Friday, October 27, 2017

When breasts turn 40 #bakeithappen

My breasts and I turned forty this last year. Generally, we are pretty happy about it. I've got stray grays and I hope my thinning scalp means that the rest of my body hair is thinking about letting itself go as well. Aside from my body, I know what I want to be when I grow up. I started graduate school. My kids have reminded me that laughing like I did at 8, 10, and 12 is the best thing about living.

But my breasts and I, we have other concerns. I got my first mammogram a few months ago. That's something that you have to add to your well-being checklist when you turn forty. Breast health, being on the look out for dodgy menstrual cycles, and last ditch efforts by your ovaries to trick you into having twins or triplets. ("These eggs aren't getting any more viable," your ovaries say to you, "so whaddya say we make a half dozen babies RIGHT NOW?") So you track your period more closely, wonder when you'll start having hot flashes, and worry, if only a little, about breast cancer.

I'm worried, if only a little, about breast cancer.

For one thing, I don't know a single woman over the age of forty (though younger women and men certainly get breast cancer, too!) who doesn't have or isn't directly related to or friendly with one other woman who has or has had or is dying from or has died from breast cancer. I worship with breast cancer survivors. I know women who are dying from metastatic breast cancer as I type this very essay. And as of three months ago, I know that I have a small spot in my left breast that my doctors want to keep an eye on.

For women, breast cancer is always a lingering at our annual checkups. And for women who get metastatic breast cancer, death follows. In fact, 40,000 deaths a year in the United States, over 500,000 worldwide.

And yet the funding for metastatic breast cancer research, according to a 2014 study by the Metastatic Breast Cancer Alliance, "found that only about 7% of all breast cancer research funding goes towards researching metastatic disease. Researchers still don’t know which breast cancers will metastasize and which won’t, because we still don’t know how cancer metastasizes."*

Metastatic breast cancer is currently incurable. You get it, you die. And men get it, too. It's not a pink ribbon problem, it's a human problem. It's not a loss of your breasts/femininity problem, it's an end-of-life problem. 

And it is also a recurrent disease problem. Most people who get metastatic breast cancer get it after their initial treatments for a non-metastasized breast cancer. Rebecca, the founder of The Cancer Couch, explains. "Many people are under the impression that once you go through the typical treatment for breast cancer – whatever that is for each person – a lumpectomy, mastectomy, chemo, and/or radiation – you are done with breast cancer and can go on your merry way. For some people this is true. However, what many people – even those with breast cancer – don’t realize is that 30% of those diagnosed with early stage breast cancer (even Stage 1) will eventually progress to Stage 4 and the cancer will metastasize in another area of their body – even though their breasts have been removed. This can be 6 months, 2, 5, 10, or 20 years after initial diagnosis. Once this happens, the average prognosis remains at just 3 years and you will be in treatment for the rest of your life."**

That's the statistic that lingers in my mind, the worried mind that perks up a few minutes before I fall asleep and reminds me that I have a small spot in my left breast that my doctors want to keep an eye on. In another three months I'll go back for a repeat scan to see if that spot is a problem, or just some dense breast tissue. That's three more months of seeing the specter of breast cancer out of the corner of my eye. 

Am I worried? Not really. I got my screening, I will keep up on regular doctor's appointments and mammograms, and I know both from research and anecdotal stories from other friends that breast imaging is sometimes sensitive to the point of (appropriate) hyper-detection. 

But am I carefree? Not really. 

Because whether I will someday have breast cancer, and whether that will someday metastasize, I can't say. But I am certain that I will continue to know and love people who do get breast cancer, and who do die from it. So, in the meantime, I do the only reasonable thing I can. 

Bake cupcakes. 

These cupcakes. Which I made this morning and have already eaten two.

Because Bake It Happen asked me to support their campaign to raise awareness. Not the pink-everything, ribbon-wearing awareness. That campaign seems, however in earnest it may be, to have taught us that breast cancer is only a pink problem (i.e., woman's problem), that it's curable, that it's not big deal, this it's just a bump in the breast. Bake It Happen is raising awareness for life-ending metastatic breast cancer. And this month, every time someone bakes and shares a photo of the Bake It Happen baked goods, money goes directly to The Cancer Couch, which gives 100% of the money it raises to metastatic breast cancer research at Memorial Sloan Kettering Cancer Center and the Dana-Farber Cancer Institute.

In other words, I have to eat "Judy's Black Bottom Cupcakes" so that people won't die, if not today's patients, then future metastatic breast cancer patients. People like Beth Caldwell, like Rebecca Timlin-Scalera, and like Judy Levin, whose cupcake recipe I'm currently enjoying.

You can help, too, by either visiting Bake It Happen and making and sharing pictures of what you bake or donating directly. Why? Because chances are you like delicious things, and chances are that you or someone you love will be diagnosed with breast cancer. That's reason enough. 

Here's what you do next:

** The Cancer Couch,