I'm waiting for the day when breast cancer will become routine

I hate to be the bearer of bad news. Sorry to say, breast cancer touches everyone. If there is no one that you love that hasn’t been affected by breast cancer, just wait. It’s coming.

I have had personal experience with friends and family with breast cancer. There’s Tina, who was my roommate in medical school. There’s my mother, now a survivor for 20+ years. I have already flirted with abnormalities on mammograms: Believe me when I say it’s frightening.

More recently, I was talking with my father, who generally keeps things to himself. I knew a little of my family history, but had never heard this particular story. We had been watching Saving Mr. Banks, where there is a scene with a guy who has tuberculosis, and is coughing up blood. The next day I was out for a walk with my dad, when he started to tell me this story out of the blue, about how the movie had jogged his recollection of his mother’s (my grandmother’s) death. He told me she had had a mastectomy, and then cobalt treatment, but that the cancer spread. He described seeing her so very sick, coughing up blood; his older brother sent him to go get the doctor as there were, of course, no phones, back in those days. When he returned, she was gone.

It’s not hard to understand how over time, people have developed justifiable fear about this disease. All the more reason why the aberrations give me hope for the future.

Recently, I had occasion to take care of an individual who is already a breast cancer survivor, who went around again with a spot on a mammogram. Biopsy showed this to be a new breast cancer, and so she was referred to me for surgical treatment. I always approach the patient with a new diagnosis of breast cancer gingerly, because it is such a nerve-racking experience. This time was different.

We discussed the diagnosis, possible treatment options, adjuvant therapy, all the usual. I always expect questions about prognosis, and questions about treatment side-effects. This time around, the patient took me by surprise.

“How long after my surgery can I have a perm?”

I was speechless. What was this? What could she possibly be talking about?

“Well, my girlfriend said she had general anesthesia for a hip surgery, and then she had a perm and all her hair fell out, and her hairdresser told her it was because of the general anesthetic. So I want to know, how long until I can get my hair done?”

And then it began to dawn on me. This lady is not the garden variety patient, who just heard the C word for the first time. For her, it was all been there, done that, boring.

There have been many advances in breast cancer diagnosis and treatment in the last decade or two, and when I counsel breast cancer patients, and barrage them with facts until they can’t take anymore, until they’ve stopped asking questions and tell me enough, they need time to process, I always tell them (when it’s true, which is most of the time) to try to remember just two things: This disease is treatable, and it is curable.

But this lady, she already lived it. She already incorporated this truth into her understanding of reality, and here she was worried about her next hair appointment, the biggest problem in her life.

There are advances in oncology research just about every month. We now know so much more about the spectrum of diseases that we call breast cancer, and since we can predict what a breast cancer cell will have a proclivity to do (with oncotyping), it’s really a whole different ball game. It’s not the death knell it once was.