If you’ve found your way to this blog, there’s a good chance you know me personally! And if that’s the case, then you’ve already seen the text below, which is the announcement e-mail about my cancer diagnosis. I’m pasting it here as part of my documentation process so that in a year, after the chemo and after the surgery, I’ll have a full view of things. Why document? To be honest, I’m not sure. I’ve never been a particularly good diarist. I write in fits and starts, and I don’t think I’ve ever successfully filled a journal. But I suppose if there’s going to be a life-changing event that spurs reflection and contemplation, then this is it…

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Subject: News. Not the awesome kind

Dear friends,

You might be confused as why to this e-mail address is being resurrected– mostly, this was the most expeditious e-mail to use with all the contacts of people I love in one place! I got some unwelcome news at the beginning of October, and it has been challenging for me to figure out how to best deliver it. So, since there’s no great way of easing into it, here goes: I’ve been diagnosed with Stage II (early stage) breast cancer.

I apologize for the impersonal feel of transmitting this news via mass e-mail, but it’s better than a facebook update, isn’t it?

If I were to receive such news from a friend, I know that I’d have a lot of questions, and 1) I wouldn’t know where to begin and 2) I wouldn’t know what I should or shouldn’t be asking. So, to mitigate all that, I want to say explicitly that no one should be afraid to ask the questions they want, because in the short time I’ve been dealing with this, I’ve learned that cancer is mysterious and complex and there is a lot to learn. There is also a lot of misinformation on the internet, and there’s also a lot that is still unknown about the disease. Breast cancer, in particular, is a hard case because there is no clear cause, unlike for example where the link between lung cancer and smoking is well-established (but it should be also noted there are cases of lung cancer that are wholly unrelated to anything and which happens spontaneously). In order to facilitate question asking, I’ve created a handy google form, through which you can ask questions about anything anonymously, and I’ll do my best to answer them… perhaps in a group e-mail or a blog (I’m still deciding on the right venue for capturing my thoughts.)

But here are the basics about what has led up to my sending this e-mail: in September, I had a cough (likely unrelated to the cancer) and I had a coughing fit. As I was clutching my chest, I suddenly felt a lump. While I am ordinarily someone who avoids going to the doctor as much as possible, the lump was big enough to be concerning, and it was just… weird. I decided to make a doctor’s appointment and thought perhaps it could be respiratory related since it was up relatively high on my chest, and almost to my sternum.

In the end, of course, making a medical appointment immediately was a good move on my part, and I am glad to report that my PCP (who I met for the first time at that appointment) took the mass seriously enough to then direct me to make an appointment for a mammogram and ultrasound for the next day. At that point, though, I wasn’t feeling that concerned since a breast cancer diagnosis seemed rather inconceivable. It wasn’t until the radiologist was reviewing the images with me that it became apparent that I was dealing with something that was possibly not benign. And even then, I wasn’t really thinking cancer until the radiologist sent me upstairs in the same clinic to speak to the PCP, and then I saw it on her face. The radiologist had taken a very even tone with me in describing what she saw on the imaging, but must have communicated something more serious to my doctor, because then my PCP explained that she had already called Brigham & Women’s hospital on my behalf to get me an appointment with the specialists there.  To fast forward, later results from a biopsy confirmed the diagnosis as invasive carcinoma.

“Invasive” is a very scary sounding word, but what I think I’m learning through this experience is that medical terms are just kind of blunt. At first glance, to me, “invasive” makes me think of these nasty cells dividing like crazy and overwhelming me, but it’s not like that. This cancer is “invasive” simply because it has the potential to grow and spread, but that’s what treatment is for—chemotherapy to arrest the growth, and surgery later to remove the tumor. (On another note, I appreciate the direct language in my medical record where my oncologist noted from the physical exam that I am a “well-nourished and well-developed female.” See, if this were another context, then I might wonder what “well-nourished” was connoting…)

If you’ve seen me in the last month and a half, you might be thinking, “what?!? I didn’t see any signs of this! (She looks well nourished!)” and you’re right, because there are no outward manifestations of my cancer, at this point. The strangest part about writing this e-mail now is actually publicly declaring that I have a disease, but, I actually don’t feel sick at all! In fact, I feel perhaps at the height of my health, and I’m proud to report that just over a week ago, I completed my first ever marathon! Pradeep and I ran the Mt. Desert Island Marathon up in Maine (near Acadia National Park) and it was just the victory I needed. The day was cold, the course was crazy hilly, and I came in towards the back of the pack, but the fall colors were spectacular, my greatest champion was beside me the whole time, and my mom was at the finish line, so what else could I ask for?

You might be wondering, what can I do? To tell you the truth, I’m not sure! I’m in good spirits, I have plenty to read, and Pradeep and I are moving in with my family soon (which was planned long before this medical development). One of the great privileges of living in Boston and having exceptional health insurance through my school is that I have access to top-notch medical care, so there are few concerns there. And of course, I know that I have all of you, near and far, in my corner.

I start chemotherapy tomorrow. That will continue over the course of 4 months (IV infusions once every 2 weeks). It’s, admittedly, a bit terrifying, but that’s mostly because I simply have no experience with this. So… I’ll keep you all posted!

With love and cheer,

Amy