Say “Cheese” – It’s Today!
Growing up, this day, the 5th of December, has always been more special than others on the calendar. Being one member of a family of six, there were six of these such days in the year. Of course I’m talking about birthdays and today is my father’s birthday. It was this birth date that gave him his name, Nollag or Noel, and the coming round each year of this day also always serves as the push I need to get going with preparations for Christmas.
Officially now, Noel is an old-age pensioner (and I hope he won’t mind me publishing his age here) and a very proud recipient of his free travel-pass for use on Irish public transport. As he said himself, there will be no stopping him now, not that you could’ve stopped him beforehand anyway. Free travel or not, Dad has had itchy feet as long as I can remember and this year has seen him complete another St. James’ Walk in Northern Spain and his annual eight week voluntary stint in The Daughters of Charity convent in Mekelle, Ethiopia.
I almost forgot to wish him a Happy Birthday before he took the plane with my mother, back home to Ireland this morning. My parents have accompanied me throughout my breast cancer journey, providing the practical and emotional support I’ve needed at various stages along the way. I am so fortunate that they have been here to help out. I think, with absolute admiration, not bad for two “old-age pensioners”, who have more energy than me (for now!) and a vision only years of living experience can provide.
“Congratulations!” I said to my father at the airport and I really meant just that. Each passing year and birthday is an accomplishment in itself and worthy of celebration.
Since I got to know Carlos (sixteen years ago) and all his family, today the 5th of December has another significance for me. This day eight years ago, my warm and affectionate mother-in-law, María Josefa (Maruja) left us. I recall with fondness, among many other days, but especially today, her arm-linking on the street, sharing an afternoon snack of milk and roasted chestnuts in her white kitchen in La Cañiza and her roguish titter when she’d catch you playing Ludo,
” Vas tu o quieres que te llevo a casa?” (Will you go or will I send you home?).
I was the Irish girl who came to Spain to “hunt down” one of her twin boys, the last of her six children and I have always felt fortunate to be loved and accepted by my Spanish “political family”, as your in-laws are called here in Spain.
Today is a day for remembering my entire family, immediate, extended and political. Family is a unit, which I could not live without (literally), and which I think society benefits from too. I raise my virtual glass of bubbly alcohol to family and I look forward to the real thing at Christmas.
And finally this day, the fifth of December 2016, marks the “grand finale” of my breast cancer treatment. Today I will have my last radiotherapy session and my body will be given back to me, delivered in a rail-car, at the end of one very long, steep and scary rollercoaster ride. The journey is by no means over. I will take tamoxifen, my hormone therapy, taken in the hope of avoiding recurrence, for the next five to ten years. In January I will begin the biannual revision tests also for five years. And if this cancer does not come back by my 45th birthday, I will be deemed a “cancer-free survivor”.
I said on my fortieth birthday, which I celebrated in the hospital the day after my mastectomy, “roll on my forty-first”! And I’ll continue to say for the rest of my life,
“Bring on the years, the wrinkles and the grey hairs, the children’s “coming of age”, partners, grandchildren or whatever else my future and theirs holds.”
Thank you for following me here on my blog and here’s to life, health and living. I shelve my “pink cancer folder” and I park my cancer story blog in the hope that it stops here.
End of Story!
Octobers and Genetic Testing
Ever since Pablo, my first child was born in October, it has become one of those extra special months on my calendar. I remember in 2007, the year he was born, when finally October arrived, how my heart used to skip a beat on seeing his forecasted date of arrival of the 8th as the sell-by date on the milk cartons. He kept us all in suspense until the 13th of that month though, one of the longest 5 days wait of my life. And we’ve been celebrating every year since with themed birthday cakes and fun parties.
Then there’s Halloween. I had it buried in my calendar as one of those festivals that I wasn’t keen on remembering with any special celebration, but alas it has been unearthed from my childhood and marked excitedly every year with masks and face paint, spooky tunes and hanging apple games, evening house callings and poem recitals, pumpkins (at a push), apple cake (Barm Brack hasn’t reached the Spanish shores) and lots of fresh tasty nuts.
This year Halloween will be made extra special by the presence of my sister and her youngest son Ronan. And we’ll be celebrating more than ghosts and goblins too! Spilling in to the 1st of November, I’ll be ditching chemotherapy sessions (hopefully forever) out of my life and burying that bitter spirit with a bottle of the bubbly stuff.
But October of 2016 has become more booked up than ever with four chemo sessions still to complete, the usual fortnightly collection of my sick certificates, the first of my biannual revision tests and on the last day of the month, I’ll be genetically tested for alterations to the “Brackey genes”, as I affectionately call them.
I first heard about these menacing genes, correctly named BRCA 1 and BRCA 2, from the lovely girl who supervised my fourth year biochemistry practicals eighteen years ago. These genes, when altered, were just around then being discovered to play a major role in many incidences of familial breast and ovarian cancer in women. I remember listening with interest at the time but since it was not a disease that had ever affected my family at the time, that information was very swiftly shelved at the back of the top most recess of my mind, where memories of passing interests fade into darker and darker haziness.
Until the day I was told I had breast cancer and the possible genetic implications of that were mentioned. The memory of that pretty girl, who my class mate asked out on a date, reluctantly were dug up, dust blown off it and the future date of the 31st of October 2016 assigned to bring to fruition the practical reality of what was once for me just a fleeting wonder.
If anyone is familiar with Dr. Seuss’ (rather surreal) tale of “The Cat in The Hat”, you’ll know the mysterious characters who appear midway through the story, Thing One and Thing Two, running out of a closed box and running amuck up and down the corridors with kites and dresses while “mother is out”. Well they’re like Brackey 1 and Brackey 2, in their mutated forms.
When functioning properly, BRCA 1 and BRCA 2, located on chromosomes 17 and 13 respectively act as tumour suppressor genes. So the genes create proteins to autocorrect damage to its own DNA in order to prevent the formation of cancerous tumour cells, normally in the breasts or ovaries at some relatively early stage in a young woman’s life.
But when they take on the characteristics of Thing One and Thing Two, and decide to run amuck in the body, it is almost always due to an inherited mutation (spontaneous mutations in these genes caused by environmental factors are extremely rare). There are different ways that the genes can be mutated or altered, and some are more harmful than others (changes in the BRCA 1 gene being more detrimental). But only 5-10% of breast cancer cases are attributed to these mutations. The rest of the cases are caused by…well whatever (see my post on “Why Me?”).
At the end of this month, October, I’m going to be taking the initial steps to find out into which category of breast cancer cause I fall, genetic or whatever. A history of a medical nature of my greater family will be taken and stored as a family tree, then blood samples taken to be sent off for rigorous genetic analysis and the results will be presented to me at some unknown time next year.
If I test positively for any mutation in either of the BRCA genes, the most immediate consequence for me will be the removal of my other breast and ovaries as soon as possible, the prophylactic surgery, which Angelina Jolie gave a public image to in 2013.
If I test negatively, I’ll go on my merry way, continue with my hormone treatment and biannual screening tests for five years and hopefully become a cancer-free survivor statistic for many years to come.
With my familiy’s medical history as it stands today, the indicator is pointing in the direction of a negative result. To really qualify for an analysis of your BRCA gene state, there would have to be many more incidences of breast cancer in the female branch of my family tree as there currently are (and I have my mother and sister, six aunts and twenty nine female cousins!). But my age and the type of tumour that I had (invasive lobular carcinoma) may indicate some sort of genetic involvement.
So what result am I hoping for?
Well, on the one hand, a positive result would provide an explanation for my breast cancer occurring at my age, which although I’ve accepted it, a reason for it would be conclusive for me. It would also justify the removal of my other breast, which although deemed healthy now, I view it as, my oncologist called it, a “disease time bomb” (hearing those words from a professional cancer doctor are more that disconcerting).
I think it would be safer to remove my left breast, a kind of insurance policy, but since the removal of a healthy breast from women who have had a unilateral mastectomy, has not demonstrated an increase in survival rate or decreased the reoccurrence of breast cancer, doctors are reluctant to perform the prophylactic surgery, unless there’s a genetic implication.
On the other hand, whereas a positive test result would be good news for me now, it could provide a possible future legacy for my two daughters in particular and somewhat for my son, an inheritance which is paved with medical tests and screenings and futuristic decisions of an ethical nature.
The laws in Europe concerning genetic testing and applying the results to embryos and even to the unfertilized egg are changing, the result of which is in the provision of more and more leniency to couples and doctors to choose in advance the genetic make-up of a child. Already 30 families have “benefitted” from this action in Spain. So it could mean that if either Ana Maeve or Ellen tested positively for the altered BRCA genes, they could have their own eggs tested and only the “unblemished” ones harvested.
To me it sounds like taking up the role of God here on earth. And if you asked me if I’d prefer to have had breast cancer or be unborn, my reply should be obvious. Having this disease is not pleasant but it is moulding me into a stronger person, at least emotionally and spiritually.
Testing negatively won’t exactly liberate my girls from future screening either. If your mother has had breast cancer, it is recommended to begin screening for this disease ten years younger than her age of diagnosis so my girls will inherit that legacy either way from the age of twenty nine.
The genetic testing will be an interesting end to October and the suspense of the results I will have to contain until next year. In the end, I have concluded that it doesn’t really matter whether I test negatively or positively. What will be will be. More and more I realise how little of life we can actually control.
Concerning health and illness, I think the best I can do is to educate my children from a young age to be mindful of their health and their obligations in looking after it and to allow them to see, through my actions and behavior, how having a major illness isn’t the end of the world. Life can still be looked on with a smile. We can continue to celebrate the passing of the years and seasons with joy and thanksgiving and accept the reminders and coming of the end with a hopeful peace.
I was dreading turning 40. Saying goodbye to not just one but two decades of independent adult living was making me stop and review my life’s decisions, my achievements to date. What really did I have to show for my 40 years of existence?
A house with a tree planted in the back garden: tick. A loving husband: tick. A baby: tick, tick, tick. What were those other items on the list of things you must do before you die? Tick, perhaps? Write a book: unticked. Voluntary work with those less fortunate than me: unticked….
And then I found a lump under my arm, about a month before my 40th birthday. I was on the way to Vigo with Carlos, my husband and three children, relieved that we were all on our Easter holidays and relaxing into a relatively stress-free weekend, in the company of María, my sister-in-law. Non-chalantly throwing my arms back, I started to scratch myself deeply and there it was, the whopper of a walnut-sized lump, which has since become the most recent “before and after” of my life.
I would have gladly stuck with the “having a baby” as the most significant transforming event in my life but it has been superseded by the big C, well the big BC to be precise: Breast Cancer. (And I might later write a post comparing these).
So, I’ve already lived 6 weeks, almost every thought accompanied by the looming idea of breast cancer. Three of those were spent in a frenzied whirlwind of tests and then more tests, the dreaded “staging”of the disease: how far advanced in my body the cancer is. Then there was a week of lull; a pocket of calm after that first storm before the next one brewed up. It was a welcome time, to absorb the initial shock and assimilate to a certain degree the confirmation of having cancer.
On the 10th of May 2016 I had my right breast completely removed and a full emptying of the lymph nodes under my right arm, in medical terms what’s known as a modified radical mastectomy. When I woke up on the 11th May, the following day, I was 40 years old! A very young woman, in cancer terms ( and I’ll grasp on to that idea!), a middle-aged woman by the average age of mortality in Europe.
I opted to have my hair done by the roaming hospital hairdresser. Surprisingly, considering I was in a hospital surrounded by professional “care-givers”, she was the first person to offer an added cushion to my operating-table twisted back and make me somewhat more comfortable. I didn’t decline as I sank into the softness of the pile of pillows and I succumbed to having my hair washed and blow-dried, fiesta style, as the lady insisted to celebrate later with my family.
By then I hadn’t fully realized the implications of my 40th birthday and that’s when I asked Carlos to return that evening with the children and a birthday cake. We couldn’t let this extra special occasion go unmarked!
My 40th birthday, the 11th of May 2016: Day 1 of my recovery from breast cancer. I will never dread a birthday again. I look forward to my 41st birthday. It will be year 1 free from cancer. Each passing year will be an extra mark notched up on the wall. Suddenly my birthday has taken on a whole new meaning. This is the “before and afer” I have needed to jerk me into living.