Evelyn Gale
and
C A N C E R
* * * * * * * *
Why Am I Writing This?
The reason I have written this is because cancer is not who I am;
not what I have. I am not a victim; I am an overcomer. Just like I had a car accident
two years ago and got over it. I had cancer. I don't think about it every day. I
didn't and don't want special treatment, but I did covet your prayers. Just as I
pray for all my friends and family every morning, I asked them to pray for me every
day -- not just for cancer, but that God would bless me in all areas of my life --
He took care of the specifics. I didn't want to be coddled. But if you'd have elbowed
me in the boob I might have punched you in the eye (that did happen at Ken's company
picnic the Friday night after surgery, but I didn't punch her - next time, though?)
The prayers of people all over the country gave me the peace and courage I
needed. It's amazing how many friends and friends of friends were praying. I found
out about some of them through e-mail, some through cards and some through visiting.
Since I can't possibly even know everyone who prayed for me there is a new addition
to my daily prayer list: "all of those who are or who have ever prayed for me." The
people I work with were extremely supportive. I have a lot of friends and I have a
God who loves me. He is my healer and he took care of me through cancer; I trust Him
with the rest of my life, too.
I will gladly share my experience with anyone who needs encouragement and
especially with anyone who thinks they don't need a mammogram because they haven't
felt any lumps. I never felt a lump. This kind of cancer doesn't make a lump until
it is well advanced. To quote the PDQ Statement from Cancernet, "Each breast has 15
to 20 sections called lobes, which have many smaller sections called lobules. The
lobes and lobules are connected by thin tubes called ducts. The most common type
of breast cancer is ductal cancer. It is found in the cells of the ducts." That's
what I had.
If you are 40-49 years old you need to have a mammogram every other year. If
you are 50 years old or older you need to have one every year. If any of your
relatives have had breast cancer, talk to your doctor about the frequency of your
mammogram. I never felt a lump. My annual mammogram is what saved my life.
If you have horrible memories of a mammogram technician from hell, then when
you go in for your next one, tell the technician you know you have to be squeezed
tightly and it will be uncomfortable, but you also know that there is a knob they
can turn to ease it in slowly. Let them get it as tight as you can stand it and no
tighter. I had a technician who only used the foot pedal that squeezes by larger
increments and came out of there more bruised than I was after surgery. Don't put
up with that. If you get a technician like that (wait till she lets you loose) put
on your clothes and walk out of there; I wish I had. Call your doctor and tell him
you will not allow that technician to touch you. The one who hurt me probably won't
be hurting very many more women in Norfolk. I complained to the hospital and I've
told every woman I've talked to, what her name is. Yes, a mammogram is uncomfortable,
it has to be tight, but you should never be slammed in the machine! It should hurt
no more than what you can forget after your next cappuccino or ice tea or Pepsi or
whatever turns your crank.
Make Your Appointment to get your Mammogram
T O D A Y!!!
Ps. Men can get breast cancer, too.
e-mail me at egm@evelyngale.com
May 18, 2001
I had a mammogram.
May 24
Because my doctor thought there was a suspicious shadow -- micro-calcification in a duct, I had another mammogram. This time I had the technician from hell and ended up with bruises that lasted for a week and a half.
May 31
I had a needle biopsy to rule out malignancy and as soon as I was off the table I took off for a weekend in Omaha for a writers' conference. I also spent an enjoyable evening with my eldest brother.
June 2
While at the Omaha Press Club I received Dr. Birch's call. The preliminary report was in and it was negative, but he wants me to have another mammogram in six months without fail.
July 5
Dr. Birch called to say the second pathological opinion says that the calcification is quite likely malignant. It seems that if the calcification cells are round they are benign and if they are jagged they are malignant.
July 10
I saw Dr. Hehner, a surgeon, and setup an appointment for surgery. Dr. Hehner just about bounced off the walls, he was so gleeful. He kept saying, "That's what mammography is all about - get 'em early; get 'em small."
July 11
I worked until time to go to the hospital at 10 a.m., Ken took me to one hospital where they put me on a table with a hole in it for my breast to hang down and they squeezed it in an Xray machine took a picture, stuck in a needle, took another picture (I think they did this a couple times) and then Ken took me to the new Surgicenter with the needle still in place and a piece of wire hanging down to my thigh. (The reason they had to do that was because the bad stuff was so small the surgeon had to follow the needle in order to find it to cut it out.)Several hours later they knocked me out when I wasn't looking and I only know what they tell me about what happened in the meantime.
According to the pathology report the doctor left the needle in there to mark the spot and cut a slice out of my left breast 8.0 x 6.0 x 1.8 cm in size.
I woke up about 3:30 p.m. and Ken took me home. I'm so taped up I can't see what happened. I was given instructions on how to empty and record the contents of the drain. That drain is a pain, literally. It drives me crazy. It's a plastic tube with a bottle on the end.
July 12
The tube inside my breast pokes me so it's hard to sleep and it hurts whenever my breast jiggles when I move. I can't wear a bra to stabilize it, and because of the tube and bottle at the end, I have to wear loose-fitting clothing. I went in to work from 7:00 a.m. to 10:00 a.m. and then did some errands and bought groceries; I spent the rest of the day resting.
July 13th
I went back to work full-time; took time out to visit Dr. Hehner hoping he would take out the drain; he didn't. Nor did he have a pathology report yet. I asked him if I was going to list very badly; he doesn't think so; in fact he said he'd made the incision following the lower natural curve so it would be less noticeable. To which I replied that I didn't dance topless very often any more. He did, however, remove the tape, so Ken could count the staples and measure the incision - 15 and about 4". That evening we went to Ken's department picnic at his boss's home.
July 14th and 15th
I did several loads of wash to get Ken ready to go to Chicago for a week. He left early Sunday morning and I was pooped. After church I rested.
July 16
Dr. Hehner took out the drain and half of my staples. That's when he gave me my preliminary pathology report. What I had was low grade ductal carcinoma in situ. Low grade is good - not real fast-growing; ductal means in the duct (see cancernet quote below); everybody knows what carcinoma is; in situ means it was all in one place, hadn't spread, they probably got all of it. Yipee!!
July 17
I wore a bra all day to work -- not a good idea - I couldn't wait to get it off when I got home after work.
July 18th
I spent the morning at the county fair judging 4-H computer projects. It was easy to find nice looking shorts and a baggy top and it felt so comfy, I wore that outfit the rest of the day at work.
July 19th
Dr. Hehner removed the rest of the fencing so I can now go through airport security without showing them my staple job. He turned me loose with the caution to keep my appointment next Tuesday with the oncologist. Evidently some people don't do that?
I'm still too tender to wear a bra and found a little talcum powder sure feels good at the incision site. I still walk very carefully and don't jiggle any more than I absolutely have to, but I have full use of my arm with little discomfort now.
July 24th
Ken and I went for a consultation with Dr. Zahra, a radiation oncologist at the Johnny Carson Cancer Center here in Norfolk. He patiently described the radiation process and the reasons for it to our satisfaction. I went in with the idea I could request a second opinion, but decided it was not necessary. What Dr. Zahra said coincided with what I've read on the Internet.
According to Dr. Zahara "radiation damages rapidly-dividing cells and therefore kills cancer more than it kills normal tissue. The region of radiation treatment is carefully defined . . . and irradiated each day." He explained all irradiated cells will be agitated, but the healthy cells will recover before the next day. The unhealthy cancer cells, however will not recover so quickly and by hitting them day after day for six weeks (28 days) the healthy cells will survive, but the cancer cells will become too weak to divide and therefore will die. After the entire breast has been zapped for 23 days, I will be given five additional treatments to the actual site from where the malignancy was removed. After the final treatment, I will need to have a physical exam every three months, a mammogram of my left breast every six months for two years and after that I can go back to the once a year schedule.
The reason for the radiation therapy is to make sure there isn't even one cell that escaped Dr. Hehner's knife and that there is not another site that is about to become cancerous in the near future.
Because the pathologist who examined the tumor didn't do an estrogen receptor test on the tissue, Dr. Zahra has requested it be re-examined to see if the tumor was fed by estrogen. If it was, then I may need to take Tamoxifen daily for several years to block estrogen receptor sites and therefore starve any estrogen fed cancer cells.
August 6th
This morning I had a CT scan and site alignment marks were put on my skin. These "marks coincide with lasers positioned overhead and right and left of the treatment machine." My expectation was a few little dots and I knew they were going to cover them with tape so I didn't accidentally wash them off. What I have is a green road map complete with taped boundary stripes. Cool!?!
Late last week I had a real bad bout of depression. A wonderful weekend camping in Sioux Falls, SD fixed me up great, and I'm once again the Pollyanna who drives you crazy.
August 9th
Today at 4pm I had my first treatment. It wasn't so bad. The girls drew a few more lines. Now I look like a real highway map--in color even: I have green lines and I have black lines. I was out of there in less than 45 minutes and back to work.
August 10-16th
Every weekday morning since the 9th, I've had a treatment. The actual zap lasts a minute on each side. I've figured out how to dress to speed things up. I put on the nylons I'll wear to work under a pair of slacks with only a blouse and jacket over top and leave home at 7:00. Usually I sit a bit before they tell me to change into that cute hospital gown. Then I go into this dimly lighted room and am helped onto this really long, really narrow table under a round thing that looks a whole lot like those big magnets they use in scrap metal yards to pick up cars.
Before I lay down, I do an excessive vamp thing and shrug my left arm out of the gown. There is an arm-hand holder thing on the left side into which I put my arm when I lay down. There is a holder thing for my head that keeps it in one position, but my head and arm aren't strapped down. One of the girls puts a wedge under my knees for comfort and then, I don't see it, but I feel her put a rubber band around my feet.
From then on it's pure sci-fi. There are usually two women (I call them girls, but they are very well trained professionals.) One woman raises the table I'm laying on; the other one runs the controls for the round thing to line me up with the red laser beams that triangulate across the room from wall to wall. These lines must line up with the streets and roads on my breast.
The round thing, (I later learned it's called a collimator) has what looks like a huge camera aperture, but they put a piece of white metal or something over that and then they put in a half-inch piece of clear Plexiglass that has my name on it and has a whole bunch of holes drilled into it. On it is screwed a lead die or cam or mold. The lead thing is specially made so the radiation doesn't hit parts of my body it shouldn't.
This contraption is then swung around to my right side, it is connected to a large post at the head of the table on which I'm lying. The collimator is on my right side and on my left side is the other arm of this thing which consists of a thin piece of aluminum-colored metal with a small hole in it attached to a big thick painted arm. This arm is so low on my left side I can't see it. Of course, I'm not allowed to move my head. The arms of this thing move around the table in unison. The red laser beams line up so one goes through the hole in the other arm.
The girl on one side says, "That's good." The girl on the other side says "Yup." One of them says, "Okay, Evelyn we're going to leave the room now." I hear a door slam and a half minute or so later I hear a buzz that lasts for a minute (do you really realize how long a whole minute is?) and then there's kind of a winding down noise. The women come back in and rotate the arms so the one with Plexiglass is on the left, but so low I can't see it. All I see is the red laser beam disappearing into the little hole on the arm with the metal sheet on it. The girl on one side says, "Yup." The girl on the other side says, "Yup." One of them says, "Okay, Evelyn, we'll be right back." Again they leave the room and I hear the buzz thing and when they come back into the room we start the dismantling process and I'm back home by 7:30.
Thursday, August 17th
On Thursdays there is a little bump in this routine: They don't let me off the table after the treatment. They have to take a couple "pictures." I don't think they'll show up on the internet, cause I think they're really X-rays. They do this by changing some of the equipment on the arms on either side of me. After I get off the table on Thursday I'm told to dress and wait to have some blood drawn. They send in a pale little girl who draws a bottle of my blood and then this first time Dr. Zahra came in early so I saw him right away. He doesn't usually come in until 7:30, so I may have to wait for him sometimes.
This time I didn't really know what to expect so I forgot to ask him if the cancer was estrogen fed. He said I could call him with any questions, but I don't guess it's that important, I'll wait until next Thursday. He asked how I was getting along and if I had any questions, duh. He explained I probably don't have any effects from the treatments yet and that I have had six treatments and will have another twenty-seven more.
How do I feel at this point? Fine. I'm taking better care of my sleep habits so I don't get so tired because I've had a few total exhaustion times. I've gained weight; not from radiation, but because there's been too much temptation and I have a tendency to eat when I'm--you name it: stressed, happy, unhappy. They want me to keep my weight even so the size and shape of my breast doesn't change so I gotta work on that. Occasionally I have sharp twinges of pain in that breast, but I understand that's part of the surgery the nerves are learning new pathways and healing. The breast is quite tender, but has improved a lot. I'm just anxious to get back to wearing a real bra instead of these makeshift things. They put thin strips of tape over the lines and they irritate my skin a little, but that's all the skin irritation I have so far. It's extra sensitive, but not painful.
Because I've taken only a day off work, so far, for this and have twelve days of vacation and comp-time as well as my sick leave yet, I'm not concerned about time off of work. I have been able to do all I'm supposed to and keep up with what I do at home, too, for the most part. I've not given up anything I did before, so this is just an extra half-hour or so out of my life every day. I don't get to write as much as I'd like, and my office at home looks awful, and I've not been able to keep up with the correspondence and phone calls.
I have received so many cards and phone calls and e-mails. I don't know how to thank everyone who is praying for me, except to pray for them in return, so that's what I do--every morning. I'm getting up at 5:00 or 5:30 instead of 4:00 now, and I spend a little more time in prayer than I used to. So if I don't get back to you with a call, e-mail or letter, just know I'm praying for you and I appreciate your prayers and cares more than you will ever know until you are in a position like this, which I hope you never are.
August 31
Today I had my seventeenth radiation treatment; I'm over half way through. I also got tatooed today. I asked for a butterfly, a daisy or Pierce Brosnan, but got a few freckles instead. This past week I've had a problem with what I suppose is a burn on the tenderest part. I've started using Tea Tree Oil on the burn and hydrocortisone mixed with Radea Gel on the rest of the area treated.
Fatigue is becoming a problem. I'm not getting up until 5:00 a.m. and am very tired by 3:00 p.m. I've tried to take a nap at noon, but telemarketers don't allow that. So far they've been leaving me alone between 5:00 and 6:00 p.m. so when I don't have a meeting, if Ken doesn't come right home and if I get home from work early enough I get a short nap then. I'm so thankful that I've learned to relax to sleep quickly.
Otherwise I feel fine. I found myself sliding into depression one morning this week. I'm quite tired of going to the hospital every morning, but recognizing the symptoms of depression and remembering what all I have to be thankful for are blessings I appreciate. Visiting this week with two other women who have had breast cancer was also blessing.
I see Dr. Zahra once a week. I remembered to ask him and yes, the cancer they took from me was 90% estrogen fed. He says that's good, because there are drugs to block estrogen receptor cells and therefore after my radiation treatments are done, a clinical oncologist will probably put me on Tamoxifen. Then I won't have to worry about estrogen fed cancer in any part of my body. That does not rule out other types of cancer, though and when I looked up Tamoxifen on the internet, I learned that it has been implicated in causing uterine cancer and leg thrombosis. I also learned there is currently a test being conducted between Tamoxifen and Raloxefene (Evista). Raloxefene is not implicated in uterine cancer, it protects against heart disease and osteoporosis, but it also causes blood clots in the deep leg veins. I have my first appointment next Wednesday with Dr. Verdirame, a clinical oncologist and should learn more then about my options.
September 13, 2001
A week ago yesterday, I met Dr. Verdirame. He said it was my choice whether to take Tamoxifen or not. He didn't think I should take Raloxefene because there isn't enough known about its value yet. In regard to Tamoxifen's contribution to endometrial cancer, he said the average woman has a 1 in 1,000 chance of getting it; Tamoxifen doubles that chance. Well, 2 in 1,000 doesn't sound so bad, I guess, but when one of my friends mentioned that is a 1 in 500 chance, that sounded a little riskier to me for some reason. He gave me a prescription for Tamoxifen and set my next appointment with him for September 3, 2002. He wants me to have a mammogram of the left breast in March of 2002, six months after the end of radiation.
I've thought and prayed and studied and prayed and today when I had radiation I asked Deb, Dr. Zahra's assistant what she thought. She said she wouldn't be afraid to take Tamoxifen, but then she doesn't have breast cancer and she might change her mind if she did; and perhaps I could start out with one or the other and if the side effects were unacceptable, I could switch to the other. I asked Dr. Zahra and he said since they got all the cancer that was there, and since I will have a full 33 radiation treatments to make sure there is absolutely no cancerous cells in my left breast, the reason for taking either of the drugs would be to prevent new cancer from developing and either drug would do that. He said I should talk to Dr. Birch if I wanted to change my prescription.
Back at the office, I talked to Tracy. She dropped out of med school to go into ministry and is a very dear friend. She, too, thought I should talk to Dr. Birch since I trust him and his judgement explicitly. So I called and got an appointment to see him this afternoon at 1:15. I told him as I've told Dr. Zahra and Dr. Verdirame that I never was afraid of breast cancer because I was checking for it, but that I'm scared to death of ovarian cancer which is the fourth greatest killer of women and not detectable until it's too late. I told him I was afraid of endometrial cancer because it is not detected by a pap test and of colon cancer because my dad died of it. Bless his heart, Dr. Birch said if I'm afraid of Tamoxifen, then I should take Raloxifene; and he'll call Blue Cross/Blue Shield to find out if they'll cover the cost of an ovariectomy; and he'll ask Dr. Hehner what the cost of a laproscopic ovariectomy is if I decide to pay for it myself. He will also see if the Blues will pay for a colonoscopy.
Right now I've had 25 of 28 regular radiation treatments on the whole breast and next Wednesday I'll have the first of three treatments on the incision. Then I'll be finished with radiation. My breast is pretty red, but not sore right now. Sometimes the skin is tender, sometimes it itches and/or burns. I'm tired all the time. Now I don't get up until 5 a.m., try to take a nap at noon and one before I fix dinner, but that usually doesn't happen because I have meetings at noon and after work, so I'm just tired, very, very tired. I've not given up any of my usual activities except I'm spending less time writing and corresponding. Other than that, I'm keeping up my usual schedule of work, church and other commitments.
September 25, 2001
Today I had my last radiation treatment. Hallelujah!! When they took the tape off
some of my skin came also. I'm pretty badly burned. It is very good to be finished with radiation.
I don't have to go back to any doctors until six months. Well, since I usually get my mammograms in May both Dr. Zahra and Dr. Birch said I could wait until then and get a mammogram on both breasts. I've not heard anything from Dr. Birch about a colonoscopy or ovariectomy.
October 28, 2001
A month after treatments ended I was almost back to normal as far as energy was concerned. I still have a tendency to get tired easily, but part of that could be that I've not had near the exercise I was used to before. The burn took a couple weeks to heal and now I can wear a bra. I have no pain to speak of; just occasional mild stabbing pains that last anywhere from one to thirty minutes. I'm taking Evista and might be having mild hot flashes. I'm not really sure, that's how mild they are. The middle of October I even scrubbed (and I mean SCRUBBED) the outside of our 5th wheel trailer. I'm doing everything I did before surgery and feel very well.
October 2006
I have had a mammogram every six months. My mammograms and my blood tests show now recurrence of the cancer, so I need only one mammogram per year from now on. I do perform thorough self examination during every shower.
Statistically, I am now a cancer survivor. Don't call me that to my face, however. I consider myself a cancer overcomer. There's a difference. I wasn't a victim. I took charge and evicted that evil thing from my body and overcame the pain of the drain, the incision, the radiation burn. I overcame them all through Christ my Lord. I didn't sit still and let them conquer me, over-run me or overcome me. I overcame them all and I want God to receive the glory. Mine was an active, not a passive role in the battle and don't you forget it!
God bless you with health and prosperity even as your soul prospers.
Evelyn
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