“You only get to live your life once, so live it to the most.”

We often hear such advice that it seems to have lost its essence. But for those who battle chronic diseases as cruel as cancer, it’s another story.

In June of 2018, at 52, during a normal health check in the Samitivej Hospital Bangkok, the doctor saw in the mammography a lump in my right breast. It wasn’t round – the shape like a real crab 😉 the size of a golf ball. 

Diagnosis

Your entire life can change in an instant. You don’t think it can, but it can. 

My plan was to flight to Germany for 3 weeks’ holiday and I told the doctor – before we start with any treatment or surgery or examinations I will go home for recharge my energy, enjoy my life, having fun with friends, see my family, eat and drink my favourite German food, much hiking, etc.

The biopsy revealed a mix of ductal carcinoma in situ (DCIS) or pre-cancerous cells and invasive ductal carcinoma (IDC), the most common type of breast cancer. I learned breast cancer vocabulary very, very quickly. I was diagnosed on 16 June 2018, and my right breast-preserving operation was on 18 July 2018.

During a mastectomy, a breast surgeon also examines the lymph nodes to see if the cancer has travelled outside the main tumor in the breast. Before surgery I only knew that I wanted – no, I needed – negative nodes. I knew that if the cancer had spread beyond my breast, treatment would be more complicated. Women who die from breast cancer don’t die from cancer that stays in the breast; they die when that cancer spreads to other parts of their body, commonly the lungs, liver, brain, and bones.

My surgeon removed 7 lymph nodes and during the surgery the pathology find out that there had been cancer in three of those nodes. Scans of my lungs, liver, and bones were, thankfully, clear. My cancer was hormone receptor positive, which meant I would need hormone therapy for the next 4 – 5 years to keep my body from using oestrogen. But before that I would need chemotherapy and radiation.

Treatment

My chemotherapy regimen was called TAC for the three drugs I would receive via an IV, every three weeks for three infusions. (Each infusion and rest period was called a “cycle.”) The list of possible side effects of these drugs were terrifying and endless. The first infusion was my learning one. I spent all night vomiting. I was exhausted down to my bones. I lost my sense of taste so I could barely eat or drink. Water tasted foul. No bitter taste – like beer or coffee. I had to avoid all of my favourite foods because they tasted nothing like they used to. My hair fell out two weeks after my infusion and I shaved it off. In that moment I looked like a cancer patient. Something that felt private became very public. 

I hated chemotherapy but I am grateful for it because it works very, very well, but I hated the way it made me feel. I had horrible nerve pain, problems with the bowel movement, the first days I had the feeling that I wear a heavy metal coat, my fingernails were very sensitive and under my skull was a heat like in an oven.

I had my last infusion on 16 of December, 2018. At the end of chemotherapy, I started hormone therapy. I would receive a shot called Zoladex every three months to put me into menopause and I would take an Aromasin pill daily. If surgery was to cut out the cancer and chemo was to poison it, then hormone therapy was to starve it so it could never grow again.

I started radiation on January 2019. I had to be at the Chula hospital five days a week for a total of 30 radiation sessions. Radiation was much easier than chemotherapy; the only inconvenience was the daily commute to and from the hospital. I did not experience any real side effects from radiation except for a little sore throat and dry skin. Unfortunately, after 3 weeks I had very burned skin (I couldn’t wear a bra). And then active treatment was over.

Survivorship

It has been more than two years since my diagnosis. I have found navigating survivorship to be surprisingly difficult. When you are in treatment your doctors are responsible for you. Your life is all about “killing cancer.” And then it’s done and you’re meant to live your life and hope that you’ll never have to go through it again. But you might. Or you might not. So you live in this limbo that can make you crazy.

“Tell me, what is it you plan to do with your one wild and precious life?” – Mary Oliver

Sometimes I am so scared I can hardly breathe, and sometimes my life is full and busy and I go without thinking about cancer. Some days I am filled with gratitude to be alive today, to be done with treatment, to feel about as close to normal as I guess I will ever feel. My bones ache and I get hot flashes all the time from being forced into menopause. But I am here- from the moment I was diagnosed, that is all I ever wanted.

I lost friends when I went through treatment. Many people don’t know how to act around someone that’s going through something so hard, especially something as scary as cancer. But it’s not nearly as complicated as people seem to think. When you love someone, you show up. You stand by them. You hold them up when they’re falling. You listen to them rant and rave about the unfairness of it all. You throw them a magical, sparkling unicorn party to celebrate the end of chemotherapy. You treat them like the person that you love, the person that needs you to just love them, to stick by them, to invite them to things even when they are too sick to go.

We are all going to die. We just think that it won’t happen until we are old and ready for it. Cancer took a lot from me, but cancer helped me understand an important lesson: none of us are promised tomorrow. You know this already, but you really don’t. So listen to me. Be happy now. Go on that adventure now. If you’re unhappy, change your life. There is no “right time” for the things you love. Now is it! Because this life is all we get.