The Screening Debate

There's been a lot of coverage in the news this past week about recently issued guidelines, by various organizational bodies, pertaining to recommended screenings for women for both breast and cervical cancer. On the breast cancer front, mammogram, as a routine test, is only officially being recommended for women over 50, and for cervical cancer, Pap tests are only being recommended for women over 21 and only once every two years.

After having the "early detection saves lives" messages rammed down our throats for the last 20-odd years, predictably there's now much consternation and brouhaha over these changes. Many of my friends have been asking what I think about this latest set of developments in the the World of Cancer.

So here's my two-cents for what it's worth.

If you've been doing your reading on the subject of breast cancer screening, you would know that these recommendations aren't new. In fact, the debate on this issue goes back at least as far back as the early 1970's. (See recent New York Times article, New York Times Op-Ed column, and Breast Cancer Action press release). The boffins have long known, that STATISTICALLY speaking, early detection and so-called breast cancer awareness, doesn't actually significantly alter mortality rates or outcomes at least as far as breast cancer is concerned.

All it's really meant for many of the breast cancer-stricken population is that they are simply in treatment for longer which may or may not be helpful. The reality is that for many women, breast cancer is still an aggressive disease for which there is still no cure. The thinking has been that the earlier your cancer is detected, the better the chance that you get to live a little longer, and of course the drug companies still get their annuity. On the flip-side, because of the over-success of the "early awareness" campaigns by the Pink Ribbon brigade, some detected cancers are being unnecessarily treated and/or operated on when in reality so they are so low-grade and slow-growing that they would have been better just left alone.

Statistically-speaking, the number of deaths prevented in screening women under-50 comes out to something like 1 in 1900 (a statistic apparently deemed uneconomic and insignificant by the boffins). Well I guess that's reasonable so long as you're not the 1 woman out of 190o, right ?

So this is all well and good, and I don't necessarily disagree with the new recommendations, but the bottom line is this. Both the old and new guidelines failed me, and will continue to fail those women who fall outside the statistical norms. Let's not get caught up in statistics when it comes to our own bodies. Let's have policies and a health system that encourages us to be our own advocates. Let people make up their own minds, in consultation with the medical professionals, as to whether they want the stress and other risk factors associated with cancer screenings.

If you think something is wrong, find your voice. Be heard. You might just save your own life.

Big Faker

It's funny how the old saying of life imitating art, more often than not, proves to be true.

Last night I was watching a rerun episode of Seinfeld: The Scofflaw. It was the one about George and Jerry's friend who admits to George that he faked having cancer, all the whilst taking advantage of Jerry's kindness, including buying a toupee with a gift card given by Jerry.

Turns out that recently there was a woman in Texas who did pretty much the same thing. She told everybody she had breast cancer, shaved her head to imitate chemotherapy effects, raised money for her "care", and then spent said money on a pair of fake boobs. (Read the full story as reported by MSNBC late last week).

Of course after watching the Jerry episode, and then hearing about the Texas story, I knew there had to be a sassy blog entry in there somewhere, so here goes.

First of all, I can't imagine the efforts that this women went to fake having breast cancer. Would it really be that much fun and worth it just to have a couple of hard-feeling, saline filled sacks inserted into your body ? I mean really, let's think about this. She had to keep her head shaved, wear makeup to imitate pasty yellow chemo-skin, always make sure she looked her worst, bring on the teary waterworks on cue, spend an inordinate amount of time lying on the couch watching a lot of crap daytime TV, have lots of dreary deep and meaningful conversations about her feelings, eat copious amounts of bland and tasteless food and then throw it all up to fake chemo nausea, write a bestselling book on "Why I Wore Spanx to Chemotherapy" or something similar, spend hours in doctor's offices reading about the scintillating adventures of Speidi in People magazine, and worst of all drape herself in garish pink survivor gear and bop out to "We Are Family"or "I Am Woman, Hear Me Roar" at any opportunity to rally the support of her community. Phew !

Nope ! It doesn't sound like something I would want to do. In fact I want to do just the opposite. Folks, I am going to fake NOT having breast cancer. Just think about what I'll have to do to pull it off. Spend my evenings draped in designer gear partying my ass off and all after 9pm, constantly laughing and smiling and lighting up rooms with my brilliant and interesting presence, field compliments on how beautiful I look and what am I using on my skin to look so youthful and healthy, never wear pink, excel at my high-paying professional career, go to the doctor once a year (and only to refill my Pill prescription), have so little time because of my busy and vibrant life that I am barely able to find time to blog about NOT having cancer, harvest my crops on Farmville, or update my status on Facebook, and best of all, enjoy and revere my REAL size 32A boobs !

Facebook, Farmville & Fighting Cancer

I attended a networking session last week where it was suggested to me that I might like to try Guided Imagery to help combat the stresses of dealing with my stupid cancer. My immediate thought was, why the hell would I need to when I have Facebook ?

I discovered Facebook about a year ago and I can tell you I have drunk a kegful of the Kool Aid. I LOVE it ! I get to be the "me" I was before all the cancer crap came into my life.

In my Facebook world there is no cancer. Just me and my virtual pinup board which charts, in pictures, the most wonderful moments of my life and is a rich history of friendships formed over many years from childhood, the schoolyard, university, work life, travelling abroad, marriage to present day. Life's magical journey, fully documented, and relevant to somebody, somewhere in the rest of the world.

I get to be witty, fun, mysterious, flirty, seventeen, twenty one, thirty five, world traveller, arbiter of popular culture, gossipy, icon of coolness, 80's music aficionado, literary genius, reporter of current events, tastemaker and above all a picture of health in the minds eye of my Facebook family. Well, at least that's how I like to use it.

I am surrounded by my loved ones 24-7, in all manner of far flung corners of the world and there is always someone to talk to, laugh at, gossip about, learn from, read about, catch up with, no matter the time of day or night.

Updating my Facebook status, although annoying and mundane to some, is a real opportunity for me everyday to find joy in the days events and shout gloriously to the rest of the world that my day wasn't wasted. With Facebook, I never feel alone. Ok, that's a multimillion dollar ad campaign right there. Excuse me whilst I go and call my agent to discuss terms.....

Whilst you're all still here for the ride, let me tell you about another joy of Facebook which I only just discovered. Farmville ! Yes folks, that's right, Farmville ! Why would I need to go into a darkened room with an aging hippy, listen to monotonous ohm chanting, to take myself on a mystical journey to find my inner fourth chakra that will apparently fight my cancer cells if I just focus, when I could just log on to Facebook and go play Farmville ?

What a wondrous and devilishly delightful guilty little pleasure this has become for me. There's something completely mesmerising and hypnotically peaceful, about virtual agriculture and animal husbandry. I find myself completely enraptured by the inner workings of my virtual farm, and take the responsibility of keeping my farm beautiful (and profitable) very seriously indeed. It's a gorgeous place I have created. A little cottage in the corner with flowers in the garden, surrounded by a hedgerow and all manner of fruit trees. Walking down a path and out the front gate, there are fields of potatoes, pineapples, coffee beans, carrots, a little pond with ducks and turtles, and whatever else takes my fancy that day. The animals are healthy and happy in their paddocks with hay and water troughs, and even trees to shelter under when the heat of the Farmville sun gets to hot.

In Farmville, the sun always shines, the animals make contented noises, and Mother Nature is generous with her bountiful gifts. My husband has also got in on the game now, and I think he also finds similar attractions in being able to retreat to the fantasy farm-life we have created, and spends time in the evening perfecting our own little slice of paradise. We want to live on our farm.

I know some people think Facebook and games like Farmville are a waste of time, but when you're living with cancer, the real world can be a lonely old bitch and sometimes it's nice to have a place to retreat to that doesn't involve wheat grass enemas, inner chakras and motley old hippy yogamasters.

Cancer Catchphrases

Here we are in November already, and somehow I managed to let another month slip by without managing to post nary a 1-line zinger or another rant and rave at Breast Cancer, Inc, or even another "Woe-is-me" type story. No excuses really - just finding it continually hard to collect my thoughts in a rational and logical manner, and more importantly in a form that is appropriate for a public forum such as this. Plus I like to inject a little comedic spirit into my writing, and sometimes, dammit, my funny just ain't there !

Anyway here I am now, so time to have a rant about something that's been on my mind lately. In the World of Breast Cancer (and maybe other types as well) you hear a lot of what I like to call "Cancer Catchphrases". I really need to take some kind of unscientific survey on how many times in a month I might hear some of my personal favorites.

DISCLAIMER: Now folks, I know people mean well when they utter these phrases, but when you've travelled the same road that I have for this length of time, you start to get a bit cynical. So apologies in advance if anyone is offended by my poking fun but if you'd been there you'd get it.

1. "My thoughts and prayers are with you"....Well what else does one say ? Hi ? Want to go out for lunch ? Got some really good gossip for you ? Yada, yada, yada.

2. "God only gives us what we can handle"....Thanks, but I would have preferred to handle a mansion on the beach, $10 million dollars in the bank and a completely carefree existence !

3. "Please let me know if there is anything I can do for you".....Sure. Do you think you could come over and clean my gutters, clip my dog's toenails, unblock the septic tank, and then cook me dinner ? How's Sunday for you ?

4. "Cancer can now be thought of like any other chronic disease".....Errrr okay, and it's raining Pink Elephants outside my window. See my earlier post for how I really feel about this one.

5. "Keep a positive attitude".....Mmmmm this is a tough one to mock but let me give it my best shot. It's a good thing, regardless of whether you have cancer, to maintain a sunny disposition, positive attitude and general zest for life. But unfortunately these things can't cure cancer. It's a physiological affliction and cancer doesn't care if you have a smile on your dial 365-days a year for 24 hours a day. If it did, you can be sure I'd be so juiced up on happy pills that the sun would shine from my proverbial you-know-what. I would be on Oprah talking about my best-selling book, "Stick it where the Sun Does Shine". People would pay millions to come and listen to me speak. Hell I would have my own talk-show, magazine and multi-billion dollar empire. Oprah would be calling me for advice. Okay enough of the fantasies. Of course I try to be positive. But sometimes it's hard. It's okay to have a blue day. It's not going to cause the cancer cells to multiply. It's perfectly normal.

6. "Cancer doesn't define you".......Okay. This one is my favorites for this month. I've been doing the rounds of various doctors and therapists and spending a lot of time gabbing about the stupid cancer. I hear this one ALL the time and I used to agree with it, but now I'm not so sure.

What does this really mean ?

Let's just take a routine day in my life right now. I get up and change the sheets due to the night sweats that I had the night before. I go and eat breakfast. Exactly 30-minutes after eating I take my chemo pills for the day. I wait around for at least another 30-minutes after that staying close to the bathroom in case of urgency's which can sometimes be a side-effect of the chemo. I take a shower, get out and look at my scars, and then put an SPF moisturizer on my skin because it cannot be exposed to sun for any length of time due to the chemo. I put another moisturizer on my hands and feet to try and keep "hand and foot syndrome" at bay, another chemo side effect. I blow dry my hair and wonder if all the hair that is falling out, is normal or whether it's the chemo again. I go to Pilate's to keep my surgically altered shoulder and back muscles limber, and keep my general fitness level up. I come home and have a lie down due to feeling a little nauseous and fatigued. I go through the mail and reconcile all the medical bills with the insurance claims. I pay the medical bills that the stupid insurance didn't cover. I ponder the pain in my right side and wonder if it's anything to be concerned about. I call my Doctor to schedule the next chemo appointment. I think about organizing a vacation around the next set of body scans and how to fit the chemo in. I sit down and eat dinner. Exactly 30-minutes after eating I take more chemo pills. I go and watch TV and zone out. I go to bed and take a sleeping tablet so I can sleep uninterrupted. I get up the next day and do it all over again.

Now I might be oversimplifying things a bit, and I've certainly left out the little things that can make a day great, but the fact is, a lot of my everyday life now is consumed with dealing with the stupid cancer. Cancer seems to be my job and I'm certainly a career girl. If I could resign from the job I would as it's certainly not the life I envisioned for myself. Is cancer who I am ? No I don't think so, but it sure does suck the life out of you and it's a struggle every day to remember who you were before the stupid cancer barged uninvited into your life.