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6 things you should never tell cancer patient

6 Things You Should Never Tell a Cancer Patient

January 27, 2018

Five years ago, on June 1, 2012, I found out that, like one in eight women in America, I had breast cancer. Within a two-week period, one of our cats died, my husband lost his job, his aunt passed away and, while he was in Illinois attending her funeral, I got the news by phone.

It was caught early by an eagle-eyed radiologist who saw a small spot on my digital mammogram. Insurance companies often won’t cover this more sensitive test because it costs more. In January of 2016, the U.S. Preventive Services Task Force raised the recommended age at which women should begin mammography screening from 40 to 50. (The medical community had opposed the change since it was first proposed in 2009.) Had I waited that long, I might be dead now.

I had a lumpectomy on July 3rd, followed by chemotherapy and radiation, which finished up at the end of January 2013. Five years later, I’m still cancer-free.

I bonded with several women going through the same thing. We’d pass our time in the waiting room joking about how none of us had lost weight from chemo despite what movies show, and how easy it is to forget where your eyebrows were after they fall out: Sometimes you draw them on and look angry or surprised, or angry on one side and surprised on the other.

We also talked about the comments well-meaning people said to us when they found out we had cancer. I related my friend’s story of how strangers touched her belly when she was pregnant, then got offended when she told them to stop. With cancer, too, people feel entitled to weigh in, assuming a level of familiarity that may not exist.

Here is my list, gleaned from my experience, of six things you should never tell a cancer patient:

1. Everything happens for a reason. Yes, the reason is cancer. Is it because I paid the gas bill late or didn’t send a Christmas card? Think this through, please. Even if there is some cosmic plan, is that supposed to cheer me up? (“Your death will provide a valuable life lesson for your family.”)

2. [She] is fighting a battle with cancer. My chest is not a war zone. I prefer to say I’m having a slap fight with cancer. Sounds less ominous and it’s a nice visual, too. I’ve rarely heard anyone say, “She just gave up. What a wuss!”

3. Check out this email from Johns Hopkins about what really causes cancer. This is a hoax that’s been circulating since 2008. Johns Hopkins has repeatedly refuted it, but it still terrifies people. Whoever who wrote this should be flogged.

4. This [alternative therapy] really works. Ever meet someone who cured cancer by drinking his own pee? Probably not. Want to talk to Steve Jobs about the miracle macrobiotic cure he did for months before agreeing to conventional treatment? Oh, that’s right, you can’t: he’s dead.

5. Cheese causes cancer. I blame some Internet sub-genius for starting the Big-Dairy-doesn’t-want-you-to-know-this-is-killing-you panic about casein, what Alex Jones likes to call an excitotoxin. (Funny, that’s what I call him.) Casein is a protein found in mammalian milk, including human milk. So…breastfeeding causes cancer? Milk is murder?

I’m not saying I’m an expert. Having cancer doesn’t make you an expert any more than sitting on an airplane makes you a pilot. I understand that sickness scares people; it’s only human to want to define it and reassure themselves it won’t happen to them. Bullshit artists like Louise Hay have made a lot of money blaming people for their own illnesses. Which brings me to:

6. Negativity causes cancer. If that’s true, the person who says this must be riddled with it.

You know how they say a stranger is just a friend with an unsolicited opinion you haven’t heard yet? (Okay, nobody says that, but I’m trying to start a trend.) Everyone from my cat’s veterinarian to a city’s worth of taxi drivers felt compelled to share their wisdom. I wish I’d had the presence of mind to say, “Oh, this isn’t from chemo. I shaved my head to commemorate that time I killed someone for sticking his nose in my business.”

Sometimes a little negativity can be fun, no?

I’m Radioactive – Laughing at Cancer

January 26, 2018

June 31, 2012: On Friday, I had a radioactive seed implanted to mark the exact site of my cancerous breast tumor. The isotope is Iodine 125 with a strength of .13 millicuries. Though Marie Curie was a pioneer in radiation research, she died as a result of long-term exposure. It’s silly, I know, but the use of her name in dosage measurements doesn’t give me a warm fuzzy feeling. She died in 1934 and even her cookbooks are still kept in lead-lined boxes and can’t be handled without protective clothing. It’s a shame, too, because I’ve been looking for a good banana bread recipe.

Before it was injected, it was checked with a Geiger counter. The meter looked the same as ones in old Civil Defense films during the duck-and-cover, build-a-bomb-shelter-in-your-backyard era. As if the contrast to the high-tech equipment in the room weren’t enough, the clicking noise sounded like the reading of radioactive coconuts on a show about Bikini Atoll I watched recently.

So I’m radioactive. Which reminds me of this song from the 80s:

The post-implantation instructions are interesting. I have to minimize contact with young children or pets where the seed is implanted. If the seed becomes dislodged, I need to use a piece of tape or tweezers to pick it up, store it in a remote location such as a cabinet or closet as far away from carbon-based life forms as possible, and call the Radiation Safety Office immediately. So, inside boob: good. Outside boob: call the hazmat team. Iodine 125 has a half-life of 59 days but it will be taken out tomorrow morning during surgery. Today, I had a contrast dye injected. This will help my surgeon locate the lymph nodes she wants to take out. The dye contains technetium 99. This stuff is a gamma-ray emitter. Woot! Bruce Banner time!

More technetium, with a blue dye added, will be injected during surgery. So I’ll have Smurf pee for a day or two. I know I sound like I’m freaking out but really, truly, I know that without all these things, the tests and dyes and machines and doctors who use them, my prognosis might not be so good. All these things have saved many people and undoubtedly will save many more. That said, I want to leave you with one factino I learned about technetium 99. It’s reported to be dose equivalent to 500 chest X-rays. And that reminded me of this quote from Repo Man.

“Radiation. Yes, indeed. You hear the most outrageous lies about it. Half-baked goggle-boxed do-gooders telling everyone it’s bad for you. Pernicious nonsense! Everybody could stand a hundred X-rays a year. They ought to have them, too.”

That’s just how my brain works, people. See you on the other side!

Update – January 26, 2018: I’m still here. Five years have passed since my lumpectomy, chemotherapy and radiation treatments, with no cancer recurrence. So far, so good!

Pink Ribbon Products from Car Horns to Handguns

October 26, 2014

Breast Cancer Pink Ribbon Products bagel

This is a bagel. (What did you think it was?)

What would Breast Cancer Month (aka October) be without a smorgasbord of pink-tastic breast cancer awareness-themed treats from cookies, mints, hard lemonade, jelly beans, popcorn and PEZ to ribbon-shaped cakes, chocolates, cupcake sprinkles, lollipops, pasta and bagels? Rarely has life-threatening illness tasted so delicious.

Of course, we shouldn’t forget the memorial pink ribbon products not meant to pass through the alimentary canal: perfume, knee socks, beer koozies, curling irons, chewing gum, flip flops, beach balls, tote bags, vegetable peelers, bathrobes, fishing rods, chip clips, aprons, emery boards, tiaras (tiari?), golf tees, teddy bears, car fresheners, tablecloths, tambourines, mailbox covers, guns, gnomes, cowbells and vibrators.

Puns are a perennial favorite and seem to grow more tortured with each passing year. Suit up in a pink ribbon Speedo from Breaststroke 4 Hope, “designed to inspire the aquatic community to dive in and make a difference. Let’s fight breast cancer together, one lap at a time.” (That last bit would make a good strip club promotion, too.) While I’m sure this is an earnest, worthwhile endeavor, with its website listed as Coming Soon and 12 likes to date on Facebook, someone needs to get out of the pool and get to work.

The Keep A Breast Foundation appeals to youth culture with “i❤boobies!” wristbands and makes early detection cool with its #checkyourselfie Twitter campaign. I’m happy that, aside from a few confused bird lovers, its site reaches hip youngsters who won’t pay attention to important things with boring or yucky names. Though its moniker is catchy, I wish KAB had found a different play on words to suggest we keep both breasts. Perhaps the bracelet should say “i❤booby!”, though it seems wrong to play favorites with one’s breasts…or fun bags, for any young people reading this.

Baker Hughes, an oilfield service company, painted 1,000 of its drill bits pink, apparently to raise awareness miles underground where they will hydraulically fracture rock to free patches of oil. It then donated $100,000 to the Susan G. Komen Foundation and adopted the slogan “Doing Our Bit for the Cure.” The company reported $5,700,000,000 in revenue with a net profit of $336,000,000 in the first quarter of 2014. Projected annually, Baker Hughes has given .007% of its profits to the charity. In this instance, it would seem that the “bit” has a third meaning, as in “Giving a Little Bit for the Cure.”

The Komen foundation, which licensed the use of its signature pink hue, has come under fire for partnering with a company that pumps toxic chemicals into the earth, potentially poisoning drinking water and off-gassing pollutants that accelerate climate change (if you believe in that sort of thing). Perhaps Komen could use a new motto for its tees, hats and gloves: Frack Cancer. It’s a tad naughty but still appropriate for a church picnic. That idea is free of charge but if you use it, can I claim it on my taxes?

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I began my journey into the heart of pinkness innocently enough, intending only to write about JC Penney’s ads, in which pennies (get it?) are held over women’s breasts. Critics complain they devalue women but I say kudos to them for sexualizing small change. Lincoln would be so proud. At least they tell us to save them, not pinch them. That would be disrespectful.

Breast Cancer Pink Ribbon Products JC Penney

Once I started looking into the subject, I couldn’t help but notice that there are an awful lot of products associated with Breast Cancer Awareness Month. I have catalogued some of the more memorable ones here. It is by no means an exhaustive list but I can tell you it has exhausted me.

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Gear for the sportswoman or man who’s comfortable in his masculinity.

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No matter how you choose to adorn your garden and car or wildly overestimate the resale value of commemorative coins, please do not ever do this to your dog.

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At least two of these items make bath time lots of fun. Getting drunk and needing more cowbell is up to you. Unfortunately, researching the be-ribboned vibrator has negatively impacted my Amazon recommendation list.

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Breast Cancer Pink Ribbon Products Pedi Egg

Perhaps my favorite product tie-in is this special, limited edition of the PediEgg, a cheese grater-like callus remover, which makes sense because, as we all know, feet are the boobs of the legs.

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Of the above products, gun, alcohol and vibrator sales benefit cancer research. The National Football League is the real hero here, donating 8% of profits from sales—this month only—of its half dollar coins. (Why not give them directly to charity? They are money, right?) Since October is also Domestic Violence Awareness Month, the NFL will do its part to raise awareness by continuing to beat women with impunity and children where indicated. You’re welcome.

Tales from the Waiting Room – Laughing at Cancer

July 1, 2012

First one mammogram, then another mammogram plus ultrasound, then biopsies. That’s how I spent the last two weeks of May. I got to know the radiology office better than I’d ever wanted to. On June 1st, I received my diagnosis of breast cancer. I needed an MRI to look for more tumors but couldn’t schedule it until my insurance company authorized it.

Once United Healthcare was sufficiently convinced that a malignancy justified further diagnostic testing, I had the MRI done on June 6th. Then I got a call that I needed a second MRI. The first had “lit up” as if there were multiple growths on both sides but they were pretty confident this was due to hormones, and the images would be “quieter” the following week. I hoped so since my mother had a bilateral mastectomy five years ago for multiple tumors.

On June 12th, I found myself once again in the same waiting room. As before it was nearly full of people, mostly women, in some stage of fear, worry or, worst of all, resignation. Some were drinking contrast dye from a cooler marked DO NOT DRINK. From their involuntary cries of disgust, I gleaned it might be the same barium I drank for a G.I. test 18 years ago. It tasted like moldy drywall. This begs the question: with all the advancements in technology, including the digitally assisted mammography that caught my cancer early, why can’t someone make a contrast solution that tastes better?

While I waited to have the test that would tell me if I had a little cancer or a lot, a news program playing on the wall-mounted TV caught my eye. Someone had shot a guy who was writing a book called Kindness in America. Was this a joke? The report continued: he was hitchhiking across the U.S. gathering stories for his memoir about the kindness of Americans when a drunk man in Montana rolled down the window of his truck and shot him. For no reason.

I cracked up. In my defense, the story also stated that the guy had only been hit in the arm and was okay. I reasoned that getting shot would help him get a book deal. He’d need to find a way to turn it into a positive experience. He had certainly cheered me up in a rather grim setting.

Update: It turns out that the guy shot himself to get publicity. Perhaps he was affording emergency room staff the opportunity to display kindness by treating him?

Back on planet Waiting Room, I hear my name called. The nurse recognizes me and helps me with the sticky safe lock in the changing room; the phlebotomist remembers which vein she stuck the needle in for the contrast-dye IV catheter (no taste, yay!); and the doctor remembers the classic rock radio station (104.3) I favor from last time.

I ask him if people freak out about MRIs because of the TV show House. He sighs. “All the time,” he says. He’d seen an episode once where green sparks were flying out and had to stop watching because it was so inaccurate. He says it’s too bad because he hears it’s a good show. I tell him the show’s over and people were always having seizures during MRIs, and someone vomited blood in almost every episode, so maybe he hasn’t missed much. He puts the headphones on me, and as the bed rolls me inside, the radio plays Pink Floyd’s Welcome to the Machine. Perfect.

Good News. Really.

June 16, 2012

A couple weeks ago, I got the news that, like one in eight women in America, I have breast cancer. Thanks to digital mammography and excellent doctors, I’m going to be fine. You’re not going to get rid of me that easily.

Considering my posts about vaginas and fart filters, it’s strange that I find this difficult to discuss. Writing about a breast shouldn’t make me feel shy. In this case, though, I am the owner of the body part that’s gone on the fritz. I have a titanium clip in there, soon to be joined by a radioactive seed for precise tumor location. I’ve dubbed it Robo-boob.

I wasn’t going to address this at all since I write an allegedly humorous blog and this tends to be pretty dramatic stuff. But here goes. I’m going to have a lumpectomy on July 3rd. (Thieves be warned. My house is staffed with attack cats.) If the excision has clear margins, meaning the entire growth has been removed, I will begin radiation a month later.

I’m not very worried about the surgery. I’ll be having “twilight sleep”–the good stuff that Michael Jackson favored. I have been assured that, unlike Michael, I will continue breathing on my own. The idea of radiation is scarier to me. Luckily, it’s not the kind that will turn me into Godzilla, the Hulk or a giant spider. Phew.

Unfortunately, my insurance won’t cover a scooter. No handicapped parking either. I did get a binder from Mt. Sinai Hospital to keep track of appointments, post-op instructions etc. But I saw some women walking around with reusable grocery bags emblazoned with the pink ribbon on them, so I’m hoping for more swag. Gotta find a silver lining to this thing.

I know that prayer is a comfort to people and makes them feel less powerless. But when someone says, “I’m praying for you,” what I hear is, “You are so screwed that only a deity you don’t believe in can save you now.” As far as I’m concerned, everyone except my surgeon is helpless in this situation. There will no Tebowing in the OR, let’s put it that way–at least while I’m awake.

A proliferation of cancerous cells will not result in a conversion experience for me. That seems like a faulty basis on which to start (or stop) believing. So, while I love my Christian friends for caring, I respectfully ask them to understand it does not make me feel better to hear about it and to please keep it to themselves. Surely I can’t be the first person to feel this way?

I’d like to address a few popular sayings/beliefs trotted out regarding cancer.

Everything happens for a reason. Yes, the reason is cancer. Is it because I paid the gas bill late or didn’t send a Christmas card?

[She] is fighting a battle with cancer. My chest is not a war zone. I prefer to say I’m having a slap fight with cancer. Sounds less ominous and it’s a nice visual, too.

Here’s an email from Johns Hopkins about breast cancer. It’s a hoax that’s been circulating since 2008. The person who wrote this should be flogged.

This [alternative therapy] really works. Ever meet someone who cured cancer by drinking his own pee? Probably not. Want to talk to Steve Jobs about the miracle macrobiotic cure he did for months before agreeing to conventional treatment? Oh, that’s right, you can’t: he’s dead.

I should point out that I am not saying I’m an expert. Having cancer doesn’t make you an expert any more than having your driver’s license makes you a Formula One racer. But I don’t think I’m so unique that no one else has had these thoughts. Bullshit artists like Louise Hay have made a lot of money getting people to think they have all the answers, which brings me to my final thought for those who would easily pass judgment on someone like me:

Negativity causes cancer. If you believe that, why don’t you have cancer, too?

I See Your Breast and Raise You a Penis: A Word Game

November 16, 2009

Today, the United States Preventive Services Task Force released its recommendation that women begin routine breast cancer screening at age 50, instead of 40. It has based this on the modest benefit of mammograms versus the harm of overtreatment.

First, let me explain that the study’s idea of modest benefit is a fifteen percent reduction in breast cancer deaths. That number sounds kind of good to me. If I were one of those women, I’d be one hundred percent happy with that.*

And the harm of overtreatment? Cancers might be removed that would have grown too slowly to kill the women in which they are detected. As you can imagine, this is a real drag for insurance companies who have to pay for the procedures when they would be happier to spin the Wheel of Fortune and bet their customers will die of natural causes. And since insurance companies are for-profit organizations, that’s exactly what they do when insuring us.

The other egregious harm the task force cites? Can mammography kill us, as cancer can? No, but unnecessary tests can cause anxiety. Isn’t it so much better for us just not to worry our pretty little heads about it? After all, only fifteen percent of our mothers, sisters, and daughters will be saved. What a tough choice.

According to one statistician, although this will save billions of dollars in health costs, “the money was buying something of net negative value. This decision is a no-brainer. The economy benefits, but women are the major beneficiaries.” I’m no number cruncher, but when did a fifteen percent reduction in mortality have a negative value?

So, what I’d like to do is play a little word game with a New York Times article published on this subject. Wherever there’s a mention of women and breast cancer, I’m going to substitute something else. See if you can tell where:

Overall, the report says, the modest benefit of the exam — reducing the dick cancer death rate by 15 percent — must be weighed against the harms. And those harms loom larger for men in their 40s, who are 60 percent more likely to experience them than men 50 and older but are less likely to have their balls fall off, skewing the risk-benefit equation. The task force concluded that one death by cock rot is prevented for every 1,904 men age 40 to 49 who are screened for 10 years, compared with one prick withering for every 1,339 men age 50 to 74, and one fatal phallus for every 377 men age 60 to 69.

But the new report conflicts with advice from groups like the American Cancer Society and the American College of Radiology. They are staying with their guidelines advising annual knob screening starting at age 40.

The cancer society agreed that man-o-grams had risks as well as benefits but, he said, the society’s experts had looked at “‘virtually all” the task force and additional data and concluded that the benefits of annual exams starting at age 40 outweighed the risks of unnecessary dickectomy.

Private insurers are required by law in every state except Utah to pay for a chubby checker for men in their 40s.

But the new guidelines are expected to alter the grading system for health plans, which are used as a marketing tool. The message for most men is to forgo ensuring their johnsons aren’t killing them if they are in their 40s. In fact, even though exams are of greater benefit to older men, they still prevent only a small fraction of dick cancer deaths.

Researchers worry the new report will be interpreted as a political effort by the Obama administration to save money on health care costs.

Of course, Dr. Dingle Berry noted, if the new guidelines are followed, billions of dollars will be saved.

“But the money was buying something of net negative value,” he said. “This decision is a no-brainer. The economy benefits, but men are the major beneficiaries.”

Do you doubt that if the above were true, there would be a million men brandishing pitchforks and torches marching on Washington right now? You know the answer as well as I do. I’m just being a tease.

P.S. On a serious note, check out this study on digital mammography funded by the National Cancer Institute and published in 2005. Digital mammography is much more accurate in detecting breast cancer in women under 50 and in older women with dense breast tissue than traditional mammography. It saved my mother’s life. I may need it to save mine someday. But even at high risk, my insurance will not cover the computer-assisted exam. The superior technology exists, right now, to save more women. Why isn’t it recommended? Because it’s a lot more expensive than telling us not to worry or to wait to have the inferior test. Statistically speaking, we’re not worth it.

*Update 2018: As it turns out, I was one of those women. In June of 2012, at the age of 47, I was diagnosed with breast cancer. It was caught early because of a digital mammogram that showed enough detail for a radiologist to see a very small tumor. I’m lucky that my insurance covered the more sensitive test. If I’d had to wait until age 50 to get it, I could be dead now, and my little word game would just be a sad coda to my smart-alecky life. I’m happy it didn’t turn out that way.