Fall 2016 in The Feminist Psychologist
1 in 8!
by Jill Kuhn, PhD
One-in-eight women will be diagnosed with breast cancer in their lifetime. I was diagnosed with breast cancer the day before my 19th wedding anniversary. I had, had my annual screening mammogram and was called that evening in July (2016) about having “abnormal results.” A few days later I had a diagnostic ultrasound. The radiologist came in to meet with me and was confident in her diagnosis of breast cancer. The next day she did 4 core needle biopsies. My husband came with me and we spent our anniversary watching my biopsies on an ultrasound monitor. The radiologist assured me that because it was small (9 mm) I would have to go through the inconvenience of a lumpectomy and node removal and then radiation, but then I could get back to my life.
Core Needle Biopsy results came back and I met with my oncologist who indicated that although it was an early stage cancer and that they were treating it clinically (i.e. until I had surgery) as Stage I, I also had a more rare sub-type called Triple Negative Breast Cancer (TNBC), which occurs in about 15% of breast cancer diagnoses. My lumpectomy, less than two-weeks later, confirmed the diagnosis. (Luckily my lymph node was negative for cancer.) Having TNBC means that I am negative for the three most common types of receptors known to fuel most breast cancer growth–estrogen (ER), progesterone (PR), and the HER-2/neu gene. Thus I am ineligible to take a targeted medication (e.g. Tamoxifen or Herceptin). The best treatment to kill any cancerous cells that may have escaped is chemotherapy. It can cut risk or recurrence (metastases) in half. It is a relatively aggressive cancer and although I have a lot to live for, most importantly I have two daughters (17 and 12) that I must be here for! There is no choice except to do everything possible to keep it from coming back. In fact, TNBC may respond even better to chemotherapy in the earlier stages than many other forms of cancer. TNBC is much more likely to be diagnosed in younger women and is also more common in African American and Hispanic women and in those with the BRCA1 gene mutation.
After my surgery, I was staged as having Ia Triple Negative Invasive Ductal Carcinoma. I was fortunate that it was caught early on a screening mammogram. I have had mammograms faithfully every year since about the age of 37 (I was adopted, so my primary care provider agreed we start them on the early side.) I believe my mammogram saved my life! If I wasn’t having them done regularly or was haphazard about having them done, who knows how big the malignancy would have gotten before it was found? As it was, it was not palpable to me, my surgeon or oncologist. As I write this, I am one day out from my first chemotherapy infusion. I will have 4-cycles (one every 3-weeks). I then will have 4-6 weeks of radiation. So I am pretty booked and dealing with a lot as the holidays approach! I’m also trying to maintain my private practice. I put fall decorations up this past weekend, while I was still feeling well and to create some normalcy in our home.
The hardest thing I had to do was tell my daughters, with their dad by my side. It terrified and upset them. Now we have inside jokes and laugh and talk about “silver linings,” but I also reassure them that before I am someone with cancer, I am their mother. So, I want to be able to help them with my diagnosis. I explained how early it was caught and why I needed chemotherapy. I am lucky that my chemotherapy is intended to be curative, but only time will tell. There were some early fears, from my youngest, that I was going to die. I believe her dad and I have been able to reassure her and her sister about their fears, worries and questions. I also hate the timing (although there is never a good time to have cancer). My oldest is applying to colleges and I hope I can continue to be a big part of that process. I want my daughters to see me take on the hardest thing I’ve yet had to do! I intend to go forward and “Fight Like a Girl!”
I have been blessed with an incredible support network of friends and family who have showered me with words of love, encouragement as well as cards, texts, emails, flowers, care packages and meals. I also have a spouse who loves me no matter what and wants to help me travel this road and ease my burdens. Even though I don’t live in the same state as my parents my dad, a retired oncologist and cancer survivor, has also been a huge support and has helped me by not only getting a colleagues expert opinion and caring about how I’m doing and also by helping me with what to expect from the perspective of someone who only a few years ago travelled a similar path. My mom has been so warm and loving (as always) and I know it’s hard (for both of us) not be close by (sometimes a girl just needs her mom)!
It has been a difficult journey, so far. I have felt all the expected emotions and had days where I just couldn’t rally. I am sharing my very personal story to encourage women to avail themselves of mammograms, do regular breast self-exams and talk to your primary care doctor about family history of breast or ovarian cancer and whether genetic testing is right for you (my testing was all negative). I know not all women have the privileges I have, including up-to-date and accurate information, decent access to health care and financial resources (in spite of meeting our high deductible/out-of-pocket max, we are able to eventually pay it off) so I have listed some resources for women who are in need or have TNBC. I have also been happy to see so many organizations that provide help with finances, free wigs or head coverings, free help with homecare, rides, pet care, and lots more.
Resources:
-https://www.plannedparenthood.org/learn/womens-health/breast-cancer-screenings
-http://www.nationalbreastcancer.org/triple-negative-breast-cancer
-Online forum for women with TNBC: tnbcfoundation.org/
-Free program including wigs, hair coverings, make-up and in-person tutorials: http://lookgoodfeelbetter.org/
-Free support services including counseling, and support groups over the phone and in-person, educational workshops, publications and financial and co-payment services: www.cancercare.org (or 1-800-813-4673)
Jill may be reached at drjillkuhn@gmail.com