Chapter 13: When Cancer Comes Back

There I was, lying in bed on a sunny Sunday morning in July with the newspaper and a cup of coffee, enjoying feeling well. After five months of cancer treatment and five more months of recovery -- gaining energy day by day, remaking my life to fit my new values -- it was the kind of moment I’d learned to savor: The sun through the blinds, buttery yellow and warm but not too hot; the coffee, strong and rich with cream. And then I rubbed my hand across my chest where my right breast used to be and felt a lump.

There was little doubt in my mind that I was feeling cancer: a new tumor, just five months after finishing chemotherapy and less than a year after my mastectomy. I didn’t panic. I didn’t tell anyone, but I did call my oncologist at eight the next morning to make an appointment. I had to wait a week to see him, which was hard, but when I did see him, he had few doubts, either. "I’ve been fooled before, but ... " he said, while arranging for me to see my surgeon the very next day. Then he explained what kind of treatment he would recommend if the lump was cancer. "There aren’t too many doubts in either of our minds," I thought.

During the next few weeks I whirled from doctor’s appointments to surgeries to high-tech tests. I had surgery to remove the lump, then a long wait for biopsy results (positive), another surgery to remove more tissue around the lump, a bone scan, a CT scan, a PET scan, and more consultations on treatment options. The scans, meant to search for evidence of other tumors in my bones, my internal organs, or my lymph nodes, introduced a new fear: the possibility that the cancer had already spread beyond my chest.

During the several weeks of testing, I felt distant and spacey. I wasn’t sad or angry. Somehow I was resigned to the fact that my life might be over, except for the really nasty part: dying of cancer. I didn’t feel too many regrets for myself; I’d done most of the things I’d wanted to in my 44 years. The only regret I felt was that my children were still so young, 14 and 9. But even that was a distant regret -- not a hard, in-my-gut, my-children-need-me kind of feeling.

I did have a recurring, "New Age" kind of thought: Maybe the cancer had come back because I had not yet learned the lesson I was supposed to learn from having breast cancer. This kind of thinking is not really my style, but the idea hung on for days. What was I supposed to learn? What was I supposed to change? Was I supposed to move to the country and raise ducks and llamas, or what?

One of the Unlucky Minority

Finally, when the results of CT, bone and PET scans came back -- all negative -- the fact that I had only a local recurrence of breast cancer felt like good news. It could have been so much worse. My oncologist told me that only 3 percent of women with breast cancer who have the treatment I had -- mastectomy and chemotherapy -- have a local recurrence. I don't quite know what to do with that little fact, but there it is: I am one of a tiny, unlucky minority.

My doctors were able to determine that the second cancer was the same cancer as the first. It came back after chemo because some breast tissue containing ductal carcinoma in situ (DCIS) remained after my mastectomy, and the new cancer broke out from those cells in the few months after I completed chemotherapy.

My doctors recommended chemotherapy with Taxol: four treatments three weeks apart, plus six and a half weeks of daily radiation treatments at the same time.

Suddenly, I broke out of my funk, started sleeping well again and set myself to focus on getting through more chemotherapy, a daunting thought for anyone who’s had it. Chemo makes you so sick it’s demoralizing. Even though you know you’re doing it to save your life, you feel so sick, and after that so exhausted, that it’s hard to hang on and just endure.

Facing chemo again, I made several promises to myself: First, to stay away from people who seem to believe I am going to die or people who depress me with their own fears about cancer. Second, to exercise through my treatment if at all possible. Exercise has made me feel so wonderful during my recovery, and I’ve read that it helps the fatigue of chemo. And third, I decided not to let the cancer treatment take over my life.

So, I promised myself, I’d swim, walk, do yoga, have fun with my kids and friends. I’d even run in the Seattle leg of the Race for the Cure, the nationwide series of fun runs sponsored by the Susan G. Komen Breast Cancer Foundation to raise money for research.

Chemo the Second Time Around

I learned some things from the first round of cancer treatment that have made facing it the second time easier. I’m not afraid of chemo this time. I know the hospital, I know the staff and I have a pretty good idea what is going to happen, even though I’m getting a different drug. Even knowing that my hair will fall out - again - is not that big a deal.

I headed to my first chemo with Taxol on September 3, feeling pretty calm. Taxol causes severe allergic reactions in some people, so I had medication to take 12 and six hours before the treatment to help prevent problems, and then more "premedications" to take half an hour before the Taxol IV started. This IV takes three hours to run, an awfully long time when you're sitting in the chemo room with nothing much to do. But there was a man there, the husband of a cancer patient, who was trying hard to cheer us all up, dancing around with different hats on his head. He succeeded.

I went home feeling pretty okay, and spent the evening eating pizza and watching videos. But the next day, a Saturday, I was miserable. My joints ached as if I'd run a marathon and contracted the worst flu of my life at the same time. I spent the next three days hiding in my bed crying with pain. Late on the third day, I was able to walk around a bit. On the fourth, still feeling achy, I went back to work, and for a swim afterward. By the following Sunday, I felt well enough to run in the Race for the Cure.

The race was just what I needed. I ran with my two sons and a dozen friends and co-workers, caught up in a crowd of 15,000 people on a beautiful, hot morning in Seattle. Here and there in the crowd were women in pink baseball caps, the breast cancer survivors. And I was one of them.

@ Jeanne Sather 2006