Holding My Breath

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Each Cancerversary I have marked the day. With a post. With a "woohoo!" With shock and dismay. Each time July comes around I start with a feeling of dread. My stage III diagnosis came on a July 8. My re-staging to stage IV mets came on a July 11. This July is four (4) years.

I have no "woohoos" to send up as yet. To be candid, the thin veil of dread that blankets me at the moment, psychically, is as palpable as the 115 degree temps with the 45% humidity we are currently experiencing.

I have my 3 month follow up with the Onc this Friday, July 12.

When I started to lose weight back in April / May, I started to try and pound denser calories. The pericarditis, however, makes it uncomfortable to eat. Today, I am still struggling to flirt with the 100lb mark. I know I sound like a bee-atch complaining about weight -- but its not like I am looking hot in a bikini, mini or skinny jeans!

The chest pains and breathing are becoming more of a challenge, again. (That's the good news.) Although, this time now my entire rib cage feels like it is splintering. Its worse in the morning, when I try to exercise, and when I lay down. Other than that, its tolerable. I am still trying to track down a better cardiologist - one that is not so anxious to discharge me with a treatment plan of hospice.

Then, there is the broken foot. More than six months and still has not healed. I got so tired of indulging burning pain with flats that I rebelled and went back to my killer high heels for the court room. The pain is constant regardless, so why the hell not sport the power-heels. (Note...no power heels with bikinis or minis - but yes with the skinny jeans!)

Then there is the persistent nodule in my neck. Its been there for the last 2+ months. Most likely nothing, right?

So, here I sit on the cusp of my two Cancerversaries, wondering how this July is going to play out. In 2009 two medical oncologists, one surgical oncologist, and one radiation oncologist told me I had only a 4% chance of a five (5) year survival rate. I so need to prove them wrong. Need at least one more July in my life-book.

Holding my breath, with cautious optimism . . .

Overselling and Promoting Over Diagnosis...and the Winner is ?

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Breast Cancer: Komen Oversells Mammograms, Doctors Say By SYDNEY LUPKIN August 2, 2012—

abcnews.go.com

Medical Journal Column Calls Pink Charity Out for Bad Math

Two Dartmouth Medical School professors have called out Susan G. Komen for the Cure, accusing the pink-ribbon organization of overstating the benefits of mammograms in its advertisements.

The accusation comes about six months after the breast cancer charity came under fire for cutting Planned Parenthood funding, which it claimed was not a politically motivated decision. According to the foundation's most recent Form 990, it netted about $114 million in 2010.

The ad in question ran last October in several major magazines, and said, "The five-year survival rate for breast cancer when caught early is 98 percent." Its not. It's 23 percent."

"It sounds like you'd have to be crazy not to get screened. It sounds like a huge benefit," said Dr. Steven Woloshin, co-author of the article in BMJ, the British medical journal. "The statistic is totally distorted."

The problem is that a five-year survival rate is easy to manipulate, he said. The ad compares five-year survival rates for early-stage cancers and late-stage cancers, which Woloshin said is not a meaningful way to measure the benefits of screening. Here's why:

Suppose three women are diagnosed with breast cancer at age 67 when a doctor finds a small lump, and they die of the disease three years later, when they're 70. That five-year survival rate is a miserable zero percent because no one lived five years past their diagnosis dates.

Now, suppose the same women were diagnosed when they were 64 because the cancer showed up on mammograms, but they still die of breast cancer at age 70, he said. The new five-year survival rate is a triumphant 100 percent, even though the women actually survived cancer the same length of time. They just didn't know how long they had it.

"If there were an Oscar for misleading statistics, using survival statistics to judge the benefit of screening would win a lifetime achievement award hands down," Woloshin and his co-author Lisa Schwartz wrote.

More useful numbers, he said, are derived from randomized trials. They show that 0.53 percent of women in unscreened trial groups died over 10 years -- compared with 0.46 percent of the women who were screened. That's not much of a difference, the authors said.

This problem is further exacerbated by overdiagnosis, which happens when mammograms detect cancers that never grow or cause symptoms, he said.

For every woman saved by an early screening, two to 10 are falsely diagnosed, the authors wrote. This means patients endure biopsies, chemotherapy and radiation even though they don't have a threatening cancer.

"There's no way for an individual to know they've been overdiagnosed," Wolostin said, explaining that the only way to tell whether this has happened to a specific person is if that person is diagnosed, does not seek treatment and eventually dies of something else.

Doctors have seen evidence of overdiagnoses in long-term follow-ups to randomized trials and analyses of population data, he said.

In response to the article, Komen's Vice President of Research, Chandini Portteus, stood by the foundation's stance on mammograms, calling the screenings "the best widely available detection tool that we have today."

She said Komen has contributed funds toward even earlier detection.

"We think it's simply irresponsible to effectively discourage women from taking steps to know what's going on with their health," Portteus said, adding that the foundation is also funding research to determine which tumors will spread.

Woloshin said his article is not saying mammograms are bad.

"Some people benefit while other people are harmed," he said. "If you don't know, you can't make an informed decision."

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What this article, as well as Komen do not express, is that mammograms can also be ineffective as a diagnostic tool. My form of b.c., invasive lobular - which started as a nearly imperceptible node, was consistently misdiagnosed as "fibrous breast tissue" for years before it grew to 6.2 cm and a biopsy followed by a MRI confirmed its true nature. My history of mammograms gave both my doctor and myself a false sense of health. Until the tumor insisted on recognition.

Additionally, this article and Komen do not address the cumulative nature of radiation - which is the energy behind mammograms; and our bodies inability to naturally purge this and all of the other daily exposures to radiation we encounter. All of which create a toxic environment within our bodies where cancer can happily proliferate.

I personally know many women who have been "diagnosed," via mammograms, with stage -0- / in-situ carcinoma (a pre-breast cancer state). With this diagnosis they have gone on, with full encouragement of their medical teams, to undergo the slash/burn/poison protocol. Their outcome: "cured." Yet, they all seem to be experiencing some after"gift" of their treatments -- no one should leave a party empty-handed. It begs the question: what were they actually cured of?

And, if they and their medical team had not relied so heavily on mammograms, would they have made a different choice?
                                                                                                    ~ TC

The Purgatory of Cancer

****** Being a survivor is a life sentence. There is no beginning, nor end, per se other than the inevitable we all face.

It is a matter of waiting...waiting...waiting. These are prophetic words articulated by so many of the blogs that I follow off the Being Cancer blog-os-phere network. What all these individuals dealing with caner seem to have in common is that they all opted in for the cut/slash/ and or burn protocol after being told those karma-changing words... "it's cancer.". Even my anti - pink fellow marauder, Anne, opened up her veins to the "juice." I am not making any judgment here. This is purely observation and the musings that arise therefrom.

I don't think of myself as a survivor. It seems that moniker more aptly belongs to those who have come through the horrific battleground of adjuvant treatment. Does this make me a coward? A deserter? Did I burn my draft card with my post-operative bra? Since I am not a survivor, then what I am? I experience the same immutable waiting game...waiting...waiting...for the what next. I have the same objective ... out live the odds. I crave to go back to "normalcy," i.e. pre-cancer existence where tomorrows had a boundless meaning; when day to day life did not feel internally controlled by the tolling of a time bomb; when I felt that I could outrun my own mortality by wearing my seat belt, avoiding semis on the interstate, and keeping the speedometer under 110 mph. Instead, I am neither survivor nor casualty. I am in cancer purgatory. Dante could not have conceived of a more stifling environ. Which would be fine, if I wasn't Jewish.

Marking the Day

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A birthday. A milestone of time? Yeah, but what else? Hash marks on calendars? Crow’s feet on the face? A skirmish with the forces of gravity? In its sum, what does celebrating “a birthday” mean?

A compelled moment to take stock? Hmm…new year celebrations and anniversaries allow (if not insist) for that.

A reminder to be appreciative for last year and look forward to the next? Too Hallmark-ish.

A time for tolerated narcissism? A time to be personally recognized for our basic essence…that is, being US…ME? Maybe.

Why do we want, no need, to have the anniversary of our birth actually mean something? Is it because we are a narcissistic species who like to believe ourselves capable of appreciation, reflection, optimism and therefore recognition? Probably getting closer to the truth.

From where I sit, I think it may simply mean that, today on the marking of my birth, I have the scoring advantage. . . .

“Visitor (Reaper) -0- / Home (Me) -49-“ 

For today, that’s enough.