The Most Costly Disease In The World

If an interviewer asked "people on the street" what they thought was the greatest threat to worldwide health, the answers would most likely be "AIDS", "Malaria", "Flu", or another infectious disease. I would have given a similar response.

Surprisingly, the answer is - "cancer".

At a global cancer conference being held in China this week, the American Cancer Society presented new findings about cancer: not about treatments, cure rates, or research, but that cancer is now the world's leading cause of death, and literally costs more than any other disease in terms of disability and years of life lost.

A staggering $895 billion was attributed to cancer's economic cost for 2008 - this is roughly 1.5% of the entire world's GDP (gross domestic product). And, this is only the figure linked to disability and life-years lost to the disease. The costs of treatment, which are not included here, are also astronomical, and will only increase in the coming years.

The World Health Organization has estimated that cancer would replace heart disease as the leading cause of death this year. In 2008, 7.6 million people worldwide died of cancer, and each year, 12.4 million new cases are diagnosed.

This is an impending world health crisis of unimaginable proportions. Some are now comparing it to the global crisis leading to increased spending on AIDS in the early 1990s. The current 3% of public and private funding dedicated to global health must be greatly increased if we are to have any hope in turning the tide against cancer.

Many Women Not Informed of Reconstruction Options

Last Sunday, New York signed a new State Law requiring hospitals and physicians to discuss breast reconstruction options with patients prior to performing cancer surgery.

Sadly, although breast reconstruction following cancer surgery has been a Federally mandated covered benefit since 1998, the rate of post-mastectomy reconstructions is far lower for poor and minority women. I know that this is the case.

I had personally been asked to research this issue a while ago, and I was completely taken aback to see the incredibly low rate of reconstructions vs. mastectomies in the Bronx. It did not ring true that 80% or more of these women would actively choose to live the rest of their lives this way, when the law says that they are entitled to reconstructive surgery. Not all women are medically eligible for reconstruction, but this could not possibly account for the disparity. Were these women not aware that reconstruction is indeed a covered benefit? Could something be done to raise awareness of the situation, and help these women to be "whole" again, following the devastation which cancer had caused them?

A major factor is that women undergoing mastectomies at hospitals which do not offer breast reconstruction were not informed of their right to have this procedure performed at another hospital equipped to offer this service. From now on, if the hospital where the mastectomy was done does not offer breast reconstruction, it is mandated that the patient be referred to a facility where the procedure is available. In the NYC area, breast cancer patients at academic medical centers, which have breast plastic surgeons on staff, are far more likely to be informed of, and to undergo, breast reconstruction. The new legislation will ensure referrals to these institutions for post-mastectomy patients.

I was fortunate enough to undergo surgery and treatment at a facility of my choice. This legislation means that other women will have access to the same level of care and treatment options, no matter where they are initially treated for their breast cancer.

The Kindness of Strangers - Angels Everywhere

Last Wednesday, I traveled into Manhattan to attend an all-day conference in Midtown. After leaving the conference, I was walking to meet my husband at his office, when I tripped over an electrical cord which was taped to the sidewalk. The cord was not flat the entire width of the pavement, and as I stepped around to avoid it, my left foot was caught in the space between the sidewalk and the light pole where the cord originated (!). I fell hard into the street, right next to a man who was hailing a cab.

He immediately stopped what he was doing, grabbed both my hands, and lifted me back up onto the sidewalk. He asked me if I was OK, and said that if I needed to, he would use the cab to get me to the nearest hospital.

I said that I thought that I could still walk, but that I had hurt my left knee, elbow, and ribs, as I landed on my left side when I fell. I thanked him several times for his kindness, and he said that he would not leave me until I was sure that I was OK. He was a sweetheart. I told him that he was going straight to Heaven for being so kind to me. He was very modest, and said that he was only doing what anyone else would do in a similar situation. I really was somewhat in shock at the time; I was still trying to process what had happened to me.

While this was going on, a very petite Asian woman was silently brushing the dirt from my pant leg with her hands, and she patted me on the shoulder. I couldn't believe that she was doing this - it was so sweet. I thanked her, and she just smiled - I don't think that she spoke English. Several other people stopped and offered their help as I tried to get myself back together after falling. They were being kind to a total stranger in one of the busiest cities in the world, a city with an underserved reputation for having cold, unfeeling citizens.

I can say this because I was met with similar acts of kindness and generosity when I was run over by a van 15 years ago in Manhattan. People were absolutely wonderful to me, and I actually made friends as a result of that experience.

So, even though I'm writing this while I'm still in pain, recovering from my brush with the "mean streets", the truth is that there were caring, kind people who stopped what they were doing to give aid and comfort to someone they didn't even know.

I feel very grateful for that, and I do believe that there are "angels" everywhere, in the form of people who will stop and help a total stranger who has been hurt.

The drawing accompanying this post was done by a little girl who was dying of the cancer which ultimately claimed her young life. Even though she knew that she was dying, she still saw herself as being watched over by angels.

Right now, I am thinking the very same thing. These people were my "angels", and I wasn't alone.

When You Look In The Mirror

What do you see when you look in the mirror? And, how do you want others to see you?

I know how very difficult it is when you are diagnosed, undergoing surgery and treatment, to see the person in your mirror as anything else but a "cancer patient".

Your entire waking existence revolves around office visits, x-rays, scans, lab testing, blood drawing, taking meds, and trying to cope mentally, emotionally, and physically with your new unwanted identity. Cancer has erased the person whom you used to be prior to your diagnosis; you will never be the same.

Most of us are forced to lose part of our body to cancer; but, you don't have to relinquish your identity to it as well. You may even decide to see this as a kind of "rebirth" of the rest of your life. Now, as someone facing your own mortality, what is truly important is very clear; and the person whom you see in the mirror is indeed still you, after everything which you have experienced.

As more and more people living with cancer (over 12 million, at last count) finish treatment and enter their survivorship stage, they will be redefining their own lives. As survivors, we also have a real opportunity to empower and help others; both our fellow cancer patients, and those who might someday also face the disease. This is the reason why I am writing here about my experiences, and sharing them with you. I'm almost 3 years from diagnosis, and there are days when I don't even think about cancer.

It's unfortunate that cancer patients are continually bombarded with the "warrior" and "fighter" personas which are automatically bestowed on us. I believe that the very best way to diminish cancer's power over us is to be true to ourselves, and to define our own lives. Remember, you are not defined by your disease; or by what image society attributes to someone in our situation.

There are many times, even now, when I don't particularly feel like a "warrior" as I deal with my daily symptoms. I don't feel particularly strong or empowered when I'm overcome, literally, by the severe hot flashes caused by my anti-estrogen meds. This happens at least a dozen times a day, and during the night: besides any normal activity, it can be set off by things like standing too close to the toaster, drying my hair, ironing clothes...but I have chosen to laugh it off, and say to myself, "Only 2 and a half more years of taking this drug - I'm almost halfway through!" And, I was the person who was always cold...!

When people describe me, I think that they would most likely say, "She's an upbeat, funny, short woman with blonde hair, who always has a smile for everyone. She loves reading, sci-fi, architecture, history, gardening, pugs; she loves Hawai'i, and plans to move to Maui in retirement. She also happens to be a person who had breast cancer." Cancer is far from the first thing people associate with me, and that's exactly the way I want to be seen, because that's how I see myself.

I have vowed that even though cancer could take my life, I will never allow it to claim my smile, or change the essence of my personality: then, it will have "won" in another way. That, to me, would be even more tragic than dying.

When you feel overwhelmed by fear and worry, think about this: no one knows how much time they have left in this world. And, have you ever considered that you may die from something other than your cancer?

Put your life in perspective, and focus on your present and your future. Be as "you" as you can be; this is the best advice that I could possibly give to the person you see in the mirror.

32 Years!!

On June 17, 1978, two very young people in love got married outside in a wooded setting, by a little pond with ducks, on the grounds of a historic New England restaurant. We had been engaged for four years, the entire time I was attending college. Our wedding day was a little over a year after I graduated from college and my groom graduated from art school.

As we stood there and said our vows, to remain together "...for better or for worse, in sickness and in health, 'til death do we part", our entire history together was yet to be made. There is something brave and touching about seeing any two people get married: so much love and hope for the future is present on that special day.

Yesterday marked our 32nd wedding anniversary; we have walked through all of life's experiences together, no matter what. We have seen beloved parents and family become ill and then be taken from us; we moved from our hometown, left everything and everyone we knew, and started a new life together 20 years ago in "the Big City". We have traveled halfway around the world together, knowing that we truly are at home wherever we can simply be in each other's presence.

We have had our share of problems, as all couples do; but our commitment to each other and to our marriage has been a constant force in our lives. Most of all, we have gone through my cancer experience as a team every step of the way, and it has brought us even closer together. I will never forget the look in my husband's eyes as I was being prepared for my cancer surgery; no words were needed to let me know how much I mean to him, and how much he wanted to have me in his life for many years to come.

I cannot believe that we have been fortunate enough to be best friends who have been married to each other for 32 years. The day after our anniversary, I said to my husband, "Today is the first day of the next 32 years of our marriage!" We both would be very happy to walk through life, holding hands, for as long as Fate gives to us.

Every single day that I have him in my life is a gift. He is the one person I can trust, the person who can make everything all right, whose love is truly unconditional. He loves and accepts me exactly as I am; and I feel the same way about him. We have found a "home" in each other.

My dream is to continue growing old with him: that is what life and love means to me.

Another National Cancer Survivors Day

Tomorrow, June 6th, is National Cancer Survivors Day: this is traditionally observed on the first Sunday in June.

It is a day for cancer survivors, their loved ones, and their caregivers to all celebrate life. Today, there are 11 million cancer survivors in the US, and I am very grateful to be one of them. I owe my life to my wonderful surgeon, radiation oncologist, oncologists, radiologists, and their support staffs: I am forever in their debt.

I was diagnosed almost 35 months ago; that day now seems very far in the past. As I have written elsewhere, the diagnosis of cancer is no longer a death sentence, as it truly was earlier in my lifetime. By living, we have robbed cancer of its power to overcome us, and each day is a victory.

The fact that National Cancer Survivors Day even exists is testimony to the tireless efforts of researchers and caregivers to find new ways to improve and prolong the lives of those who have been diagnosed with cancer. And, it is also a testament to those who have invented and improved methods for detecting cancers in their earliest stages (my cancer was Stage I, could not be felt, and was only visible as a cluster of microcalcifications on my mammogram).

The day is also intended to demonstrate that cancer survivors everywhere can lead active, productive lives; in most cases, much like those in their community who are living without cancer. I am still amazed that during my entire cancer treatment, including 2 surgeries, that I never spent one night in a hospital, and that I didn't have to take any work-related disability leave. I was able to work throughout my treatment.

All of us who are living with cancer face varying survivorship issues, but the important thing is that we are alive: that is what tomorrow is all about!

Take one day at a time; find joy in each day, and with those close to you. Do not allow worrying about your future to cloud your present!

Below are some links from the "Coping With Cancer" website:

More information on cancer and cancer survivorship:
National Cancer Survivors Day: www.ncsd.org
National Cancer Institute: www.cancer.gov
American Society of Clinical Oncology: www.cancer.net
American Cancer Society’s Cancer Facts & Figures:
http://www.cancer.org/docroot/STT/STT_0.asp
American Cancer Society: www.cancer.org

I Got My Wish!!

I haven't posted anything for a while, but I had a very good reason: I just came back from MAUI!!!

My husband had read my January post about how much I missed Maui, and so, on my birthday, my surprise present from him was - 10 days in Maui!! My greatest gift in life is having him in it; but this is a gift I will always hold most dear.

It meant so much to me psychologically to be able to go there again after my illness; it is the farthest that I have ever traveled, and I'm happy to say that the trip was amazing. Just to have the chance to be there again was restorative, and soothed my soul.

Emerson wrote: "Live in the sunshine, swim in the sea, drink the wild air" - this is exactly what we did there. To me, Maui is a most spiritual place, even though I am not a religious person. Just being there, I feel tremendously at peace; it's difficult to put into words.

I know in my heart that I will return there; hopefully one day to spend the rest of my life in my beloved Maui. Maui, you will always have my aloha...!