Breast Cancer Awareness month is over. My friend C spent it at home, sleeping most of the time, not taking much food or water, her husband and daughters at her side as her body slowly shut down. Today I learned that she died in the early hours of the morning, Pacific Standard Time. We’d known for months that it was coming, but you always hope for just a little more time – right up until the day you don’t, when hope shifts from “more time” to “peace.”
She’s at peace now.
After a loss, we try to find comfort where we can, even in odd thoughts. Those strong winds from the west during yesterday’s marathon? I’m pretty sure that was C. And I’m choosing to think of the timing of her death as a final act of defiance, a “fuck you” to pink merchandise and beribboned platitudes and demeaning, sexualized slogans. No way was she going to die during Pinktober. And she didn’t – she held on until the calendar flipped a page.
You go, sister.
C and I (I’m using her initial out of respect for her and her family’s privacy) were both diagnosed with early stage breast cancer at the same time, in early 2008. We never actually met in real life, but we were part of an online support group that became, over time, deeply intimate. We helped each other through the various effects of our treatments, some of them gruesome, some of them embarrassing – constipation, diarrhea, crippling pain, sexual dysfunction, mental fuzziness. We raged and grudgingly accepted and then raged some more about the way surgery, chemotherapy, radiation and anti-estrogen drugs had changed our bodies. We bitched about our doctors and our jobs and our partners and families. We talked frankly about how the kids we loved so fiercely also made us crazy. We developed code words and in-jokes (shovels, kolaches). Over the intervening years, two of the group died. Three of us, including both C and I, got married or remarried. Some of us lost our parents.
We called one another “sisters,” and within the group we shared things we could never, ever share with our flesh and blood sisters. The weird mixture of closeness and distance we found online encouraged self-revelation, while cancer itself turbocharged our passage through middle age, leaving us stunned and bewildered and desperate to make sense of it all. How better to do that than through long, online conversations with other women going through the same thing?
C was one of the youngest in our group, and had young children – two girls, the younger not yet in high school, both of them beautiful and talented (like their mother).
I’ll pause here to let the full weight of that sink in. Where words fail, let blank spaces scream.
C’s cancer was found early (1 cm tumor, no lymph node involvement), and treated with lumpectomy, chemotherapy and radiation. (Unlike most breast cancers, it wasn’t fueled by estrogen, so ongoing anti-hormonal treatment wasn’t an option.) After treatment, she went on with her life. She got divorced and then met a great guy and married him. They built their dream house together. She went to her kids’ gymnastics meets and dance recitals and drew on her show business background to help with musical theater productions.
Then, in the summer of 2012, she was diagnosed with metastatic disease in her lungs. When breast cancer escapes the breast and its surrounding lymph nodes, it can be contained for a while (a long while, if you’re lucky); the symptoms can be treated (though the treatments can themselves be debilitating); but it never goes away. And eventually it will kill you.
Every October, we hear a lot about “awareness,” a lot about early detection saving lives. We hear relatively little about metastatic disease. But early detection failed C. Her Stage I tumor was surgically excised, she had all the recommended treatments, and still, for some reason that doctors don’t understand, her cancer cells seeded themselves in other organs, burrowed in, and started multiplying.
So by all means, go and get your mammogram – statistically, they save some lives, just not as many as you probably think. But please don’t conflate “awareness” and “early detection” with “cure.” Too often, the overwhelming focus on early detection shades into subtle (or not-so-subtle) victim blaming, little whispers of “such a shame she didn’t catch it in time” or “why didn’t she get a mammogram?” At its worst, it tumbles headlong into denial – cue the congressional candidate who announced (right around the time C learned she had metastatic disease) that Americans now don’t die from breast cancer.
What C needed – what the roughly 3,400* American women who died from metastatic breast cancer this past Breast Cancer Awareness month and continue to die each and every goddam month, year in, year out, need – is a cure.
. . .
Rest now, C. Know that you are loved and missed. The sum total of beauty and kindness in this world is a little less without you, but we’ll get to work on that. Today, though, we just cry.
*Based on 40,931 deaths in 2011, the latest year for which numbers are available from the Centers for Disease Control.