Breast can­cer is se­ri­ous. Pink is not

It in­sults pa­tients like me to con­join our fem­i­nin­ity and this fright­en­ing dis­ease as pink does not tell the whole story

Gulf News - - Perspective -

cto­ber is Breast Can­cer Aware­ness Month, and I have breast can­cer. The United States is fully pinked out in sup­port of breast can­cer screen­ing and re­search, and though I know all the pink is meant to make me feel good, to tell me that the en­tire coun­try has my back, I ac­tu­ally find it pro­foundly alien­at­ing. Pink is not a se­ri­ous colour, though can­cer is a very se­ri­ous dis­ease. Pink is about fem­i­nin­ity; can­cer is about stay­ing alive.

I am lucky, if one can say that, within the con­text of pos­si­ble can­cer di­ag­noses. My breast can­cer is small, has the tu­mour mark­ers most favourable for treat­ment (oe­stro­gen and pro­ges­terone-pos­i­tive, HER2-neg­a­tive) and is very slow-grow­ing. A friend of mine, a doc­tor, try­ing to al­lay his anx­i­ety and mine, joked that based on th­ese re­sults, I didn’t re­ally even have breast can­cer. But breast can­cer, even when one has a good prog­no­sis, al­ways raises the pos­si­bil­ity of mas­tec­tomy, a surgery that re­moves the pa­tient’s dis­ease but is also said to dis­fig­ure her in a way that can com­pro­mise her fem­i­nin­ity.

I have to say, speak­ing as a breast can­cer pa­tient, that the ques­tion never crossed my mind. I am not wor­ried about los­ing my fem­i­nin­ity to breast can­cer surgery; I’m wor­ried about los­ing my fu­ture to the dis­ease. The real worry with breast can­cer is metas­ta­sis: spread. And even though my present prog­no­sis is good, there are rea­sons pro­phy­lac­tic dou­ble mas­tec­tomy would not be an un­rea­son­able choice for me. How­ever, af­ter ge­netic test­ing and an MRI, I chose lumpec­tomy, with ra­di­a­tion, in­stead of mas­tec­tomy. It’s in­ter­est­ing, that con­trast be­tween the frivolous­ness im­plied by fem­i­nin­ity and the solem­nity that marks a di­ag­no­sis of can­cer. I’m an on­col­ogy nurse turned hospice nurse, and though I’ve seen many can­cer pa­tients re­turn home to live their lives, I’ve seen more than a few of them die of their dis­ease. It is not an ab­strac­tion, nor an ex­ag­ger­a­tion, to de­scribe can­cer as a killer.

And it’s that fear of can­cer’s po­ten­tial dead­li­ness that over­whelm­ingly pre­oc­cu­pies all the breast can­cer pa­tients I’ve heard from since I re­ceived my di­ag­no­sis in mid-Septem­ber. A col­league who has had a cou­ple of biop­sies since her treat­ment, but no new dis­ease, wrote elo­quently to me about how tai chi and dark choco­late help tamp down her fear that her can­cer will re­turn. A friend re­minded me that her mother has out­lived her di­ag­no­sis by over 20 years. And a friend of friends, who chose to have a dou­ble mas­tec­tomy, spoke of the enor­mous peace of mind the op­er­a­tion gave her and her sis­ter, who also had breast can­cer. What res­onates in each of th­ese sto­ries is two words: I lived. Th­ese women sur­vived their can­cer and keep on liv­ing.

Harsh treat­ments

In my own work in on­col­ogy, I pri­mar­ily took care of pa­tients with what we call liq­uid tu­mours: leukaemia, lym­phoma. We say in on­col­ogy that bad dis­eases re­quire bad treat­ments, mean­ing sav­age and harsh, and treat­ments for acute leukaemia are very bad. The chemo­ther­apy causes pa­tients to lose their hair, de­velop ter­ri­ble mouth sores, suf­fer gas­troin­testi­nal dis­tress and see their im­mune sys­tems com­pro­mised.

I did ask my hus­band, “If I lose my breasts, will you love me the same way?” I was half-jok­ing, but the ques­tion was also ridicu­lous be­cause I knew the an­swer. Knew it: “Yes.” Still. I feel that my ask­ing it re­sulted from a kind of pri­mor­dial sex­ism that, de­spite my best ef­forts, con­tin­ues to in­fect my thoughts. The as­so­ci­a­tion of fem­i­nin­ity and breast can­cer is per­ni­cious, be­cause it gen­ders the dis­ease, mean­ing that a di­ag­no­sis of breast can­cer marks pa­tients as women first, peo­ple sec­ond. It im­plies that our wom­an­li­ness is dis­eased, not our bod­ies.

“Be more than pink,” the Su­san G. Komen web­site says, with links to in­for­ma­tion about sup­port­ing breast can­cer re­search. The phrase sug­gests that pink doesn’t tell the whole story of breast can­cer. I would take that state­ment fur­ther, ar­gu­ing that it in­sults breast can­cer pa­tients to con­join our fem­i­nin­ity and this fright­en­ing dis­ease. My can­cer was di­ag­nosed via screen­ing, a call­back af­ter my yearly mam­mo­gram. The tech fin­ished the fol­low-up ul­tra­sound, and then the ra­di­ol­o­gist, af­ter a wait, came in. She stood a long time, say­ing noth­ing, and I re­alised be­lat­edly that her si­lence re­sulted from con­cern. Be­cause then she said, “We see a mass here at 9 o’clock.” I cried in the screen­ing room while the tech held me, as tightly as if I were her own child, and I didn’t fear for some ephemeral sense of girl­ish­ness or sex­i­ness, but rather for my life.

Theresa Brown, a hospice nurse, is the author of The Shift: One Nurse, Twelve Hours, Four Pa­tients’ Lives.

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