Hope Shifts: COVID19 to Cancer

I begin and end with hope. Born, we hope to live a long life. We haven’t a clue as to the concept of “not being” yet. It’s hard not to think about the concept of no longer breathing: rising to the sweet smell of ion charged air after a spring rain. The concept of seasons hasn’t penetrated our small forms yet. Fascinating that the eyes never grow and at birth we grow around our big eyes. Can we see more as our unfettered brains not yet cluttered with fear, with not knowing how we may find another meal. We love our mothers. Maybe because she feeds us. Maybe our primordial love grants us the will to cry out in pain, in hunger, in loneliness. As we grow into full fledged human being do we also grow into beings of more fears?

The “fears that we may cease to be” as John Keats wrote so long ago in his poem of the same title at the ripe age of 24, he’d lived in a time when the average age wasn’t approaching 80 as today in 2021. Or perhaps we grow into our hope. Maybe we hope to find love come to dry our tears from our adult sized eyes. Maybe these eyes bring in the light of hope, like the leaves on a tree draw in the sunshine to grow the fruits and flowers. Our fruits and flowers as human beings, at least for most of us, deliver the nourishment of awareness of the good in the world. Some believe in using fear for gain. My world shrinks to nothing if I hurt even a spider. I cannot imagine the feeling of killing either by my own hand or through my power over the way others think. Like in war or in cults.

If it feels like a broad topic, and it may be, it’s personal, too. What’s eating the United States, and from what I’ve read and seen, the United Kingdom, from the inside? Those who we hired by vote to protect us continue to stand aside watching m violence to drip like sweat from the pores of rioters inside the capitol of the United States. My own eyes were struck with fear as I studied a photograph of a police officer whose hand sat on the back of a riotous angry white man. Outside of the picture, he then entered the speaker of the house’s office and sat with bravado and his feet upon her desk. Within 24 hours he was arrested and given a sentence of just one year. Yet, were a black man, I guarantee he’d be a dead man. Of this I’m quite certain.

Yet there’s too much fear to face the disease of racism in such audacious act of treason. A crime against the state. A crime punishable by death. I’m immoderately unsure he deserves such a dear punishment. The brainwashing and propaganda disseminated by the short lived current administration ramped up many without facts that support the arguments of an unfair, illegal vote count. There’s no evidence as such. My own eyes wept with frustration and fear.

The reality of the COVID19 virus and it’s newly transmuted much more transferable viral brother continues to plague the world – specifically the United States and the UK. The first world countries that quickly gave us the vaccines are also hotbeds of exhausted first defenders and maxed out hospitals. We live in counties, my own Nevada County included as of today, where beds in Intensive Care Units reached 100% capacity and makeshift tents hold the sick and ailing infected by the virus. It’s as though we’re living through a war on our defensible land. A land we never thought we’d need to defend on our own soil.

Breast cancer’s not preventable by a mask. Or by self isolation. Or by remaining alone dying the holidays for a year. But we do this in some cases not of our choosing but because we are treated as though we had COVID19 all along. Our concerns include isolation and uncertainty. The concerns people about of COVID19 too include isolation and uncertainty. Do we believe the lessons of the many will translate into the care of us, the few in comparison, with MBC no matter the cause, our skin color, of socioeconomic positions? No, I doubt it. So there’s a connection between Covid and cancer. We’re doubly afraid to become ill, to be ghosted by former friends and family, to be alone and uncertain as to when we will die? It’s not if but when although the incidence of MBC has shrunk by 1.8% according to the statistics.

This country, is the same in which my own cancer center cannot give me an approximate idea of when I will receive the vaccine. This country where as we watch, we become voyeurs of a kind of war I hope to never see again. I watch with the same eyes I saw my mother bring a spoon to my mouth full of bananas and apple sauce. Such a vast amount of time has passed since I came into being as the Vietnam war started to become a reality. One of my favorite writers probably described it better than anyone. Susan Sontag who wrote “On Photography” and “Illnesses as Metaphor” was

“…probably the most influential writer on the intersection of violence and photography, didn’t buy this argument. With forensic prose, she cut through complacent apologias for war photography and set photojournalistic images of violence squarely in the context of viewers’ voyeurism.”

Tejeau Cole, The New York Times Magazine, 24 May 2018

Have we become wide eyed onlookers, ready to lose hope and lives simultaneously as the country must be bribed with stimulus checks like pornography? Have we lost hope in our own ability to find the heavy sadness of mass graves holding the unidentifiable dead who were dropped off at hospitals and found themselves alone, miserable, and dying?

Such feelings of anger well up in my heart: if we had the ability to create vaccinations against a deadly pandemic virus so quickly, what about cancer? Why can’t we put the pharmaceutical community on notice right now and give them the ability to produce an injection against something we supposedly know so much more about? Cancer won’t cause an economic depression. In fact I argue we need cancer to prop up the economy as we require less outputs from the military industrial complex. Who needs to die now in order to inject money into a false economy of unknown and unseen wars? It’s not Iraq or Afghanistan. It’s in my bones. I’m one metastatic cancer patient is worth hundreds of thousands of dollars a year – I read one figure that a metastatic breast cancer patient brings the value of an oncologist to her organization upwards of $600,000 US per year. That’s insanity, statistically speaking. Take a few hours and read through gif following

American Cancer Society’s Facts and Figures 2020 ACS 2020 Fact Book – there’s an obvious problem from the outset. Cancer by definition is a pandemic not treats as such and in my estimation it’s because were worth so much to keep alive. If death is a protest I’d rather not participate. How will you protest our plight? Will our country be well enough to participate in the Die In this year? It do we stand by and watch as we die from what seems to be preventable except in 5-10% that are gene mutations from heredity – and even then is it possible to prevent those people from diagnosis? Here’s a nice neat list pulled together of facts in Breastcancer.org latest statistics:

  • About 1 in 8 U.S. women (about 12%) will develop invasive breast cancer over the course of her lifetime.
  • In 2020, an estimated 276,480 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S., along with 48,530 new cases of non-invasive (in situ) breast cancer.
  • About 2,620 new cases of invasive breast cancer are expected to be diagnosed in men in 2020. A man’s lifetime risk of breast cancer is about 1 in 883.
  • About 42,170 women in the U.S. are expected to die in 2020 from breast cancer. Death rates have been steady in women under 50 since 2007, but have continued to drop in women over 50. The overall death rate from breast cancer decreased by 1.3% per year from 2013 to 2017. These decreases are thought to be the result of treatment advances and earlier detection through screening.
  • For women in the U.S., breast cancer death rates are higher than those for any other cancer, besides lung cancer.
  • As of January 2020, there are more than 3.5 million women with a history of breast cancer in the U.S. This includes women currently being treated and women who have finished treatment.
  • Besides skin cancer, breast cancer is the most commonly diagnosed cancer among American women. In 2020, it’s estimated that about 30% of newly diagnosed cancers in women will be breast cancers.
  • In women under 45, breast cancer is more common in Black women than white women. Overall, Black women are more likely to die of breast cancer. For Asian, Hispanic, and Native-American women, the risk of developing and dying from breast cancer is lower. Ashkenazi Jewish women have a higher risk of breast cancer because of a higher rate of BRCA mutations.
  • Breast cancer incidence rates in the U.S. began decreasing in the year 2000, after increasing for the previous two decades. They dropped by 7% from 2002 to 2003 alone. One theory is that this decrease was partially due to the reduced use of hormone replacement therapy (HRT) by women after the results of a large study called the Women’s Health Initiative were published in 2002. These results suggested a connection between HRT and increased breast cancer risk. In recent years, incidence rates have increased slightly by 0.3% per year.
  • A woman’s risk of breast cancer nearly doubles if she has a first-degree relative (mother, sister, daughter) who has been diagnosed with breast cancer. Less than 15% of women who get breast cancer have a family member diagnosed with it.
  • About 5-10% of breast cancers can be linked to known gene mutations inherited from one’s mother or father. Mutations in the BRCA1 and BRCA2 genes are the most common. On average, women with a BRCA1 mutation have up to a 72% lifetime risk of developing breast cancer. For women with a BRCA2 mutation, the risk is 69%. Breast cancer that is positive for the BRCA1 or BRCA2 mutations tends to develop more often in younger women. An increased ovarian cancer risk is also associated with these genetic mutations. In men, BRCA2 mutations are associated with a lifetime breast cancer risk of about 6.8%; BRCA1 mutations are a less frequent cause of breast cancer in men.
  • About 85% of breast cancers occur in women who have no family history of breast cancer. These occur due to genetic mutations that happen as a result of the aging process and life in general, rather than inherited mutations.
  • The most significant risk factors for breast cancer are sex (being a woman) and age (growing older).

In this I shift my hope again. I shift it to the general population and their eyes – the same eyes they’re born with and will die with to my and so many others bodies that have turned against us. Don’t look away. Don’t run when you become aware of a friend or a cousin with metastatic cancer. I leave you with a poem to describe my feelings in this matter.

Beaming with Hope

Hope Leaves on
Lemon trees fruits
Subject to yellow
So one tart section
Bites all the sun.
Drip juices ascetic
The most acidic of
The citrus
The gods gift to us
Coming forward to trust
The peel’s oil, metal rust
Can take the tin
Cans bring them all back
And then
Go hone a skill
And sip a little water from
My will.

I beam with a mess
Of healing light.
I received some, too
Today maybe the perfume
Left by a sweet
Mass, blood in a chalice
Quenched as
I dressed up like a goddess.
Secretly becoming
Scarred. Interested less
In hiding.
Can I remain in a nest
Like a red robed Robin
Born from blue
Shells that belie my lacking oxygen. On a beach
A great beam of
Might from
The lighthouse mirrors
Cut out a collage
Of media mixing
Flies and I file
Away the thinking
I can fix anything
Back anew.
Single file out into
A line we become one
Place where health walks heel to toe.
My place comes
Like everyone’s, eventually.
When can I conquer the enemies?
When does the line stop? What time Will it take up to heal the world?
We’re listening.
Without the next answer
Every green sings again
Every blue sleeps again
Every color clears again
Every hell
Finds its heaven again.
Open mouths breathe in to
Blow out the candle of our spirits.
Our lungs absorb – All the tears
Our hairless heads – All the rain
Our sore mouths – All the laughter
Our frail bones – All the power
Our thin skin – All the weakness
Our open hands – All the dealers
Our empty wallets – All the takers.
The gamblers and the monks
The grifters
The punks
And the lines of the me’s and the you’s
Lose all the freedom.
To know my soul
Existed before I boarded this train:
Crossing borderless countries
I am Aimless and unclothed
And I Break in my body.
There’s no optioning
No ownership
No forever
Not even a
Time share.
This time I cannot
Work to pay
All the rent.

As a spawn of the dead
A pawn of this life
For what I deplore
And who I defend
The punch
Line without any joke
Echoes in lustrous
love
And up in the
Attics unpacked
Into those dusty
rafters of hope.

Signed “Final report”

Have you ever read a report from a PET scan or a CT scan? Those things that give people with cancer what’s known as “scanxiety?” I am sharing here the narrative sent to me and my oncologist for discussion. This was the one that led to the decision to radiate my vertebrae when the radiologist found the new (now demolished) tumor on my lumbar 4. Enjoy. I will leave you with the exact document I have to translate on my own prior to my appointment.

Narrative clinical history female metastatic breast cancer. 55 years old. This PET sequence for comparison view and evaluate responses to therapy.

Tracer information into the right mediport. Not the wrong mediport. They take from me in safety they give to me in danger for I am scanned from my head to my toes. Relieve me of the seas of yellow fluid yet my livers not included

Scan algorithms based on a phantom, clear sinuses, no lymph nodes.

Paranasal sinuses: Clear

Thyroid: Not well visualized.

Chest:

Lymph nodes: No FDG-avid or enlarged supraclavicular, mediastinal, hilar, or axillary adenopathy.

Lungs: Scarring in the posterior right upper lobe. No FDG-avid pulmonary lesions. Lung parenchymal evaluation, including for punctate nodules, is limited by low dose CT and non-breathhold technique.

Pleura: Unchanged pleural-based nodule along the periphery of the left lower lobe between the sixth and seventh ribs with minimal uptake above background measuring 1.5 cm with SUV max of 2.6.

Chest Wall: No FDG-avid lesion. Unchanged dense soft tissue within the bilateral breasts without significant focal uptake.

Heart: Atherosclerotic calcification of the coronary arteries is present. No pericardial effusion.

Other Findings: None.

Abdomen/Pelvis:

Liver: No FDG-avid liver lesion.

Gallbladder: Normal.

Spleen: Normal in size and metabolic activity.

Pancreas: No FDG-avid lesion.

Adrenals: No FDG-avid lesion.

Bowel: Physiologic FDG uptake is seen in the bowel. No focally FDG-avid lesion.

Kidneys/Bladder: Normal physiologic excretion of the radiopharmaceutical. No FDG-avid lesions.

Lymph Nodes: No FDG-avid or enlarged abdominal, retroperitoneal or pelvic adenopathy.

Vasculature: Normal abdominal aortic diameter (<3cm).

Other Findings: Diffuse peritoneal thickening is similar in appearance to prior CT, with unchanged more focal nodularity along the right lower pelvis which is additionally unchanged in CT appearance with mild associated uptake with SUV max of 2.4 (212). The latter is newly apparent from more remote PET. Increasing now moderate volume ascites.

Musculoskeletal:

Bones: New focus of uptake within the L4 vertebral body with unchanged underlying sclerotic focus with SUV max measuring 4.8 (172). Unchanged sclerotic appearance of the axial skeleton and ribs, and patchy sclerotic appearance of the proximal appendicular skeleton compatible with diffuse treated osseous metastases. Mild asymmetric linear intercostal uptake along the posterior right chest wall (135) without convincing underlying CT correlate, overall non-specific, but with attention recommended on follow-up.

Other Findings: None.

Impression

1. New moderate focal uptake within the L4 vertebral body concerning for progression of osseous involvement from PET/CT 4/12/2019. Diffuse sclerotic osseous lesions are otherwise not hypermetabolic.

2. Increasing now moderate volume ascites with persistent peritoneal thickening and regions of peritoneal nodularity with mild uptake, remain concerning for malignant involvement. Evaluation on PET is limited due to variable physiologic bowel uptake

I have personally reviewed the images for this examination and agree

with the report transcribed above.

Signed”Final report”

Blog | Living Beyond Breast Cancer – how writing and creative expression produce research-proven therapeutic beneficial results

Be sure to check out my latest blog post on Living Beyond Breast Cancer’s site, for which i also volunteer my time as a patient advocate. My post covers tips on how you can use journals and creative expression for emotional well-being when faced with a cancer diagnosis. You needn’t have cancer or breast cancer to benefit from the article. There’s a lot to deal with these days, facing a global pandemic with the promise of vaccinations but no end in site. Please read and comment – it’s important to get the word out to for LBBC.org and all of its beneficial resources.

If you want to read the latest breast cancer stories, studies, and news, as well as learn more about treatments, support, and side effects, visit our blog here.
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