I remember the morning this picture was taken . . . for some reason, I had on my Grandma Canterbury's nightgown.  I remember she always loaned it to me when I stayed with her and somehow I must have figured how to smuggle it home. It was very roomy, with a white background and some kind of a dark blue or black dot or print on it, and had three large gold buttons up the front. I loved it.

On this particular morning, I am remembering that my Mom woke me up because my brother had arrived home for a visit. He was either in training or had gone to Vietnam at this time. We were all so exited that he was coming home, and I think the general neighborhood was, too, but my Mom and Dad were visibly happy. I remember them singing around the house as they did their chores and making special trips to the store to buy special things they thought Wayne might like to eat. 

Then, he arrived! I remember especially how relieved and glad I was to see him and to know that he was safe. He was all smiles that morning, and I guess he was happy to see us, too. He brought Mom and Dad presents--I don't recall what those were--and he brought me a flashy "cutting star" sapphire cocktail ring. To this day, I don't know exactly what a cutting star sapphire is, but it sounds exotic, doesn't it? I sure thought so.

That gorgeous, heavy ring, with sapphires stacked up into a dome was not appropriate for a little girl to wear and was way too big for me then, but I loved it all the more because I considered it a grown-up girl's accessory.

I still have that ring and have found occasions to wear it from time to time. I smile when I think of the circumstances surrounding its gift to me. Not only was my brother safe and well, but he came with gifts to cheer us.

The fact that he was safe and well was no small thing to our family. He was the only son, oldest, my father's pride and joy. When I was six and seven, I'd listen to the evening news with my parents. Afterward, my Dad would mark the areas of fighting by placing pins on the map of Vietnam he'd put up on our dining room wall.  I would then go to bed and pray fervently for my brother. My prayers had an obsessive, desperate quality to them. Six and seven times in and out of bed, down on my knees, begging the Lord to keep my brother safe and in one piece.

Little did any of us know all that he would experience; three wars in total and some very dangerous places and situations. But we believed that God would keep him safe through all. He still keeps him safe in his job now as an air ambulance (helicopter) pilot, which is rated one of the most dangerous jobs of all. The Lord truly is our hope and our salvation, but our mother has worn out her knees as she assures herself daily of that fact.
 She loves her one and only son so very much. 

I got some news lately that made me want to get down on my knees and get a little desperate in my prayers. Not for my brother, but for myself. Over a month ago, I learned that I have a particularly aggressive form of breast cancer.

It all started at this same time last year when I had a stereotactic biopsy to check out an area that looked suspicious on a routine mammogram. This kind of biopsy is sort of surreal. You lie on your stomach on a special table and the doctor uses a Mammotome machine to extract a core biopsy. 

After my doctor was finished getting the biopsy, she then placed a small titanium marker in my breast to mark the spot for future mammograms or studies. It was an extremely painful process in my case and one I hope never to repeat. I was so very relieved when that biopsy report came back negative for cancer. 


When a little knot appeared at the scar from the biopsy a few months later, I assumed it was a problem with the titanium marker. I'd had a problem with titanium screws and a plate used in a wrist surgery I'd had years before, so assumed this was the same issue. 

But as the knot on my breast grew bigger and harder, I sought the advice of my surgeon and she agreed to remove the marker, remarking it looked like a hematoma. Only upon opening up the old incision did she realize that the knot had characteristics of cancer and so she did what is called an incisional biopsy (which means a sample of the tumor was taken, but not with clean margins).


Then I got the news that the tumor was positive for cancer.

Just when I was thinking everything was cool because it had been two weeks since the procedure and I had heard nothing, I got my report back from the doc. It was the 11th of June, 2010.  She asked me to meet her in her office in two days to go over all of my reports. My husband and my mother accompanied me and we asked lots of questions, but so many could not be answered.


Like why a tumor in the same spot as I'd had a biopsy the year before? My surgeon had no answer to that, but the radiologist I saw the following week had some ideas.

He suggested that it was due to one of three things: 

(a) just a coincidence;

(b) cancer had grow in the area that was biopsied and had run along the scar area. He explained that an old scar is the path cancer can often travel;

or (c) the tumor was missed last year during the biopsy and had been growing for over a year. 

I found the last option to be the most scary.

I wanted to get my MRI as soon as possible, but CAMC Women and Children's Hospital only does breast studies on a few days during the week and they were already well-booked,  I had to wait two more weeks (the 30th of June) to get an MRI. And it was the 6th of July 2010 before I got the results back. At that time, I also got the results of the FISH Fluorescence In Situ Hybridization) report which indicated I was HER2 positive.

The status of my lymph node involvement is still unknown.


Right now, I only know part of the equation that is the sum of my cancer, and that information has come in dribs and drabs. At this point, I do know the following:


(1)  I have two large (over 4.6 cm and possibly 8 cm. x 2.4 cm) tumors in my right breast, diagnosed as invasive ductal carcinoma or. IDC. It's the most commonly diagnosed breast cancer;

(2)  The tumors are estrogen receptor positive (meaning estrogen fuels them);

(3)  The tumors are aggressive, with an overall grade of 3 on a 1-3 scale;

(4) The tumor is strongly HER2 positive, another sign that my tumor is aggressive;

(5) My order of treatment is currently mastecomy, chemo, then radiation;*


*Note: The final order of my treatment was chemo, radiation, followed by mastecomy.
 
A pathologist looks at the tumor cells and checks for three microscopic features:

• degree of tumor tubule formation (percentage of cancer composed of tubular structures);
•  tumor mitotic activity (rate of cell division);
•  nuclear grade (cell size and uniformity);

Each feature is scored on a scale of 1 - 3.

Feature Score 1: Slow cell growth rate
Feature Score 2: Intermediate cell growth rate
Feature Score 3: Fast cell growth rate

The score of all three features are added together for a total between 3 and 9.   My tumor scored 9. 

Lions and Tigers and Bears, Oh My!

The molecular study of the tumor indicated I was HER2 positive.  HER2, which is also called HER2/neu, and HER-2, is the acronym for Human Epidermal Growth Factor Receptor 2. If  a tumor proves to be HER2 positive, that means that the body's HER2 genes are over-producing the HER2 protein, and that those cells are growing rapidly.

My status was determined by FISH, or Fluorescence In Situ Hybridization. This test uses fluorescent probes to determine the number of HER2 gene copies in the tumor cell. More than two copies means the tumor is HER2 positive.

The typical treatment for an aggressive HER2 high-scoring tumor is Herceptin along with standard chemo protocols, which might include Adriamycin, Cytoxan, Taxol or Taxotere, or Paraplatin. 

Herceptin has some risks to the heart and increases strokes and blood clots, but as I read somewhere, cancer patients can't afford to worry about this when they're fighting an aggressive tumor. Don't stop to tie your shoes when a train is coming down the track.
 
Time seems to have slowed to a crawl since I had the original incisional biopsy on June 2, 2010. Like most people who get this kind of news, I was going about my daily life, busy with my family and my dogs and my garden.

I spent the month of June trying to get into MD Anderson hospital in Texas because I'd heard it was The No. 1 cancer hospital in the United States. The initial contact I made left me dissatisfied with the patient coordinator, who I felt was unfriendly and not the least bit helpful. The experience was so different from CTCA in Philadelphia, where I'd received my treatment for oral cancer in 2006. 


It dawned on me after more discouraging conversations with the folks in Texas that maybe I should trust the signals I was getting and abandon the idea of MD Anderson for treatment. God was not pointing me there or making it easy for me, so why fight the feeling?

But that left me once again with no plan and anyone who knows me knows that I hate being without a plan. I need to know who, what, when and where will be caring for me. I had none of that information. I felt like an untethered balloon, drifting toward it's inevitable p-o-p!


Then, the next week, a long-time friend and breast cancer survivor, Mary Jane (Caudill) Bradshaw, phoned me up and mentioned that Duke University in Durham, NC, was a great place and that I should give  them a call. I did just that. The warm attitude and helpful information I received from their patient coordinator left me feeling:"This way, please."


I've spent a lot of time wondering and thinking about my reports, feeling annoyed that it's taken so long to get the results and that it's been hard to get timely treatment. That's another thing; I like to have information and I'm not happy without it. 

But reflecting on this has given me a different way of looking at the situation. While the delays have been difficult in one sense, I feel that God was providing a little bit of reprieve, a bit of time without the worry of a complete diagnosis hanging over me.  As I said to one cousin in a flash of honesty, "Before I have to wade through all the sh*t that is before me."

Once again, I am encouraged to trust God and to know that he is in control and seeing to my needs in the very best possible way. Who knows? Maybe I won't feel good again for a while. Maybe not ever, but I refuse to believe that. 

I'm thankful for the time I've had to clean my house, cook for my husband, enjoy my dogs, continue my endless genealogy research, and enjoy my friends and their loving attention to me. If things had been set in motion as quickly as I would have originally wished, I wouldn't have been able to have this sweet little bit of time enjoying my life.

And I do love my life. I love my life more than I ever have before. I have such wonderful friends and family and so many things that give me joy, I can't imagine losing any of that. I am cognizant of the sweetness of my life and savoring every moment.

My Dad said to me during his own bout with cancer: "I've prayed to be healed, but if God chooses not to heal me, it is a win-win situation. If I'm healed, I'll be here with you; if not, I'll be in heaven with Him."

I'm not quite as strong as my Dad was nor as accepting. The last few days, I've felt fear run through me that has not been present through much of the experience so far. I do not embrace the fear, I banish it! My mantra--which I have written on my bathroom mirror is: "I am be healthy, happy and strong."

I want to live and I will fight to live. I know heaven is waiting for me, but honestly, I want it to wait awhile. Here, my will might be opposed to what God wants for me, but I can only confess the desires of my heart to him, do my best to make good treatment decisions and accept what comes with whatever grace I can muster.

In summoning my strength to gear up for this fight, I've tried to remember God's faithfulness to our family through the years and pray in the same way I always have, believing he loves me and will keep me where he wants me. 

I've sort of been through this before. Five years ago, I was diagnosed with oral cancer and I lost one-third of my tongue and much of the floor of my mouth and was not able to speak intelligibly. I was understandably devastated. Oral cancer is a highly recurrent cancer, so I had the worry of that in my mind as well.


Buy my power of speech and my health was restored to me in dramatic fashion after prayer and anointing with oil. I know that sounds old-fashioned, but my friend, Dr. Michael Barry,  Dir. of Pastoral Care at Cancer Treatment Centers of America, was the instrument in that anointing. He looks like a bank president and talks like a college professor, but he believes in old-fashioned things like healing and he told me he felt led to pray and anoint me. His prayer for me was simple, direct and powerful and I was healed--in an hour! It was supernatural, spectacular, mysterious and miraculous, and so much more that my words can't begin to express.

To have the gift of speech regained through prayer is a wonderful thing, a powerful, mind-altering gift, but like the cutting star sapphire ring that was too big and grown-up for me at the time I received it, I wasn't quite in the place to use the knowledge the experience gave me. In truth, it left me with more questions than answers.

My history with God was that I loved him, but I was always scared of him, too.  A lot like my real Dad, actually. I spent many hours in church growing up listening to the damning power of God, but not nearly as much about the uber love he offers us. The result was the feeling that I had to please him or I couldn't feel that I was a Christian or experience his love fully.  Lots of people I know would say that was the right way to feel. But I don't accept those beliefs anymore.

I can fully acknowledge that I've failed in areas of my life, so I have never been the best Christian or even person that I could be. If my sins were bricks, I could make the Great Wall of China all over again. I've judged people, I've let hardness stay in my heart when I was wronged, I've been proud and arrogant. So when I looked at all the truly good people in the hospital who were so worthy of being healed and realized that he still chose me, I was puzzled. Could it be that God loved me without any caveats. Just Plain Loved Me? 

 I don't know the answers yet, but I've come to suspect that God's love is a no-strings-attached sort of love. I think it's we as humans who add all the conditions to it.


I simply want to focus on the love he has for us and less on the judgment, but that's just me. Everyone has to find their own way. I think when we do wrong in our lives it carries its own results but I no longer see God as a disapproving father I have to continually appease or ELSE. Instead, I see him as a loving friend who is rooting for me every second of every day. Just that shift in my perception makes me want to be better, do better than I ever did before.


As as the days count down until my appointment at Duke University Hospital for further assessment and treatment, I will be talking to God, asking him to take me by the hand again and lead me through the scary parts and share with me the joyous moments, too.  I'll be asking once more that he care for me just as I am, scared, flawed, but ever hopeful.  

Maybe he'll show himself to me in an unexpected way, reminding me again that I'm ultimately safe with him.

And I'll sing and give thanks just like my Mom and Dad did so long ago when God kept his promises to them and returned my brother to their loving arms.