Mammography, Thermography, Ultrasound: It’s Not An Either-Or

My PET Scan. Kinda trippy heatmap of the body, literally from top to toe.

In recent weeks there’s been a great debate about thermography replacing mammography as the way to identify cancerous growths in the breast. Even Straits Times’ Andy Ho had his 5-cents worth to contribute.

I had read this article on Huffington Post: “The Best Breast Test: The Promise Of Thermography”. I love Huffington Post but I have to say this was the first time I violently opposed any Huffington article; I absolutely oppose writer Christiane Northrup’s suggestion that thermography can effectively prevent breast cancer. Until the day we can actually dissect and accurately pinpoint how cancers begin and how they get aggravated, any such claim is hogwash.

Thermography could never replace mammography, not in the foreseeable future anyway. To say it can is an outright lie. I don’t think Dr Northrup has had breast cancer, and shouldn’t be allowed to make such a sweeping statement that could put women off mammograms. Already, as it is, it’s hard enough to make women go for mammograms — the pain and fear factors are big enough deterrents.

I personally had a mammogram done, plus an ultrasound, and just to play safe, I also had a PET scan done (Thermography works like the PET scan – it identifies “hot” areas in the body that could possibly reveal cancerous activity).

The mammogram showed the approximate area and size of the cancer. It also revealed microcalcifications (these show up like white dots on the film) which cannot be seen in PET Scans nor ultrasounds.

My ultrasound. The dark area in the middle is where the cancer was.

The ultrasound could more or less pinpoint the location, size and shape of the mass. My surgeon used ultrasound to do a core biopsy as the ultrasound could locate the various areas of the cancer.

The PET Scan – I don’t know enough about it yet but as my surgeon explained, this very expensive scan has been effective in showing potential areas of cancer spread. I say potential because the human body is such that heat and inflammation can be caused by a variety of factors. So it’s really all a maybe.

Currently, the surest way to know you have cancer is to locate the mass and do a biopsy. The doctor draws out samples of tissue and tests them for cancer. Anything else (for now) is guesswork.

I think perhaps the heart of the matter is this: What is going to be your reaction to having breast cancer if you do discover it early?

I have had strangers comment that my choosing a mastectomy (instead of chemotherapy or some form of partial mastectomy followed by chemo/radiation) was too extreme. I think that really depends on how you look at cancer.

For me, seeing my mother go through the same ordeal three times has been a life experience I cannot cancel. It has also ingrained into my brain that 1) early detection is good and 2) don’t fool around with cancer. If you need to remove it all, and surgery’s going to do it, then, REMOVE IT ALL.

It’s like that old story about a little lie. A pastor caught his children telling a white lie. To make his point, he baked a batch of brownies, and when they reached out for one each, he told them, he mixed in just a bit of shit in the brownie mix. A very very little bit, they would hardly be able to smell it. None of the kids wanted to touch the brownies, of course. A lie is a lie whether it’s small or big – just as crap in your brownie is crap whether it’s the whole pile or just a smudge.

To me, that’s cancer. It was that little bit of shit mixed into my breast, and I didn’t want it there. So I got rid of the whole brownie.

For some women, knowing “maybe” they have cancer (and maybe they don’t) is fine. For me, it’s not. I do still have a life to live. I have seen too many women hem and haw over whether to go organic after discovering they have cancer, or ignore that lump hoping it will go away. I have seen more of these women die from cancer than should have. I have nothing against going organic – but do it after you are rid of the cancer. And of course, do it way before any cancer begins. Being healthy is a lifelong quest.

So, all that said, I’d rather not get into futile fights over which scan works the best. My prayer (and money) is on finding a vaccine for breast cancer. Now, that’s what preventive really means.

Oprah magazine ran two of the most interesting and encouraging breast cancer stories I read all Breast Cancer Month:

1. The Potential For A Breast Cancer Vaccine: A vaccine that scientists have found to work in mice (reducing and obliterating cancer tumors) exists, but it has to be tested on human subjects.

2. And linked to the first story is this one: How Scientists Are Rethinking A Cure For Breast Cancer. This one talks about the efficacy and accuracy of scientific studies on breast cancer. Are who and what scientists have been testing on/for, the correct subjects? Are the conditions set for finding an accurate answer to combat breast cancer?

Of course, all this means that we are far from a real answer and a working vaccine. But just as scientists have to soldier on and make their research more and more efficient, we — breast cancer patients, former patients, daughters/nieces of breast cancer sufferers — have to keep hoping, keep praying, keep giving to make sure the search for a cure never stops.

Until breast cancer is stopped.

Support Kids With Cancer On HAPPEE DAY

I love it when regular people — moms and dads and kids — get passionate about helping others.

My friend Daphne Ling of the blog Mother Inc., together with her husband (my former colleague) Kelvin, have been inspired to do something for kids with cancer.

Having to face cancer when you are in your 40s is quite different from being a cancer patient when you are barely old enough to buy a kopi. I only have God to thank for the fact that I’ve never had to cross that bridge of either being a child with cancer or having one.

As Daphne writes: “Childhood cancer isn’t something we like to think about, because it’s scary and it makes you feel helpless and thankful all at the same time. It’s not something that’s within our control, like we can prevent it by feeding only organic food or taking more multivites. We don’t know why it happens to kids and how we can stop it from happening. So we hope and pray that our kids stay strong and healthy and that we don’t ever have to sit in the doctor’s office to hear those scary words, ‘I’m sorry, it’s cancer.’

“Some parents have been through that, though. More than a thousand of them. According to the Childhood Cancer Registry, 1,103 children were diagnosed with cancer between 1997 and 2005 in Singapore, with more than half below the age of 5. That’s over a thousand parents being told that their kids have cancer.

“For them, happy days are hard to come by. They’re happy if their kid makes it through another round of chemotherapy or even just another day without puking or needles or mood swings or pain.”

Mother Inc. is doing its part for 30 kids with cancer on 31 October. It will be a mini carnival at Hort Park, with mascots, balloon sculptors, face painting, magic shows, a truckload of balloons and tons of more cool stuff, and Daphne and Kelvin are calling it HAPPEE DAY. Daphne had gone to the Children’s Cancer Foundation to ask if there was anything she could do for these kids and she was told: “How about organizing an event to bring a little joy to them and give them a reason to smile, even if it’s just for a while?”

What you can do:

1. Be there and volunteer.
Mother Inc. needs help with the logistics, carnival booths and most of all, to make friends with the families who are attending the event. Bring your kids, who will have a blast at the carnival and they’ll get to make some new friends at the same time. Also, if you have some ideas or skills (like if you can eat fire or juggle chainsaws or sing with helium) that you would like to contribute, just email her at daphne@motherinc.org.

2. Donate.
If you can’t make it down but would like to help anyway, you can do so by donating to the Children’s Cancer Foundation. They provide financial aid to families who struggle with the burden of chemotherapy treatments and surgeries and your donations will go a long way in showing that you care. You can donate anytime from now until 31 October. Give a little and make someone’s day a little happier.

3. Pass on the message.
You can do like me and publicise HAPPEE DAY on your blog. Blog about the event and share it with your readers, tweet about it, share in on Facebook (you can use my share buttons at the bottom right hand of the page) tell other moms you know, shout it from the rooftops.

Just to be clear, proceeds from the fund-raising go directly to the Children’s Cancer Foundation and not to the running of this event. Mother Inc. is riding on sponsorships and personal donations for that.

Help Mother Inc. make 31 Oct a HAPPEE DAY for the kids from CCF!

Go to Mother Inc. for updates and further details.

The Prettiest Pink Ribbon Necklace Ever! Get One!

Buy this pretty necklace and wear your support for breast cancer warriors!

My friend Rosalind Ng is a breast cancer warrior who battled this terrible disease in her 20s. I knew her when she worked for the fashion brand M)Phosis. I knew she loved motorbikes and racing, and was just so full of life. To hear that she had cancer at such a young age was a shock to me.

When I was editor for Vanilla magazine, I asked Ros if she would be our cover girl and share her story. I remember the stylist Fongfan and art director Jennifer having such a great time with her — photographer Joel Low captured the very free spirit that Ros was.

This was the photo that made my heart melt — Ros with her hubby Yu Seung, a photographer.

Ros was one of the first people I called when I discovered my own cancer this year. She was the first visitor I took at home, and her presence gave me tremendous comfort. It’s such a blessing to be able to tell someone how you felt having to lose a breast, and know that she knows exactly what you are talking about. She told me about her own experience — having to go back a year after her mastectomy and have a balloon inserted to stretch her skin to fit the silicon. I remember looking at her in her skimpy tank top and thinking, “Thank God! There is hope for me!” You really couldn’t tell that she had had surgery at all!

Ros went back to her active lifestyle soon after her operation. She is in the Breast Cancer Foundation dragonboating team (and yes I am on her “target” list – I do like kayaking…). She is also a staff member of Via Ferrata, the rock wall at Orchard Central. Two years ago, she and Yu Seung drove through the Sahara on their bikes to raise funds for African children.

There is a softer side to her, though. Ros also has a thriving handmade jewelry business on Etsy.com and also on her blogsite Asian Art Jewels. She makes the loveliest earrings and pendants and charms with semi-precious stones.

To commemorate Breast Cancer Month she’s created this beautiful forged sterling silver necklace with a ribbon pendant, which features a pink Swarovski crystal bead.

This necklace retails for SGD36 (or US26) and SGD7 from every necklace sold goes to BCF.

Buy one now for someone you love and one for yourself! And help us spread the word.

You can buy your Pink Ribbon Necklace via Ros’ blogsite or through Etsy.com here.

How I Ended Up In Nuyou Magazine

The lovely photo team at Nuyou (from left): Stylist Bernard Tan, makeup artist Zen Chi, me, coordinator Pauline Lui and photographer Vee Chin.

One of my oldest and dearest friends is Grace Lee, the Editor-in-Chief of Nuyou magazine. Grace and I used to stay at the same hall of residence in NUS — Raffles Hall. You couldn’t miss her – she’s six feet tall and slim! She was a basketball player (I did drama). We never thought we would really see each other again, but seven years after graduation, I became Grace’s colleague when I joined Female magazine as the Editor. Female and Nuyou are “sister publications” – Female being English-language and Nuyou being Chinese. To this day, I think Nuyou has the most beautiful covers of all the women’s magazines in Singapore.

Grace and I would travel for the yearly fashion shows in Paris and Milan. Through these trips we became really good friends, and I believe it was her constant sharing of her faith that prepared my heart to receive Jesus eventually, in 2003.

We meet at least once a year to celebrate each other’s birthdays, together with our other buddy Clara Goh (who handles branding and marketing for Fendi).

A 2009 photo of me (left), Clara (middle with the birthday cake) and Grace

This year, however, Grace came to see me “early” because of my operation. She visited me at home two weeks after my surgery and I could see in her eyes that it pained her to see me not even being able to sit up straight. But as I shared how God had been so good to me, that my cancer was caught so early even though it already affected 5cm of my breast tissue, that the doctor was able to do the surgery and that my chances of survival are so excellent, Grace became encouraged.

A few weeks later she called me and asked if I would share my story in Nuyou for the October issue, which also marks Breast Cancer Month. Of course, I said yes — I would do almost anything in this world for Grace, even a photo shoot when I’m feeling the least pretty I’ve ever felt. I was a bit concerned, of course, if I was going to look puffy because my swelling was still pretty obvious, and my posture was still fairly compromised at the point. But I was enthusiastic about sharing an “overcoming” story with women in Singapore (even though I can’t read Chinese to save my life!!).

Nuyou writer Mindy called me and interviewed me over the phone for the story, then I had to go for a photo shoot a week later, to make it in time for their October issue. I had a good time telling my “horror story” to Mindy – she gasped at all the right places!

My story in Nuyou, October 2010

The photo shoot was at the SPH Magazines office at Genting Lane. Stylist Bernard put me in a silvery blue satin RC (by Roberto Cavalli) dress which, I was so surprised, fit me. It had a elastic waist which was great as it helped to give my now swollen torso some semblance of a shape. Makeup artist Zen gave me a really light face with really dark eyes, which is something I’ve never been able to do at home. And he straightened my hair till it swung like in a Pantene ad — loved it!

The posing was the hardest because I was still aching all over (on top of the fact that I am super kayu when it comes to taking photos. I’m no model, baby!). Photographer Vee tried her best to make me laugh.

Thank goodness I’m not an actress or model or I think I’d be out of a job in a hurry…

It was a nice experience to have just a few months after surgery because, though I’ve never really been a super-vain type of girl, losing a breast did make me feel like a freak, at least initially. Now, three and a half months after the fact, I’m getting more used to my new bosom and it’s feeling much more “real”.

I’d like to thank Grace and Mindy and the wonderful photo team for making me feel, just for a little over an hour, like a normal woman again. And I hope my story helps somebody, even if it’s just one person. (You have to let me know – I can’t read it at all!)

Dark Day: Another Friend Diagnosed With Breast Cancer

Yesterday, a good friend SMS’d me.

“Just read your article in Lifewise. Looking good, girl 🙂 I just got diagnosed yesterday evening – “abundant malignant cells”. Doctors says chemo likely. My surgery on Wednesday to discover extent. Will be reading your blog regularly.”

My heart sank like a huge rock. I don’t wish cancer on anyone — but it really breaks my heart when the sweetest, fittest, healthiest people who really have no reason to get cancer, get it. And this friend is just one such. After my surgery, she came over for dinner and brought macaroons from ET Artisan Sweets (they really are artisanal — my favourite is the Black Forest with the brandied cherry in the chocolate ganache filling). She made me laugh out loud with her funny stories, including the one about how she signed up for a 10km run and was so unhappy with herself because she walked some sections of the route. I thought to myself, “I’d be happy if I could run 1km!” And now I can, because she inspired me to think it is possible.

Hers is the fourth case I have heard in two weeks. Two of them, thankfully, have cysts in the breast, which are being removed surgically. Another one hasn’t updated me… I really hope she’s taken my advice.

My best friend Karen had a scare too, about a month ago. But thank God hers turned out to be a fibroid, not cancerous in any way.

I have a feeling more cases of breast cancer are discovered in the month of October, thanks to the fact it is Breast Cancer month. And although it’s terrible to discover it, it’s still better than not discovering it early enough for treatment to be had.

I saw my oncologist two weeks ago (you can read about my latest dilemma soon at this blog). You might wonder why, after my breast surgeon Dr Hoe Ah Leong had basically given me a clean bill, I had to see an oncologist. Dr Hoe said he felt it was safer for me to get an expert opinion as an oncologist is a doctor that deals specifically with cancers, while a breast surgeon may deal with different ailments relating to the breast, whether cysts, fibroids, or cancerous growths.

In short, Dr Tan Yew Oo of Gleneagles concurred with Dr Hoe, based on my histological reports which showed that, given my hormones levels, it would not be profitable for me to go on tamoxifen, which is often prescribed for patients who have had one mastectomy and tested ER+ (estrogen receptor positive). Tamoxifen is understood to help reduce chances of cancer in the second breast. It’s also used in many preventive situations, including male breast cancers. (See here for more on tamoxifen.)

Anyway, Dr Tan gave me some useful literature on breast self-exam. I learned how to do a self-exam when I was 20 — my mom showed me, standing in front of the mirror. I realise that most moms wouldn’t (though I do plan to teach my 2 girls), and so it would be useful for someone who’s trying to find out exactly how to do a breast self-exam (BSE) to download this diagram and practise. I’ve been told the best time to do your BSE is just after your period has ended. I personally use the circular method — mainly because I’ve used it for 22 years!

Ultimately, I have to say that I think BSE saved my life. Even though it wasn’t quite a lump, I was familiar enough with my breasts by this year to know when something didn’t feel quite right.

Breast Self-Exam Diagram

Right now I am praying for my friend, whose surgery happens this Wednesday. She is a real “can-do” lady. I am very sure she’s going to pull out of this and she will have a long, fulfilling life ahead of her. I intend to live as many years as God will give me, and I know she shares my sentiments. So though right now, it seems a tragedy, this is not the end for either of us. We shall live on and fight.