I really object to trying to pretty up the removal of breast tissue with euphemistic medical terminology. And using the term “lumpectomy” instead of partial mastectomy, for any surgery short of a full mastectomy, is an insidious example of deceptive advertizing. Words like “lump”-ectomy don’t even begin to convey the reality of undergoing such procedures. Possibly the most offensive of these medical phrases is “breast-sparing surgery,” which refers to the general category of lumpectomies & partial mastectomies; in other words, anything less than a total mastectomy is seen to “spare the breast.” Hah. Maybe this makes sense to surgeons out there, but it makes no sense to me. There is nothing “spare” about treating a group of granules whose combined volume is probably less than a pea by removing a slab of breast tissue the size of an Ipod Nano.
When you are told you have cancer in your breast, one of your first & certainly most understandable impulses is just to have someone get it the heck out of you. It’s like discovering that you have been dropped into a bad sci fi script and have been invaded by an alien life form, and you want to do whatever you have to do to remove it from your body and keep it from coming back. The surgeon who is explaining your options is your guardian angel, your life-saver, your sci-fi super-hero, and you’re just so damn grateful that this person can keep you from dying, you can’t think straight. You listen to descriptions of “breast-sparing surgery,” lumpectomy versus mastectomy, breast reconstruction, node involvement or lack thereof, odds, recurrence risks, radiation, chemo, hormonal therapy and recovery time, and your eyes start to glaze over. You nod attentively, try to look intelligent & go home, promising to come back for your follow-up visit. Life as you know it has been utterly shattered. Then you start thinking about the whole thing, about what you actually saw on the mammogram, and a bell goes off in your head. You say to yourself, “Wait a minute. These are a few granules, for god’s sake. And this is my breast. I don’t want someone cutting off my breast. Can’t they just zap it with lasers or something?”
And there you have it – the horns of the dilemma on which you are speared throughout this entire sleigh ride known as breast cancer. On the one hand, you are in a state of considerable urgency to get rid of the Monster Within. On the other, you are forced to come to terms with the remarkably primitive and frankly barbaric nature of the treatment options you are presented with, which are, in a nutshell, Mutilation, Poisoning, and Burning, or some combination thereof. Wonderful.
Peas and Pods
Naturally, I turned to the web for more information. I went to graduate school. I’m very good at doing research. I know how to read scientific research articles. It should not have been difficult to make some sense out of all this, right? Wrong. Because for all the research that has been done, despite all the progress that has been made, the improved odds of survival that have been achieved, an oncologist with any grain of honesty will admit that the treatment of cancer in general, and breast cancer in particular, is still not so far out of the dark ages. It’s still pretty much a slash-and-burn, scorched-earth, controlled chaos sort of enterprise. Don’t let anyone kid you about that. There would come a point in the not too distant future of my own adventure when I had to face the fact that my “guardian angel” breast surgeon had slipped in my estimation several notches closer to “barbarian marauder.” When my post-surgical swelling had largely resolved; when I had read all the pathology reports and knew the exact dimensions and characteristics of the tissue that she had removed from my breast; when the scar along the aureola of my right nipple pulled like packing string, and my breast and nipple puckered on either side of it, and the nerve endings in one of the most sensitive parts of my body began to object mightily to having been slashed and overstretched; when what was left of my breast turned into a wad of adhesive scar tissue and I had limped through over a month of poor sleep, constant sensitivity and emerging deformity; then, oh yes, then I came to realize in a visceral way that in order to save my life, my surgeon, this lovely and attentive woman who had given me her cell phone number five minutes after I met her, had amputated half of my breast to remove a pea’s worth of cancer, and left me mutilated, scarred and devastated.
That was not a good time, my friends. Nosiree. I had opted for this. I had chosen “breast-sparing surgery” instead of a complete mastectomy with immediate reconstruction, which is another whole kettle of fish. I had chosen to have radiation, which I was then undergoing, which would preclude my being able to have any possible plastic surgery to reconstruct my breast or even remove scar tissue for six months to a year. I had gone down this road with, I thought, my eyes wide open and, because of my own clinical education, more than the average person’s grasp of what it entailed. But nothing could have prepared me for the emotional impact of realizing that I’d had really no choice but to save my own life by submitting to this mayhem and disfigurement. And I had not even had to endure the further barbarity of chemotherapy. And that was another thing — my cancer was “early,” with no invasive components, no lymph nodes affected, at a level that is characterized as Stage Zero. Zero. I love that. Like this was nothing. A walk in the park. The word “anger” doesn’t even begin to cover how I felt.
In The Pink
As it happened, I was in the midst of receiving radiation during October, which is Breast Cancer Awareness Month. You would have to be lobotomized to miss the wholesale pink merchandising that goes on during October in this country. You would also have to be lobotomized to be able to shrug off the widespread corporate opportunism that ensues. But once you’ve become a member of the Club, it requires the patience of Mother Theresa to tolerate the pink appliances and pink bags of dog food and pink-tinted cream cheese and pink Beanie Babies and pink lingerie with pink ribbons printed all over it and the scores of other useless and ridiculous pink things that are marketed as fund-raising items and not feel deeply offended. On the other hand, there has to be a better way to treat this disease. There has to be. You would have to move to another planet to live your life without personally knowing someone who has had breast cancer and has endured the damage of cancer treatment. That’s a lot of women, and even some men, who have been slashed, burned and poisoned. Can’t we do better than this? We must. We simply must. So, if we have to resort to idiotic advertising campaigns to raise enough money to do better than this, then I guess I can put up with pink cake mixers and key chains for one month out of the year. At least I’m still alive to complain about it.
See my post “Semantics: How to Take Your Lumps” for another discussion of medical semantics.
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