Every Step of the Way: A Nurse's Cancer Diary - Entry 5
Nancy Cohen, BSN, RN, has graciously shared her personal journal, in which she writes about doing battle with cancer for the second time in her life. This is the fifth installment of a weekly blog that will enable readers to join her on the journey.
Entry 5: Down, But Not Out
November 2, 2011
Red-hot fiery anger.
That’s what I’m feeling. Anger like I’ve never experienced. I have no one to blame, no one to point the finger at.
You’re cured, I was told over and over spanning nearly a decade and a half. I’d crossed the many milestones which mark cancer survivorship, the 1-year, the 5-year, the 10-year and I’d almost made it to 15. I’d been told my risk was miniscule because of the mastectomies in 1999. I felt slightly uneasy going on estrogen after my supracervical hysterectomy/oophorectomy, but over and over and over again, the words were all the same, echoed by each and every physician who followed me throughout the years, your risk of developing another cancer is very slight. Although both my breast surgeon and my medical oncologist were eager to put an end date on the hormone. We would later discover that my years of taking estrogen had nothing to do with my developing breast cancer a second time.
Cured is a funny word and one I never, ever associated with cancer. I don’t know that I’m cured, I thought. Perhaps remission is more accurate? A word that reminded me that there are no guarantees with diseases such as cancer and no guarantees in life.
I wanted so much to place blame on my doctors, my excellent, outstanding medical team who cured me the first time with the breast cancer. But it was no one’s fault, just the weak spot in my genetic armor that would always predispose me to developing this disease, even with the prophylactic surgeries.
After 9 months, my paternal aunt was diagnosed with breast cancer, then my own sister a year and a half later. It was neither a secret nor a surprise; we all shared the BRCA1 gene, a gene commonly seen in the Ashkenazi Jewish population, or Jews of Eastern European descent. It’s also autosomal dominant, which means that one has a 50 percent chance of passing it to one’s offspring. I’d inherited this gene from my father and my son has a 50 percent chance of carrying the gene. If he has it, he’s at a much higher risk of developing prostate, colon and breast cancer in his lifetime than the average person. Oftentimes, I lay awake at night agonizing over this possibility and the threat to his health. I plan on getting him tested when he turns 18. Then I’ll have to explain what it all means if and when the time comes.
I’d experienced so many life events since the first diagnosis, such as my wedding on August 16, 1997 in historic Cape May, NJ, in 105-degree heat. I’d finished my last cycle of chemotherapy just 2 weeks prior to the wedding, and although I was completely bald, no one would’ve known. I wore my mother’s old wig from the 70s and I looked like a very excited, albeit very pale and skinny bride.
In May 1999, I underwent bilateral mastectomies.
Two years later, I was blessed with my son Andrew, now age 10 and a true miracle. (I’d ruptured my placenta and had placenta previa). Luckily, Tim called 911 and I was rushed to the nearest hospital with a labor and delivery unit. My hemoglobin was 4 and my blood pressure was 80/40. A young obstetrician I’d never met performed an emergency c-section which saved our lives.
About 3 ½ years later, my father was diagnosed with bladder cancer. He valiantly fought the disease for another 3 years but lost the battle in December 2007. Nine months before this unspeakable loss, I became unemployed due to a hospital closure after nearly 14 years. The same year, I gained employment at three other hospitals. My brother-in-law was diagnosed with prostate cancer the following year at 42. It seemed as though tragedy struck every 2 to 3 years in our family.
Who could I blame for this second cancer diagnosis? What could I blame but my own broken body, which expressed an abnormality in the 5,382nd strand of DNA? What caused it to go haywire the first and second time? Would my doctors ever know? Unlikely in this lifetime.
There’s even more stigma attached to having cancer a second time. I understand this.
I was so many years out, so many years away from the trauma of being diagnosed, the painful surgeries, the agonizing chemotherapy treatments that followed; the Adriamycin and Cytoxan combination with their accompanying nausea, diarrhea, dry heaves, weight loss and hair loss. It was like a bomb had been detonated inside my body. It had been a distant memory; my support groups and all of the women I counseled along the way when they had first been diagnosed. I had moved on, though I never forgot this part of my life. I never forgot all of the wonderful, courageous and inspiring survivors I had the honor of meeting, nor did I forget those who passed away with dignity and grace.
Loss of health, loss of employment, loss of self-esteem, feeling helpless and hopeless. It’s all part of the cancer experience for me and it’s ongoing. I need to navigate my way out of this deep dark web. I want to try and view the positives, to learn the life lessons and accept that, although I have this again, I may be lucky enough to survive,.
After all, it’s not just about me. I have the precious gift of close-knit family and friends.
Click here to read Entry 4: The Waiting Game.