Thursday, February 28, 2019

Surviving

How do you calculate survivorship? From the time you first learned you had cancer? Or the date you had surgery to remove it? Or that wonderful day when treatments are finally finished?

And what if you get a second cancer? Does the time clock start over?

These are questions I've pondered with my friends. And I think we've determined that our survivorship began when we had surgery. I know my doctors considered me a survivor after that day.

But when can you consider yourself cancer-free? Or in remission? After 5 years? 10 years? And what constitutes a long-term survivor?

Honestly, is anyone ever truly "cancer-free"?

(I just discovered an amazing article that discusses all these questions: When Can I Say I Am a Breast Cancer Survivor?)

On February 20, 2014, the one-year anniversary of my diagnosis, I celebrated tentatively with a post called One Year In. I was happy, but still nervous. I couldn't wait to get to the five-year mark, at which point I thought I would really feel like a survivor. And then I'd be halfway to the ten-year mark when I figured I'd be home free.

Looking back, reading that post, I'm struck with the realization that I still celebrate my "cancerversary" the same way. I rejoice that I have another year post-cancer under my belt. I ruminate on the ways that my life is different now because of facing cancer. And I wonder how long I still have.

Today, I'm celebrating six years since my first surgery. It feels really good to be over halfway to ten! 

And yet, I know full well that cancer could rear its ugly head again at any time. It already did, almost 3 years ago. And what did that second cancer (NOT a metastasis) do to my survival status? My doctors have said over and over that those tiny tumors (yes, they found yet a third cancer in the cross-section of my lumpectomy) are not even worth worrying about. According to them, my triple-negative cancer 6 years ago was "the big one," and my survivorship keeps counting from that day.

But I can tell you that I also celebrate the years since my second cancer, and will be thrilled when I'm ten years out from that date, too. 

There's nothing like a life-threatening illness to make you feel like you're living on borrowed time. But . . . we're all living on borrowed time. The illness is just a reminder.

I recently told another survivor friend who is awaiting more tests: we know Who holds the future, and we know Who holds our hand¹ . . . but we can't help holding our breath while we wait.

However . . . here's another truth: God even holds our breath! In ancient Babylon, the Jewish official Daniel reminded King Belshazzer of "the God in whose hand is your breath."²

I find that super comforting. I don't have to hold my breath ~ because God does! I will keep breathing, surviving whatever comes my way, "all the days of my appointed time."³


However long my life may be,
He holds the schedule in His hand
And doles my days out graciously.
I trust His perfect plan.


¹"I Know Who Holds the Future," by Alfred B. Smith
²The Bible, Daniel 5:23 (ESV)
³The Bible, Job 14:14 (KJV)



Wednesday, February 20, 2019

Six Years Later

I've been writing letters today. And every time I wrote the date (2.20.19), my heart went back . . . back six years to the day when I first heard the words, "It's cancer."

I wrote in my journal on that date:

Well, I have breast cancer. There's just no good way to put it. Not the result we were expecting or hoping for. Even the doctors are surprised: a cancerous cyst. So now I face scans, surgery, chemo, radiation, and the pill. Not a pretty picture. Hard to tell the kids; hard to see them and Greg cry. I'm numb, scared, a little angry. But we'll trust God ~ and fight this hard.

I would not know until after the surgery that my cancer was triple-negative, not one of the hormonal ones that can be battled with "the pill" Tamoxifen. It would be even later before I learned that triple-negative cancer can be one of the more aggressive, harder-to-beat forms of breast cancer. 

But by God's grace, I'm still here! He's not finished with me yet!

I've spent today not only writing letters, but also caring for my husband and daughter who are battling the flu. It's been a tough day, trying to juggle "nursing duties" with all the other things that I wanted to get done. But as we reminisced tonight about six years ago, I felt incredibly blessed and thankful that I'm here to care for my family. Somehow, remembering that I might not have been makes the task just a little sweeter. 

Life, even on the hard days, is a gift!

Friday, February 01, 2019

Rejoice!

The sky was brilliant blue yesterday, in spite of the arctic freeze. It reminded me of the February day in 2013 when I first heard the words, "It's cancer." The sky had been blue that day, too ~ so achingly beautiful that I couldn't reconcile it with the terrible news I had just received. 

I couldn't help but wonder if history was about to repeat itself.

The period between undergoing tests and receiving the results is the hardest, as anyone who has awaited a diagnosis can attest. I did pretty well the first few days; but as the week went by, my anxiety grew. 

It was kind of like cranking a jack-in-the-box. Every day I just kept cranking and cranking, knowing that on Thursday something was going to pop out at me.

Like my youngest daughter said, "It's the initial that scares me. I can handle what comes afterwards." She was remembering both times that we had come home from the hospital with grim faces and a cancer diagnosis.

By the time we sat in the doctor's office yesterday, I think Greg and I had both convinced ourselves that it was cancer again. So when the oncologist came in and, after some small talk about how the procedure had gone, said, "Well, it was benign findings," we didn't really know how to respond. I wouldn't say I was flooded with relief ~ more like calm gratefulness. And maybe a bit of disbelief: All that worry . . . for this? Are you sure?

Yes. We've come through another test with good results. I can breathe! Well, until the next test. I wish I could master the trick of waiting. But as my Canadian oncologist once said, "There's no trick. It's just hard!" And God has used this past week to continue teaching me, patiently pressing His promises into my heart again.

Last Sunday in adult Bible fellowship, we discussed this interesting paradox:  
". . . we rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope, and hope does not put us to shame, because God's love has been poured into our hearts through the Holy Spirit who has been given to us."¹ Our teacher explained it like this: "The more we endure, the more we are able to endure." I think he's right.

So this is what I've learned this week: suffering produces endurance . . . which produces character . . . which produces hope . . . because God loves us. And I'm going to enjoy each day that He gives me in the "breathing half."


¹The Bible, Romans 5:3-5

Wednesday, January 23, 2019

New Doctor, Same Drill

In August 2018, my husband and I made a life-changing move. We left Markham, ON, where we had been working to plant a Chinese church, and re-settled in my hometown of Meadville, PA. 

I think we'd known for a long time that someday we'd want to be near my parents as they aged. We left our baby church in the hands of a capable Chinese pastor, but the transition was still bittersweet: I felt excited to be going home, but sad to be leaving the place we'd called home for nine years.

One of the hardest things about leaving Canada was saying goodbye to the fantastic health care professionals who had walked with me through two bouts of breast cancer. Thankfully, God has provided a wonderful new osteopath and oncologist to monitor my health going forward.

But there were two things I had not counted on. I had not anticipated how difficult it would be to navigate the stateside insurance system, nor how emotional it would be to rehash my cancer journey with a whole new set of doctors and nurses. It was hard to think back over all that I've been through, and to stir up all the old questions of "why?" 

Nevertheless, I have been very pleased with the quality of care I've received so far, and it has been calming to hear my new oncologist confirm that all of my past diagnoses and treatments have been right on track.

Last May, when my MRI prompted a biopsy (which came back benign), the radiologist in Canada recommended another MRI in six months. So we followed through on that here, and I was able to get it done on January 14.

The very next day, my oncologist called to say that the radiologist had seen the same area of "enhancement" which had shown up last year . . . and they wanted to do another biopsy and a mammogram. He said he wasn't suspicious ~ just doing their due diligence "given my history." (To be honest, I'm starting to get a little tired of that phrase!)

My first thought (to calm my racing heart) was, "No big deal. I've been here before."

My next thought was, "I have been here before! And I don't want to be here again!" (cue heart drop)

Sigh. Must I continue to face these "what ifs" over and over?

The next morning, I poured my heart out to God. I explained to Him that what bothers me about all this is the waiting. I just hate sitting in the doctor's office, holding my breath 'til I receive the verdict: cancer again? or not?

I told Him, "It's like January 31 is a giant brick wall, and I can't see what's on the other side of it."

And then I realized, I do know what's on the other side of that wall. God is on the other side ~ and no matter what happens, He will be there with me.

True to form, my Heavenly Father had me suspended in Psalm 73 on my way through the book. I just couldn't seem to get past verses 23-26:

Nevertheless, I am continually with you;
    you hold my right hand.
You guide me with your counsel,
    and afterward you will receive me to glory.
Whom have I in heaven but you?
    And there is nothing on earth that I desire besides you.
My flesh and my heart may fail,
    but God is the strength of my heart and my portion forever. (ESV)

And now I knew why I was "stuck" there. What better counsel for the place where I (again) found myself? (These verses actually seemed strangely familiar:  a friend had shared them on my FaceBook timeline in July 2016 when I was waiting for the pathology report from my second cancer surgery.)

I love how the psalmist, Asaph, says, "I am continually with you." (italics mine) Usually in Scripture we find God saying, "I will be with you." (That's Emmanuel, right? "God with us."¹) But if God is continually with me . . . then I am continually with Him. And he holds my hand.

The rest of this passage is the perfect antidote to pre-test-result jitters. It is a beautiful combination of now and eternity.

You guide me with your counsel 
     (showing me what to do now)
and afterward you will receive me to glory. 
     (no matter what happens, my future is secure)
Whom have I in heaven but you?
And there is nothing on earth that I desire besides you. 
     (God is all that matters, in both this life and the next)
My flesh and my heart may fail,
     (my flesh will fail someday)
but God is the strength of my heart and my portion forever.
     (God strengthens my heart here . . . and my soul will go on forever)

Ahhhhh. Thank God for His Word, a rock I can stand on (as my soul-care coach recently prayed) in the face of a brewing storm.






¹Matthew 1:23

Saturday, January 12, 2019

Farewell, My Friend

Two months ago, I lost a dear companion on this cancer journey. I haven’t found the words to write about it . . . which has made it easier to not find the time to write about it. I still can’t believe she’s gone. I don’t want to write this post. But I’m going to try.

Suzanne and I grew up together in Meadville, PA. Well, sort of. She was ten years younger than me. But her grandma was my piano teacher, and my mom was her music teacher, so our paths crossed a lot.

After we both left Meadville, we continued to stay in touch sporadically ~ a phone call here, an e-mail there. But neither one of us could have anticipated the thing that would cause our lives to intersect forever.
                
In April 2012, my husband Greg and I were in Orlando where Suzanne happened to be living. Our main purpose for being there was to attend a church-planting conference; but we had brought our four children along and knew that we couldn’t leave Orlando without a trip to Disney. Suzanne, who loved Disney more than any other place on earth, offered to meet us there ~ at whichever park we chose. And so we spent a wonderful day at the Magic Kingdom, laughing and making classic memories.



                
Fast forward 8 months. I was facing some follow up on an abnormal mammogram, and I happened to notice a FaceBook post by Suzanne that indicated she was dealing with some medical issues, too. The next time we chatted by phone, we discovered that we were both scheduled for tests on the same day. And a few weeks later we were diagnosed with cancer just one day apart.
                
It didn’t matter that hers was a sarcoma on her knee and mine was breast cancer. They were both invasive and a bit rare ~ although hers was more rare than mine. Suddenly we were bonded as sisters for life.
                
From then on, our lives followed each other in an uncanny pattern, often with appointments on the same day. When one of us had a procedure or treatment before the other one, we talked each other through what to expect. It was like having the best kind of support group, even though we were over 1000 miles apart. I can’t count the times we talked by phone, or Skyped, or texted.
                
And then, we supported each other through the dreaded recurrence. Her cancer came back in February of 2016, and I was diagnosed with a second breast cancer just months later in May. Suzanne understood so well what I was going through, and was, I think, my biggest cheerleader that I would beat this thing ~ even though she didn’t have that same hope for herself.
                
Almost every time I talked with Suzanne, she sounded so strong, just like her pre-cancer self. Rare was the conversation where she sounded depressed. It seemed she was always positive, always encouraging me.
                
So I was startled by a text from her late one night last September, saying that she had been admitted to hospice.  What???? It couldn’t be time for that yet. But a call to her mom and more texts from Suzanne confirmed that her time on this earth probably wasn’t long.
                
Ever since our simultaneous diagnoses in 2013, we had talked about another Disney trip, reliving our 2012 meeting there and celebrating that we had beat cancer. One thing and another had kept me from going, but I knew now was the time. The pathos of that trip is too deep for me to recount here. Because it wasn’t a celebration. It was good-bye. And I did spend a wonderful day at Epcot with Suzanne’s mom, with the anticipation that she would join us there for dinner that evening. But a brief text let us know that she just wasn’t up to coming. She would have to “live” that day with us through our stories.
                
I flew back home on October 1. We celebrated each other’s October birthdays with packages mailed back and forth. Then, on October 27, I received this cryptic text: “Hey Anne I’m in the hospital….” It was the last text I would have from her. But we would have one more phone conversation. On Monday, November 5, Suzanne called to tell me, “It won’t be long now.” We cried together, and wished each other well. Less than a week later, on November 11, she slipped into eternity, holding her mom’s hand. Yesterday marked the two-month date, but I still struggle to believe that she’s gone.
                
I wish I had a nice wrap-up to this eulogy. I wish I could write more! But it would take a book to recount all that Suzanne meant to me and the lessons we learned from each other. Maybe some of those things will come out in other posts. But for now, though I grieve her death and the fact that she had to go before me, I am eternally grateful that she walked beside me while she did. And I live with the hope of seeing her again in Heaven.




Friday, May 11, 2018

Like a Zip-Line

Glory to God! NEGATIVE FOR MALIGNANCY!

On Wednesday, even before I met with my surgeon for the biopsy results, I was thinking that I wanted to start this post with "glory to God" whether the results came back benign or not. Why? Because I want God to be glorified either way!

My daughter Leah and I had a precious conversation in the kitchen before we left for my appointment. "Mommy, if God's fought cancer twice," she said, "He can do it again." Then she added, "I was going to say, 'If you've fought cancer twice' . . . but I read this morning about how God fought Israel's battles, and He always wanted them to give Him the glory." 

Indeed.

Meeting with the surgeon this time felt all-too-familiar, but different, too. I think I was calmer. Proverbs 3:5 had come to me so strongly the day before: "Trust in the Lord with all your heart, and do not lean on your own understanding."¹

Then a friend sent me a passage from the book Jesus Calling: 365 Devotions for Kids: "If you learn to trust Me--really trust Me--with all your heart and soul, then nothing can separate you from My Peace. I can use all your problems--even huge ones--to train you in trusting Me. . . .Don't be afraid of what this day--or any day--might bring. Put your energy into trusting Me. Remind yourself that I am in complete control, and I can bring good out of any situation."

"Trust in the Lord with ALL your heart." "Put your energy into trusting Me." Ahhhh! Those words carried me through Tuesday, the day before the verdict.

But I still greeted Wednesday with trembling. Why? I had hoped this time was going to be different, that my faith would be stronger. 

And then I realized: you can be scared and still trust.

Have you ever ridden a zip-line? I well remember the first time I rode one at camp. I was terrified to do it ~ but still, it intrigued me. And the counselor assured me it was perfectly safe. So I let him strap me into the harness and hook it to the cable. Through my fear, I stepped off the ledge, and zipped safely to the opposite hillside. It was exhilarating! I did it again, and again ~ soon feeling brave enough to step off the ledge backwards.


My first zip-line at The Wilds
I've ridden many zip-lines since then ~ always terrified beforehand, and always thrilled when I'm flying through the air, completely dependent on the harness and the singing wire above me.

I realized yesterday that this appointment was just like a zip-line. It's normal to be nervous. It's possible to feel afraid, yet still have complete faith that the harness will hold you.

Sitting in the exam room, waiting for the doctor to come in, was the longest 5 minutes of this entire week of waiting. Greg and I made small talk, tried to prepare our responses, looked at the wall, the floor . . . finally I heard footsteps approaching the door. "Here he comes . . . " I whispered. Then I heard his voice even before I saw him: "I was right!" he boomed, as he flung aside the curtain and came into the room. "Fat necrosis!" I thought he was going to dismiss us with a quick, "Adios!" But he sat down to discuss the good news and what it meant. "There is absolutely nothing that worries me about this," he reaffirmed

My pathology report reads: "Fibrous scar, fat necrosis with foamy histiocytic reaction." How do you pronounce that?!! But what I really cared about were the words: "Negative for malignancy." Whew.

There's a line that I love from the movie Princess Diaries: "Courage is not the absence of fear, but rather the judgement that something is greater than that fear." For me, that's God.

Glory to Him! Truly. I hope that those who have prayed me through this will rejoice in a positive answer. "He saved them for the sake of His name, that He might make His power known."² That's what I want to do, no matter where this journey takes me.


¹The Bible, Proverbs 3:5 (NASB)
²The Bible, Psalm 106:8 (NASB)

Tuesday, May 08, 2018

Almost Normal

I have a yearly MRI now. Plus mammogram. And sometimes ultrasound.

About every other year they come back with questionable results. (That's why a breast MRI has been added to the lineup.) And I'm in that place again.

My mammogram came back clear last month, but the MRI showed an area of "enhancement" near some "fat necrosis." (The necrosis had been noted last year, but the enhancement is new.) So my oncologist sent me for a breast ultrasound; and afterwards, the radiologist recommended a biopsy.

She explained it like this: the fat necrosis is nothing to worry about. Although it can look really nasty on the imaging, mimicking cancer, it's a normal response to the radiation, where some cells die off.

But the area of concern is a small "shadow" adjacent to the fat necrosis. It could just be more fat necrosis; but there's no way to be absolutely sure from imaging alone. That's why the radiologist wanted to do a biopsy. "I'm concerned, but I'm not," she told me that Friday. "Don't go home worried. Don't let it spoil your weekend."

So I went home and worked through my post-exam routine. (I'm getting used to this!) Whom should I contact first? Text or call Mom and Dad, the kids, and a few others. Then update my FB status. 

When I talked by phone with my son Josiah that afternoon, he said, "Mom, don't take this wrong or be offended . . . but this is starting to feel normal. When I got your text, I almost shrugged. Then I thought, 'Here we go again.'"

I'm not offended. He's right! This feels 'way too normal. And it always seems to happen at the same time of year: either Christmas (when we're welcoming our kids home and planning festive celebrations) or spring (when we're gardening and planning family road trips). Yes, indeed. Here we go again!

I sometimes wonder why I continue to go through these times of testing and waiting. Is there something more that God wants me to learn? Last fall I caught part of a radio program where the speaker (I believe it was Chuck Swindoll) said, "No test is by accident. They are all by design." If that is true, then what would it look like for me to pass this test?

I think the answer lies in what my mind and heart do in the waiting.

There's a part of me that's telling myself, "It's cancer," just because this is following a previous pattern of events. But if I've noticed a pattern in my testing, I've also noticed a pattern in my response. It's similar each time; but thank God, it's improving. I've learned a few things along the way.

About rest

When I was going through chemo five years ago, I had to rest. At some points in the treatment cycle, I just stayed in bed ~ reading, napping, doing cross-word puzzles and sudoku, and listening to audio lessons from Simplifiy101. My family handled housework and meals, friends brought food for us, my parents came often to help ~ everyone took good care of me.

And I enjoyed it! Well, part of the time. It was hard for me to let others do jobs that I thought I should be doing. And as the weeks dragged on, I did start to get a little bored. (I had never thought I'd get tired of reading!)

But I have to admit: sometimes I miss those days. Now, I see biopsies and surgeries as an opportunity to take advantage of a rest period. 

Before my biopsy last Wednesday, I announced that I was taking the rest of the day off. How nice to come home afterwards, crawl into bed, and get caught up on some much-needed sleep and some reading! My family kept tabs on me, and Greg fixed a delicious dinner for us. It was good to give myself permission to take a health holiday.

I'm learning to look forward to these enforced times of relaxation!

About work

Two years ago, when I was waiting for the results of another biopsy, I threw myself into yardwork, gardening as if my life depended on it. Last December, while waiting for a breast ultrasound verdict, I had the busyness of decorating for Christmas to distract me. And this month I've been organizing my house and purging papers. Along the way, I've learned that hard work is an antidote for worry. 

When I'm working away at something I love, my adrenaline flows, my heart rate goes up, I breathe ~ and for a little while I can forget the worry and loss that I'm facing.

About worry

I confess: I'm a worrier. When I was in college, I saw a poster that said something like: "Worry must work ~ most of the things I worry about never happen!" I've sort of taken that as my mantra.

But what good does worry really do? If this is cancer, worrying about it won't change the outcome. And if it's not cancer, then worrying was a total waste of time! Jesus said, " . . . can any of you by worrying add a single hour to your span of life?"¹

It already is whatever it is, whether cancer or not. And either way, it doesn't change what I'm doing today. It might change what I'm doing next week, or next month ~ but a thousand other things that I don't even know about could also change my future! I see why Jesus said: "Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own."²

My heart trembles a little as I write this, knowing that tomorrow morning at 10:00 I will be sitting in my surgeon's office to hear my sentence read. The "what ifs" loom larger as the time draws near.

But I cling to the words: "Don't worry about anything."³ It's like God is saying, "I've got this under control. I'll take care of everything." He wants me to trust Him ~ with all my heart.⁴ So I'm trying to sit back, relax, and watch with curiosity to see what He's going to do!


¹The Bible, Matthew 6:24 (NRSV)
²The Bible, Matthew 6:34 (NIV)
³The Bible, Philippians 4:6 (NLT)
The Bible, Proverbs 3:5 (NASB)