According to the Israeli Ministry of Health, about one in eight Jewish women in this country will be diagnosed with breast cancer during their lives. The figure has traditionally been a little lower for Palestinian and Arab-Israeli women but their numbers have been rising and are approaching the same levels. Medical sources agree that although only about 6% of breast cancer is metastatic at first diagnosis, close to thirty percent of all breast cancers, including those detected early, will metastasize.
My breast cancer was self-detected and them confirmed on my first ever mammography. There was already lymph node involvement and a question of distant mets. The primary tumor was about as long as my thumb. All the factors together put the staging at IIB or IIIA. It wasn’t long afterwards that distant metastasis was diagnosed – in my case, to my spine.
Practically speaking, this means that I will never be healthy again. While people can live for several years with bone mets (the most common site of breast cancer metastasis), life will never be the same. Life is never the same for anyone who has lived through a “cancer event”, but for those of us with metastatic cancer it means living with increasingly severe pain and the attendant side effects of pain relieving drugs, with increasing fatigue and the attendant frustration. It means living from treatment to treatment, and a narrowing of one’s sphere of activity and social circle. It means coming to terms with one’s mortality in a very immediate way, while helping loved ones do the same.
These are some of the commonalities among people living with metastatic cancer. But we are still individuals right up to the end. We each have our own personality, coping techniques, level of insight, hobbies, loves, fears. We still have preferences for how to live our remaining time. Some of us strive for continuous positive thinking, some become social or politically active. Some of us reach out to others, and some prefer to be alone. Some are indescribably sad; others seethe with rage. Many of us are all of these things at different times.
I am writing this post on an iPad while resting in bed. The weather was nice today and I wanted to go outside to try to repair some of the ravages that recent storms visited on my garden, but I was exhausted after ten minutes. Some days I don’t even get dressed because I know I’ll be spending most of the day in bed, but on other days I call a friend who takes me on short walks in the neighborhood. Metastatic cancer is helping me learn to be more flexible and to adjust my expectations.
I can’t say I am exactly the same woman I was before the cancer, but I don’t think I’ve changed all that much in some ways. I still prefer to avoid confrontation, and I still use humor as my primary defense mechanism. I still love poetry and novels and movies about people and feelings. I am still fascinated by the “people-side” of history, still more of a process person than a goal-oriented one, and I am still competitive. (Words with Friends, anyone?)
So here I am in bed, struggling with the WordPress mobile interface (Grrr…). The person who helps me with cleaning accidentally bumped my bed and the jarring caused me pain. “I hate being like this,” I found myself yelling and I felt ashamed of myself for “breaking down” in front of the cleaner.
He looked at me with kindness and a little smile. “I know,” he said in a broken combination of Hebrew and English. “For you, this is very difficult. You are a very strong person,” he made a fist, ” and you love life and living.” He held his arms out in front of him, palms up, and swept them wide open. “It is very hard for you.”
Yes and yes.