The American Cancer Society reports that approximately one in eight women in the US will be diagnosed with invasive breast cancer. I never imagined those odds would catch up with me. I had no particular risk factors and no family history of cancer. The good news is that most women will survive it (a 91% 5-year relative survival rate) especially if it is caught early. Thanks to advances in treatment and earlier detection due to increased awareness about the importance of routine screening, the breast cancer death rate has dropped by 44% since 1989. Early detection and access to high-quality treatment not only improve the likelihood of surviving breast cancer, they also make better treatment options possible.
Early on in what I now understand to be my breast cancer journey, I heard a woman in an online Zoom support group make a startling comment. She said, “breast cancer has given me more than it has taken away.” I am still in active treatment, and I am not sure yet whether that is true for me, but it has caused me to think about what this experience has given me.
I have learned a lot. One surprising thing I have learned is that, with the current state of medical science, treating breast cancer is not like treating a broken arm. First, diagnosis is an ongoing process, certainly not as straightforward as reading an x-ray. Every test, every biopsy, and especially pathology results after surgery, all shed new light on what is going on with those cells in your body: how many there are, where they might be, and what might need to be done to get rid of them. One breast cancer survivor described it to me as not dissimilar to peeling an onion (and yes, it will make you cry). Each step of the way reveals a new layer. So you might start out thinking that one treatment course is the best and later learn that a different direction is required.
More fundamentally, this experience has opened my eyes to the fact that deciding what course of treatment you should have for breast cancer is, at best, an iterative process between the patient and her (or in rare cases, his) doctors. The best treatment for each patient depends on individual factors that vary greatly. Age, personal values and attitudes, and numerous lifestyle factors all play a role. Your doctors (and there are several, each one with different expertise and all of whom are essential), need to get to know you as a person and learn what matters to you. And you need to learn from those experts what your options are, and what consequences will likely result from each decision. No one else but you and your doctors should participate in those decisions.
Finally, and most happily, cancer has given me a window on just how many incredibly kind, generous, and loving people are in the legal profession, in public service, and in the state of North Carolina. So many people have offered words of support and encouragement, and shared their own stories of overcoming cancer. That is a gift I will always treasure.
Being public about this diagnosis is another one of those individual decisions that depends on each person’s unique situation. I am grateful for the women in public service who have been willing to share with everyone their breast cancer diagnosis and model how to carry out leadership roles while also caring for their health. I am also grateful for the women, addressing this privately, who give support to other women behind the scenes. The important lesson is to have those routine screenings as required. We need to make them accessible for everyone. Data shows that in North Carolina, only about 70% of women over 40 get the screenings they need for breast cancer detection. Don’t be afraid to have that mammogram. It can save your life.
