full moon too y’know lols). Perhaps I’m just feeling a bit weary of it all. If you’re reading this, and you have breast cancer, you might be feeling the same. If you don’t have cancer, do me a solid, and please make it all worthwhile for you. Eyes open. Drink it in. The two best outcomes of this month are 1. Behaviour change (checking and doing something about it if you notice a change) and 2. Donations or fundraising to fill the research coffers to help find a cure.

It’s Scary Cancer Fact Friday!

So friends, I’ve got an Oncology meeting coming up so I’ve been mugging up all things cancer. Yay! I thought I’d share a few key scary cancer facts that I’ve learned since moving on over to this side of the cancer fence. Not to terrify myself, mind, or you for that matter (we can all do without unnecessary frights) but just for a healthy dose of realism in amongst all the gratitude as I go into  Phase Two of treatment  (the shitty phase involving hard drugs, but not the fun kind).

Also because, WOW, I’ve realised how little I knew about cancer before this. And, frankly, how little so many non-cancer people know too.

This is happening a lot, for example;

Friend: I guess you’ve given up sugar to starve your cancer?

Me: Fuck off and pass the damn cake.

And this;

Me: OmiGOD, did you know that if the primary breast cancer spreads to another part of your body it becomes secondary and THAT’S INCURABLE (actual horror face)?

Friend: That can’t be true.

Me: Fucking well is.

OK, so that’s the first horrific cancer fact out of the way but I’ll elaborate a bit more because, this, as well as the other has really helped me be kind of ok with the idea of doing chemo, a thought too horrific for me to even contemplate in the early days (ANYTHING BUT THE CHEMO!!).

1. Primary Cancer is curable, secondary cancer currently isn’t. Secondary cancer is when the cancer from the original site spreads to another part of the body., or metastasised.  All it takes is one tiny little cell to break away from the primary tumour, find its way into your blood stream or lymphatic system and then latch onto another organ and start growing. For breast cancer, the next go-tos are often the lung, liver, bone and brain.. Some secondary cancers are curable, but metastatic breast cancer isn’t.

2. It can take years for a cancerous tumour to grow to a detectable size.Some cancers are really aggressive and fast growing. Some are slow growing and it can take quite a while  for one cancerous cell to become a mass** that can be felt or detected on a scan or even to present symptoms you might think worth going to the GP about.. So that means, yes, for slower growing cancers (like mine) you could be blissfully unaware of cancer until such time that it decides it’s time to present itself to you. By which time, if you catch it early, it’s primary, if not, it’s a metastasised secondary. See the first point.

3. There is currently no test or scan to reliably detect Micrometastases in the blood stream or lymphatic system.*** Micrometastasis refers to the tiny cancer cells that have broken from the main tumour but not yet formed their own growth in another part of the body. In my case, cancer cells were detected in one of my sentinal lymph nodes following a sentinel node biopsy at the time of my mastectomy surgery. That means, the node was physically removed, cut open and examined in order to find the cells. These cells were not detected by all the presurgery ultrasound or MRI scans. And they were MACRO not even micro – but still just invisible cancer sittin’ there playin’ the long game.

4. Your immune system alone is not enough to kill cancer cells. Cancer wants to win at all costs. Markers vary greatly from cancer to cancer, and researchers are learning more and more about this, but the long and the short of it is that cancer has worked out ways to fool our own immune systems often by tricking our  immune T-cells into not recognising it as an enemy and therefore fighting it. Antioxidants aren’t going to touch that bastard. It also knows how to spread and how to hide.

5. Chemotherapy kills cancer cells, but not your other cells. Chemotherapy drugs, the treatment demon I’ve been a bit terrified of, stops those insidious cancer cells from growing and dividing and eventually they die. The drugs also affect the healthy cells in our body, but these eventually recover. The chemo is all about halting a recurrence.****

Call me a masochist, but this is me squaring up to cancer’s worst so I can stomach the treatment options. Also kind of handy for you guys to know before you wave your little cancer-curing tincture at me and suggest I try meditation to un-think my cancer into oblivion.  And this is coming from a kimchi-eating, green-juice guzzling, yoga-loving, occasionally-meditating turmeric-junkie who has consciously been re-populating her microbiome for the past year.

I am actually heartened by the kind of clinical trials being funded by charities such as Cancer Research into things like turmeric and asparagine, and it’s entirely possible that the future of medicine lies in a more holistic, integrated approach with traditional and functional medicine working together, but when the chips are down, I am going for treatment with clinical evidence on long-term prevention of metastatic breast cancer.  And if there isn’t a randomised double-blind clinical trial with evidence to support the new miracle cure, it ‘aint on the table.

In short, I’ll take the damn chemo thanks very much. Cake on the side.


** Professor Trish Greenalgh & Dr Liz O’Riordan, The Complete Guide to Breast Cancer: How to Feel Empowered and Take Control, page 9.

**** Professor Trish Greenalgh & Dr Liz O’Riordan, The Complete Guide to Breast Cancer: How to Feel Empowered and Take Control, page 132.

*** According to my team, there are clinical trials currently taking place involving methods of detecting cells for triple negative cancers but these aren’t widely available.

I have referenced Cancer Research or Macmillan for definitions that might be directly helpful to link to for this piece. I have also strongly drawn upon Greenhalgh and O’Riordan’s book The Complete Guide To BreastCancer: How to Feel Empowered and Take Control . It has been a key resource for pulling disparate information together which has been key in building the bigger picture and preparing for key stages of my treatment. Cancer treatment teams tend to drip-feed information which is aligned with the treatment process. This can help people cope and process difficult information in small chunks. If however, you are the type to know more and read ahead, then this is a great bedside bible.