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St. Louis Post-Dispatch Editorial

Commentary : A survivor's tale
By Joan Lipkin
Sunday, October 15, 2000

I remember when I was first diagnosed with breast cancer. I was 42, and I was terrified. With my overactive playwright's imagination, I was already writing the obituary in my mind. At the time, I knew very few women who had had breast cancer, certainly not my age, and I imagined the worst. Four years later, I am still here. Like the 1985 Toyota I insist on driving, I am slightly dented and a little slower, but still on the road.

I am here because I had a mammogram, which detected something I couldn't find in my diligent monthly self exams.

I am here because I had information that allowed me to make decisions that undoubtedly saved my life.

But according to the American Cancer Society, many women don't get regular mammograms, although our local newscasters, reporters and even retailers urge us to do so. For a long time, for many women, the economics were a deterrent. Their insurance might not cover a mammogram. And if they didn't have insurance, the fee could feel out of reach.

This is no longer the case. Years of lobbying and growing public awareness has thankfully made a mammogram available for anyone who needs it. And during October, National Breast Cancer Awareness Month, traveling mammography vans will visit many communities to provide mammograms -- free for anyone who qualifies. For information about the traveling vans or other screening sites call the American Cancer Society at 314-286-8100 or 800-489-9370.

Still, many women are reluctant to have a mammogram. With legitimate issues of economics and access out of the way, one can only ask why. I think the reason is fear.

Fear of the procedure itself and more significantly, fear of the results. Some women are so terrified of what could happen, that, like a deer caught in the headlights, they freeze. And are unable to take action at all.

The mammogram itself is more awkward than painful. The kind of awkwardness that comes from disrobing in front of a stranger -- like when you go swimming at the Y. But the medical personnel who do mammograms perform thousands of procedures a year and are generally very sensitive to what it feels like to be on the receiving end of this experience.

More often than not, a routine mammogram turns out to be routine. But even if it is not, a variety of treatments are available and more are being approved all the time. Long gone are the days when a radical mastectomy was the only option. And should a women go that route, breast reconstruction is usually available if she wants it.

Important new technologies are developing at a dazzling rate. Just a year after I had a lumpectomy with axillary dissection, a major operation to remove a number of lymph nodes under my left arm to see if the cancer had spread, a new, simpler procedure was approved. Called Sentinel lymph node biopsy, it injects dye into the lymph nodes to detect the possible spread of cancer.

No mess. Not too much fuss. And more important, no long-term effects. This is a vast improvement over the operation on my lymph nodes, which caused nerve damage and periodic swelling of my arm and breast. Although I missed the boat with that break-through, I was thrilled to learn that life is now a little easier for other women with breast cancer. And the development of this new procedure indicates many more significant advances that are yet to come.

Lest I sound too Pollyannish, I admit to having some very dark nights and days. It was quite a while before I could talk about breast cancer without being overwhelmed by feelings. I still have difficult moments. There is no cure for breast cancer. Only treatment and a hoped-for diagnosis of remission.

But breast cancer also helped me to have clarity about what I find important and how I want to spend my time. I have realized that fear can be quite instructive. And I'd like to be able to look around the circle and marvel at the numbers of us who are surviving and even thriving. Because we faced down our fears and had a mammogram.

Please. Use your fear. If you are 35 years of age or older and are afraid of having breast cancer, schedule a mammogram today. I had one. It saved my life.

COMMENTARY\Joan Lipkin, St. Louis, is artistic director of That Uppity Theatre Co.