Making your own Decisions

In honor of Breast Cancer Awareness Month

When I met Francine, she had been diagnosed with breast cancer. She had found a small lump in her left breast because she was carefully doing self-research once every month. Her house doctor send her over to the hospital and after lots of poking, probing and pictures, there was the diagnosis: breast cancer discovered in an early stage.

The shock she had initially, quickly turned into action. Francine was a determined woman, she wanted to conquer this disease. Her sons where major motivators in this, they had just started high school.

I remember around that time there was an item on television about Angelina Jolie and the breast cancer gene that you could pass on. While the doctors had advised differently, Francine had chosen to let them cut off both of her breasts. “Better safe than sorry”, she said. 

So there I was as a first time volunteer with this organisation that accompanied cancer patients in their journey. I had just met her once and now I was accompanying her to make a scan and see the doctor about her wounds. She was a single Mom, without much of a network. There was one couple who looked after her kids when she was outdoors and that was about it. She was sensitive and passionate about living biologically and ecologically and she needed my support to get through this battle. She introduced me as her supporter with everyone we met.

There was no gentle start. Her life was on the line and I think the only thing she could do to stay sane was to keep moving forward. 

The reality-in-your-face feeling continued when we came to the hospital, she was crystal clear: “come on in the dressing room, you can help me remember what the doctor is saying.” She closed the door and started to undress her top. “No bra needed anymore”, she laughed bitterly. A flat chest with violent red cut marks and scars ran around the area where her breasts had been. I looked in her eyes and asked her how she felt. “Nervous”, she said. She swallowed hard, her eyes were shining. And then she lifted her chin up to face the nurse that brought her to the scan room. She asked for a pillow here and a blanket there, making it as much her own as she could.

The doctor came in later on with good news. The scan showed she was clean for now, there was nothing left of the tumor in her body. But to prevent the tumor for showing up again he presented a treatment plan: first radiation and after that hormone therapy. For her, this last therapy would mean an early forced menopause. 

As she rummaged in her bag and came up with a list of questions, the doctor took off and the nurse practitioner assigned to her patiently answered every question she had. 

During the pre-radiation appointment it was clear that she was not going to take everything without a fight. They had to mark the areas on her chest with a skin proof marker in order to know where to focus the radiation. It could be erased so there was a no body cream policy. She thought it was ridiculous, “they can easily repaint my body next time”. The cream helped her body recover and she felt not using it and radiation on that same skin, made her take two steps back in recovering. The radiation room was ice cold, blankets were not allowed. The nurses were obviously used to deal with all kinds of people, they stayed steady, pleasant and calm.

The first of so many radiation dates came. Waiting rooms filled with other patients, Francine reluctantly going in that cold room for her treatment, me waiting and guarding her possessions. As she came back, sometimes she needed help dressing, sometimes not but she always felt drained afterwards.

Over time her skin started to peel and show small red spots. She felt all kinds of inconveniences because of the radiation. We talked about this with the cute nurse practitioner and there was almost always a way to ease things a little. She used her cream again but not on radiation days and they had to repaint the areas multiple times. She took radiation week seriously, groceries were taken care of and she cancelled big appointments.

She felt the radiation time was a setback for her body. She was scared for her life and her sons. She was sad and confused as to why it was her. She struggled to get through.

Eventually the last time came, she was so relieved. She gratefully thanked the nurses and staff as we got to know them pretty well.

As radiation was a struggle the next step was hormone treatment. Her first question was, “Can we skip this?” and back came an answer with statistics on survival and what research had shown. The combination seemed key for survival on this type of breast cancer. So we went on. 

The radiation had already been a struggle, the hormone pills altered her mood and her body even more. She kept on eating in healthy ways and adding vitamins but she felt horribly sick. Cleaning the house and taking care of her kids was too much of a strain on her. She felt overwhelmed and on edge. We went to see the doctor several times to change pills or to reduce the dose. 

It was physically and psychologically extremely strenuous for her, it felt like a constant battle to keep going. Eventually we came to a point where she wasn’t feeling like herself anymore and she lost the feeling of purpose. She had no desire to die all she wanted to do was live her own life to the fullest on her terms.

We discussed this with the nurse practitioner and once more the statistics came to the table. According to them she had a better chance of survival in the future if she kept on taking the hormones. After that motivational talk she just said: “I think I’ve done enough”. She stopped the treatment. She still went to the checkups but chose to take the risk because she felt the treatment was worse than anything life could bring her. 

I stayed with her for some time after this. To help her recover and also to get her back on her feet without that survival urge that had been a constant factor in her life for about two years. She found other cancer survivors who could relate to what she was going through, it helped her find a new sense of normal. She is still “a risk” according to the statistics but she didn’t have a relapse up until this day.

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