Common Cancer misconceptions

When you think of someone diagnosed with cancer what comes to mind? I'm guessing it's something along the lines of a frail, pale, thin, elderly man or woman with little to no hair and maybe a head scarf on. Or maybe it's just someone who is constantly nauseous and laying in bed all day because of terrible fatigue. While these images are often true, cancer is so much more than that.

Today, I am going to debunk many common cancer myths that those of us with cancer deserve for general society (those without cancer) to know. It is my hope that in learning some truths behind cancer, you will have a better understanding of some of the hardships that come with being a cancer patient that are not frequently talked about. These statements come from my personal experience with metastatic breast cancer (MBC), so while everything may not be true for all types of cancer, I still believe these truths will help you support your loved ones who face this disease.

Myth 1: If someone has hair, they don't have cancer

This is probably one of the most common assumptions people make, and to be fair, it makes sense. As a society, we are taught so little about cancer treatment, other than people with cancer go through chemotherapy, and with chemo, comes hair loss! While this is true, not all types of chemo cause hair loss, and there is actually newer technology called "cold capping" that can help prevent hair loss while going through certain chemos. Obviously, not everyone can partake in cold capping whether it's due to cost, lack of resources, or the personal decision not to, and sometimes cold capping is ineffective, so it is still very common to see hair loss with chemo. But the other side to this myth is that just because someone isn't going through intravenous (IV) chemo, doesn't mean they aren't enduring other difficult treatments. Breast cancer is actually known as the "invisible disease" because oftentimes people with breast cancer look like normal, healthy people. This leads us to myth #2!

Myth 2: If chemo is complete, treatment is over

This has been one of my largest frustrations, especially since I am diagnosed with MBC. Many people are completely unaware that having MBC means that you will be in treatment for life. I’ve been reminded by close family members and friends to give grace to others because this is a very common misunderstanding, especially for people with minimal medical knowledge. So, while I apologize for my frustration, I ask that in return, you read this brief educational blurb. :)

Chemotherapy only skims the surface of cancer treatment. The most commonly known treatments are probably radiation, and some type of surgery to remove tumors, but there is still so much more that goes into treating cancer. In the case of a lower stage of breast cancer, women often have to stay on oral meds for five to ten years after the previous treatments listed above, to prevent recurrence. Those of us with MBC will be on a variety of treatments for life including a wide range of oral meds, muscular injections, IV infusions, and more.

I think the reason it is so frustrating when others assume that treatment is complete after IV chemo, is because the other options listed above come with side effects and difficulties of their own. They may not be as intense as chemo, but they are still serious treatments that deserve to be more well known. Since doing IV chemo the first time in 2021, I have been on Ibrance, Anastrozole, Zoladex, Faslodex, Xeloda, had my ovaries removed, had 14+ scans including PET, MRI, and CT, and had innumerable blood draws and appointments. I am also on my third line of IV chemo, Trodelvy. Explaining the details and side effects of all of these treatments would take way too long, but I think it's important to show just how life altering treatment for MBC is and why it is frustrating when it is minimized.

myth 3: When people with cancer are active and busy, their cancer must not be that bad

It is possible to have metastatic cancer, and still be living a full and active life! In fact, most of the women I’ve met with MBC are rockstars and are doing as much as they can to do the things they love and have the best quality of life as possible. Once you’re diagnosed with a terminal disease you quickly learn your next day is never promised. So, why wouldn’t you suck up the pain, fatigue, and any other side effects and do what you love while you can!? Just because someone with cancer is exercising, traveling, and enjoying life does not mean that their cancer is not a threat. While some treatments keep cancer cells at bay with minimal side affects, the reality is that cancer patients are always aware that cancer cells are lurking beneath the surface and could spread to multiple organs or other parts of the body at any time. While we try to live our lives fully, this reality never goes away and weighs heavily on us. So, please recognize that even though we distract ourselves and do the things we love most, we are still going through the toughest, physically and mentally draining, time of our lives.

Myth 4: All types of breast cancer are the same

One of the biggest things I've learned since being diagnosed is that cancer is extremely complicated!!! There is so much I have learned that was never even mentioned in nursing school because of cancer’s complexity. Not only are there different types of cancer (breast, lung, colon, brain, multiple myeloma, leukemia, etc), there are also many stages and subtypes within each type of cancer. I wish I could educate you on all of them, but we’d be here forever, and honestly, I don't know enough about other types of cancer because they're so unique. With breast cancer alone there are multiple stages ranging from stage 0 to stage IV (aka MBC), and within those stages are letters to make things even more complicated. For example, you could have stage II b breast cancer based on how big tumors are and how many lymph nodes the cancer has spread to. Breast cancer also has many subtypes including but not limited to, estrogen receptor positive (ER+), progesterone receptor positive (PR+), human epidermal growth factor receptor positive (HER2+), triple positive (meaning you are positive for ER, PR, and HER2) and triple negative.

The cancer I have is stage IV, ER/PR+, HER2- but there's a chance that with time the cancer mutates and becomes something completely different! The reason this matters so much is because it affects what types of treatment you're eligible for. Being strongly ER positive, the cancer in my body feeds off of estrogen, so a lot of the medications I’ve been on are anti-hormone, and that's also why I had my ovaries removed. As I said above, it's all very complex, but this is so important because the more you know about cancer, the more you can understand what people who are diagnosed are going through.

Myth 5: Everyone with cancer is thin, frail, and malnourished

Oftentimes we think of people with cancer as being thin as a rail because an unfortunate side effect of chemo and other meds is gastrointestinal symptoms such as nausea, vomiting, diarrhea, and decreased appetite; and with these things, can come weight loss. So, while this can definitely be true, it is not always the case. People with cancer can actually rapidly gain weight as well. Often this is due to medications, such as steroids. It also can be from hormonal changes. As I mentioned before, the cancer in my body feeds off of estrogen and progesterone, two completely normal hormones in a 29 year old woman. So, in order to stop ER/PR+ cancer from growing, doctors often prescribe medications to shut down your ovaries and put you into medication induced menopause. They may even recommend you have your ovaries removed. This is because your hormone levels are significantly decreased during and after menopause, which will therefore, hopefully prevent cancer growth. If you've ever wondered what hormones do, they do a lot!!! But this is why you may notice that your mom or grandma seemed to gain weight once they were in their 50's-60's and were always having hot flashes. So, just like a normal postmenopausal woman, women with cancer who are younger may be on medications that cause the same symptoms as menopause including weight gain, especially in the midsection.

Myth 6: Young people don't get cancer

I wish I could say this myth was true, but sadly it just isn't the case. Never in my wildest dreams did I expect to received a cancer diagnosis at the age of 26, but I did. And sadly, I have met way too many women under 40 who have been diagnosed as well. It's one of those things you don't realize until it happens to a close family member or friend, and then you start to wonder if it could happen to you as well. It very well could. This is why it is so extremely important to be diligent with breast exams (or prostate exams, colonoscopies etc.) and encourage your loved ones to get checked as well. In case you missed it, I‘m linking a previous blog post I wrote on how to perform breast exams for your convenience. https://www.laurens-healing-hope.com/post/feel-it-on-the-first

Myth 7: Breast cancer is now curable

Thanks to years of research and new developments, breast cancer patients now have much higher survival rates than they once did. Praise God for that! Many people who are diagnosed with lower stages of breast cancer will reach a point where they have no cancer left in their body or are in remission/cured. This, however, does not mean that breast cancer is always curable. In fact, once breast cancer becomes stage IV, or metastatic, it is no longer deemed curable. In other words, there is no guarantee you will ever be in remission. This is why funds for MBC are vital in order to prolong and save the lives of so many of us with MBC. There also is a high chance of recurrence of breast cancer if you've had it before. Unfortunately, this is what often leads to stage IV breast cancer because women think they've been cured and end up having a recurrence that spreads to other parts of the body. Cancer is a nasty, and sneaky disease, always looking for the best environment to grow in, and changing (mutating) to become resistant to medications. It’s pretty much the WORST! Regardless, I will never stop hoping and praying for a cure to be found to save the lives of so many who have been unfairly diagnosed with this terrible disease!

There is so much to learn about breast cancer alone; I am still learning new things everyday.Thankfully, researchers are rapidly coming up with new treatments for cancer, but it can be difficult to keep up with the latest treatments. It is a blessing to those of us with cancer when our loved ones stay informed. Not only will it give you a better grasp of what we’re going through, but you also may be able to protect yourself from this vicious disease called cancer.

Feel it on the first

It's 2023! Still towards the beginning of a new year. A time for setting goals and resolutions. In keeping with the New Years' spirit, I have a challenge for you. A challenge that is simple, yet possibly life saving. A challenge that will hopefully become a lifestyle change. This challenge is to complete a monthly breast exam.

You may have heard this phrase before, but for those who haven't "feel it on the first" is a catchy slogan to help remind both women and men to complete a monthly breast exam on the first day of the month. So, why not start off the new year the right way and put your health first in an easy and manageable way?

Why is completing a breast exam important?

Being diligent about completing a monthly breast exam is so important because it can potentially save your life. In the U.S. alone, about 41,000 people will die from breast cancer. After receiving a stage IV breast cancer diagnosis, I regret not being more consistent with my self breast exams. I remember thinking to myself, "I'm so young, it's not really that important, plus my doctor completes an exam at my annual checkup so I'll be fine." While my case is somewhat rare, there are still thousands of women under the age of 40 who find they have breast cancer, so it's definitely still important to do. When you make breast exams a priority you will learn the feel, shape, and look of your breasts, so that even if something changes slightly you will be able to detect it and report your findings to your doctor. More often than not, a breast lump is benign, but if you happen to find a cancerous lump, this will hopefully mean early detection which is very successfully treated.

I distinctly remember finding a lump for the first time in November 2020. I thought "Hmm, this is strange, but it's probably nothing." Looking back I wish I would've gone in to see a doctor the following day rather than waiting a month to be seen, so that's why I'm sharing my story to encourage others to be more proactive than I was. While there's no way of knowing if going in a month earlier would've made a difference in the staging of my cancer, it's hard to not beat myself up about it, especially since my cancer is stage IV.

What to look for

While there is no perfect guide for detecting breast cancer -- every cancer is different -- there are general things to look for as you complete a breast exam.

1. Changes in shape to the breast - often described as skin dimpling like an orange peel. There also could be a visual lump or bump that distorts the shape of your breast.

2. Changes in size of your breast and areola.

3. Nipple changes including nipple inversion, discharge, or flaking of the skin around the nipple.

Typically cancerous lumps are firm, irregular, immovable, and painless, however this is definitely not always the case. The original lump I felt was painful which is why I noticed it, and I had no visual changes to my breast, so sadly there is no golden criteria. Hence the phrase, "When in doubt, get it checked out!"

How to complete a self breast exam

Step 1. Look in the mirror without a shirt or bra on and observe if anything looks abnormal. You know your body best, so if there is a change you can visibly see (big or small) this is something to take note of. Some examples of what to be looking for include any lumps, bumps, changes in shape, size, or color, and nipple discharge.

Step 2. Use your hand to feel your breast on the opposite side of your body with your other arm raised.

There are different ways to feel and it really comes down to preference, but some of the most common ways to perform an exam are to circle around the breast and slowly move in towards the nipple, to move in or vertical lines across the breast, or to complete a wedge like pattern where you visually divide the breast into pie segments and feel each section. Whatever method you choose, you should be consistent each month so you have an easier time detecting any changes. Also make sure to feel your armpits as key lymph nodes are located there and can help with early detection of cancer.

Step 3. Repeat the process above but while laying down on a bed. A slight change in position may help reveal different changes to your breast.

Step 4. If you notice anything abnormal or different from your baseline, report it to your doctor right away. Try not to panic as more often than not, a lump or bump is noncancerous, but reporting it right away will at least ensure you get seen by a physician soon and have further testing done.

I hope this was informative and helpful! And again... don't forget to feel it on the first!!!

The Christmas Hope

The Christmas season is one of my favorite times of year. With so much anticipation for Christmas day, most people’s spirits tend to be filled with extra cheer. Words of joy, love, peace, and hope are so easily spoken—after all, “Tis the season to be jolly,” as the song says. When I think back on the many Christmases I’ve experienced, I know I’m fortunate to say that the majority of them have been filled with wonderful memories, surrounded by the people I love most in this world. Going to the Christmas tree farm, having special meals together, decorating sugar cookies, and jamming out to Christmas songs are a few favorites of mine. But I know from personal experience that with these special traditions and memories, come times of heartbreak and sadness for some.

Maybe your loved one who used to be around for your favorite holiday traditions is no longer here, or maybe you’ve never had great relationships with your family members, so seeing everyone send out their picture perfect Christmas cards can make you feel even more alone. Or maybe your Christmas will never be the same due to an unforeseen illness such as cancer. No matter the cause of your heartbreak or disappointment there are two things you should know.

1. I hear you and I see you. Even though our circumstances are probably different, I understand why you have pain around this time of year, and it is valid.

2. Despite the loneliness, bitterness, sadness, or anger you feel around this time of year, there is still hope. If you find this hope, you can experience all the joy in the world despite your circumstances.

I never understood the pain that the holidays can bring about until I was diagnosed with metastatic breast cancer right before Christmas. In fact, it was December 22nd, 2020 when I first received my diagnosis and thought to myself, “Christmas is never going to be the same.” Sadly, the trend of getting negative news around the holidays has continued for my family and me as I’ve repeatedly received bad scan reports at this time of year.

This year in particular has been especially and unexpectedly difficult. Once again my scans showed growth of cancer on my liver, but this time around my oncologist seemed less positive about the future. At this point in time she doesn’t believe that oral medications will be effective, so the plan is to go back to IV chemotherapy. Nolan and I left my appointment feeling devastated and to be frank, quite hopeless. Once again, our Christmas will be tainted by my depressing cancer diagnosis. I’ve found myself thinking “can’t we just have a normal, happy holiday again?!” Oh, how my family and I long for some good news! I’ve also asked myself if maybe God has put us through these trials around this time of year, because there are so many reminders of hope at Christmas time? After all, Christmas is a time in which we celebrate the greatest news of all, Jesus’ birth. A time where we rejoice because Jesus rescues us from our sins and frees us from the burdens of this world.

I was reading an advent devotional by Ruth Chou Simons, and a particular line really struck me. She writes, “Where you set your hope this Christmas season will determine how you find joy.” Since being diagnosed with a terminal illness, I have learned the hard way that there is so little I can put my hope in. All of the things I have trusted in the past—including my young and healthy body and medicine and medical technology—have continuously let me down. Many of my plans and dreams have been snatched away from me and each day is uncertain. The more I hope for a cancer free body, the more disappointed I become. I cannot put my hope in anything but my Lord and Savior or else my joy will be stolen for good.

This Christmas, I am once again reminded that my future is certain because of a baby boy who was born in a manger. Although my body is failing me, I have hope because I know that one day I will be freed from the awful, devastating pain I am experiencing now. My diagnosis may temporarily steal my happiness, but I know I can still experience genuine joy. This is one of the beautiful things about this time of year. As we anticipate Jesus’ birth we discover hope, and with that we receive His gifts of joy, peace, love, and when our time comes, eternal life with him, if we just believe. Instead of letting my diagnosis steal my joy this season, I am choosing to put my hope in God and trusting that He will supply me with all I ever need. This is not always an easy task, but the more time I spend in prayer and in scripture, the easier it is to remember His promises. Maybe the trials we face on earth are what we need to remember that Jesus is near, not only in the Christmas season, but for the rest of eternity. So, for the holidays this year, challenge yourself and ask: Where have I set my hope?