50 E-mail: wait...but there's more

Thursday, November 11, 2006

BREAST CANCER
I was so hopeful. I wrote what I thought would be my last entry after the party and I was glad to wrap things up. Life was settling down and there was so much to look forward to.

Don’t get me wrong. There’s still a lot to look forward to, but life isn’t ready to sit back and let me relax yet. I’ve heard about four – count ‘em, 4 – breast cancer diagnoses in the last three days. Two came on Tuesday and two came today, Thursday.

Diagnosis #1 – A friend of a co-worker’s husband. The co-worker works on the floor below me and the newly diagnosed woman is in her 30’s.
Diagnosis #2 – We’ll come back to this one.
Diagnosis #3 – A friend of a woman who works one floor above me. The friend is 36.
Diagnosis #4 – A friend of a co-worker/friend who works on the same floor as me. The friend is in her 50’s.

Circling back to Diagnosis #2, this is someone in my family. My grandpa learned this week that he has breast cancer.

You heard that right. My 82-year-old maternal grandfather. A man with breast cancer. Here’s a link if you want to read more. http://www.susanlovemd.com/breastcancer/content.asp?L2=6&L3=5&SID=224

Men have breast tissue. They don’t have much of it, but they have a little bit of breast tissue and fat. All children do until puberty when girls develop more and boys don’t. This tissue in men can get breast cancer just like women, only most men don’t get diagnosed until they are in later stages of the disease because they aren’t as aware of that part of their bodies as women. The treatments are the same, too, with sentinel lymph node biopsies and mastectomies and chemo/radiation. Dr. Love’s web site quotes that an estimated 1,720 men will be diagnosed with breast cancer this year (2006).

I have no idea what stage my grandfather is in. I’m hearing rumors of surgery, but I don’t know the details. I was shaken by the news when it came Tuesday night. I found myself crying in my husband’s arms, worried about my grandfather and upset that breast cancer wasn’t completely out of my life yet. I was depressed about it all day Wednesday. Then I saw my therapist Wednesday night and discussing the situation with her took the sting out of it. Therapy with a professional counselor can be a wonderful thing. I’m still concerned. I’m still upset. But that edge of panic has receded. Now I’m brewing on how to be supportive while I live an hour and a half away.

SURVIVORS
I went to a couple of events recently that I haven’t written about. The first was the champagne brunch and silent auction benefiting the Breast Cancer Resource Center, the local Austin-area support organization for breast cancer survivors. The brunch took place on October 8th, a Sunday. During the brunch I learned from the speaker that one in eight women will be diagnosed with breast cancer in her lifetime. That statistic shocked me.

One speaker talked about how breast cancer, while the most common cancer for women, is not the deadliest cancer for women. More women die of lung cancer than breast cancer. That doesn’t surprise me because lung cancer is very deadly once contracted. Only about 10-15% of lung cancer patients respond to chemotherapy. About 90% of the people who get lung cancer could have prevented it by not smoking, and about one in ten smokers get lung cancer. Sorry. I digress. I worry about my friends and co-workers who smoke now that I have seen statistics on how vicious lung cancer is.

During the brunch one of the speakers asked all of the survivors to stand. Different things had happened that had garnished applause before that moment. As I stood with my fellow survivors I heard applause louder than anything else that day, and it brought tears to my eyes.

Several days later on Thursday, October 12th I attended the annual Texas Conference for Women. I got to hear Martha Stewart speak that morning. I’m afraid her speech was a lot of “Look at me and buy my stuff” so I didn’t learn much. The speaker at lunchtime, however, was Nancy G. Brinker, the founder of the Susan G. Komen Breast Cancer Foundation. Governor Rick Perry and First Lady Anita Perry spoke as well, but it was Nancy Brinker’s talk that riveted my attention. Her speech was inspirational to me and I enjoyed it thoroughly.

She mentioned that breast cancer kills about 3,000 Texans and about 40,000 women across our country each year. That’s 100 people per day who die from breast cancer. To put it into perspective she compared that figure to terrorist attacks. If we had 100 Americans killed each day by terrorists you can bet the government would be pulling out all the stops to put an end to it. That’s why it is important to continue to let legislators know that we demand funding for breast cancer research so that we can put an end to this disease and find a cure.

Ms. Brinker, a breast cancer survivor (though the foundation was established in honor of her sister), asked all of the survivors to stand. I stood with a handful of other women across this huge room of 8,000 conference attendees seated at round tables. Once again the applause came, and once again it brought tears to my eyes. It was an incredible moment, and as I sat down at this table of eight women I was tempted to tell them, “You’re all safe because I’ve already been diagnosed.” The moment passed, however, and I remained silent.

AN IDEA
Seeing and hearing the founder of this influential organization gave me an idea as I sat at the table. The Pink Ribbon Cowgirls group sure has a lot of members now, and we’re finding more young survivors all the time. (Got two more just this week!) The mortality rate for breast cancer has actually gone down lately because early detection and advances in treatments are making a difference. Groups like the Susan G. Komen Breast Cancer Foundation that have made substantial contributions to breast cancer research have had a very real impact in making things better, and I’m proud to be a part of the Race for the Cure this coming Sunday even though I haven’t raised any money for it this year – I just didn’t have the energy to do fund raising and other co-workers have solicited people for money in honor of our co-worker who was also treated for breast cancer this year.

My idea as I sat as the table was to get my insurance company, Aetna, to lower the age at which they would pay for mammograms as part of the annual well woman exam. They pay for them now, but you have to be 40 years old or older. They won’t pay for mammograms for younger women unless there is a medical need. I have a medical need now, but I know from my first mammogram earlier this year that they’ll only pay 90% of it and not the 100% they cover for 40-year-olds. That kind of prejudice would be enough to push me into not getting checked if I didn’t already have a breast cancer diagnosis under my belt. How many women in their 20s and 30s are sent to get mammograms first thing when they or their doctors discover suspicious lumps? Mammograms must have some place in things if they are used as a diagnostic tool for the young. How much better are the new digital mammograms at finding lumps in the denser breasts of younger women than traditional mammogram machines? Would it make more sense to include breast ultrasounds instead of mammograms as part of exams for women younger than 40? If Aetna changed their policy would other large insurance companies follow suit?

These are the kinds of questions I have been asking myself since October 12th, and this is the goal that feels right for me to pursue. I would like to contribute to raising awareness that women younger than 40 are at risk for breast cancer, and if there is a way to find breast cancer sooner then I think insurance companies should cover that technology as part of their annual well woman exams.

I don’t know how far I can take this or what kind of momentum I can gather. I don’t know if this is the best use of my energy. Part of me wonders whether I can make any difference at all, but then I remember The Accident of 2004.

My husband and I were in an auto collision on July 9, 2004. I cannot bring myself to write out the details because it was such a horrible, traumatic experience. The short version is that the other motorist was riding a motorcycle and he died about six hours after the collision. Guy had made a left turn and the other guy hit us. In the end the police determined that the motorcyclist was at fault because he was doing around double the speed limit and he popped a wheelie as he entered the intersection. Guy was devastated because he had looked for oncoming traffic and seen nothing, so the sudden appearance of another motorist was a complete surprise.

For the next several months as the accident played out repeatedly in our memories, Guy and I tried to analyze what went wrong and how could it have happened in the first place. When we realized that the road in front of us dipped down so that oncoming traffic was completely concealed for a couple of seconds, it finally clicked in our heads and we understood how the accident was possible. When we saw the local newspaper print a map of Austin and all the fatal collisions around the city for 2004 (ours was listed, of course), we saw that several other collisions had taken place at the same intersection and we speculated that it must have been for the same reason. The left turn arrow rarely made an appearance so you were forced to turn left on a green light without an arrow, and the dip in the road made it dangerous to do so.

MAKING A DIFFERENCE
I found a place on the City of Austin’s web site where people could fill out a form online and report problems with intersections or traffic signals. I wrote. Guy helped me edit the words until we described things with clarity and intelligence. About two weeks later someone from the City wrote back and told me that a study had been conducted and research showed that there had been many collisions just like ours at that intersection over the last two years: somebody turned left and collided with somebody coming the opposite direction while speeding. Not only did they agree with our recommendation that people should only be able to turn left on a green arrow and not on a general green light, but the signal had already been changed to put that proposal into practice.

What an amazing moment that was, to see that somebody in authority had listened to my/our request and made a simple change that would save lives. I cried from joy and sent the message to our insurance claims adjuster to pass along to the family of the deceased.

Filling out the right form for the right reason made a difference.

I carry that experience with me always. Nothing can ever undo the tragedy, but at least other people won’t have to go through what we did and what the loved ones of the motorcyclist did because of the light and the shape of the road at that particular intersection. I’m not really comfortable broadcasting that experience in such a public way, but telling the tale is pivotal to explaining my determination for this idea of mammograms for the under-40 crowd. I use that memory to remind myself that one person can make a difference, and once in a while that one person gets to be me (with the help of my wonderful husband).

So maybe it’s not so crazy to think that I can start something that will ultimately contribute to insurance companies covering technological examinations of breasts of women younger than 40.

A plan of attack is beginning to form, but I hesitate to write too much about it now. I figure the first thing is to do my research on what is appropriate and reasonable to ask. If insurance companies paid for it, what is the most appropriate way to detect breast cancer in breasts dense with breast tissue? I thought I was done writing updates as events merited it. I guess I was fooling myself. There’s work to be done and I need to do as much of it as I can. From disease, accidents, or other causes you never know when your life will be cut short in the middle of things. The Alan Parsons Project wrote a good lyric in the song “Turn It Up.” The chorus goes: “If there’s something you’ve found to believe in/then the message must get through./So don’t you sit in silence/when you know what to do.”

Angela

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