Tag Archives: Breast Cancer

A Few Less Columns on My Spreadsheets, Revisited

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Last September when I was diagnosed with breast cancer, I posted an essay in this space about a vivid dream with an important message from my mother. I condensed her rather eloquent advice into something akin to a pop culture metaphor.

“I should have a few less columns on my spreadsheets.”

For those not schooled in the addictive powers of Microsoft Excel, the basic translation is that I should dial down my natural tendency to over-analyze everything. Appropriately, the software reference is also reminiscent of my mother’s characterization of me as “queen of the spreadsheet.” It’s a moniker earned by my penchant for using Excel as a tool to create order out of the inevitable chaos that is life. I had to laugh when, looking

Spreadsheet Queen

The Spreadsheet Queen

through pictures for something to post with this column, I ran across a 2008 photo in my mother’s files of … you guessed it … me working on a spreadsheet. That one was a budget for a family wedding.

In the first few weeks following my cancer diagnosis, I clung to my mother’s posthumous wisdom like a mantra. I didn’t want to research traditional treatments vs. alternate treatments or weigh my options against prognosis charts. I didn’t want to write pro and con lists or forecast outcomes using elaborate software formulas that resemble physics equations. I just wanted to do what my doctors recommended and pray for strength and grace. And I did.

I’m not sorry I took that stance. It was a good approach for someone whose emotions were raw and whose brain was on overload. It got me through the initial shock and the surgery.

However, once I felt more like myself again, I couldn’t suppress my own nature. In fact, I came close to being a complete failure at that resolution. It doesn’t really surprise me. I spent most of my public service career planning, developing, implementing and evaluating programs, and I’ve spent my most satisfying personal hours digging into topics that interest me and writing stories. Why should this experience generate a lesser response?

My first project was to research traditional treatment for Stage 1 Invasive Ductal Carcinoma. What I learned led to a couple of tough decisions. With my family’s blessing, I was prepared to reject chemotherapy if recommended. It was not. I was also prepared to reject radiation, which was pushed in a rather uncompromising fashion by a stern cancer radiologist who I’ve come to remember as Dr. Humorless. She wasn’t the reason I rejected radiation, but her demeanor certainly didn’t help sell me on her service. The one traditional treatment my research did convince me to accept is a hormone suppressant since my brand of cancer thrives on estrogen. I may not want to try to kill the beast by radiating every good cell around a few bad ones, but I don’t want to feed it either.

With those decisions made, but still no spreadsheets on my laptop, I turned my attention to reducing the risk of recurrence through nutrition. In the seven weeks since my retirement, I’ve read dozens of articles, watched multiple videos, and referenced some highly rated books on this broad subject. The volume of information is staggering. Unfortunately, some of it is also contradictory or suspect.

Take sugar for example. One claim, backed up by legitimate scientific studies, says sugar encourages cancer cells to grow. When I read that a few weeks ago, I was so shocked that my first impulse was to try to cut sugar out of my diet and write about it in this column. Since then, I’ve found reliable sources – like the Mayo Clinic and the MD Cancer Center – that don’t consider sugar consumption a bonafide risk.

In the end, I decided to trust my oncologist. She says, yes, if you inject pure sugar into the tumor of a lab mouse, the tumor will grow significantly. In real life, for humans, you would have to eat massive amounts of sugar to create the same effect. Instead, she regards sugar as a contributor to obesity, which is a known cancer risk. It’s not necessary to give it up entirely, she says, but Americans in general should eat much, much less. Naturally occurring sugar is not harmful; it’s the added sugars in processed foods that are ubiquitous and risky.

I’ve also read with interest about so-called super foods that combat cancer. There is truth to claims that apples, broccoli, cauliflower, tomatoes and other fruits and vegetables contain nutrients that help prevent or inhibit cancer growth. There is also truth to studies that show the primary benefit of consuming these foods is not to fight cancer, per se, but to promote overall wellness. Cancer, heart disease, diabetes and many other maladies have a tougher time taking control of a healthy body.

Some experts point out that, like sugar, we would have to eat massive quantities of a particular super food to truly make it singly effective against cancer. That’s not to say we shouldn’t consume them. Quite the opposite, in fact. I added pomegranate seeds and Brazil nuts to my shopping list after reading about their potential cancer benefits, but not to the exclusion of many other healthy foods that will help me trim down, bolster my immune system, lower my blood pressure, and generally feel good.

As I’ve educated myself about sugar, super foods and other nutrition strategies, I’ve simultaneously become very wary of the plethora of videos and articles posted on the Internet by people who introduce themselves as doctors but are actually clever entrepreneurs. All I will recommend, if you are inclined to click on something like “the five foods you should never eat,” is to further research any claims these people make. Almost without exception, they want to sell you something. The Internet is littered with predators out to make a buck.

Inevitably, I suppose, a couple of weeks ago I began to toy with the notion of entering all of my most reliable findings into a spreadsheet to try to isolate the best ways to approach nutrition as a cancer survivor. I could almost hear the sound of a needle scratching across a vinyl record when that idea came to an abrupt halt. It was the moment I noticed that two resources I trusted had completely opposite viewpoints on coffee and caffeine consumption. One recommended restricting caffeine to no more than 50 milligrams per day from coffee or any other source. The other said that caffeinated coffee consumption in normal amounts for Americans (e.g., up to 400 milligrams or four cups per day) is not a concern as long as every cup isn’t loaded with creamer. In fact, the latter resource said, some research indicates coffee consumption might actually be beneficial for cancer patients.

As soon as I saw those completely different schools of thought from two trusted resources, I knew I was done. I suddenly and vividly remembered my dear mother nodding when I said in my dream,

“You mean I should have a few less columns on my spreadsheets?”

This doesn’t mean I will never read another word about nutrition and cancer. What it means is that I’m going to implement the big takeaways from the research I’ve done and otherwise go on with my life. Quite honestly, I have better things to do with whatever time God grants me than obsess about everything I eat. It’s become a source of stress and, guess what, that is also a known cancer risk.

The big takeaways, if you are interested, are what we’ve been told by many respected nutritionists for many years. I don’t claim to be a subject matter expert myself, but it’s hard to argue these points.

  • Eat a variety of fresh fruit and vegetables, whole grains, lean meats, legumes, nuts and fish. Go heavy on the fruits and vegetables and light on everything else.
  • Use healthy fats like olive oil and coconut oil in your recipes.
  • Stop eating food that isn’t real food. At the top of my personal list are margarine and artificial sweeteners. By definition, margarine is “imitation butter” and an artificial sweetener is a “synthetic sugar substitute.” Imitation and synthetic have no place in a healthy diet. Based on my research, I’m striving to stick with organic butter and sweeteners like raw honey, raw stevia leaves and dark amber maple syrup (formerly known as Grade B). The closer a food is to the way nature produced it, the better.
  • Don’t try to lower your caloric intake by choosing reduced fat foods. What the manufacturers do to these foods to make them taste good with less fat is simply not healthy. Look it up or take my word for it; it’s better to just eat less of the real thing.
  • Limit processed foods, which typically contain large amounts of sodium and added sugar. Your sodium and sugar intake should mostly be from the naturally occurring nutrients in the original food.
  • Avoid foods that include preservatives and chemicals you can’t pronounce. The only things on the ingredient list should be real foods whose names you recognize.
  • Buy certified organic foods. Stop eating pesticides, antibiotics and any food that has been genetically modified.
  • If you need to lose weight, exercise portion control and get your body moving. Don’t rely on diet foods or diet aids.
1 - Mom and Me 19540001

Mom and me shortly after my birth in March 1954.

These are my big takeaways. And I don’t need a spreadsheet to convince me that they are sensible takeaways. If I happen to run across anything else that seems equally sensible, I’ll share it. Otherwise, I’m satisfied with my analysis. I’m not going to over-think this.

If I’ve learned anything from my brush with cancer, it’s that our days are not promised. Time is too precious to spend it doing anything that doesn’t give you joy. It’s not lost on me that my mother gave me her first name as my middle name. It’s a daily reminder of what she always wanted for me. JOY. Thank you, Mom. Message received.

 

Think Beyond Pink

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My mother adored autumn. Reminders of her love affair with the seasonal colors are mounted in photo albums and picture frames that still reside in her bedroom in the home we shared. Nothing was more priceless to me in her waning years than her contented smile when I drove her past hillsides and through river canyons exploding with infinite shades of red, orange and gold.

This year, my fourth autumn without Mom, I suddenly noticed that October is no longer reserved for the warm colors she so eagerly anticipated. It’s pink.

This apparently started in 1985 when the American Cancer Society and a major pharmaceutical company teamed up to promote breast cancer screening through mammography. That’s a good thing. Awareness, early detection, prevention. Who could argue with that?

Well, no one. However, the major marketing crusade that has amassed around breast cancer is disconcerting to me. Maybe it’s because I was personally diagnosed two months ago, but I can’t wait until the stores I frequent replace the current plethora of pink products with the greens and reds of premature holiday cheer. In my humble opinion, the common and effective advertising strategy known as branding has transformed breast cancer into something that’s it not.

First, let me assure you that breast cancer is not pink. It’s nothing like the enchanting ribbons that many of us have willingly pinned to our shirts and blouses since they were introduced in 1991. It has no resemblance to the eye-catching pink cleats your favorite football players show off in October games. It’s not a cute slogan on a t-shirt or a reusable shopping bag. It’s not a fanciful character in an animated television commercial.

Breast cancer is a menacing spot on a mammogram that, on an ultrasound screen, turns into a hideous intruder with ugly little tentacles stretching into healthy tissue. It’s a monster that sends you into shock no matter how gently the diagnosis may be communicated. It immediately triggers a deep and life-changing sense of mortality. It’s sends you down a rocky path that you never dreamed … not in a million years … you would have to navigate.

Once the initial shock wears off, breast cancer spawns a new lifestyle. As your calendar fills with medical consultations, tests and surgery, you pause to project how long your accumulated sick leave will last. You look at your bank account to make sure you can meet your health insurance plan’s annual out-of-pocket limit, which you are absolutely sure to reach, probably not just this year but next year as well. You start to fill a big, white, three-ring binder with prior authorization notices, medical bills, pre- and post-surgical instructions, and pathology reports that send you in search of reliable cancer websites for interpretation. There’s a breast cancer manual on your end table and a new file on your computer where you store links to websites, summaries of your research, and questions for your multi-disciplinary team of cancer specialists.

And those are just the impersonal lifestyle changes. The personal impacts are even more distressing.

Your cancer becomes a recurrent topic with family and friends. While you want and need to talk about it, you realize that you can’t let it invade every moment of your own life and the lives of your loved ones. You spend long hours awake at night because something about the cancer constantly interferes, whether it be post-surgical discomfort, fear of pending test results, anxiety about projects you want to complete at home or at work before some aspect of treatment knocks you flat, or simply wondering whether you have any other nasty, little cancer cells taking root somewhere else in your body. Even the newsfeed and pop-up ads on your social media account are constant reminders of your diagnosis because all that internet research you’ve done has turned your smart phone into a tattle-tale.

Last but not least, breast cancer demands a grave internal debate, and sometimes a tough conversation with family, about quality of life. Certainly, every one of us has had at least one hypothetical discussion about what we would or wouldn’t do if faced with a potentially life-ending disease or debilitating injury. Breast cancer makes any theoretical answers seem irrelevant. Suddenly you really do have to decide whether you want the aggressive treatments that sometimes pose greater risks to your body and your health than the cancer. You have to weigh whether you want to improve your odds of surviving 10 or 15 years by a few percentage points in exchange for short-term, or perhaps long-term, misery. Or are you more drawn to the least disruptive traditional therapy coupled with alternative approaches like nutrition and immune therapy?

Your conclusions depend on your cancer pathology, years of data about the experiences of millions of women, and your personal feelings about how you want to spend your life. Trust me, these are tough choices and no one … absolutely no one … can make them for you.

That’s what breast cancer is. It’s not a pink ribbon. It’s not a badge of honor. It’s a horrible diagnosis that changes your life. And, if you don’t have the financial and insurance resources that I am blessed to have, multiply everything I’ve said by the tens of thousands of dollars that cancer costs in terms of lost income and medical expenses.

I hope that the frightening details of my first two months as a member of the breast cancer club will fade over time, but there are moments burned in memory that will be impossible to forget. One of them is a conversation with a sympathetic co-worker who said, “I bet you wish your Mom was here.” I shook my head and responded softly as I turned to walk away, “No, I don’t. This would break her heart.”

No, breast cancer is definitely not pink. Pink is a little girl’s princess costume for trick or treating. Pink is a spray of roses in your wedding bouquet or in a crystal vase on your anniversary. Pink is the shade of your favorite lipstick and nail polish.

Breast cancer is a dark scourge that breaks your mother’s heart, if you are lucky enough to still have her around. It steps on the hearts of everyone else who loves you, too. It disrupts lives. It drains your material resources, alters relationships, and makes you physically sick even if you felt fine before the diagnosis.

Physically sick. That’s an apt description of how the all-consuming October crusade built around breast cancer makes me feel. Contrary to the original, altruistic purpose of the pink ribbons and the designation of a month to raise awareness, breast cancer is now a branded, marketable product. It kills more women than any other cancer, with the exception of lung cancer, but there is almost a fanciful aura around it that makes it seem like the trendy “disease du jour.” It is exploited as a money-maker by opportunists whose concern is less about breast cancer and more about selling their wares to good-hearted consumers. Worst of all, in an effort to capture the imagination of younger audiences, hip advertisers have come up with questionable slogans like “Save the Hooters” and “Save Second Base” that some say inappropriately sexualize the fight.

As a newly diagnosed breast cancer patient, I know I’m at a vulnerable juncture, and I could be over-reacting. Yet, something deep down inside tells me I’m not. The corruption of breast cancer awareness is real. For now, though, all I ask is that the next time you think of breast cancer, think beyond pink. Think ugly. Think devastating and life-changing. Once that is embedded in your mind, think hope. Think cure. That’s truly where the pink should lead us anyway.

A Few Less Columns On My Spreadsheet

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A little more than four months after my mother died, I had a vivid, intense dream about her.

That characterization appeals to most people, which is why I use it. However, if I’m truthful, from my perspective it was not a dream; it was a visit. I’ve had enough of these kinds of nocturnal journeys after the death of a loved one to know the difference between a misty, rambling, illogical fantasy that is easily forgotten and a genuine encounter filled with stunning detail and brilliant color that is inscribed in memory. This was most decidedly the latter.

Either way you chose to look at it, there was a message in the experience for me. How do I know? My mother said so.

Mom was sitting on her bed surrounded by presents all wrapped in blue paper and ribbons. I asked, “Is it Christmas?” She said, no, it was the Awakening. Since this visit occurred after I went to sleep on Easter Day 2014, the correlation made perfect sense, as did her counsel about love and renewal. Then she said there was a message in the Awakening for me. To paraphrase, she said I shouldn’t be so analytical about everything.

Her advice made me chuckle. The older I have gotten, the more I have approached every significant decision with detailed research, painstaking work to forecast outcomes, and plenty of agonizing internal and external debate. My pro and con lists are on steroids in multi-tab, colored-coded, formula-driven Excel spreadsheets. Mom didn’t call me “the spreadsheet queen” for nothing. In the dream, I asked her …

“You mean I should have a few less columns on my spreadsheets?”

She smiled and said, yes, that’s pretty much what she meant.

Regular readers of this column may recall that my June 18th edition this year was all about reaching a coveted milestone in my recovery from the grief surrounding Mom’s death, the loss of my sweet Springer Spaniel, and career-changing events at my place of employment. In a nutshell, I had finally come to the joyful realization that there was still life ahead for me!

I kept an additional twist to myself but, while writing that column, I understood with a pleasant jolt that I had entered into the Awakening my mother had referenced during our visit in dreamland. I’ve literally been walking through a time of love and renewal these past nine months. I love myself again, I’m optimistic about the future, and I’ve been busy renewing my body by losing weight, getting fit, and catching up on neglected wellness and prevention activities. I feel more like myself – both mentally and physically – than I have in several years. It’s amazing and energizing.

In a movie, this is where you would hear dark, foreboding music. The main character doesn’t hear it. She is blissfully unaware that her life is about to change. All you can do at the theater is cover your eyes and peek through the cracks between your fingers. All you can do right now is read on.

On August 17th, I had my first mammogram since 2011. They called me back the following week, but I wasn’t the least bit worried. “It’s just been a while,” I thought, “and they need more images to compare.” However, after upgraded 3D pictures and an ultrasound, the radiologist looked down at me with her magic techno-wand still in hand and said gently, “You have cancer.” I actually think she said, “a little cancer,” but all I heard was “cancer.”

Everything after that was surreal. I didn’t absorb a thing that was said to me by the appointment scheduler, but I somehow managed to book a biopsy for the next day. I went back to work but couldn’t think, so I confided in two close friends – one in person and the other on the telephone. I met a couple of my cousins for lunch as they were passing through town and, after they swore to keep mum, told them at the end of our meal. I saw my husband at the restaurant, too, but he was lunching with his department director and co-workers, and I didn’t want to distract him. Instead, I broke the news to him and our grown children that night.

Interestingly enough, I didn’t say, “I have cancer,” to any one of these precious people. The radiologist had said it with no reservations. What she saw on the screen was definitive. But I said, “The doctors think I might have breast cancer.” I maintained that stance until the biopsy results came back the next week. Then I had no choice but to say it out loud.

The first night after the radiologist confirmed her diagnosis, I woke up every hour with one thought in my head, “I have cancer.” I imagine it was my unconscious mind working overtime to help my conscious mind believe it. That was essential since everything moves at light speed after a diagnosis like this. I had very little time to wallow in shock, denial and anger. Acceptance had to come quickly so that decisions could be made.

It’s now been a month since that first mammogram – the day a routine wellness check morphed into a life-altering medical condition. I’ve done a little reading on the internet to better understand breast cancer; being careful to avoid anything about prognosis and risks. I’ve gotten words of wisdom from two very close friends who are breast cancer survivors and suggestions from a few friends stricken with other varieties of this dreaded menace. The Cancer Resource Center associated with our local hospital gave me a wonderful book that literally answers a hundred questions, of which I have read about a dozen. My surgeon patiently presented every option; repeating information whenever necessary during our 30-minute encounter. Yesterday I took an hour or so and got a handle on the expenses associated with the diagnostics and surgery.

During this process I have not constructed one single spreadsheet. I have not designed formulas that estimate costs within a fraction of a cent or that compare the benefits of this treatment vs. that. I have not ranked my choices with a DEF CON color coding system or created tabs that categorize options and establish priority. There isn’t even a rudimentary pro and con list on my home desk. This time – this life-changing time – I am listening to the sage advice of my dearly departed mother and am not being so analytical about the situation and my choices. Instead of …

“a few less columns on my spreadsheet”

… there will be no spreadsheet at all. There will be only prayer for strength and grace, coupled with hopeful trust that the good Lord will help me see the blessings in this experience and make it count for something in my life and perhaps in the lives of others.

My lumpectomy with sentinel node biopsy (the most common choice of women in similar circumstances) is scheduled for Friday, September 22nd. I will let you know what happens as soon as I am able.