My Cancer and Me, We go Way Back

The good news is that yesterday and today were pretty normal days for me. I got to be much more of "Lawyer person" than "CANCER person" (and no, those are not actually the same thing) and that was pretty nice. The bad news is I don't really have a blog story for you. Or is that good news?

But I have been reading. Gone, for awhile, is the great reading streak I was on B.C. (and come on, you know what that means) when I finished The Elegance of the Hedgehog, The Little Book, and People of the Book in just a few blissful weeks of fireside fiction-fest. No, now I am all about such exciting and all-too-true books as "The Breast Cancer Survival Manual" and "Breast Cancer: Real Questions, Real Answers."

Perhaps this amply demonstrates my life change.
BC v AC.







I'm thinking it's less fun, AC. But, I'm certainly more informed. So I'll share some of that information.

I've learned many surprising things, but way up on the list was this fact: by the time a breast cancer mass (fancy word for "lump"; unless you are trying to apply it to your spouse--It doesn't work the same) can actually be felt, those dastardly cancer cells have been hard at work in the breast for 6 to 8 years. Years! I've had cancer for years! (I'm totally expecting phone calls, cards and flowers from some of you...the way you've treated me...and I had cancer then!!!). Modern technology can't detect the cancer in the beginning years of growth (nope, not the mammogram, not an MRI, and you can't feel it either...these are just little tiny bad-guy cells), so it's only after they've divided and multiplied and turned into a gang that they get discovered. In Dr. Chan's book "Breast Cancer: Real Questions Real Answers" on page 68 he has a nifty little chart. I wish I could insert it here but I can't (copyright or some such; damn lawyers).

Basically, it follows the life and times of a fertile little cancer cell which then reproduces to be 2 cells in about 100 days, then 4 cells at 200 days, 8 at 300, 16 at 400 up until at about 5 years the cancer party is now about 1mm in size. Millimeter...not centimeter. Only at 8 years have they divided in number to get to the 1cm size, which is generally considered the smallest "palpable" tumor (meaning you can feel it--if you were trying; the machines might pick it up before this...if you were getting regular mammograms). At 10 years that could be 2 or 3 cms, or larger, depending on the rate of growth.

Let's just think about my rude little invading tumor bastard (just a little pet name I have for it). I have been good and I've had a mammogram every year since I turned 40. So that would be 5 mammograms that didn't pick up on the party going on. The last of these was July of 2008. Then in maybe November I could actually feel something, but I wasn't sure what it was. By December it was clearly "a lump." And it turned out to be a 1.7cm lump. It had maybe been growing there for 8 years??

Among the many tests and numbers and scores and ratings that go on when the folks in white are figuring out what sort of nasty little bastard has invaded, is one known as a Ki-67. No idea what that stands for, but it's "...a test that detects a protein that is important in cell growth in the nucleus of the cancer cells. If a cell is about to divide, there is a lot of this protein present within the nucleus and this can be seen by a special staining technique with a microscope. Having more than 10 percent of cells with Ki-67 staining is considered elevated. The higher the number, the greater the growth rate of the cancer. Very fast-growing breast cancer can have a Ki-67 levels of 60 to 80 percent, indicating that 60 to 80 percent of the cells are preparing to divide." (Thank you Dr. Chan, "Real Questions Real Answers" p.61).

My Ki-67 was 50%. Quite a party of evil. Which explains the change from July to December. It also, in part, explains the chemotherapy as necessity. We don't know if there are other cells starting a party o' bad somewhere else in my body that just hasn't been picked up yet--some of the gang-banger party attendees could have flowed out into the street and down to a neighbor's where they are hiding out (cowards, really) until there's enough of them to make their presence known. We need to flush those out and banish them.

As I believe I mentioned before, I didn't really spend a lot of time with the "how" or "why" this happened to me. Despite triple over time with the Catholic Church as a kid (Catholic school, regular mass attendance, and CCD), I'm not that big on guilt (I mean mine; I'm all about inflicting it on others). But I did wonder, momentarily, if increased wine consumption of the last few years (I blame and credit France) and/or my new found taste for red meat (I couldn't tolerate it as a kid so never ate much of it--much like chocolate--but man, can Chris grill an incredible steak. And once he started melting bleu cheese on top of it....I was a goner) had anything to do with the cancer. But it couldn't have. This bad little party of infidels has been there for 8 years or so! And both books and many articles I've read and all doctors I've talked to (and yeah, there have been a lot) seem to say "no" to just about any "did ____ cause the cancer?" type of question I or anybody else may have.

My favorite "real question" in that book is basically did stress cause the breast cancer. The answer is that studies have not shown that stress causes breast cancer. But um, yeah, let's think about this...Breast cancer is most typically found in older women. Let's be wide-sweeping and assume that means women over 40 (since that's the group they suggest get mammograms). And the cancer has been growing for years. Okay, so you are testing to see if women who had stress in their life were more likely to get breast cancer....ummm...where's the control group for that??? Where do you find the group of women over 40 who haven't had major stress in their lives to see what their rate of cancer occurrence was?!! If stress caused cancer, I'd be Stage IV. We all would.

So what have we learned? a) Teresa is very, very wordy, but you can't say anything because the poor thing has had cancer for 8 years now! b) Do your self-exams--know what's normal in your breast and what isn't and get things checked out before the party gets out of control!! and c) I didn't start this cancer thing, but I'm darn sure going to end it!