Life after breast cancer tests mind, body and wallet
BY MATTHEW SCHWERHA For Sun-Times Media
Shadows from the past: The journey through breast cancer carries on for years after diagnosis and treatment — taking a toll on the mind, body and wallet. | FILE PHOTO
what to watch for
Women who have been treated for breast cancer sometimes develop the following:
Breast cancer survivors face the possibility of developing lymphedema, or swelling of the arm from buildup of fluid, for the rest of their lives. Any treatment that involves removing or giving radiation to the axillary lymph nodes carries the risk of lymphedema.
2. Uterine cancer.
Women who are taking tamoxifen or toremifene are at increased risk for uterine cancer and should have annual pelvic exams. This risk is highest in women who have gone through menopause.
3. DIminished bone health.
Women who are taking an aromatase inhibitor or are pre-menopausal and taking tamoxifen or toremifene, especially need to monitor their bone health. A bone density test may be in order.
If symptoms, exams, or tests suggest a recurrence, imaging tests such as an X-ray, CT scan, PET scan, MRI scan, bone scan, and/or a biopsy may be done. Your doctor may also measure levels of blood tumor markers.
The American Cancer Society
For a woman who makes her career in the healthcare industry, it is difficult to not be reminded of your own bout with breast cancer on a daily basis.
“It still enters my mind,” said Darcy Winston, 50, of Highland, Ind., and a 12-year breast cancer survivor. “I work in the healthcare field and I go to a breast cancer conference every Tuesday morning.”
Like many cancer survivors, Winston is now cancer-free and looking to live a long and happy life.
According to the American Cancer Society, breast cancer death rates decreased 2.2 percent per year from 1990 to 2007, after having increased 0.4 percent per year from 1975 to 1990. The decline in breast cancer deaths has been attributed to improvements in breast cancer treatment and early detection.
Winston recommends women diagnosed with breast cancer educate themselves with as much information as possible. Before enduring her own journey with breast cancer, Winston was much less aware of all the things she needed to know and she needed support to lean on.
Mary Maryland, patient nurse navigator for the American Cancer Society at Loyola University Bernadine Cancer Center, finds herself in one of those support roles.
“Part of my responsibility is to help newly diagnosed cancer patients navigate their way through treatment,” Maryland said.
Sometimes the scariest part of the process takes place after the cancerous cells have been removed via surgery.
“To some degree, after whatever intervention has happened, there is a ‘now what?’ feeling,” Maryland said.
What sickened Winston the most was thinking about how her son and her husband would get along if she were to die.
“My next door neighbor was a widow with three children,” Winston said. “His wife had died of breast cancer. All I could think of going through my treatment was I had to be strong because my husband was so helpless. I worried about my son remembering me if I was to die of cancer. That is what drove me to fight harder. I wasn’t scared of dying. I was just worried about what would happen to them if I did die.”
As is the case with many breast cancer patients, Winston’s treatment and recovery went on for years after her initial diagnosis.
“I was on tamoxifen for five years,” she said. “They would inject an implant into my abdomen once a month as well. When I was done with the tamoxifen, I was switched to an aromatase inhibitor for five more years.”
The price of breast cancer treatment can add up long-term. A 2009 synthesis of published evidence on the National Center for Biotechnology Information’s website reports that the estimated lifetime per-patient cost of breast cancer in the United States ranges from $20,000 to $100,000. Continuing care accounted for the largest share of lifetime cost due to the relatively long survival of breast cancer patients. Susan G. Komen For the Cure reports in its “Facts for Life” that a generic form of tamoxifen costs about $100 per month.
According to Dr. Patricia Robinson, assistant professor in the hematology and oncology division in the department of medicine at Loyola University, after diagnosis, treatment and recovery, the process comes full circle.
“Don’t let one’s diagnosis define who they are, but take it as one step in their cancer journey,” Robinson said. “When you transition from treatment to cancer survivor it loops back to prevention. Employ strategies to reduce the risk of getting any type of cancer, like colonoscopies, pap smears and dermatology.”
Now, Winston said she lives life with a much more free-spirited attitude.
“You re-evaluate your life and think ‘Maybe I should be thankful for what I have’ and start living life for what you do have,” Winston said. “You can’t let anxiety eat you alive. My husband made me go to an AC/DC concert with no hair when I was going through treatment.”
No matter how hard you try to live life in the present, Winston said, the cancer experience of the past is always in the back of a cancer patient’s mind.
“No matter how far out you are from your initial diagnosis,” she said. “I don’t think you ever stop thinking it will come back.”