By Susan Nelson, 5-year Breast Cancer Survivor (As of July 2007)

For all of you who held my hand … you will forever hold my heart.

Most everything that I know about breast cancer, I learned in 2002. This is the long and the short of it.

• Breast cancer is the most common cancer among women in the United States. In 2001, approximately 192,200 individuals were diagnosed with the disease. With approximately 40,600 deaths that were attributed to it. In Tennessee alone, 42,000 new breast cancer cases were diagnosed in 2001; and 900 died from breast cancer-related causes.
• I have learned that 90 percent of all breast cancer cases occur among individuals with no family history of the disease. Seventy percent occur in women with no identifiable risk factors.
• Thirty percent of women over the age of 50 are not getting regular mammograms. By the time that a mammogram detects a breast lump, the lump has existed in the breast for six to eight years. By the time that it can be detected through a physical examination, a lump has been forming, on average, for about 10 years.
• Seventy-seven percent of women diagnosed with breast cancer are over the age of 50 at the time of diagnosis; 23 percent are younger than 50. Approximately 1 percent of all breast cancers occur in men.
• I know that a breast cancer diagnosis is not a death sentence. In fact, the five-year relative survival rate for localized breast cancer has increased from 72 percent in the 1940s to 96 percent in 2001. And thanks to research and early detection, mortality rates continue to decline.
• Currently, an estimated three million people in the United States are living with breast cancer—two million have been diagnosed, and one million do not yet know that they have the disease.
• Every three minutes, someone new is diagnosed with breast cancer. Every 12 minutes, breast cancer claims another life.

With Thanks: This is What I Now Know About Living Through Breast Cancer

During 2002, I also learned that, although a breast cancer diagnosis is absolutely one of the most frightening and disruptive things that can happen in life, having the disease is manageable—with a little help from your friends.

• I have learned that when breast cancer is diagnosed early, lumpectomy with radiation generally is the preferred treatment and does, in fact, provide as much opportunity for long-term survival as does mastectomy.
• I have discovered that there are thousands of medical professionals in this country who devote their lives to helping people with breast cancer. Among them—some of the very best—are those at the University of Tennessee Medical Center’s Cancer Institute.
• I have learned that all doctors are not created equal. A good doctor is one who listens to and inspires confidence in the patient. There are a number of those around. A truly great doctor, on the other hand, is one who makes every patient feel as if she is the only patient—and these are rare.
  (Thank you, Dr. Bell, from me and all of your other “only’s.”)
• I have been surprised to learn that there are physicians who can explain in great detail the miracle of modern medicine as it relates to the treatment of breast cancer and who will readily admit to faith in a power beyond that miracle.
  (Thank you, Dr. Bertoli, for including me as your patient and in your prayers.)
• In 2002, I found out that when you have cancer, your mother—the strongest person you know—will cry when your surgeon tells her that your cancer has been successfully removed.
  (I love you, Momma, for one more reason.)
• It has become clear to me that if you husband refuses to let you face the trauma of a cancer diagnosis and treatment without him at your side, and he responds readily to your slightest need yet somehow learns to recognize when you just need some space, then he probably meant it when he vowed “for better or for worse.”
  (Steve, I can never repay you. You are my life.)
• I have learned that a really good friend will fly in from Texas to be with you for surgery (without being asked) and will change your dressings for you (without being asked), all the while reassuring you that your surgery site looks great!
  (Thank you, Katy. It was a forgivable deception.)
• I now know that losing your hair is a bit less traumatic if you let go of it before it lets go of you. And a “ceremonial head shaving—if you are blessed with a dear friend who will recruit a dozen or so of your best girl friends for the event—is a great time to let go.
  (Thank you, Sharon. As always, I couldn’t have gotten through it without you.)
• I also have learned that after you have shaved your head, you may feel a bit self-conscious … at least until your 24-year-old son comes home for a visit with his head shaved, too!
  (Thank you, Zach. You are my heart and my joy.)
• I now know that wigs are very hot and very itchy; and that heavy-duty eyeliner, along with big earrings, will do just fine.
• I have learned that a “bad hair day” is, in fact, a very good day.
• I have discovered that there are medical professionals who will put your comfort and convenience ahead of their own, even staying beyond office hours to see you, so that you don’t have to take your sick, miserable self to the emergency room.
  (Thank you, Ruth. Thank you, Nicki. Thank you, Dr. Miller… OK, you did put up with a lot.)
• There are lots of people to thank. I have been blessed to know that there is an angel living on the sixth floor at UT Medical Center. She is a nurse, and her name is Melly. Cindy usually will get a vein on the first try. Scott can draw blood with very little pain, and that a port would probably be a good idea anyway.
• I have learned that “magic” really does exist—it comes in a mouthwash.
• I have been amazed to discover that, in a doctor’s office, I can strip to the waist in 6.3 seconds—with or without an audience—no blushing!
• I have discovered that the “cancer cloud” has numerous silver linings. Among them is the fact that people bring you stuff: an endless flow of cards (thank you, Terrye), gifts (thank you, Kim) and food (thank you, Sissy, but I hope to never see another bowl of potato soup).
  

In 2002, I accumulated a great deal of knowledge that will come in very handy if they ever have a Breast Cancer Survivor’s version of “Who Wants to be a Millionaire?” Ask me about clear margins, sentinel lymph nodes, estrogen receptors, HER2neu, Adriamyacin, BRCA studies, etc.

I have observed that when you are forced to face the prospect of dying, you begin to take great joy in the mundane. I have, for example, recently realized that there are few greater pleasures in life than walking without pain.

To my joyful amazement, I discovered in 2002 that, in Knoxville alone, there were more than 8,500 people who were willing to donate $20 to $35 each, endure terrible traffic conditions and walk more than three miles in the cold at 8:30 on a Saturday morning in order to lend their support to the Susan G. Komen Foundation and to the eradication of breast cancer. I felt as if each one of them was there for me. In 2002, I learned that hope is abundant.

Since 2002, I have begun to realize that there comes a time when you stop thinking of breast cancer as the worst thing that has ever happened to you and begin to embrace the event as one of only a handful of defining life experiences.

I discovered, in 2002, that a breast is, in fact, a very small price to pay for the privilege of continuing on this magnificent journey—with eyes wide open.

In 2002, 203,500 women were diagnosed with breast cancer—203,501, counting me.