Marsha Carow Markman

Breast Cancer Diary, 1990

Saturday, February 24 [1990]

What a shock I had yesterday! I went to Dr. R. for the results of last week's mammogram, fully expecting him to tell me that all is well. By 4:00, however, I had taken a chest x-ray, EKG, and blood test at nearby Humana Hospital in preparation for a biopsy and excision on Monday! The "nodule" that he saw six months ago is "considerably larger" and has to be removed. And the "something" on my left breast, although it has not changed in size for two years, should also be taken out. That he is hurrying me into surgery and did not mention a needle biopsy, leads me to believe the worst. I dare not say or think that dreadful word.

Mark is a most sensitive husband and a source of great strength; and I am looking on the bright--rather than the bleak--side of this event. Hopefully, in these next two days, I will remain optimistic and the results will bear witness to my positive attitude.

Tuesday, February 27

. . . I came home early yesterday evening, feeling quite good, to my surprise, but what an ordeal Monday's surgery was: first a visit to the Breast Center where the radiologist poked a needle and wire into each breast in order to locate the "nodules." Then to the guillotine (for that is what the mammogram brings to mind) to be sure that the needles were on target. He had to readjust them several times (OUCH!) before returning me, by wheelchair, to my hospital room. Then into surgery to have each nodule removed (lumpectomies) and biopsied.

Alas, the growth on the left breast is benign, but the one

on the right is MALIGNANT! What an evil, ugly word that is!

Bone and liver scans were taken today in order to determine if the Cancer (does that word really belong to me now?) has spread. Dr. R. will give me those results on Friday when he removes the staples on both breasts. He believes, however, that the Cancer was detected in an early stage of development, and was completely removed. Now I must wait and hope that the "evil" has not preyed upon other parts of my body.

Meanwhile, I repeat that dreadful word over and over, and stare at it on my computer screen. CANCER CANCER CANCER. Perhaps with repetition it won't look and sound so malevolent, so . . . final.

Wednesday, February 28

Last night I dreamed that the malignancy had spread throughout my body and that the liver and bone scans had confirmed my worst fears. I awoke in a panic. . . . But it is 3:00 now, the sun is shining outside my study window, and my anxieties have once again receded. Are they merely lying dormant, ready to attack me with further doubts and fears? I must think sunshine thoughts and hold onto those thoughts until I see Dr. R. on Friday. . . .

Friday, March 2

. . . Today's visit with Dr. R. brought good news: no cancer in the bones or liver. However, the tissues in the left breast (the one with the benign tumor) are "suspicious" (a word nearly as frightening as Cancer). The hospital's pathologist, therefore, has sent a tissue sample to the Armed Forces Pathology Lab in Washington, D.C. for another opinion, the deciding opinion.

Dr. R. believes that, if the report should suggest a pre-cancerous condition, the most risk-free path to take is double

mastectomy! An option is radiation, following removal of the lymph nodes on the right side. Unfortunately, radiation seems to distort the cells so that they may not in the future be recognizable as cancerous. Some option!

Can I reconcile myself to a double mastectomy? Should I choose the lymph node and radiation options with their effects on my arm and on the cells. Most important . . . can I endure one more word that slashes into the English language and into my life with such violent force?

As we were leaving his office, Dr. R., looking saddened, gently touched my arm and said, "I'm sorry I had to bring you this news." At that moment, I felt sorrier for him than I did for me. . . .

Now I must lost fifteen pounds; should I have the mastectomy, I'll feel better about myself (less grotesque?) if I am slimmer.

/////

Saturday, March 10

Spoke with Dr. R. yesterday. Still no word from the pathologist on the report, but he said I am risk free for now and needn't feel as though I'm sitting on a keg of TNT. I needed that reinforcement, for I keep sliding into a funk. . . . Still, life goes on. And it is good.

Friday, March 16

7:30 a.m. I awoke at 5:30 this morning in a panic. What will the pathology report conclude? Am I ready for a double mastectomy? The most radical surgery seems so likely in the

night of early morning. Mark and I are meeting with Dr. R. at

3:30 today, so I haven't too long to wait for the report.

I worry about Mom and Mark, and about the children . . . how they will handle this. I hope they are strong so that I don't have to worry about them. I hope I am strong so that they don't have to worry about me.

Evening. Our visit to Dr. R. brought good news and relief from a morning of anxiety: the pathology report on the left breast was negative; therefore, Dr. R. does not recommend bilateral mastectomy . . . although he didn't hesitate to remind me that it is the most risk-free option. (Like avoiding a hangnail by severing the finger?) The ultimate choice is mine, and Mark agreed: removal of the lymph nodes under my right arm, followed by radiation (both accepted procedures). . . .

The lesser verdict has lifted my spirits, and repetition of that dreaded word seems to work well. I am able to say and type "cancer" with relative ease this evening. I will try to think of it hereafter with a small "c" and keep it in its proper perspective with LIFE.

Everything, it seems, is relative: could I have imagined a few weeks ago being happy to have my lymph glands removed and undergo radiation?

Monday, March 19

Mark and I saw the radiologist today. Dr. L., a pleasant, caring man, spent a great deal of time reporting research findings on the various surgical procedures involved in breast cancer (mastectomy vs. lumpectomy and removal of the lymph nodes). And he detailed the radiation portion of my procedure:

While I am in surgery, he will implant twelve (he had to tell me how many?) needles into my breast near the site of the cancer. Following surgery, those "needles" will be filled with radioactive "seeds," which will be removed two days later. This radiation "booster" goes directly to the source of the cancer and also reduces follow-up radiation by two weeks.

I'm not thrilled about the 12 needles!

Friday, March 23

4:30 a.m. Can't sleep. Have to be at the hospital at 6:30 this morning, with surgery scheduled for 9:00 a.m. In the dark and the quiet, anxiety invades my otherwise cheerful and hopeful outlook. I am anxious about the anesthetic--going to sleep and not waking up; about the possibility of finding Cancer (there's that big "C" again) in the lymph nodes; and about the worry I am causing Mark and the children and my dear friends who have phoned all week with their love and prayers. (I am truly blessed. How much I owe these dear people in return!) But I must push these destructive anxieties aside. . . .

Monday, March 26

I'm home and feeling not too terrible after all. The lymph node surgery, however, proved more painful than the lumpectomies. Perhaps this is because of the staples and drain under my arm and the 12 radiation implants in my breast which, thank God, were removed yesterday before I left the hospital. Tender places to have all of that cutting and probing.

I was "radioactive" during my hospital stay and therefore had a private room and a limit of 20 minutes for each visitor. Women of child-bearing age were not permitted in the room at all while the implants were in place; and the nurses, while there when needed, made themselves understandably scarce, especially the young women. Fortunately, I didn't need much attention. A peculiar feeling, however, when their geiger-counter-like instruments ticked away as they came into the room. After two days I was sure that I could read without switching on a light!

Tuesday, March 27

Good news! The lymph nodes are negative! I am a lucky woman!

Dr. R. removed the staples and the drain today; I need only change the dressing until there is no further seepage and the hole (yuk!) closes. Mark helped me with the first dressing. What a guy!

Monday, April 2

I feel better today. No need for the naps I've taken daily, but the "knots" under my arm are most uncomfortable. Each

tomorrow, however, will bring improvement, I am sure.

I postponed my lecture on women's Holocaust memoirs, which was scheduled for tomorrow--much too soon to do a decent job of it. The new date is May 15th. What a relief! Still, I continue to teach and this work schedule is probably good therapy.

Monday, April 16

Today was the first day of radiation and I spent close to an hour lying on the "table" being measured, marked, and x-rayed in order to establish the precise point of radiation. The pain under my arm was worse afterwards as a result perhaps of the strained position of my arm during the long procedure.

The technician drew red and black ink marks on my breast and down the center of my chest, beginning a few inches below my neck. These marks will remain as a guide for the duration of treatment, so I have to be careful not to soap the area. Nor can I wear an open-neck blouse without exposing this elaborate tattoo.

Friday, April 20

I had a blood test today, as I will every Friday during the course of radiation to be sure that the white cell count does not get too low. If it does, radiation will be discontinued for a few days. Meanwhile, Dr. L. cautioned me against losing weight (I was doing so well on my diet). He reminded me to eat foods with lots of protein and not to cut calories. So . . . I bought a chocolate bar on my way home! (Am I going to interpret his caution as permission--encouragement--to indulge myself?)

Wednesday, April 25

Today is one month since the lymph-node surgery. I felt downhearted this morning, no doubt as a result of the oh-so-slow healing process and especially yesterday's pain under my arm. I may have done too much, but will I ever find a balance? While I feel better than yesterday, I seem to have taken a few giant steps backward. A cozy chat with Mark this afternoon helped me to shake off the doldrums before going for radiation treatment. Now I'm once again looking toward a better tomorrow.

Friday, April 29

. . . Radiation treatment itself is not painful, and I am only on the table for about ten minutes each day--with my arm in that still-uncomfortable, sling-like position. The two-step process focuses first on one side of my breast and then on the other, with the technician changing the position of the machine each time. A rather high-pitched buzzing is a signal that the radiation is in progress; and during that time I am alone in the otherwise quiet room.

Fixed to the ceiling above the table is a large color photograph of one of the Hawaiian islands. Bright orange flowers in the foreground, a sandy beach at the rim of a blue sea in the distance, and soft white clouds in the sky above. I sometimes imagine myself sitting on the shore of that beach or on a boat in those calm waters. Alone. Just as I am alone in that room. Just as we are all, ultimately, alone.

Then the procedure is over, I say my good-byes to the kind technician, get dressed, and leave . . . happy to carve one more notch in my radiation belt.

Friday, May 11

. . . Yesterday and Wednesday were filled with fatigue and increased pain (a giant step backward it seemed). On both days I was in bed at 8:00 p.m., reading and dozing. None of my medication relieved the pain and I felt discouraged. . . . Besides fatigue the treatments occasionally cause nausea; and sometimes (alas, not often enough!) I lose my appetite.

However, today the pain under my arm is diminished, along with the fatigue; and this morning I did a thorough housecleaning, including the stove and refrigerator. Later, I cut flowers and arranged them in vases, so the house is alive with color and the smell of roses. Tomorrow I'll cut gardenias, which are now in bloom.

Tuesday, May 15

Tonight I got into bed at eight o'clock with a book and an ice bag. Dr. R., whom I saw yesterday, says I am doing well (!) and have good mobility in my right arm. (The wall inside my closet is lined with pencil marks attesting to my improvement.) He explained that fatigue is normal during radiation and that the pain under my arm is the result of the surgery, as well as swelling from the radiation and its irritating consequences.

I won't be disheartened now--not with just four more treatments and the few weeks that it takes for the radiation to begin to dissipate. Better and better days will follow, I am sure. . . . Meanwhile, with the semester over, final exams evaluated, and grades recorded, I can rest more during the day.

Friday, May 18

10:30 a.m. This is the first morning since I began treatment that I feel tired. I just finished some housecleaning projects that I began at 7:00 a.m. and which do not normally wear me out. I've been lucky that this kind of day-long fatigue has only just begun--with two more treatments to go! Hopefully, the radiation will recede quickly following the final treatment so that I can once again feel energetic and pain free. . . .

It is so unlike me to invest journal time on my health. I'm beginning to find it tiresome.

Sunday, May 20

Tired again today and, although I awoke at 9:30 this morning, I was back in bed two hours later for a rather long nap. Needless to say, my list of to-do's looks much as it did when I wrote it last night--few items are crossed off. . . .

I will recover from this episode, I know. But I can't help but feel that, with a propensity now toward Cancer (the big life-threatening "C"), it could turn up again . . . in the breast or elsewhere. Am I going to battle this dreaded disease for the rest of my life? And how long a life will that be? Such questions and the thoughts they evoke, contradict research findings for cancers such as mine. But my emotions are not always grounded in reality.

Meanwhile, in the early hours of this morning--between sleep and wakefulness--I imagined a science classroom fifty years from now. The teacher is speaking about the now-defunct use of

radiation for treating cancer, prevalent in the late 20th century. A handsome and serious child raises his hand and says: "My great grandmother was treated with radiation for her cancer. She wrote about it in her diary."

[Marsha Markman recovered fully and has been cancer-free.]