love, cancer, etc.

7 years since surgery

2015-11-20T09:44:00.000-08:00

7 years since surgery. thank you, Dr. Michelle Chu. seven years without recurrence or any health issues at all. seven years of loving my children and friends. four years of being back in davis - swimming and riding my bike and taking long walks, loving the farmers' market, the library, the olive tree path, the sheep farm, Mr. Jennifer, my beautiful home. three years of loving everything about the farm and never wanting to leave it. i don't take any day or any moment for granted. i am grateful that i had cancer but especially grateful that it hasn't come back in these seven years.

happy thanksgiving, every day

xo

FINALLY!!!!!!!! California Governor Brown Signs End-of-Life Bill!!!

2015-10-05T14:26:00.001-07:00

Governor Jerry Brown Signs End-of-Life Bill

- by Nannette Asimov, San Francisco Chronicle

-- For the first time in California history, terminally ill people who wish to end their lives can be prescribed a lethal dose of drugs under certain restrictive conditions. Gov. Jerry Brown signed the “End of Life Option Act” into law on Monday, ending speculation over whether the former Jesuit seminarian would veto the bill opposed by the Catholic Church and some advocates for the sick and disabled.

The bill is not an ordinary bill “because it deals with life and death,” Brown wrote in his signing message. “The crux of the matter is whether the state of California should continue to make it a crime for a dying person to end his life, no matter how great his pain or suffering.”

In making California only the fourth state with such a law when it takes effect in January, Brown wrote that he considered the issue from “theological and religious perspectives that any deliberate shortening of one’s life is sinful.” He said he read letters of opposition from doctors and others, and said he did not know what he would do if he were dying and in pain.

“I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill,” he wrote. “And I wouldn’t deny that right to others.”

Assembly bill X2-15 sunsets in 10 years and narrowly defines the circumstances under which mentally competent, terminally ill patients can receive the lethal dose of medication.
Before the drugs can be prescribed, two California doctors must agree that such a person has no more than six months to live.

It is then the patient’s choice whether to take the drugs. Those who want to must affirm their intention 48 hours in advance and must take the drugs on their own, without help.

California has seen five previous efforts to pass an aid-in-dying law since 1992, when state voters rejected a ballot initiative by a 54 to 46 margin. Similar laws failed to make it out of the state Legislature four times between 1995 and 2008.

State Sen. Lois Wolk, D-Davis tried again this year after the conversation in California about medical prescriptions for terminally ill people grew more personal a year earlier.

Brittany Maynard of Alamo, a 29-year-old elementary school teacher, was diagnosed terminal brain cancer in spring 2014. Aware that her rapidly growing tumor foretold a painful death, Maynard and her husband of two years, Dan Diaz, left California and moved to Orgeon to take advantage of that state’s “Death with Dignity” law and receive the barbiturate Seconal that would let Mayard die painlessly. She described her decisions on video, and the recording — now one of several she made — went viral.

“I want this law to change for Californians and all Americans,” she told the Chronicle last October, weeks before she ended her life on Nov. 1. “To be a part of getting the ball rolling is something I feel good about. I want to make sure no one else has to do what I did and pack up their family and move to another state to not die horribly.”

In addition to California and Oregon, Washington and Vermont offer the option to the terminally ill.

Nanette Asimov is a San Francisco Chronicle staff writer. E-mail: nasimov@sfchronicle.com

Contact info to thank Governor Brown: https://govnews.ca.gov/gov39mail/mail.php

6 Years Since End of Cancer Treatment

2015-07-05T14:57:00.001-07:00

and very grateful

xoxo

2015-06-08T16:30:00.001-07:00

The Journey - David Whyte

2015-05-20T06:13:00.004-07:00

THE JOURNEY

Above the mountains
the geese turn into
the light again

Painting their
black silhouettes
on an open sky.

Sometimes everything
has to be
inscribed across
the heavens

so you can find
the one line
already written
inside you.

Sometimes it takes
a great sky
to find that

first, bright
and indescribable
wedge of freedom
in your own heart.

Sometimes with
the bones of the black
sticks left when the fire
has gone out

someone has written
something new
in the ashes of your life.

You are not leaving.
Even as the light fades quickly now,
you are arriving.

- David Whyte

Love After Love - Derek Walcott

2015-05-03T08:11:00.000-07:00

Love After Love

The time will come
when, with elation,
you will greet yourself arriving
at your own door, in your own mirror,
and each will smile at the other’s welcome,
and say, sit here. Eat.

You will love again the stranger who was your self.
Give wine. Give bread. Give back your heart
to itself, to the stranger who has loved you
all your life, whom you ignored
for another, who knows you by heart.

Take down the love letters from the bookshelf,
the photographs, the desperate notes,
peel your own image from the mirror.
Sit. Feast on your life.

Derek Walcott

Combination of carboplatin and chemotherapy improves outcomes for triple-negative breast cancer patients

2015-01-08T08:55:00.002-08:00

http://www.dana-farber.org/Newsroom/News-Releases/combination-of-carboplatin-and-chemotherapy-improves-outcomes-for-triple-negative-breast-cancer-patients.aspx

Combination of carboplatin and chemotherapy improves outcomes for triple-negative breast cancer patients

December 11, 2014
Eric Winer, MD

In a clinical trial involving women with triple-negative breast cancer, patients who received the drugs carboplatin and/or bevacizumab in combination with standard chemotherapy prior to surgery were more likely to have their tumors disappear entirely from the breast, according to data presented by investigators during the 2014 San Antonio Breast Cancer Symposium.

Although bevacizumab doesn't reduce long-term rates of cancer recurrence, the results raise hopes that carboplatin can be an important part of the fight against triple-negative cancer, say the leaders of the study, which was organized by the Alliance for Clinical Trials in Oncology with extensive involvement of physician/scientists at Dana-Farber Cancer Institute.

The investigators analyzed data from 360 patients with triple-negative breast cancer, the vast majority of whom had a form of the disease known as basal-like tumors. Triple-negative cancer, named for its cells' lack of three key receptors, accounts for about 15-20 percent of all breast cancers and tends to be aggressive, but can often be treated successfully if caught early. Basal-like tumors are made up of cells that resemble the basal cells lining the milk ducts.

In the trial, patients with triple-negative breast cancer were treated with "neoadjuvant" chemotherapy — which helps shrink tumors so they can be surgically removed — either alone or in combination with bevacizumab or carboplatin or both. (Bevacizumab prevents tumors from developing networks of blood vessels; carboplatin is a platinum-based chemotherapy agent.)

The researchers found that 61 percent of patients with basal-like tumors who received a combination of carboplatin and chemotherapy experienced a pathologic complete response — no microscopic evidence of cancer in the breast following surgery to remove tumor tissue — compared to 47 percent of those who received chemotherapy alone. Roughly the same improvement was seen in patients with other types of triple-negative breast cancer.

"In general, patients with triple-negative breast cancer who have a pathological complete response (pCR) with neoadjuvant chemotherapy are much less likely to experience a recurrence," says the study's senior author, Eric Winer, MD, director of Breast Oncology at the Susan F. Smith Center for Women's Cancers at Dana-Farber. "While we are optimistic about the role of carboplatin in triple negative breast cancer, we still do not know if it will lead to a high cure rate. Ongoing studies are addressing this issue and attempting to determine how and in whom to use carboplatin."

Funding for the study was provided by the National Cancer Institute, Roche-Genentech, and the Breast Cancer Research Foundation.

The lead author of the study is William Sikov, MD, of Brown University. Co-authors are William Barry, PhD, Sara Tolaney, MD, and Mehra Golshan, MD, of Dana-Farber; Katherine Hoadley, PhD, and Charles Perou, PhD, of University of North Carolina Lineberger Comprehensive Cancer Center; Brandelyn Pitcher, MS, of Alliance Statistical Center, Durham, N.C.; Baljit Singh, MD, of New York University Medical Center; Charles Kuzma, MD, of Southeast Cancer Control Consortium; Timothy Pluard, MD, of Washington University-St Louis Medical Center; George Somlo, MD, of City of Hope Comprehensive Cancer Center; Elisa Port, MD, of Mount Sinai Medical Center, New York, N.Y.; Donald Berry, PhD, and Lisa Carey, MD, of MD Anderson Cancer Center; Olwen Hahn, MD, of University of Chicago Medical Center; and Clifford Hudis, MD, of Memorial Sloan Kettering Cancer Center.

Hello, 2015! I love you!

2015-01-02T10:07:00.000-08:00

From Bryce Andrews' book, "Badluck Way" -

"We let the fire die when the storm broke, and rode together toward the higher pastures and the barn. Every tree was dripping and the creeks had swollen. It occurred to me that I had achieved a rare thing: I was living at the center of my heart's geography. And I knew it."

That's how I feel about my life. I am living at the center of my heart's geography: my love for my children, for my life in Davis, for my friends at the farm, for the farm itself, for all my friends and family, for my healthy body.

So, hello, 2015. I love you! Happy New Year!

These photos reflect what I've loved about 2014.

Ignore all that stupid breast cancer pink B.S. in October - do this instead

2014-10-01T08:00:00.000-07:00

Finally! An organization that exposes the bullshit of the pink ribbon and all things pink in the breast cancer race for making money off of us! Thank you, Kevin, for leading me to this group, Breast Cancer Action:

http://bcaction.org/2014/09/30/think-before-you-pink-stop-the-distraction/

Think Before You Pink® – Stop the Distraction

By Karuna Jaggar, Executive Director

September 30, 2014

It’s Breast Cancer Industry Month and the pink floodgates have opened. And again we ask: what have all these pink ribbon products and promotions done for women living with and at risk of breast cancer?

Together, over the years, we’ve changed the landscape of pink ribbon marketing. Pinkwashing is now a household word. People understand that you always have to “follow the money” in pink ribbon marketing. We’ve exposed the hypocrisy in pink ribbon fundraising and achieved some momentous wins against corporations.

This October, we’re taking it further and targeting some of the most outrageous pink ribbon promotions that exemplify everything that’s wrong with pink ribbon culture. We’re calling out the empty awareness, the misinformation, the profiteering,the pinkwashing, the degrading of women, the “tyranny of cheerfulness” that hides the harsh realities of this disease.

We’re sick of marketing giants raking in billions of pink ribbon dollars while women continue to be diagnosed with and die from this disease.

Pink ribbon culture distracts from meaningful progress on breast cancer in six fundamental ways:

Pink ribbon products spread empty awareness. “Awareness” has failed to address and end the breast cancer epidemic. Who isn’t aware of breast cancer these days? Pink ribbon trinkets on store shelves that promote “awareness” ultimately change nothing. We have more than enough awareness, but not nearly enough action that will make a significant difference to whether women get breast cancer or survive it. By making the public think “awareness” is the end goal, pink ribbon culture defuses anger about breast cancer and its devastating impact, and distracts us from the meaningful actions that will achieve health justice for us all. Oriental Trading, for example, is spreading empty awareness via its endless supply of plastic pink ribbon trinkets – the company pockets all the money from these sales!

Instead of more meaningless gestures that defuse righteous anger and distract us from the real issues, we need bold action to address and end the epidemic.

Pink ribbon promotions spread misinformation. Whether by over-inflating women’s risk of developing breast cancer, spreading the myth that “early detection is your best protection,” focusing on a five-year cure rate for a disease that remains a risk throughout a woman’s life, or other ways of cheerfully fudging the statistics, many pink ribbon promotions fail to tell the whole truth. These inaccuracies allow pink ribbon marketers to manipulate consumers’ emotions through fear-mongering and false promises—in order to sell more products. The NFL, for example, is spreading misinformation about breast cancer by repeating disproven and misleading advice about mammography screening in their “Crucial Catch” campaign.

Breast cancer campaigns must offer evidence-based information that does not fuel fear or offer empty promises in the attempt to sell pink products.

Corporations exploit concern about breast cancer for profit. Each October, marketers take advantage of people’s sincere concern about breast cancer to make money and generate good publicity. Companies sell products, make profits, and seek customer goodwill by claiming to care about breast cancer. Yet, most of these promotions ultimately benefit corporations far more than they help women living with and at risk of breast cancer. By tapping into our generosity and genuine desire to help, these companies avoid transparency about where the pink ribbon money goes and too often leave consumers unable to accurately evaluate the promises made in product advertising. Kohls’ recent “Pink Elephant in the Room” promotion, for example, was outrageous profiteering; it exploited concern for women affected by breast cancer to make millions for the company.
Companies and charities must honor people’s good intentions with full transparency and accountability in their breast cancer fundraising and marketing.

Some pink ribbon products are linked to causing breast cancer. Years ago, Breast Cancer Action came up with a term for this, pinkwashing: the outrageous corporate practice of selling products linked to an increased risk of breast cancer while claiming to care about (and profiting from) breast cancer. It is outrageous and deeply hypocritical for companies to make money and gain customer goodwill from products that increase the risk of the very disease they claim to care about! Alhambra Water, for example, is pinkwashing by selling plastic polycarbonate water bottles which contain BPA, a hormone-disrupting chemical linked to breast cancer.
Companies that claim to care about breast cancer should make sure their own products and services don’t increase women’s risk of breast cancer.

Pink ribbon promotions often degrade women by objectifying and sexualizing women’s breasts and bodies. From “save the boobies” to “save the ta-tas” to “save second base,” campaigns like these demean and insult women—and distract from the true focus of saving women’s lives. They highlight narrow standards of beauty (thin, white, able-bodied, and young), depict women as coy sex-objects and too often promote the fantasy of “perfect” breasts. These sexy/cute campaigns hide the lived experiences of women in all their diversity and complexity. NASCAR, for example, is selling breast cancer awareness t-shirts that say “Check Your Headlights” which degrade women by objectifying and sexualizing women’s breasts and bodies.

We must honor women’s rich complexity and full diversity, rather than obsess over narrowly defined body parts as the focus of breast cancer campaigns.

Pink ribbon culture obscures the harsh reality of breast cancer by creating a single story of triumphant survivorship based on positive thinking, beauty tips, and sanitized, carefully chosen images of women living with the disease– and sometimes women who do not even have breast cancer. Breast cancer is not pretty and pink, and many women who “fight hard,” “fight like a girl,” and try to “beat breast cancer” develop metastatic cancer and still die from the disease. Breast cancer is only profitable when it’s palatable, and the pink ribbon covers up the devastating, harsh reality that so many women and their loved ones are dealing with. Hooters’ breast cancer campaigns, for example, obscure the harsh reality of breast cancer by promoting a story of triumphant survivorship based on positive thinking, beauty tips, and sanitized, carefully chosen images of women.
We must value all women living with and at risk of breast cancer and recognize the hard realities of breast cancer, including and especially metastatic disease.

If these marketing giants really care about addressing breast cancer, they’ll Stop the Distraction! They’ll take bold action, provide evidence-based information, be accountable and transparent in their fundraising, stop degrading women, value women’s diversity, and stop hiding the harsh realities of this disease.

Take a stand against the industry that is taking advantage of our goodwill, profiteering off this disease, and distracting the movement from meaningful progress on breast cancer.

Whether you are joining us for the first time or are a long-time Breast Cancer Action activist, thank you for taking action with us and demanding real progress on breast cancer.

P.S. After you let these pink offenders know what you think about breast cancer campaigns, join us on Facebook and Twitter and share our “Stop the Distraction” graphics with your friends and family and let the world know why many pink ribbon promotions do more harm than good.

This entry was posted in BCA Action Alerts, BCA News, E-Alerts.>>

60 years young

2014-09-24T09:42:00.000-07:00

it would be ridiculous to whine about being "old" at 60, considering what i went through to get here! but it does feel weird, oh so weird, to say i am 60. but 60 feels wonderful and i've never been more grateful - both of my kids are very happy and healthy and i see them often, i love the farm and my farm friends, i ride my bike instead of drive my car 99% of the time, and i love everything about davis and my life here. la vie est belle and i look forward to growing older!

xoxox

Tested Negative for BRCA 1, BRCA 2 mutations

2014-08-26T14:33:00.001-07:00

I heard from the Kaiser genetic counselor today that I tested negative for the BRCA 1 and 2 mutations. It's good news for my birth family and also my kids. The counselor said there is a possibility of an unidentified gene which caused breast cancer for me, my birth mother, and my birth grandmother, so my birth sister and her daughters need to be vigilant about yearly mammograms and self-exams. It's good news for me because I don't have to go make plans for an oophorectomy. Here's a good summary of what testing negative or positive means:

http://www.mskcc.org/cancer-care/hereditary-genetics/inherited-risk-breast-ovarian

I'm grateful for Obamacare and the fact that genetic counseling and testing are now free for members of high-risk families. This may save many, many lives.

BRCA 1 and 2 Genetic Testing Today

2014-08-12T13:51:00.004-07:00

I was adopted in 1954, and in 1997 I found my birth family and discovered that my mother and grandmother had both died of breast cancer. But I decided against genetic testing for BRCA 1 and 2 because I knew that I would not be able to get health insurance with a new company if I left California, if I had tested positive. I was also very afraid to find out.

In 2008, I was living in Nevada and was diagnosed with breast cancer and had a double mastectomy. I had genetic counseling, but decided against genetic testing because the genetic counselor said that based on my family history (including the fact that my mother and grandmother and I had breast cancer after age 50), the formula indicated that my chances of testing positive for BRCA 1 or 2 was 7%, hardly worth the $3,000 out of pocket since Myriad held the patent and my health insurance would not cover it. I was also still very afraid to find out.

Myriad has now lost that patent, and Kaiser offers the genetic testing to high-risk patients free of charge as a result of Obamacare. So today I met with a Kaiser genetic counselor and he recommended I have the test. He said he thinks I will most likely test negative because of the same factors that my other genetic counselor stated, but because testing positive means there is a very high risk of ovarian cancer, he said it's important to know and then be able to make the decision about having an oopherectomy or not. I would also like to know if I test positive for BRCA 1 or 2 so that my kids can be more informed about their chances for breast cancer. I have a half sister who has two daughters, and I have four half brothers, and this information will be very important for them since we share the same mother and grandmother.

There's something about knowing I'll be 60 years old next month that's made me not afraid to find out if I test positive for these genes. So today I had the blood test. The genetic counselor handed me a kit which I gave the phlebotomist in the lab, she drew the blood, it was quick and painless, the lab will mail the kit to Ambry Genetics, and they'll send the results to my genetic counselor. I should have the rest results in two to three weeks.

There are many genes that can cause breast cancer. Even if a person tests negative for BRCA 1 or 2, it doesn't mean they won't get breast cancer caused by another gene which is undetectable at this time. But I'm glad we have this test for these two genes, which enables us to make informed decisions going forward.

More info about genetic testing: http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA

This is an excellent video from Dana-Farber Cancer Institute about BRCA genetic testing:

http://blog.dana-farber.org/insight/2014/08/the-truth-about-brca-testing-and-genetic-risk/

five years since treatment (!!!!!)

2014-07-05T07:39:00.000-07:00

being diagnosed with breast cancer is so frightening. and finding out that it's triple-negative breast cancer compounds that fear because of higher rate of recurrence within the first 3-5 years compared to non-TNBC. i remember after the first christmas after my diagnosis, i didn't buy gift wrap on sale for the next year because i didn't think i'd be alive for another christmas. i was 54. since TNBC can't be treated with hormonal therapy (tamoxifen, aromatase inhibitors) after chemo and radiation, all i can do is stay as healthy and active as possible, do self-exams (much, much easier, with a double mastectomy and no reconstruction, checking the scar area for recurrence), and enjoy life. it's been five years and i'm almost 60 - my life is so full and so happy - being with my kids, swimming, riding my bike, volunteering at the farm, writing a book, working on photography projects, loving my life and so happy to be back in davis.

i know recurrence can happen at any time, but having reached the 5-year mark helps me look ahead without the anxiety i've had over the last five years. 'Triple-negative breast cancers have a relapse pattern that is very different from hormone-positive breast cancers: the risk of relapse is much higher for the first 3–5 years but drops sharply and substantially below that of hormone-positive breast cancers after that. This relapse pattern has been recognized for all types of triple-negative cancers for which sufficient data exists although the absolute relapse and survival rates differ across subtypes.' - https://en.wikipedia.org/wiki/Triple-negative_breast_cancer

much progress has been made in treating TNBC with targeted therapies:
http://www.mayoclinic.org/diseases-conditions/cancer/expert-blog/triple-negative-breast-cancer/bgp-20090306

a good overview of all aspects of TNBC: http://www.healthline.com/health-slideshow/triple-negative-breast-cancer-recurrence#1

5 years!

xoxoxo

Chemoprevention drugs available for women with increased risk of breast cancer covered under Obamacare

2014-01-09T07:12:00.002-08:00

Now we can add chemoprevention drugs to the other preventative services covered under Obamacare - mammogram, Paps, and genetic counseling.

http://www.huffingtonpost.com/2014/01/09/obamacare-breast-cancer-drugs_n_4564993.html

And a list of all preventative services for women: https://www.healthcare.gov/what-are-my-preventive-care-benefits/#part=2

And for everyone: https://www.healthcare.gov/what-are-my-preventive-care-benefits/#part=1

WASHINGTON -- Certain medications that are intended to prevent breast cancer will be fully covered under Obamacare, in new guidance set to be issued by the Department of Health and Human Services Thursday morning.

Women at increased risk of breast cancer can receive so-called chemoprevention drugs, including tamoxifen and raloxifene, without a co-pay or other out-of-pocket expense.

Under Obamacare, most health insurance companies and employer plans must offer certain preventive services at no cost to patients.

The new coverage comes after the U.S. Preventive Services Task Force recommended in September that women at increased risk of breast cancer, due to age, family history or other factors, take drugs such as tamoxifen and raloxifene. The panel said it found "adequate evidence" that treatment with one of those drugs "can significantly reduce the relative risk (RR) for invasive ER-positive breast cancer in postmenopausal women who are at increased risk for breast cancer."

The Preventive Task Force is composed of independent, volunteer physicians and academics selected by HHS. The group makes recommendations to physicians on which preventive services to offer to patients, giving treatments letter grades.

Items or services rated A or B by the Preventive Task Force must be covered under Obamacare without co-pay or deductible by non-grandfathered plans.

"A preventive service is something that is intended to keep something bad from happening," Virginia Moyer, chair of the Preventive Task Force, said in an October interview with PBS NewsHour. "What we do as a task force is we carefully evaluate the science. The science that tells us whether a preventive service is going to benefit people."

Explaining Thursday's clarification, an HHS official told The Huffington Post, "What this means is HHS is making sure people know that because of this recent Task Force recommendation, there is now an additional option available for free for women who are at an increased risk of breast cancer."

Women older than 40 can also receive free breast cancer mammography screenings every one to two years under Obamacare. Genetic counseling and chemoprevention counseling for women at higher risk for breast cancer are covered as well.

Since the passage of Obamacare, USPSTF has also recommended services like screenings for HIV, counseling for obesity and vision screenings for children.

Below is the clarifying language HHS released:

On September 24, 2013, the USPSTF issued new recommendations with respect to breast cancer. What changes must plans make to comply with the new recommendations?
The USPSTF recently revised its “B” recommendation regarding medications for risk reduction of primary breast cancer in women. The September 2013 recommendation now says:

The USPSTF recommends that clinicians engage in shared, informed decisionmaking with women who are at increased risk for breast cancer about medications to reduce their risk. For women who are at increased risk for breast cancer and at low risk for adverse medication effects, clinicians should offer to prescribe risk-reducing medications, such as tamoxifen or raloxifene.

Accordingly, for plan or policy years beginning one year after the date the recommendation or guideline is issued (in this case, plan or policy years beginning on or after September 24, 2014), non-grandfathered group health plans and non-grandfathered health insurance coverage offered in the individual or group market will be required to cover such medications for applicable women without cost sharing subject to reasonable medical management.

christmas 2013

2013-12-24T14:59:00.002-08:00

this is how i spent christmas eve day - tilling soil in a field to prepare it for planting peas. super, super, super fun! it's very warm in davis, sunny, and being on the farm is such a joy. five years ago i had had the bilateral mastectomy a month earlier and was preparing for chemo in january. i could never have dreamed that five years later i'd be back in davis, working on a farm, driving a tractor, and loving life more than ever. i am so very grateful.

xoxoxo

No, we will not be the same after cancer.

2013-12-13T07:16:00.002-08:00

i love cary tennis' thoughtful advice, and this is quite wonderful:

http://carytennis.com/2013/12/after-cancer-will-i-ever-be-the-same/

Dear Cary,
Last year, at the age of 29, I was diagnosed with a rare kind of thyroid cancer. I was halfway through graduate studies and was just about to embark on a year of research as a student, in Central Asia, where I wanted to explore a new region, do some neat environmental work, and enjoy the adventure.
A quick recap: a handful of days before my plane took off from a city in North America to Asia, my dentist casually mentioned that my throat looked unusually large. I’d had a goodbye party and was all set to leave, but decided to follow up with my doctor. The initial test results were inconclusive. I thought hard about some unnerving statistics presented to me (e.g., a 5 percent chance that this could be something scary). Some of my friends advised to just take my trip, saying, Hey, just go and live your life, I’m sure it’s nothing at all. Eventually I opted to cancel my trip in order to follow it up properly. I’m grateful for that, as it turns out it WAS a scary kind of cancer with a significant mortality risk. There had been no symptoms and the doctors keep saying I dodged a bullet to catch it early enough for successful treatment. Over the last year I’ve marched along, finishing my thesis and the treatment. I know that I’ll need to check in with the doctors every six months for the rest of my life to watch for reoccurrence. But other than that I’m physically in the clear.
I’ve recently returned to the full-time job I had before graduate school. It has health benefits, a decent salary, and demanding work. I go to work every day and stare at the papers. I’m not getting along very well with my new manager and I hear her say that I am not paying attention to the details.
I can’t seem to reconcile the stress of this job with the gravity of all that has happened. Sometimes, when I am alone in my office, I cry. I return home and stare at my boyfriend. We aren’t having a lot of fun these days. I certainly don’t feel a renewed purpose/appreciation for life, as I’ve heard some people can feel after finishing something scary like cancer treatment. I continue yoga and daily meditation, and have tried counseling, but still feel incredibly fragile. Some other young friends of mine with cancer have passed away recently. I feel some kind of immense responsibility, given my recent reminder that life can be short and luck plays a key role. I want to channel this “lesson” toward good, but I don’t know what or how.
Despite having an incredible network of family and friends and boyfriend, I want nothing more than to leave it all behind and sit quietly on a mountain somewhere. My boyfriend and I have been together for five years and had been talking about marriage and starting a family, but now we just argue every day. There are opportunities to do well in my work organization and contribute lots but I am crumbling in the face of the politics and consecutive deadlines. I just can’t seem to get it together, nor give myself the permission to rest and recover from the shock of the past year. Instead of accepting the offerings of love and stability, I feel angry, empty, and fearful of reoccurrence and regret. I don’t trust myself to make big decisions (e.g., quit my relationship and job) since I’m so obviously reeling. I’d really appreciate any advice on how to wade through. Thank you.
Survivor
MarconiAd_2014

Dear Survivor,
I hadn’t yet finished reading your letter when all the shame and wonder and guilt and majesty and gratitude of being a cancer survivor poured in like light through a hole in the ceiling and the tears came like they haven’t come in a while. I’m coming up on four years since my own cancer surgery. I guess that’s it. Plus your letter just moved me — to anger and to tears.
We know things now, you and I and all the other cancer survivors, and when we meet by chance sometimes that knowing floods in. The crying is a kind of knowledge. And it is a kind of prayer: The body’s prayer, the body’s way of saying Please, I like this life. I’d like to keep going, please. I get it, I might be dead in six months or a year. But please, I’d like a few more years. Thusly the body makes its salty prayers. To whom? To the earth that gave birth to us? To whatever mystery sustains us? Who cares? We make our prayers.
So listen: You need permission to rest and recover. You absolutely need this. To think that you would be back 100 percent already is ridiculous. Your life has changed. You need time to recover and grow strong and learn how to live conscious of the grave, precious thing life is.
Your boyfriend and your boss don’t understand. The survivor of cancer needs time to grieve and adjust and recover. The survivor is fragile and explosive and can’t go back to life like it was.
A door has closed.
I can hear someone somewhere saying, Well, you know, when one door closes another door opens, and I want to slap that person. Why do people persist in saying that pernicious and ridiculous cliché? When a door closes, a door closes. Another door might open or might not. (Thank you, Sheldon of “The Big Bang Theory,” for pointing that out.)
So yes, you are angry. Hell, yes. You want to survive like a motherfucker and I don’t blame you. Who wouldn’t be angry? Who wouldn’t be reduced to tears at the sudden realization of just how miraculous it all is? So fuck ‘em if they don’t understand.
You need your time on the mountain. You need your time in a tent in the woods or on a running stream or up high somewhere. So you need permission. If you won’t give it to yourself, then I will give it to you.
As the tears roll down my face I just have to say that you have been through hell and you might be fragile for a while and that’s OK. Cancer changes a person.
Maybe you’re here for a reason. Maybe that’s what this means. I don’t mean that in a superficial way but maybe there’s something you were supposed to do. I wonder if when you heard the diagnosis something flashed through your mind. That moment is a kind of whiteboard, a litmus test: Whatever is most present, big and pressing in your life will show in that moment.
I haven’t read the last paragraph of your letter yet. I’m still crying and writing but let me see about your last paragraph. There’s probably something there.
OK, you want to channel this “lesson” toward good but aren’t sure how. Well, environmental work is important. We came from this planet and we owe it our lives. So maybe your life belongs to this planet and what this is telling you is that your environmental work is your life’s work. How can that not be true? So if there are barriers, which there always are, then you set about overcoming them.
As to the career: Listen, it might not all make sense to you but it does to me. You are studying the environment because you fucking care about it. There is a big problem with the environment. And it is our fault, we humans, how stupid we have been, how we live, and more generally how we minimize what is harm, what is a wound, what is destruction. It’s all connected. After injury and loss comes grief that cannot be outsourced or cut like a line item from the budget but as a culture, we don’t see that. Or if we do, we don’t act on it with compassion. And that is all connected: Our refusal to make time to grieve and repair injury is connected to our inability to see how our behavior injures the environment and to take the time and spend the money necessary to repair it.
Compassion and sentience of life: These things are connected.
To do good for the planet you can start by doing good for yourself. You are a child of the planet and you must care for yourself before you care for the planet. Treat your own wounds. See them as real. Be reverent before them. Recognize that it’s all connected: Your thyroid cancer, the planet, the failure of those around you to respond to the gravity of what you went through: It’s all connected. A cultural critique rises naturally from this: Our economy of endless growth, our unrealistic expectations, our minimizing of your emotion, your illness, your grief, your own hesitation to do what is natural, your own inner conflict: These are all connected.
You say, “I just can’t seem to get it together, nor give myself the permission to rest and recover from the shock of the past year.”
OK, well, if you won’t give yourself permission to recover from the last year, then I will. Permission is hereby given.
You need to mourn and grieve and take as long as you need. You are a new person. This new person is not all full of bright cheer and gratitude and consciousness of life’s preciousness. This new person is also fierce and angry. You will need time to let this new person in.
This mountain you speak of:What does that mean? Does that mean solitude? Does it mean perspective? Does it mean connection to the earth, to something powerful and eternal?
You don’t need to quit your job and your relationship. But you need some time off. And you need help. About a year after my surgery I became deeply, clinically depressed. It was awful. I needed serious help. I got it. It took a year or so to come out of it.
So, yep, while reading your letter I’m crying and I’m still crying. What’s that about? Fragility and beauty of life? Guess so. My own cancer? Guess so. Dec. 17 it’ll be four years since I went into UCSF for surgery for a sacral chordoma and Dr. Christopher Ames and his remarkable posse of skilled, dedicated, brilliant surgeons, doctors and scientists turned their terrible and precise knives and saws upon me. And then turned me back out into the world a week later to hobble about and adjust.
Am I incredibly grateful to be alive? Yes. Do I feel tenderness toward you, whom I don’t know, who have just given me your story? Yes. Do I feel that same thing for the many millions of people who go through this? Yes. But why is it so intense right now?
I dunno. It just is. Trust me, it just is.
I went through hell. I survived. My friend Lori in Seattle went through hell but she survived. You went through hell. You survived.
But we’re not the same. None of us are. Don’t expect us to be.
If I could say one thing, that would be it: Afterwards, we’re not the same. Don’t expect us to be.
Readers: Just a reminder. Feel free to share this column via the social media buttons above. Many people are helped and encouraged by this column, so know that in sharing it you are doing a good thing. Thanks! Happy Holidays!–cary t.

happy thanksgiving

2013-11-27T15:00:00.000-08:00

5 years since mastectomy

2013-11-20T06:39:00.002-08:00

five years since surgery!

it's been absolutely wonderful not wearing a bra for five years!

i remember the morning of surgery, my son james and i arrived at the hospital very early. we were walking through the parking lot attached to the hospital, and i said, "well, this is the last time my boobs will be in this parking lot." and he said, "i wouldn't be too sure. they might be wheeling 'em out of here pretty soon." so the day started off with a big laugh.

i remember waking up after surgery and my two sons were right there next to me in the hospital room, holding my hands.

and the night ended with laughing so hard my stomach hurt, when james spent the night with me in the hospital room and we were debating who had it worse, me with the surgery and upcoming chemo and radiation or him trying to quit smoking.

i am so grateful for these past five years without recurrence. although it's a milestone, i will actually breathe a sigh of relief on july 5, 2014, five years since end of treatment. i never, ever thought five years could pass without recurrence. what a gift. i'm so grateful to dr. michelle chu and her brilliant surgery, and to bobbi gillis, my nurse navigator, who helped me in so many, many ways. and i'm so grateful to my sons and friends and the farm for making these last five years some of the best of my life.

xoxoxo

another birthday!

2013-09-24T11:39:00.000-07:00

so thankful for another birthday - my last year to be in my fifties. it's a fun trip!! still working on the farm, visiting with james, swimming, loving Mr. J., tending my porch garden, enjoying trips back to pacifica. and matt and molly are back in the states for the winter!

4 years since end of treatment!!!!!

2013-07-05T06:08:00.000-07:00

It’s really fun being alive right now.

Four years since the end of treatment!!

This is such a wonderful summer! Farm work and driving the tractor!!!!; visits with Jimmy; Matt in Colorado; delicious farm food – watermelon, tomatoes, onions, peppers, chard, garlic, carrots, kohlrabi, blackberries, strawberries, basil, ambrosia melons, squash, beets, herbs, and chickens; swimming every day; picking peaches and plums and pluots at an orchard down the road; coffee at 5:30 a.m. on my porch glider, beautiful Davis morning air; my porch garden with tomatoes and basil and lots of jalapenos; good library books; evening bike rides; my delightful farm friends and community.

I remain very, very grateful.

xoxoxo

spring!

2013-04-07T13:51:00.000-07:00

springtime!

this is my ninth month of documenting the farm, working on the farm, loving every minute i'm there!

la vie est belle -

xoxo

working on a farm

2012-12-01T18:03:00.000-08:00

since june, one of my lifelong dreams has come true! i work on a beautiful organic farm, as a volunteer, at least three days a week. it's 5 miles up the road from my home, up road 99. pacific star gardens, owned by robert and deb ramming, 40 acres of my idea of heaven, plus 400 turkeys, birds, chickens, and ducks. for half a year now, with lots of instruction and patience on the part of robert and deb, i've learned to plant and harvest all kinds of vegetables (some i had never even seen before), i've been pitching straw, shoveling bird shit, pulling up drip tape, wheelbarrowing pumpkins and butternut squash, transplanting strawberry daughters, shucking corn, weeding, and watched the butchering of birds for thanksgiving. most fun of all, i get to drive the tractor! and now i've got muscles! and i'm happier than i have ever been.

i hope to keep working on the farm for as many years as robert and deb will let me! i can't thank them enough - and their son adam, and my volunteer friends robb, ashley, tarra, pouya, brian, DD.

love and vegetables!!

xoxox

Thank you, New York Times and American Cancer Society!

2012-11-16T14:57:00.002-08:00

Thank you, New York Times and American Cancer Society, for including me in this wonderful book, Picture Your Life After Cancer!!

This week is the fourth anniversary of my mastectomy.

best summer ever!

2012-08-31T12:31:00.000-07:00

being in costa rica with matt

meeting ursula and nils in costa rica

working on a farm 5 miles up the road!!!!!! big, huge fun!!

swimming almost every day

peaches, watermelon, corn, tomatoes

volunteering to photograph dogs and cats at SPCA

going to the state fair & horse races

finishing hospice training

sleeping at night on my porch glider

tending my summer garden

riding my bike way out in the country and all over davis

spending the last week of summer with jimmy

3 years since end of treatment

2012-07-05T07:42:00.001-07:00

three years ago today was the end of four months of chemo and two months of radiation. three years! every day without recurrence is a milestone for any of us who have had breast cancer, but for triple negative breast cancer, three years is a biggie. ""Triple negative breast cancers have a relapse pattern that is very different from hormone-positive breast cancers: the risk of relapse is much higher for the first 3-5 years but drops sharply and substantially below that of hormone-positive breast cancers after that. This relapse pattern has been recognized for all types of triple negative cancers for which sufficient data exists although the absolute relapse and survival rates differ across subtypes.""

how am i celebrating today? after my daily bike ride and swim, i've volunteered to take photos of all the animals at the SPCA for their website. three years ago, when i finally walked out of that hospital after my last day of radiation treatment, i would have been thrilled to know that in three years i'd be biking and swimming in my beloved davis, then goofing off with a bunch of animals at the SPCA!

xoxoxo