Would My Diagnosis Interfere With My Sister's Wedding?

How To Treat Stage One Breast Cancer

Some people worry after a medical test; they can’t relax until they get a call to say everything’s okay.  I’m not like that.  Being deeply, unabashedly, chronically optimistic, my assumption is always that nothing is wrong.  If a doctor doesn’t call me after a blood test or MRI, I forget I had it.  So when my radiologist called the day after my annual mammogram/sonogram to say that the needle biopsy she’d performed showed invasive breast cancer, my first response was, “You’re kidding, right?”

She wasn’t.  It was a gray Thursday in mid-January.  I was sitting at a desk on East 37th Street in Manhattan, only my second week in the offices of a new and important client.  I listened to her words, trying to figure out how something bad could be happening just when I was getting so busy professionally.  But work was only one issue: my husband and I had closed the week before on a little cabin an hour north of the city, I had tickets to go to Florida in ten days, my sister Stefanie was getting married in four months. The truth is, I was really busy.  

“I assume you want to keep your breast?” was the distinguished surgeon’s first question. Yes.  I did. He explained that I had a 5 millimeter lump of invasive carcinoma as well as a small area of DCIS, or ductile carcinoma in situ, which is more common and less alarming.  5 millimeters is very small, about 3/16”.  It couldn’t have been found by a breast exam.  We scheduled surgery for February 7.  I left for Florida the next day, racquet and tennis clothes in my bag.  We had a plan. I was happy going away for three days of sunshine.

The surgery was successful.  The lymph node nearest the tumor was clear – no cancer.  My husband and sister were with me all day. I took the week off, telling my new client I had an unexpected medical situation.  I told my other, longer-term client, more detail.  I needed the week; the anesthesia of even day surgery knocks you out.   By March my calendar was back to full.  My sister asked me to see her gown fitted on March 3. I co-hosted the bridal shower on Saturday, March 7, buying and arranging the flowers for it the day before.  My sister is eighteen months younger.  We are not at all alike but we are each other’s best friends.  In part this is because we lost our mom when we were 23 and 21, by which time our father had moved far away. We both stayed in New York; I married, moved to Brooklyn and had two boys, she stayed single and had an apartment on the Upper East Side.    So when my sister met someone online and got engaged two years later at the age of 49, we were all pretty psyched.  It fell on me to host an engagement party in the Hamptons, a bridal shower, and to be at her side at the wedding.  After all, she did those things for me.  At her shower it was exciting to see both sides of our family in the same place for the first time since my wedding over 20 years earlier.  
My tennis partner and I resumed our Sunday morning games on the 15th. I met my medical oncologist on the 18th ; she told me I’d need radiation but not chemotherapy.  She said it would be tiring. Later that day I attended a committee meeting, then met my sons at Men’s Warehouse for their tuxedo fittings.   The best news came on March 24 when the radiation oncologist said I was eligible for a three-week radiation protocol that she had pioneered; if I started on March 30, I would be done by April 17.  I couldn’t stop crying. I’d have two weeks to recover; the radiation would be over before the wedding.  Of everything, that was greatest relief.  While mostly my sister was supportive - and I for her - there were a few surreal moments. She called me every single time someone RSVP’d.  That’s about 125 calls.  One afternoon I had been on the phone with the insurance company for 45 minutes, trying to get reimbursed $2,800 for one of the MRIs, and she called just as I was finishing, asking if I thought she should wear waterproof mascara.  I was, like, really? I was going from one client to another Monday through Thursday, half a day at each.  My days were organized to work from 9 to 1, and 2 to 6.  I scheduled the radiation for 1:15 every weekday.  Amazingly, the two client offices were just five blocks apart and the cancer center was between them.  I walked from one office to radiation to the other office every day except Friday, when I just went to radiation.  By late April I knew every brownstone in Murray Hill between 32nd and 37th Streets, Madison Avenue to Third.  
Here’s the thing about Stage 1 breast cancer: it’s not that scary.  It was distracting to have to get undressed and be irradiated every day.  But I kept thinking about all the women who had more difficult circumstances than I, which is almost everybody:  women with jobs that docked their pay for time off, even medical time; anyone who had to travel further than four blocks to get to treatment; women with less generous health insurance; women with small children climbing on them, demanding attention at the end of each day; women who were older or sicker or younger; and women who were going through radiation at the same time as, or right after, chemotherapy, where your body is being depleted by strong chemicals even as you’re attacking cancer cells in another way.  During this period I kept thinking, “I am so lucky.  I am so lucky.”  The wedding was May 2nd.  We were ecstatic.  I can’t explain how profoundly happy I was seeing my sister as a bride, beaming in her gorgeous gown, our friends and family surrounding us.  My dress, which we had chosen in late January, covered the scars.  Everything went as planned.  It was perfect.  Because my tumor was receptive to estrogen, i.e., estrogen stimulated the cancer, the medical oncologist suggested taking tamoxifen, an estrogen suppressant, for five years, which brought my risk of recurrence down to 14%.  The side effects?   You get thrown into menopause pretty violently, for starters.  Hot flashes, a certain lack of clear thinking, weight gain, loss of libido –name a characteristic of menopause, I’ve got it.
I’ve gained ten pounds.  Many of my clothes don’t fit.   I’m not thrilled. But I hear that you get your brain back and sometimes even lose the weight once you’re off the medication; I have three years to go.  I’m committed to both annual mammograms and, until next year, an MRI every April and October. I don’t think of myself as a cancer survivor or victim.  I think I had a problem, it got solved, and I have my full life.  I realize I’m lucky. I wish every woman could have breast cancer the way I had it: found very early, treated very well and spoken of in past tense.    
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