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Archive for May 23rd, 2010

MAMA

‘Mama, until the day that we’re together once more’

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SHE

This was my mums favourite song.

I had planned to wait until what would have been her next birthday in June, she died a few days later. I had only just sent her flowers to celebrate and within days sending a wreath for her funeral.

I was too sick to fly to England and never had the chance to say good-bye.

If there is one thing I am thankful for, my mother did not know of my illness .

Mum…this is for you.

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Hard to believe women who find lumps in their breast refuse to see a doctor and are in complete denial they may have cancer. In such cases ignorance is not bliss. It will cost you your life.

Ignoring it and hoping it will go away?

It won’t , instead it will spread to other parts of your body by which time treatment will be too late.

This article is by….

SANDEEP JAUHAR, M.D.
Published: June 13, 2000

. .The woman, in her 70’s, answered my questions with a shrug of resignation, as if we were talking about the price of beef or the inevitable loss of youth, not her breast cancer. Her words and body language conveyed a clear message: it was no big deal.

The tumors had sprouted on her left breast like mushrooms in a dank forest: different shapes, sizes and colors. As they were mostly on the underside of her breast, she claimed not to notice them. Like the doctor in Solzhenitsyn’s ”Cancer Ward,” I wanted to ask her: ”Why didn’t you come earlier? Why come here when you are practically a corpse?”

All cancers provoke denial, but something about breast cancer drives some women to such extreme denial that when they first see a doctor, tumors are literally growing out of their breasts. The literature on the subject is vast and has been accruing for at least 30 years.

Exactly what provokes this response is not clear, but studies show that fears of disfigurement, dependency and death play big roles. A 1991 study of some 2,000 Nigerian breast cancer patients, for example, showed that fear of mastectomy was the most common reason for delays.

Breast cancer kills: 50,000 American women will die of it this year, and it kills more ruthlessly the longer treatment is delayed. At Stage 1, the least serious of four levels, when cancer is confined to the breast, the five-year survival rate is 85 percent. At Stage 4, when it is widespread, the rate is below 20 percent.

Despite this sobering fact and major efforts to educate women about the disease, studies show that a third or more of women who feel a breast lump delay seeking help for at least three months.

Delay can occur for a number of reasons. Some women can’t afford a doctor. Others don’t want to see one because of bad experiences. And sometimes people, especially the elderly, attribute abnormal physical signs, like a lump, to aging.

A 1991 study showed that poor, elderly black women receiving care at public hospitals were almost four times as likely to go to a doctor with late stage tumors as younger, more affluent white women going to private hospitals.

But psychological factors, particularly denial, surely contribute to delay. In small doses, denial has its advantages, mitigating severe anxiety and depression. But when denial extends more than a few months, it rapidly becomes harmful as tumors grow and spread.

The patient in her 70’s is a retired registered nurse. When she first felt a lump several years ago, cancer didn’t occur to her. ”I didn’t think about it,” she said. ”It didn’t hurt or feel like anything.”

It grew to the size of a Ping-Pong ball before she showed it to a doctor.

At the time, it was painless and surrounded by healthy tissue. If she had had it removed then, in an early stage, and received radiation and hormonal treatment, she probably would have had about a 50 percent chance of cure. But, she said, a biopsy proved inconclusive, and she was all too ready to forget about the problem. She left America soon afterward for her native South America, where her terminally ill husband had wanted to go to die. While there, she said, the tumor shrank and disappeared.

But it’s not just patients who delay treatment; sometimes, inadvertently, it’s their doctors. Failure to diagnose breast cancer is the most common cancer misdiagnosis, resulting in the most legal claims against doctors and the second most money paid out, behind cases involving brain-damaged infants, according to a 1995 study by the Physician Insurers Association of America.

Since most breast tumors are benign, doctors can easily mistake a malignant tumor for a benign cyst, especially in young women. Also, often there is no lump, just an itch, or nipple retraction, or discharge. And mammograms aren’t foolproof: they can miss up to 20 percent of breast cancers.

When the woman returned to North America two years later, the fronds of tumor were beginning to sprout from her breast. Friends and family insisted that she see a doctor; she ignored them. Several months later she developed severe pain where the cancer had metastasized to her hip. She took ibuprofen for months without relief, still refusing to see a doctor until the pain became unbearable. Then, when she heard the diagnosis, she said she was surprised.

Exactly what provokes denial remains a mystery. A large part of the answer is undoubtedly fear, which overwhelms and paralyzes. Fear not only of cancer and death, but of mastectomy and disfigurement. Fear of, as the writer Audre Lorde described, ”the absence of that beloved swelling I had come so to love over 44 years.”

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Few things are harder than looking into the eyes of a child and talking about breast cancer. Parents wonder what to say, how to say it, and just how much information their children really need. And while experts have advice, each woman needs to follow her own instincts and do what is right for her family.

When and Where to Talk

Most experts advise that parents talk to their children about the cancer as soon as they are able to manage their own emotions. When talking to your kids, you want to be able to support and inform them. This does not mean you should not cry or share your feelings, but be sure to wait until you can focus on the needs of your children and not your own.

It also may be best to wait until the whole family can be together, possibly with the support of another person, such as a close friend or relative. Make sure everyone is free of commitments so each person has the time and space to digest the news.

The best location for this important discussion will vary depending on the family. For some, home is the best place because everyone is comfortable and can retreat to his or her own rooms for time alone. It also allows children to react without worrying about other people around them. But for some families, an alternative location such as a park might be better. Think about where your family communicates best and how each individual might react.

What to Say

It is not necessary to follow a script, but it might be helpful to think about the topics you want to cover. For example, many women feel it is important to address the issue of hair loss. Talk about why people who have cancer lose their hair and, depending on the ages of your children, assure them that they will not lose their hair, too.

Remember, children will not react the same way as adults. So be prepared for everything from temper tantrums to a desire for extra cuddle time.

Here are some age-specific tips on talking to your kids:

•Under age 3:
Even kids this young can sense a change. Use words in their vocabulary, like, “Mommy has a boo boo,” or “Mommy needs medicine,” to help them make sense of what is going on.

•Preschool aged:
At this age, children tend to focus on the concrete, like the side effects of drugs. Be sure to tell them that cancer is not contagious. Keep the conversation brief and be prepared to talk again.

•Older children:
When talking to children in this age group, try to find language they can understand. For example, if they have studied cells in school, use that knowledge to talk about cancer. Provide details about the treatment plan and acknowledge your fears without wallowing in them. Be sure to let them know that, for the most part, they will be able to maintain their activities and interests.

•Teenagers:
Teenagers know a lot about cancer, so they will likely be worried about survival rates, treatment plans and side effects. Girls may ask about the hereditary nature of the disease. Remember that only 5 to 10% of breast cancers are inherited, and if your family does have an extensive history of breast or ovarian cancer, genetic testing is available. Try to anticipate concerns and have that information available. After initially divulging the diagnosis, follow their lead. Ask what they would like to talk about. Be prepared for an emotional or even inappropriate response, either during the conversation or afterward. For teens who have a difficult time, encourage them to find an online or local support group.

The Importance of Honesty

Many parents may be tempted to keep their cancer diagnosis secret to protect their children. Experts advise against this. Children are able to discern even small changes in their environment and, if it is not addressed, they may draw erroneous conclusions. Let the children’s school know what is going on. If your child seems to be having difficulty with your diagnosis, talk to a psychologist or recruit a favorite teacher. They can provide additional coping tips or might suggest some therapy.

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I fell in love with and still am to this day with France and the French people.

Stephan and I were married in France. It was a magical time. We both love this song and no one will ever sing it the way Joe Dassin did.

This song reminds me of the days when the world was our oyster and we were invincible.

Stephan drove to England to collect my mother so she may be with us on our wedding day. We laughed when he said to her that night ‘ I must be the only man to take his mother in law on his honeymoon with him’

Wonderful memories.

I miss you mum.

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Amy tells her very moving story and how she discovered she had breast cancer.

Amy says something that may shock many , she does
not regret having breast cancer.

I feel the same way, had I not had cancer I would not have met some wonderful people, who are now my friends. I am ,or at least I hope I am , a better wife. I am certainly a better and kinder person. I love and feel more deeply about everything.

Most of all ,as summer begins, I am SO glad to be alive.

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There are those who are bald through choice . They choose to shave their heads and yes they are beautiful.

However, Cancer patients do not have such a choice.

Amongst these wonderful photographs are cancer patients. The pallor of their skin makes them easy to depict. Even so they wanted to be photographed and to be PROUD of being bald.

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