When Cancer Returns: How to Cope with a Recurrence

More women than ever are surviving breast cancer, long enough to face a new threat: a recurrence of breast cancer.

By Louisa Kasdon

By the time I hung up the phone with him, people were starting to show up for a support group I was leading. I had no time to think about what to say. I just blurted out that I had a patient emergency and I had to leave, and please start without me.

My meeting with the surgeon was short — all we needed to talk about was when to schedule the surgery. I wasn’t interested in reconstruction, so there was no need to go through that whole conversation. I knew that I couldn’t face all that surgery. It works for many women, but it wasn’t the path for me.

When I walked back into my office, there was this lively support group discussion in progress. After a few minutes there was a pause, and somebody asked me if the emergency worked out. I took a deep breath and said, "Actually, I was the emergency." Then I told them what had happened: The pathology report showed a new primary cancer in the same breast where my previous cancer had been. As you can imagine, people were upset, because they like me and care about me. They were also scared to death.

Q. It’s complicated, because you’re a role model.A. Absolutely. I’ve been everybody’s life insurance or talisman, and I know that it’s been very soothing to lots of women through the years, women who don’t even know me, just to know about me or to see me walk through the treatment area and think, "Look, she had breast cancer umpteen years ago, and she’s fine." My recurrence really blew the lid off that sense of security. And everyone knows that my husband is the head of oncology here, and they wonder to themselves, "If they can’t even keep Hester safe, how are they going to keep me safe?" My experience has been very hard on my patients.

My surgery was the following week. A simple mastectomy without reconstruction is psychologically hideous, but as surgery goes, it’s not bad. They’re not poking around in your abdomen or anything. The recovery was pretty straightforward, and then I came back to work and started chemotherapy in a few weeks. That was harder. In spite of the advances in chemotherapy in the years between 1993 and 2005 — and certainly the nausea control is better — the chemotherapy itself is much more intense. And I was 12 years older. I’m 57 now. Physically, it was a much more difficult experience than it was the first time.

Q. What were the side effects? Did you lose your hair?A. Today’s drugs guarantee baldness, which I hadn’t had to experience before. I had learned from so many women how to handle that: I didn’t wait for my hair to fall out. Ten days after having my first chemotherapy, about a week before my hair would have started to fall out, I had my head shaved. I knew I couldn’t bear the slow, here’s a handful, there’s a handful. I told myself, just do it. But I found being bald excruciating. I hated the way I looked: I felt very public, and very vulnerable, at work. Yet at the same time, working in oncology is the best possible place to work, because half the people who are here on any given day are bald.

Q. It must be hard for patients to see you sick with their disease.A. It became an issue with every single appointment. For women I thought I would see just one time, I didn’t bring it up unless they did, although I would wonder, "Do they know?" If it was somebody I was going to see in an ongoing way, I needed to tell her, because she was going to find out. So it was very tricky clinically.

Q. Do you think your breast cancer has made you more effective as a caregiver?A. The first time, although I would have much preferred not to have breast cancer, it absolutely made me better at what I do. I don’t think the recurrence has done that. It’s just more of the same. Physically I feel fine. I don’t like the way I look. Before I shaved off my hair, it was brown and chin-length. Now it’s gray and so curly, I have to keep it very short. When I look in the mirror, I don’t know who I’m looking at, my hair is so different. I’m okay about the flat-chested part. I wish I could take credit for this phrase, but I stole it from somebody: "I feel as though I’m in the witness protection program." I look so different than I looked a year ago.

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