October 17, 2012

Lessons I learned from breast cancer

October is Breast Cancer month. I remember my family and friends who became victims of Breast Cancer. Having touched close to home, let me share some lessons that I learned.

Hope and victory for breast cancer.

LESSON 1: The earlier the diagnosis and treatment, the longer the life expectancy.

Ninang Eva, my maternal aunt, was diagnosed early when the lump was still small so an immediate lumpectomy was all that was needed. Fortunately, she was a nurse so she was aware of the signs of breast cancer. Unfortunately, she had colon cancer about 15 years later. She wanted to quit her continuing colon cancer treatment six years ago but persevered because her children wanted her to. She died two years ago from complications due to metastatic colon cancer. This was about 20 years from the time she had the lumpectomy and her death was not traceable to breast cancer.

Ninang Nene, my father's only sister, felt the lump in September of 2010 but did not seek medical attention thinking it would go away. It did not. When it progressively grew in size a few months later, she sought medical advice. It was too late because it was in an advanced stage. The doctors she went to said they could not do anything to cure it. She found an institute based in Tijuana, Mexico offering a cure for even stage 4 cancers. Because of this, she went there on February 2011. She kept it a secret from her extended family (brother, cousins, nieces, nephews). We found out about it in April during our family's first ever grand reunion because her absence was so obvious—there being only two surviving in her generation. She died in June 2011, nine months from her first encounter with the lump in her breast.

LESSON 2: The best advice from the doctor is not always the best for the patient.

I used to share the same clinic with Dr. Y. I wrote about her in my article last year. She found out about her breast cancer while pregnant. They have waited long for this 2nd child and so even if she was advised by her doctors to undergo aggressive treatment, she opted for a treatment known to be less effective but less dangerous to her unborn child. When she delivered her baby, her cancer has gone up higher in the severity scale. People were saying she should have heeded the doctors' advice for her cancer to have been controlled in its early stages especially when she developed metastasis (spread) to her brain. She has accepted her fate but does not feel bad because her decision brought about another little girl into their family. Against all odds, she is still alive now, more than two years from the time her cancer cells reached her brain. To her, choosing to postpone the doctors' advice for aggressive treatment was the right choice.

LESSON 3: Same stage, different outcome.

Menchie, Cleng, Gigi and Lei: all with stage 2 breast cancer but different stories.

Menchie was my co-resident in at Medical Center Manila. She in Ophthalmology while I was in Ob-Gyne. She was able to establish a good practice immediately after her training, both in MCM and in her hometown in Lucban, Quezon. About three years into her practice, she was diagnosed with breast cancer and had her mastectomy and chemotherapy. Despite doing all these, she developed metastasis to her lungs shortly after. She died in her early 30s.

Cleng was at the peak of her career as a cardiac anesthesiologist when she was diagnosed. She had all the treatments done. She lost her hair and her confidence. Now, seven years later, she has both of them back. Not wanting to be bothered by questions, she played incommunicado from me and many of our common friends until last year. She reinvented herself and is now into the wellness industry both as a business owner and the in-house medical provider. Looking at her, there is nary a clue of what she has been through. Her sparkling eyes and ever ready smile shows how much she appreciates her second lease on life.

Gigi is a pulmonologist. Her mother's sisters had breast cancer. She didn't think too much about it until she felt a small lump in her breast. Her life was turned upside down with the diagnosis of breast cancer. She immediately had surgery and started chemotherapy. Her maternal cousin visited during her confinement and Gigi encouraged her cousin to be screened for breast cancer. It turned out that her cousin has cancer, too. Seeing that her advice saved at least one person, she decided to write a handbook for similarly situated people. She wrote about her experience, bits of information and other topics like where to buy wigs and how to cool your head while wearing so. She is now undergoing extended oral treatment but is back practising her profession. Although at times she feels very tired as a side effect of the drug, she religiously takes it with the hope that she can see daughter Lisa become a doctor and son Luis finish his college course. She is hopeful that she can weather this storm and come out victorious.

Lei is a pediatrician and a mother of four. Diagnosed with breast cancer stage 2 in 2009, she had mastectomy done. Unfortunately, a year later, her other breast had cancer, too, so she lost both her breasts. In 2011, she had cancer again on the previously removed breast and lymph nodes. This was so rare that her case was presented as an interesting case in the hospital. Early this year, she felt pain on her leg, which turned out to be metastatic cancer to the bone. Then, a few months ago, she felt a lump in her scalp. Her oncologist said this cannot be metastasis or spread of the cancer to her scalp because she does not have enlarged neck lymph nodes ("kulani"). He said this is a rarity, so he had a biopsy done. It turned out to be cancer cells, indeed. Lei has accepted the fact that she is dying but abhors the pain that keeps her from sleeping. Looking at her though, you will not see a trace of the pain which she courageously hides. After all, she is the source of our mantra "Composure at all times." She wants to leave a legacy for her children as she will not live long enough to see them have families of their own. She admits though that despite having accepted her fate, she cries when alone through all the pain and the realization she is leaving her loved ones behind. She prays to God to take her soon because the pain is getting to be too much for her. Behind the smile and "kakikayan", she is hoping for her life to end soon.

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