by Joan Lunden
Despite her advice, I’ll admit, I didn’t ask my doctor to add the ultrasound that year, or even the year after. I don’t even have a good reason or excuse. I just didn’t do it. However, a few years later, I was given that advice again while interviewing Dr. Susan Love for Health Corner, a show I was hosting for Lifetime. The interview was about breast cancer and what age women should start having mammograms.
During the interview, Dr. Love spoke about a new study she was involved in to shed some light on what causes breast cancer. She said that the majority of women who get breast cancer have none of the known clinical risk factors.
Off camera, Dr. Love asked if I was getting regular mammograms. I told her I was and that it was incredibly nerve-wracking because I always had to go back in for more images due to my dense breasts.
That was when she said that if I had dense breast tissue, the mammogram might not be able to pick up a cancerous tumor. I most likely needed an ultrasound every year, in addition to my mammogram, to be thorough in my examination.
Okay. Wow.
That was the second time I’d heard this advice.
This time I’d be a fool to ignore it, that’s for sure.
At my next mammogram appointment, I asked my gynecologist to write a prescription for my annual mammogram and an ultrasound. It became a routine part of my yearly exam, and until this appointment, I’d always exited my radiologist’s office and gone on my merry way.
While I know there are some women who are afraid to get their boobs squeezed, I’m not one of them. I didn’t really enjoy it, but subconsciously, I also didn’t believe I could ever be one of the statistics—you know, one of those one-in-eight women. Perhaps it was the power of positive thinking that kept me in that mind-set every year. Or, more likely, the assumption that I was risk-free.
When I arrived at the radiologist’s office, the nurse showed me to a tiny closet of a changing room, handed me the powder-pink robe, reminded me to wipe off any deodorant I was wearing, and said, “We will come get you shortly.”
I quickly changed, took my place in the waiting area with half a dozen other women, and started making a mental checklist of where I was headed as soon as I was done here. I looked around the waiting area and noticed some of the women were flipping through magazines—not reading, just nervously flipping the pages. Others had their heads angled straight down, looking at their phones, furiously swiping up with one finger, or reading their Kindles.
No one was making eye contact. Women don’t seem to make small talk in this area. I’ve always thought it was because we were all nervous or feeling awkward, waiting half naked in our matching robes. I couldn’t help thinking, In any other social setting, it would be a faux pas to be wearing the same outfit as the woman next to you. Here, it’s all the rage.
What would Anna Wintour think?
Does she fashionably belt her robe?
Maybe she ties hers with an Hermès scarf?
Oh, what we do and think to pass the time waiting for our mammograms!
Even though I didn’t consider myself at risk for breast cancer, deep down, the process made me feel a little fidgety and apprehensive. Sitting there waiting was a bit nerve-wracking. I think it’s safe to say that every woman in that room, anticipating her name to be called, secretly worried she may not escape her visit without hearing those dreaded words: “We saw something that concerns us.”
Over the years I have been called back for further images several times. Even with the extra look, I have always been able to walk out the door with a clean bill of health, let out a giant exhale, and start breathing once again.
Am I alone in this? Don’t we all sit there, holding our breath, waiting to hear the words “You’re all done, and you are clear for another year”?
Whew!
We can’t get dressed and get out of that place fast enough.
Once I was done with the mammogram, I still had to wait for an ultrasound room to open up. While this took a little more time, it was always worth it for my peace of mind. Besides, I was breathing a lot easier: The worst part was behind me. The ultrasound is completely painless, merely a precautionary step. I considered it an extra insurance policy. Ever since I started getting ultrasounds, there had been no sign of anything to be worried about. I was practically home free.
As my name was called and I walked down the hall, my mind was already past the possibility of something going wrong and on to birthday cake and decorations. After all, I did just get a clean bill of health across the hall, right?
Another year, another clean mammogram, I thought.
Exhale.
Smile.
All I had to do was get naked one more time for another technician to poke around at my boobs!
It is so weird and embarrassing.
And yet it is a lifesaving exam, so we just have to get over feeling uneasy and uncomfortable with allowing a perfect stranger to fondle us in all sorts of awkward ways. “Hiya, nice to meet you . . . Yup, that’s my boob!”
To break the ice, I always engage with the technician as soon as she comes into the exam room. I chitchat and joke around as my way of coping with the discomfort I’m feeling with the situation. Somehow, talking with the technician about the latest news story or the hottest TV show distracts me from how embarrassing it is to have a stranger staring at my half-naked body. I know I’m not alone here. They must have all sorts of funny, nervous, and sometimes odd conversations, because they go through this fifty times a day. Without missing a beat, they usually play along with my banter as I lie on the exam table with my right arm extended over my head and my right breast totally exposed.
The tech squeezed some of the cold gel all over my breast; the gel would somehow enhance the image.
(I’ve always thought they should keep that goo in a warmer—kind of like the warmers you can get at Babies “R” Us to keep your baby’s bottle warm—so that it isn’t so uncomfortably cold when they spread it across your bare breast. Brrrrrrrrr! Doesn’t that seem like an obvious idea?)
The technician then guided the cold ultrasound instrument in a circular motion around my right breast, as she always did. However, this time she kept going back to one spot, again and again. It was right around this time that she stopped engaging in dialogue with me.
She checked my left breast but said she wanted to go back once more to check my right breast.
Uh-oh.
I remember thinking, That can’t be good. She must be seeing something bad.
Techs aren’t supposed to tell you anything, good or bad, but the journalist in me felt compelled to ask her anyway.
Of course, she said she wasn’t allowed to tell me anything. However, she did say she needed the radiologist, Dr. Calamari, to come in and take a look at something.
Shit.
She left the room while I lay there.
My right arm was still up over my head, the clear cold gel smeared all over my right breast.
I suddenly felt frozen in time.
It seemed like hours passed before the radiologist came in, though it was probably more like four or five minutes. Our perception of time can be so warped when we are waiting for the worst.
Dr. Calamari looked closely at the screen and then took the ultrasound instrument and moved it back and forth, again and again, over the same spot on my breast. Without saying a single word, she snapped more images, a lot more. Then she said, “Get dressed and come see me in my office so we can discuss this.”
I didn’t know exactly what she was about to say, but I did know I didn’t like the sound of it.
My heart was racing almost as quickly as my thoughts. I had no time for this. I had things to do. I had parties to plan, family coming for the weekend, kids leaving for camp, my husband about to leave for the summer, work obligations, commitments . . . I was making an endless list of all the reasons Dr. Calamari’s news simply wouldn’t fit in to my schedule right now.
No.
Absolutely not.
Not
now.
Not ever.
No.
Hell no.
No, no, no, no, no, no, no, no, no, no,
PLEASE
GOD
NO.
YES. Dr. Calamari told me she had seen something on the screen that looked like it could be a tumor at the back of my breast, near my chest wall. She needed to do a needle biopsy to see exactly what we were dealing with. She said she would like to do it right there and then, that afternoon.
What?
Really?
Right now? You want me to go get undressed again and let you stick a big needle in my breast and cut a small piece to send to a lab?
WOW!
NO!
These were just the thoughts I was having—I knew I was going to have the biopsy—but I definitely wasn’t prepared to do it that afternoon. I had the perfect out, and I shared it from my best “Mother of the Year” point of view: “You see, I promised my nine-year-old daughter, Kimberly, that I would be at her gymnastics show this afternoon, and I don’t want to disappoint her.”
“Oh, I completely understand, my daughter used to take gymnastics at the same place when she was younger. I remember those end-of-the-season shows for parents so fondly. You don’t want to miss that. You can come back in the morning and we’ll do it then,” Dr. Calamari said.
Whew.
At least I bought a little time.
Dr. Calamari explained that she was usually reluctant to allow a woman to leave the office without doing a biopsy on the spot, because women all too often never return, fearful of potentially bad news. She also pointed out that the following day was a Friday and that normally she didn’t do biopsies on Fridays, since her patients had to wait the weekend to get the result, and women find that excruciatingly stressful.
Under the circumstances, we agreed that I would come back first thing in the morning for the biopsy and would return for an early appointment on Monday to hear the results.
Dr. Calamari reminded me that while it looked like a cancerous tumor, it might turn out to be just a cyst. If that was the case, once the needle pierced the cyst, the fluid inside would be extracted with the biopsy needle, and life would go on as if nothing happened.
Life would go on as if nothing happened.
Those were the words I couldn’t get out of my head.
Those were the words I needed to focus on.
Those were the words I desperately wanted and hoped and prayed would be true.
On the way home, I called Jeff to tell him what had happened. I really wanted to make light of it, so I wouldn’t worry him and make him feel bad if he couldn’t be there should something be wrong. After all, I didn’t know what I was dealing with yet. There was no reason to panic him.
How do you make this kind of call?
“Hi, sweetheart, I may have cancer, but don’t worry, I’ll be home in time for dinner.”
“Hi, it’s me. Remember those breasts you liked so much? I’ve got good news and bad news . . .”
I tried to sound somewhat nonchalant during the call, but my emotion started to surface, and my voice began to break. All of a sudden a few tears were trickling down my cheeks. Fortunately, he couldn’t see them. I always wanted to appear the healthy vibrant woman Jeff met and fell in love with, and I wanted to be strong for him, especially at this time of year.
I told Jeff not to worry, that it may turn out to be a simple cyst, and if so, it would drain right out when she inserted the needle.
“Really, it may be nothing at all, sweetheart, so we don’t need to be worried quite yet.” I did my best to sound convincing, though I don’t know if I pulled it off.
I have an exceptionally close relationship with my three older girls. Now that they are grown up, they’re like my best friends. But I knew this would be upsetting news. I thought long and hard about burdening them with it.
Jamie is my oldest. She lives and works in New York City as an executive in PR, a relentlessly demanding field. She loves her work and is really good at it, but I feel she is always stressed to the max from its demands. As the saying goes, she is truly “a chip off the old block.” She is an overachiever, a loyal hard worker who will go to the end of the earth to be the best at what she does, whether it’s jumping horses in an international competition or landing the biggest, most impressive client for her company. Jamie and I spent a lot of time together on the road when she was growing up because she was a nationally ranked athlete in the equestrian world. We ventured to top competitions all over the country and became very close along the way. I think we are similar in our drive and our passion, although I gave up jumping horses after my last broken shoulder. Now I jump big fences only in my dreams, but I’m really great in those dreams. Jamie is still really great in real life.
My middle older daughter, Lindsay, worked in the fashion industry after graduating from the University of Pennsylvania. One day she asked to go to dinner with Jeff and me—on a Saturday night! Really? What big news could she want to share? we wondered. That night Lindsay presented her plan to work with me at my company and help take it to new levels. Believe me, that is exactly what she has done. It is the most wonderful gift when your daughter joins you in your life mission and dedicates her days to your goals, helping women stay healthy and happy. We have become incredibly close since she came to work with me and have traveled the country together for years now. However, when I received my troublesome news, Lindsay was six months pregnant, so I was terribly worried about divulging it to her and having it possibly impact her or her unborn baby in a negative way.
Then there was Sarah, who was my “baby” until the two sets of twins were born. Actually, she still is my baby. Like Lindsay, she graduated from the University of Pennsylvania. Sarah immediately joined the page program at NBC. It is the ultimate training ground for anyone interested in working in television broadcasting and entertainment. Pages work as studio tour guides and audience ushers on NBC shows including The Tonight Show and Saturday Night Live. The competition is so stiff that only 212 pages are selected each year out of the nearly 16,000 applicants, making it a harder program to get into than Harvard! Luckily for Sarah, her dream of becoming a page panned out. NBC executives hire from that pool of workers and she was soon tapped to be the personal assistant to Frances Berwick, the president of Bravo. It was such a wonderful learning experience for Sarah, but she decided to pursue the other side of the business—the production side—and moved to Hollywood to work for a production company.
While she lived the farthest away from me, Sarah was the one I needed to connect with first. You see, I know my children. I inherently understood that she would feel bad because she wouldn’t be able to come right over, wrap her arms around me, and tell me that everything would be all right. That’s the kind of compassionate girl Sarah is.
So after I spoke to Jeff, I called Sarah and shared my news. I wanted her to hear it from me. I told her that it might be nothing, but I was having a biopsy in a few days. I would let her know any news as soon as I had something to report. I did my best not to sound panicked or scared. I just stated the information as I knew it.
At first Sarah thought I had a “different” kind of cancer. It couldn’t possibly be the kind of cancer that required chemo or killed people. She thought perhaps I’d had a bad mammogram and ultrasound, and they were just being precautionary. She told me that we’d take everything one step at time, sounding completely calm and rational, because the reality of what I had shared hadn’t set in with her yet. And how could it? She was three thousand miles away—and frankly, I’m not sure the reality had started creeping in for me yet, either.
Later that day, Jeff and I left the house as if nothing were wrong. As far as I was concerned, there wasn’t anything wrong. Out of mind, out of possibility! At least that’s what I kept trying to convince myself.
We took Kimberly to her gymnastics demonstration, sat behind the glass partition, and watched with the other parents as she popped on and off the balance
beam and the uneven bars. I smiled and took pictures, but despite my best efforts to ignore the ten-thousand-pound elephant, I couldn’t erase the obvious from my brain for a second.
CHAPTER 2
The Big C
Courage is being scared to death and saddling up anyway.
JOHN WAYNE
Actor, diagnosed with lung cancer in 1964; credited with coining the term “The Big C”
When I awoke the morning of the biopsy, I did my best to convince myself there was nothing to worry about. I didn’t have time for cancer. There was no solid evidence of it, anyway.
I needed proof.
Some concrete data before panicking.
You know what?
I needed to stay calm, center my thoughts, and breathe.
After all, the doctor had said it could turn out to be a cyst, and she would know better than anyone.
Right?
I mean, what else could it be?
It couldn’t be a tumor.
No way.
I raced around, keeping myself nervously busy until it was time to face the possibility of some other reality.
Maybe I should just call and postpone!
No, you can’t do that! That’s not you.
What’s the point in postponing possible bad news?
Damn. My conscience got the better of me. I’d promised Dr. Calamari I’d be there first thing that morning, and so I faced the music.
Dr. Calamari spoke to me as she was doing the ultrasound-guided aspiration and core biopsy. I was really nervous about the procedure.
Why?
Because it involved the doctor sticking a needle in my breast and poking it around until she found the suspect mass, then clipping little parts off of it and pulling them back out.
Ouch!
That sounded like it would hurt.
A lot. I was lying facedown on a table that had an open area where my breast fell down through. Before the procedure began, I was given several shots of a local anesthetic to numb the skin and breast tissue around the suspicious area. Then an MRI machine was moved into position to take images of the area in question. The radiologist watched the MRI image of the breast (an imaging technique that generates detailed 3-D pictures) on a computer screen in order to guide the positioning of the hollow needle into the breast until it reached the mass. Once the needle penetrated the mass, the doctor would know immediately whether it was a fluid-filled cyst or not. If it were a cyst, the fluid would be extracted with the needle, which was what we were hoping for. Otherwise, it was a tumor.