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Starting The Year Right

Posted by on 11 January 2009

People greet the coming of the New Year in so many ways. Fireworks is one of them — probably inherited from the Chinese superstition that the noise will chase away evil spirits — but now practiced more because of their aesthetic value. Filipinos greet the New Year with some money in their pockets in the belief that it will guarantee money all year round. I’ve grown up thinking that anyone vertically-challenged should, at the strike of midnight, jump up and down so that they’ll grow taller in the coming year. And as preparation for media noche (the midnight meal), my favourite aunt would scour the wet market and supermarkets for all sorts of round fruits to put on the dinner table — for luck, she’d always say. Other people would start making a list of their New Year’s resolutions — stop smoking, lose weight, reduce caffeine intake, limit their shoe purchases.pink ribbon
Me? I’m more practical. I start the year right by doing the two most important tests that every woman must do annually — a Pap smear (which can detect cervical cancer) and a mammogram (which can detect breast cancer). I used to do these two tests separately, whenever I remember to do so sometime during the year. Then one day, I got to thinking — why don’t I just get them done every January so that I’ll never ever forget again? What better way to start the year right than by taking care of my health, the most precious gift of all?

According to the Centers for Disease Control and Prevention (CDC), all women are at risk for cervical cancer, although it occurs most often in women aged 30 years and older. In 2004, 11,892 women in the United States were told they had cervical cancer, and 3,850 died from the disease. The CDC stresses the importance of getting tested for cervical cancer because “6 of 10 cervical cancers occur in women who have never received a Pap test or have not been tested in the past five years“.

As for breast cancer, the CDC says that it is the most commonly diagnosed cancer and is the second leading cause of cancer-related death (after lung and bronchial cancer) among women in the United States. In 2004, 186,772 women were diagnosed with breast cancer, and 40,954 women died from breast cancer.  CDC data shows that screening mammography can reduce mortality from breast cancer by approximately 20% to 35% in women aged between 50 and 69 years and approximately 20% in women aged between 40 and 49 years.These two cancers, if detected early, can be cured. And that is the key — early prevention. All sexually-active women must get the Pap smear done once a year. All women, once they reach the age of 40, must do their mammogram scan every year because not all lumps can be detected in a manual breast examination. For women who have a history of breast cancer in the family, an annual mammogram is a must starting at age 35.

I’m one of those women who have a history of breast cancer in the family. My mother was diagnosed with invasive multi-focal breast cancer, stage 2A, in July 2007. That’s why I’ve got to get my mammograms done every year, even though I’m not 40 yet.

My Mother, The Fighter

My mom’s story all began with a hysterectomy some 10 years ago. She had some fibroids in her uterus that no longer responded to any treatment which led to progressively worse bleeding episodes. The surgeons suggested to have her ovaries removed, as well, in order to avoid any potential problems in the future (such as cysts or other forms of ovarian disease). She consented, as she was already well past child-bearing age anyway.

After the surgery, with both ovaries gone, my mom then had to go on hormone replacement therapy (HRT), to replace the hormones that the ovaries normally produce, including estrogen and progesterone. The only problem with HRT is that it has been known to cause breast cancer.

Having known that risk from the start, my mom had her mammograms done faithfully year after year after year. Except the year 2006. She figured that, since her past 5 scans were normal, it would be safe to skip it just once that particular year. Boy! She was so wrong! So very, very, very wrong…

In 2007, a friend of hers wanted to do a mammogram but didn’t know the way to the National Cancer Society Malaysia (where they do mammograms and pap smears at very reasonable fees), so my mom accompanied her. At the centre, the nurse persuaded my mom to have her mammogram done, too, since she had to wait for her friend anyway. So my mom did.

In an ironic twist of fate, my mom’s friend’s results were clear but my mom ended up having a long talk with the radiologist on duty that day. He told her that there was some calcification in her right nipple and two small but suspicious-looking lumps — one at 12 o’clock, the second one not too far away at 1 o’clock. He gave her a list of recommended breast surgeons and told her to go for a second or even third and fourth opinion…but fast.

My mom was stunned and thought that maybe, just maybe, the radiologist was wrong. So she went to see one of the doctors in the list — Dr. Patricia Gomez of Pantai Medical Centre. Dr. Pat, who came highly recommended for her surgical skills, which were likened to that of a talented seamstress, is a very upbeat doctor with an infectious chuckle and so much zest and optimism in life.

I was with my mom for her first appointment with Dr. Pat, who immediately ordered her to undergo an ultrasound exam, as well as a biopsy. I held my mom’s hand as she went through the image-guided needle biopsy. And I was at her side when Dr. Pat gave us the news that we dreaded the most — it was cancer all right. Dr. Pat minced no words when she gave my mom her diagnosis and told my mom in no uncertain terms that she’d have to get the breast removed in order to prevent the cancer cells from invading the rest of her body. Dr. Pat said if my mom were to do a lumpectomy and if the lump turns out to be malignant, given her age, it would not be wise to subject her to the knife two times. Furthermore, Dr. Pat explained, my mom’s cancerous growth was invasive — in less than 2 years since she last had her mammogram, the growth was already some 5 cm (almost 2 inches) in diameter. Think of it as a nasty weed — the type with offshoots that spread in different directions and plant their roots deep within the soil in order to create more offshoots.

So, 4 days after Dr. Pat’s diagnosis, my mom decided to have her mastectomy done, with some of her lymph nodes removed, as well, to check if any of them had signs of being invaded by the cancer cells. I knew it was a tough decision for her to remove a part of her that represented part of her womanhood but she had her priorities straight — life is more precious than saving a breast.

Thank God for the outpouring of love and support from friends and colleagues. The night following her surgery alone, she was up until 2 am answering text messages on her phone. She had no time to feel depressed! :)

[NB: Her lymph nodes turned out to be clear and it’s something that we are very grateful to God for because it’s a good indication that the cancer cells may not have had the chance to extend beyond her breast area just yet.]

But her mastectomy was nothing compared to the six cycles of chemotherapy that came next. Chemotherapy tested her patience, her limits and her strength — both physical and mental. She battled with nausea and loss of appetite (which isn’t good, when one has to eat the right foods in the right amount in order to build up immunity!). She also had to contend with a metallic taste in her mouth that made her extra-sensitive to certain tastes and especially to spicy food. And despite the treatments’ sapping her of her energy, somehow, as though in defiance to the disease, she still found the strength to drive herself to the hospital for her booster shots, in between her chemo sessions! (My brothers and I took turns driving her to her chemo treatments though. And on the days when none of us could make it, a driver would send her.)

All those side-effects were nothing compared to how the drugs wreaked havoc with her immune system, making her easily susceptible to diseases. That was the worst part of all — the seclusion. My poor mother had to separate herself from her beloved grandchildren in order to avoid getting sick, as children are nature’s most efficient carriers of all types of germs and viruses.

Despite the difficulties, it was amazing how she could still find something positive in her situation. Like the time her hair started falling off. She bravely asked me to shave off the rest of it…then asked me to take her photograph! I still have that photo of her, grinning directly into the camera, her head newly shorn of their silver locks. She then used that photo to do virtual online hair makeovers for herself, ‘trying on’ curls, experimenting what it’s like to be a blonde and a redhead.That’s my mom — always finding the silver lining to every cloud!

Things improved a bit after her chemotherapy. She regained most of her strength and she started going back to work. Would you believe me if I told you that she also drove herself to the hospital for her radiotherapy sessions? Because she did. For all 20 of them! Mostly because the sessions didn’t last long and were scheduled on weekdays, in between her classes (she’s still teaching at her age!).

It was the longest 6 months of our lives — from her diagnosis in July 2007 to her mastectomy, chemotherapy, radiotherapy, and the long road to her recovery. It felt like forever, but she made it through. A new chapter in her life began. Her health started to improve, hence giving her grandchildren the opportunity to hang out at their Lola’s house again. Her nails slowly returned to their normal colour, which was a relief after the chemicals previously rendered them black. Her hair started to grow back — curly, like what most people told her would happen — and surprise, surprise, with many black strands interspersed among the ivory ones. Only the sensitivity of her tongue took the longest to ease up.

In August 2008, my mom had to do the first of five annual medical checkups that she is obliged to undergo in order to keep an eye on the slightest sign of any recurrence of those pesky cancer cells. Praise be to God, she was given the all-clear. One year down, four more to go before her doctor can pronounce her as cancer-free…

For now, she continues to take her anti-estrogen hormonal therapy, given that her cancer was tested estrogen receptor positive (ER+), or in simpler terms, they depend on estrogen to grow. Her medication is meant to block the receptors or reduce the amount of estrogen that can get into the receptors. She also must avoid foods containing soya beans because they contain phytoestrogen or chemicals that mimic the effect of estrogen.

For the rest of her life, my mom needs to regularly do some exercises with her right arm in order to prevent lymphoedema, a common occurrence when lymph nodes are removed from under one’s arm. She must also take extra care not to carry anything heavy with her right arm (a tall order — given that she’s right handed!) and to avoid getting her right hand/arm burned, bitten, stung or wounded.

Today, my mom is living life to the fullest, enjoying life and love with family and friends… and finally fulfilling her long-time dream of seeing the world. In a span of just under a year, she flew by herself to stay with a former student in Bangkok for a few days, spent a couple of weeks in Sydney with a former colleague who has migrated there, climbed up Mt. Bromo in Surabaya with me and my family, took a bus to Singapore where she stayed in a youth hostel for the first time, tried snorkeling for the first time ever in Phuket, went up Mont Blanc in Switzerland while I was stuck in a conference, soaked in the sights and sounds of quaint Geneva, belle Paris and vibrant Amsterdam with me, became a kid again at Tokyo Disneyland with friends who are like family to us already. She’s currently saving up for her US trip.

Everywhere she goes, she proudly wears her pink ribbon pin — the universal symbol of breast cancer awareness. And every chance she gets, she spreads the word to every woman she knows about the importance of early screening because early detection means immediate treatment which just might save your life. For women over 40, an annual mammogram and/or ultrasound is a must, because some lumps can’t be felt during a manual examination, like my mom’s lumps which were just hiding behind her nipple.

So today, I pass on that message to you — get screened now because early detection can save lives. And please pass on this message to every woman you know.

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WOMEN’S CANCER DETECTION & BREAST CLINIC
66 Jalan Raja Muda Abdul Aziz
50300 Kuala Lumpur
Tel: 03-2698 7300
Monday to Friday: 8.00am — 4.00pm

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