My 52nd Birthday

 Tomorrow is my 52nd birthday. As I write this, I am outside on our newly-redecorated patio, surrounded by our newly-installed fence, admiring the newly-acquired planters, their profusion of blooms cascading in multi-colored waterfalls. Watching the dogs enjoy their semi-freedom, chasing cicadas and butterflies. Lovely and idyllic. 

I’ve lived a little over half a century. How will I celebrate? With more new stuff. No, not jewelry or other shiny, pretty things. Nothing so nice as that. Tomorrow I’ll celebrate my birthday with chemo for a new cancer. My third this year.

I’ve thought a lot about whether I wanted to share this latest chapter in my life, and if so, how. Even now, as I type the words, I struggle to fully comprehend the sorrow and gifts 2021 has bestowed upon me, only six months in. And I really struggle to find the humor in it, though I know it’s there. Those knee-slapping stories will come later, when I give myself leave to laugh at my plight. This tale is simpler; distilling complex, life-threatening issues to the essentials: the good and bad, the curse and the blessing.

On the surface, my life completely and utterly sucks right now. If life is a coin toss, and one day it’s a happy side of the coin and the next day you get the sad side, then it would appear, on the surface, I’m decidedly stuck on the sad side of the coin. 

In December of 2020, after wrapping up seven long months of recovery from a concussion, I ended the year with genetics testing and a newly-detected lump in my left breast. 2021 came in with a vengeance for me.

In January, a mammogram, ultrasound, and biopsy confirmed not one tumor, but two. One in each breast, because I’m an over-achiever that way. Not one type of breast cancer but two. Because I’m extra.

In March my breasts were removed, amputated, cut down in their prime. I really, really loved those girls. So that sucked.

The surgery and ongoing adventure with tissue expanders (placeholders for my new fake boobs, if you will) sucked big time and continue to do so. So much pain, not nearly enough drugs. Drains, tubes, scars, blech! Fourteen scars so far and counting. Some days it was all too much. Not being able to look at myself in the mirror was devastating. Please don’t ever tell a breast cancer survivor that at least she got perky new boobs. Just don’t.  

Reconstruction began the morning the real girls left me, and in their place were the terrible, horrible tissue expanders, painful and misshapen reminders of what used to be that would stay locked in my chest for at least three months. Eventually they’d be swapped out for the implants. How I looked forward to that day! But then, OOF! Chemo. The implants would have to wait and I’d spend at least four more months with these expanders. That damn coin was still very much stuck on the sad side.

One round of chemo took my hair and caused such severe abdominal pain that I ended up in the ER. And there, instead of finding a blockage or other non-threatening, hardly scary reason for my pain, the CT scan unfortunately showed a mass on my pancreas. Super bummed.

Lab work for cancer markers, biopsy, PET scan, and a couple of doctors’ visits later confirmed the third cancer – pancreatic. A tumor in my pancreas and, party bonus, one in a lymph node in a whole other area of my body. Why? No one knows. It’s just there for the ride. Now, that sucks more than I can say.

I switched my cancer care from my local oncologists and hospital to Penn’s Abramson Cancer Center, going between their Center City and Radnor offices. Now I’m too complicated for just any oncologist or surgeon. Now I require specialists, and not your run-of-the-mill specialists, I need the best of the best. Well, shit. This is all terribly inconvenient and scary as hell.

The breast cancer chemo has to end so I can commit my body and current tumors to the brightest and best of medical science. And tomorrow, on my birthday, I will begin a different chemo cocktail in an attempt to destroy the pancreatic tumors prior to surgery. And after surgery? More chemo. Does this all suck or what? Seriously.

But let me tell you what doesn’t suck. Because, yes, there is actually a silver lining to all this. There always is.

The lump that kick-started this cancer shit show in December 2020 was discovered in the most off-hand manner, almost a fluke; a “let’s-just-check-your-breasts” afterthought during my appointment for genetic testing. I wasn’t expecting a breast exam during a genetics appointment. To be honest, I wasn’t sure if this was reportable behavior or not, but I went along with it. Turns out, that appointment was the start of all manner of terrible things. I’m BRCA-2 positive. Damn. And two malignant tumors were found. What?!? As upsetting as it was to hear I carried a gene mutation that put me at high risk for some pretty serious cancers, and learning that both tumors were cancerous, the moral of this part of the tale is that those lumps were found, and early enough that neither breast cancer spread. What a relief and a blessing. That did not suck.

And it doesn’t end there, this silver lining. Between the onslaught of horrible, devastating things was everyday beauty, which I saw with new eyes. And love. So much love. 

My family’s support, my mother’s care and coaching, as she is, rather unfortunately, the Cancer Maven of our family. 

My children wordlessly tuning in to my moods and anticipating my needs. John, my best friend, my partner, my solid foundation walking every step with me, holding my hand. 

My friends and their unconditional support and unwavering devotion to me and my family. 

Meals and visits and a flood of cards, gifts, and flowers from dear friends and people I don’t even know. It was overwhelming in the best possible way. I saw and felt how deeply I am loved and how abundantly blessed.

The chemo. Who could ever claim chemo as a blessing? I can, because had I not needed chemo, and had it not sent me to the ER, I wouldn’t know about the pancreatic cancer until it was too late. As in end-of-life too late. I’m forever grateful for that chemo and that CT scan. Just like the breast cancer, finding this cancer early means it’s operable and treatable. The negative becomes the positive.

Being BRCA-2 positive. How can the genes engineered to kill me be a good thing? Well, oddly, it turns out that BRCA-2 positive pancreatic cancer patients repond better to chemo than non-BRCA-2 patients. So the genes that want to kill me can actually help the chemo kill the cancer. I don’t pretend to understand it, but that’s the truth of it. In the end, those offending genes will help me. The coin flips again.

Because I’m so extra, I’m getting the best care available in our area. Yes, it’s a hike to Center City, but my oncologist is a leading researcher in BRCA-2 positive patients with pancreatic cancer. She’s the author of the latest articles on pancreatic cancer treatment. I’m one of her few patients to have both pancreatic and breast cancer at the same time, a dubious distinction to be sure, but I’m lucky she’s so tuned in to my unique needs. And my surgeons are all the leading pancreatic surgeons. I couldn’t have assembled a better care team if I’d tried. I’m in a place where all eyes are on me and my treatment. I’m not happy I’m such an important patient, but if this is the way it has to be, I’m exactly where I need to be.

But wait, what about the breast cancer, you ask. Don’t you have to resume chemo for that? Ah, here’s the beauty of this new chemo. One of the drugs in my particular cocktail is useful against breast cancer, as well. So no need to resume breast cancer chemo after recovering from pancreatic chemo/surgery/chemo. That is a huge blessing!

But wait, you ask. Aren’t you upset? Aren’t you angry?  Yes, and sad and scared and freaked out. Occasionally I need lots of cake and ice cream and more than a few wee drams of Irish whiskey to drown my sorrows. Xanax is high on my list of must-haves, too. But on my 52nd birthday, I’ll be gifted with life-saving treatment that will give me a third chance at life, and will allow me to continue loving my family and friends. I will continue adoring John and my children, and I will have many more years to sit outside in the sunshine, soaking up all the goodness of life. And that, my friends, is the biggest coin flip of all. Happy birthday to me!

breast cancerCancerpancreatic cancer