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.

Better Be Good To Me

Breathe. Let go. And remind yourself that this very moment is the only one you know you have for sure. ~ Oprah Winfrey

I love Oprah. She is practical, frank and honest. With herself and with other people. She’s ending her talkshow — the final season of Oprah has just begun on US television — because times have changed, ratings are down, viewers are looking for something fresh.

When I worked at Vanilla, we had to find quotes for every “opening page” in the sections of the magazine. This was both a great and painful task. However there were two sources that never failed me: Eleanor Roosevelt and Oprah.

This quote from Oprah reminds me of the first time I read O magazine. It was such a new concept — this is Oprah in print and she is on the cover of the magazine every single month! (Unheard of in women’s magazines!) But it was the content that did it for me — she gave out wisdom on how to be good to yourself so that you are in shape to be good to others. If you can’t love yourself, there’s no way you can love others.

I always believed I looked after myself, but when my breast cancer happened, one of the most mind-blowing revelations I received was that I didn’t know how to be good to myself any more.

I didn’t know how to stop and do nothing, and simply rest.
I didn’t know how to say no to somebody asking for help.
I didn’t know where to draw the line in doing things for other people.
I didn’t know how not to give to others, mostly at my own expense.
I didn’t know how to express my feelings, for fear of hurting someone else.
I didn’t know how to write creatively anymore, because my mind was full of criticisms, comments, and the most famous retort of all “DON’T YOU HAVE ANYTHING BETTER TO DO???” Like work for money, make more money so you have more money to give away to other people?

I had grown so fearful of being selfish that I was becoming one big blob of “selflessness”. I lost myself. I didn’t care about “stuff” — because “I’m a kind and generous person and that’s the only thing that counts.” The last time I went shopping for clothes was out of sheer necessity — I needed elastic-banded pants after surgery. I think manicures and pedicures are a waste of money. I used to cut my hair once a year and do home-colour — I reckon I saved at least $5000 in the last 7 years doing that. I used to think massages were the most wicked luxury (but now I need back and neck massages purely to ease the pain).

But being home after surgery, I faced a body that said to me, “STOP! I’m not going anywhere anymore. You. Have. To. Stop.”

And so, I was forced to stop. And consider my life. Yes, I had helped people for many years in a row. I had given most of my savings away and I’m not even Warren Buffett. Looking back the last 7 years, my bank account has dropped by 80%. Most of it had gone to a “bigger cause”. I don’t regret any of it, but it was quite stunning to do the sums. I can only pray I’ve “invested” in good ground, and that the people I put my faith and money in are now living better lives.

This year, because I had committed a certain amount to a project that is very dear to my heart, I told my husband we should forego our annual holiday. My kids need an increasing number of tuition classes and therapy, and our cost of living has escalated in the last two years due to growing children and aging parents. What we make, disappears before we get a chance to carve off a bit for saving.

Then the cancer happened. And I found myself regretting that I did not go on that holiday. I also came to realise I had put my self — my body, my mind, my personality — on hold for everybody else. I can’t bring myself to buy a designer item anymore: I was faced with a gorgeous Fendi snakeskin bag two years ago. It was a sample sale and it was going for a fraction of its original cost — a mere $1000 for a Fendi oversized hobo bag made from treated snakeskin that was iridescent in colour. It had my heart. I still can’t believe it but I walked away from that bag because I could use that $1000 for a shower head that my husband liked.

Practical Me won again. “I have too many bags already”, “How many shoulders do I have? Why do I need another bag?”, “It’s cruel to kill snakes for their skin.” i think I came up with 1000 excuses not to buy it.

I know how frivolous it sounds, but you’re looking at a girl who used to spend $3000 on clothes, shoes and bags every month. Being editor of ELLE meant I got discounts for everything – but it also meant I had to go shopping every month to make use of this privilege.

But while I am proud that I am no longer addicted to my Previously-Must-Haves — my YSLs, my Hermes, my Gucci — I didn’t realise I had swung the other direction and become Poverty Patsy.

Cancer has a way of waking people up. It may not be the most pleasant “wake up call” but it does make you stop and take stock.

• I have probably passed the mid-point of my life. I have less than half my life to go. And the hard truth is, cancer a second time is a very real possibility.
• I am going to be 43 — what legacy have I left for my kids (scary one, this one)?
• God gave me XYZ talents — what have I used them for (this one threw me into an abysmal depression and I am still feeling its effects). Am I living someone else’s dream instead of the one God gave me?
• Have I been a faithful steward and built lasting treasures (spiritual and physical) for my children and my children’s children? (A big NOT YET here. Terrifying. If I had died from this cancer, I would never have the chance!)
• If I had died from this cancer – would I regret not going on the holiday earlier this year? The answer is yes.

I watched Queen Latifah in the hilarious Last Holiday (2006). She plays a department store worker who is diagnosed with a terminal illness. She decides to cash out everything and “go out with a bang” — on her final holiday. It seems like a cliche — but right now, I can identify with that feeling. Finally, I deserve to be nice to myself, for once. (I still can’t say that without twinges of guilt, but hey at least I’m saying it.)

So I am going on that holiday at the end of the year. I know my money can be “better spent” helping others but … this time, the “needy person” is me. I just helped raise $600 monthly for a widow and her sons (it’s a 2 year commitment so she’s going to get at least $14,400 from the Women Make A Difference campaign we started) — and I’ve made sure I am one of the donors too. (Wanna join in our campaign for Madam Rokiah Bte Atnen? She lost her husband in a freak bus accident, and she has four sons to care for, one of whom has kidney failure. Click here to find out more.)

So, I think, spending $350 on a ticket to watch U2 — yes, for ME ME ME — is a small reward I can give myself for staying alive. I have put it off over and over again because it just seemed too much money to make myself happy. Well, TOUGH. I’m really doing it this time.

I'm going to watch U2 live! I'm going to watch U2 live!

I refuse to feel guilty about treating myself reasonably any more. I won’t have it. I don’t want to pretend that I am so selfless that everything I have is meant to be given away. I don’t hoard it, but I’m not going to kill myself for spending some of it on me and my own family for once.

The Bible says “And let us not be weary in well doing: for in due season we shall reap, if we faint not.” (Galatians 6:9).

I’ve always read this passage as “doing good to others”. But “well-doing” is not just being good to others: it is being faithful to God, it is being consistent with my daily spiritual disciplines, it is to keep hoping when doubts come rushing in, it is keeping myself in a place where I will not be weary to keep doing what God wants me to do. I am weary — and it is because I am not taking care of myself so that I can run a long race. I am running on fumes, and that’s not how God wants me to run. I must be prepared to run the full race — I must be in good shape spiritually, physically, prospering in every way even as my soul prospers.

So why am I writing all this? Probably I am feeling guilty about doing something for myself, and need to justify it to myself. (I have to be honest, right?) But it’s a done deal. The tickets are booked. I am leaving on that jet plane and I am going to enjoy that U2 concert if it’s the last thing I do.

And I hope it is not!