Monday, October 15, 2007

Because Cancer exists

Time for a check:

How have you spent your time today? This week? This month?

How often have you done things that gave you joy or were deeply meaningful to you?

How much have you been close to the important people in your life?

At those times when you had a choice, how often did you choose to pursue connectedness and passionate engagement, versus rote activity that bores or deadens you?

When you were working, how much of your work did you invest with commitment, and how many of your accomplishments do you look back on with pride?

How much have you moved your body, felt your muscles and bones equal to the challenges you set for them? How well have you guarded your health and made choices to exalt your body?

How have you loved? How have you been loved?

If you felt bad, did you embrace the experience and live with it?

Who knows how much life any of us has. We have right now. One of my lessons from cancer was to live right now, and not wait to live years later.

Justice (and Treatment) for All

Again, a flurry of recent news stories. I was particularly interested in this piece on, which tackles the issue of "socialized medicine" and effective cancer treatment. It's interesting that this coincides with the American Cancer Society's activism drive to increase access to cancer treatment. The ACS wants more people to be treated, and to eliminate insurance problems as an obstacle to treatment. One obvious way to do that is to extend healthcare coverage through universal coverage options. Of course, that stirs panic among both right-wing and small-government types, and among ordinary people who might rather face the devil they know.

I could easily be among the latter. I am one of the incredibly lucky people who, when struck by cancer, had a fantastic health plan. I work at a university with a cancer research and treatment center, so I had access to physicians who were highly expert and used the most up-to-date treatments and resources. My university has a self-insurance plan with 90-10 coverage, a low deductible, and a low out-of-pocket annual cap. (I have thanked my 2005 self over and over for deciding to pay the higher monthly premium for this plan, rather than choosing the cheaper HMO.)

It's easy to imagine that a universal-coverage plan could limit my choice of physicians. Or perhaps it would limit what they could do to treat me--for example, maybe all medical care would be restricted to HMO levels. For someone who's had fewer limitations, like me, that is scary. On the other hand, I don't believe we have to fear such extreme restriction. And even if some restriction occurred, it seems only just for the few of us who now enjoy wildly disproportionate benefits to accept a mild adjustment downward so that our millions of disadvantaged neighbors can finally get some basic care.

And that's where the Slate article is especially reassuring. Looking at all nations with some form of socialized medicine, other than England--which is apparently abysmal for cancer treatment and survival--outcomes are far better there than here. Which tells me that, for all my choice and luck, I could be doing even better yet.

A couple of other links:
I took Taxol. My tumor was ER negative. Sucks for me.
Death rates are dropping. Hooray!

Saturday, October 06, 2007

Are you aware?

Yes--we think about Black people in February, and women in March. Now it's October, and if you're not seeing black and orange, you must be seeing pink. It's Breast Cancer Awareness Month. All together now...


I've started to become one of those girls who aren't playing nice. The pink, the fluff, the incessant marketing machine... It feels a lot like the post-9/11, "Be patriotic! Go shopping!!"

There are some good reasons for a cancer to have a month--better than for large racial categories. Women over 40 should get an annual mammogram, and maybe seeing ads for pink toasters and pink toolbelts at this time of year can help them remember.

I also think there is some legitimate merit to giving people a way to do something about this disease. Getting breast cancer makes you feel helpless. I am certain that watching someone get breast cancer also makes you feel helpless. When I inventory my own personal relationships, I think of my husband, who had to go through 8 months of treatment and all the fear and anxiety, with nothing that he could really do to change my outcome. My parents, my friends... I am also a spooky exemplar of how many women are getting breast cancer, and how little we can do to predict or stop it. I'm a magnet for everyone else's breast cancer experiences, especially guys whose moms get it--I have heard from more than I can count on a hand, in the last year.

I know that people close to me want to change my outcomes, and I know they want me to understand how urgently they care. So what can they do? They can shop, and they can participate in big group activities like runs--the latter are even better, because they require personal pain and sacrifice. (By the way, one of posts referenced above links to a great Onion article, 6000 Runners Fail to Discover Cure for Breast Cancer.) After 9/11, I wanted to give blood, because--literally, and don't laugh too hard at my hokiness--I felt a desire to bleed for the sake of all the other people who had shed blood. A common fate kind of thing.

Yes, there are better things to do. Giving money directly to research and advocacy groups, volunteering at a cancer treatment center or a wellness community, regularly contacting members of Congress to lobby for better cancer funding (and healthcare, maybe?!)...all of these may be more powerful. They're also harder to do, and now that I'm back to my busy life, I know that it's a lot easier to do a few website clicks between meetings than to keep track of bills in the Senate.

[Along these lines, I got the following email a few days ago--it seems to offer the way to do something real, very quickly, and very easily. So of course I was suspicious!

> Please tell ten friends to tell ten today! The Breast Cancer site is
> having trouble getting enough people to click on their site daily to
> meet their quota of donating at least one free mammogram a day to an
> underprivileged woman. It takes less than a minute to go to their site
> and click on 'donating a mammogram' for free (pink window in the
> middle).
> This doesn't cost you a thing. Their corporate sponsors /advertisers
> use the number of daily visits to donate mammogram in exchange for
> advertising.
> Here's the web site! Pass it along to people you know.
So I searched for this pitch on urban legends sites, and had the following:
Except for the part where it says "The Breast Cancer Site is having trouble getting enough people to click on it daily," this dated email flier (circulating since 2001) remains basically true. In 2002 alone, the highly successful site and its advertisers funded a total of 1,624 free mammograms for underprivileged women, thanks to the daily clicks of visitors. The Breast Cancer Site has been reviewed by health advocacy groups and various media outlets and recommended by sources like Ms. Magazine. It is well worth a daily visit.

That is good news, and not even hard to do.]

Anyway, I started by objecting to the month, and here I've really defended it. It's harder to express my objections, but I'll try. A Month is reductive. The pink onslaught is infantilizing and trivializing. There is a tyranny to breast cancer culture that allows only a narrow range of expressions, emotional responses, and actions. (I'll never forget my first--non-Wellness Community--support group experience, in which new women like me were told not to think things we said, not to feel what we expressed, and more than anything, that praying was the only thing to do. I never went back.) I don't want to be either a pink-wearing blubberer, or a pink-wearing "survivor" in the mold of The Movement. Basically, I guess it's that breast cancer, though widespread, is still a really personal and individual experience--no two women I know have had exactly the same treatment--and I don't like feeling my personal experience forced into the dehumanizing context of the mob.

And finally--an annual reminder to get a mammogram didn't do a damn thing for me. I was too young to be getting mammograms. This week, I was on a conference call with three other fantastic bloggers (their blogs are now linked, at right) who were also all too young for mammograms when they were diagnosed. And I guess that's another reason I dislike The Movement--it's focused so much on women who are older, with different concerns and different worldviews. Perhaps Breast Cancer Awareness Month should be urging younger women to get their breasts groped--by themselves, by others (hello, Noah!), whatever it takes--get some hands on those boobies and check for things that shouldn't be there!

One last note for today. Today is the one-year anniversary of my completion of cancer treatment. I had my last radiation treatment last year, I got my survival certificate from Noah, and I walked out of the center and into my "new reality" as someone cured, post-cancer, and on the way to being healthier than ever.

My oncologist told me it can take a year for some side effects to ease. My hair is still only a few inches long; my feet have only recently stopped having pain and burning from the Taxol; my right armpit and lat are still a little numb from surgery. But overall, I am healthier and in better shape than I've been in years. My life, knock wood, is back "on track"--as a relatively young woman (and junior professor), there is a climb and a progression that characterizes the life path, and I'm no longer sitting on the bench watching other people hike by.

A year past cancer treatment. I gotta say, it still seems like yesterday.