TheraBionic Device May Help with Advanced Liver Cancer

I just heard about a new treatment device for advanced hepatocellular carcinoma (liver cancer) and wanted to share the news with my readers. This bioelectromagnetic device is called TheraBionic, and according to some friends whose child has liver cancer, it

has successfully completed Phase I & II trials, and will soon undergo Phase III. The device itself is very non-invasive—a small box about the size of a pencil case with a spoon-like attachment. Patients turn it on, put the spoon into their mouths, and sit for an hour while it sends low-level electromagnetic waves through the body. Patients do this three times a day and experience virtually no side effects.

It’s not so easy for people living in the United States to join the trials for TheraBionic, however, as they have been conducted in Brazil. So my friends, with help from doctors at MD Anderson in Houston and Northwestern in Chicago and a patient advocate at the University of California at San Diego, applied to the Food and Drug Administration to use the device on a compassionate basis.

They started this process in December and just received approval. They gave me permission to publicize the device on this website.

I was not aware that individuals could set up their own trial with approval from the FDA. That’s good to know.

Here is some information from the website:

TheraBionic has solved a central problem in the treatment of hepatocellular carcinoma. Because most drugs are metabolized by the liver, many patients do not tolerate therapy for this disease as they have severely impaired liver function.  With current treatments on the market, patients with hepatocellular carcinoma have a very limited life expectancy, ranging from 6-12 months.

In contrast to current treatments, no significant side effects have been observed with the use of the TheraBionic device in the treatment of 41 study patients with advanced hepatocellular carcinoma and severely impaired liver function. TheraBionic treatment showed clear benefit in 20 of the 41 (49.8%) patients who experienced either significant tumor shrinkage (4) or stable disease for more than three months (16). Seven of the 11 (63.6%) patients who experienced pain prior to TheraBionic treatment initiation reported either complete or partial disappearance of pain. There were several very long-term responders to TheraBionic treatment, which suggests that TheraBionic treatment may offer control of advanced cancer for several years.

So, TheraBionic shrank the tumor in 4 out of 41 patients, and 16 others lived three months longer than they would have otherwise.

The overview page on the website also mentioned a 2012 Phase II trial for advanced breast cancer.

 

Beth’s Journey to Radiation

Gallery

This gallery contains 22 photos.

How Beth got to her radiation treatments at the University of Colorado Hospital from the 15L bus stop at Aurora Court and Colfax. (Unfortunately, she forgot to photograph the sign outside the radiation oncology department.) Continue reading

The Beginning of the End

Today Todd and I visited the radiation oncology department at the University of Colorado Hospital. We met the radiation oncologist, her resident (cute!), and a med student who mostly stood in the background. The two doctors got to take my history and examine me, but the med student only got to watch. Maybe students never get to do an exam? Or maybe there wasn’t enough time? At this point, I don’t care—so many doctors have examined me in front of my husband that it seems normal.

After that, I had a CT and four tiny black tattoos so the radiation technicians could decide exactly where the radiation beams should go. The doctor came in and pasted metal strips around my right breast; the laser can get through fabric but not metal. One of the techs showed me the picture, and I said, “Amazon!” It was impressive.

I will be having 6 weeks of radiation to the right breast around the incision, to part of the area where lymph nodes were removed under my right arm, and to my chest below the collarbone. Radiation is “local” therapy designed to destroy any remaining cancer cells, as opposed to the “systemic” therapy (chemo).

Next time I won’t be wearing a skirt and sandals. It was cold in that room.

Now I have 4 tattoos, 4 incisions of varying lengths, and one thick bruise the size of an egg in my right breast (no drain for lumpectomies, I guess, though I had a drain for the lymphectomy). My right arm is still pretty tight, but I’ve started physical therapy, and the exercises seem to help.

I wanted to show you the ON-Q Painbuster that was installed during surgery. I wore it for 6 days. See the length of tubing by the measuring tape? About 8–10 inches of that was inside my body. It functions like a drip line; the black areas dripped anesthetic into my right side. breast cancer triple negative

Todd had to pull it out. That was probably one of the more disgusting experiences of his life. It didn’t hurt me, but I bet it made him a little queasy.

 

Hair Today, Goon Tomorrow

“I’ve grown to love your bald head,” Todd told me in passing today. I replied that he had become used to it after seeing it so often for five months. When I’m at home, I don’t put on a wig or hat unless I’m cold. I go commando a lot at home, and if the weather stays this hot, I may start going commando on the street.triple-negative breast cancer, bald women going commandoSo far, I’ve felt comfortable baring my head only when nobody is looking. I’m no Xeni Jardin.

I told Todd I worried that my hair might never grow back. It was thinning before my diagnosis; maybe the chemo just finished off those valiant but malnourished hair follicles.

“You’d be edgy,” he suggested.

“But I wouldn’t be Beth with beautiful hair,” I said, getting teary-eyed. (We’re talking Beth circa 1992 here.) edgy women, bald women flaunt it, going commandoI was surprised when he told me he wished he had beautiful hair. When I met Todd, his hair, although thick and curly, was already receding, and he had always told me he was used to it. But perhaps not completely.

The End of the Beginning

I’m almost done. This Friday, May 4, 2012, is my last chemo.

I don’t want to go, but I’m doing it anyway—because I don’t want to be a quitter. Because I don’t want to reproach myself later if the cancer comes back. Because I don’t have the courage right now to say, “Chemotherapy is a very messed-up way to deal with an illness. I choose a different approach.”

Sometimes I think half the things I do in life, I do to avoid reproaching myself later. And I don’t really trust my own intuition.

But, as I’m telling myself this week, I can trust myself after this last treatment.

And then we will PARTAAAY! Well, maybe in about three weeks to a month … before the surgery and radiation … or maybe afterward …

Throughout my life, I’ve been blessed with good health and strength. I never needed a doctor other than my gynecologist until I was in my thirties and developed a repetitive motion injury. Now I’m pushing fifty and will be going to see doctors about triple-negative breast cancer for many years, if not the rest of my life, and yet I still don’t really believe I have it. All the disease ever did to me was enlarge my right armpit. The “cure” has afflicted me much worse than the disease.

I grew up with a mother who had rheumatoid arthritis that later destroyed her aorta and carotid arteries (in my opinion) and a father who was raised Christian Scientist and then converted to Catholicism. He had nothing against doctors; in fact, he convinced his mother to see one, I think about the congestive heart failure that killed her. He had polio when he was nine months old and always walked with a limp. He couldn’t jog, but he did learn to water-ski, and he rode his bike around our neighborhood. Once he even did a hundred, riding into the wind on the way out on some south Kansas City highway.

My mother didn’t talk much about her auto-immune illness, and I didn’t ask her about the effects I couldn’t see. Each of us wanted to be strong in our own ways, though I would ask her now, if I could. December 21 is the twentieth anniversary of her death. You learn, after the death of someone you love deeply, that grief doesn’t fade so much as shrink. In time, your life grows up around it but never completely obscures it.

Last night I thought of calling my father to tell him I have almost finished chemotherapy. But I told my siblings I wouldn’t talk to him about it anymore because it upsets him. He has Alzheimer’s and can’t remember certain things. The last time I mentioned it, he said he had forgotten, and I knew he felt bad about it.

Perhaps the next time I visit him, I will tell him about all the strange places I went because of cancer last winter and this spring and summer. I could say that the knowledge of it rose like a cold current in my body but very seldom spilled over. I could describe my rages and crying jags and the long drives to the infusion room.

But what was most unusual and wonderful, this year, was my acceptance of all the help I received. I remember a man long ago saying to me, after I paid him the exact amount he had lent me, “You don’t want to be obligated to anyone, do you?”

Well, no. When I was sixteen, I told my parents I was “completely independent.” Somehow they managed to restrain themselves from pointing out the food they provided and their car that I drove (and wrecked) and their house where I lived.

I have never felt so cared for in my life as I do now. Thank you.

But it’s weird to feel so much gratitude and so much cognitive dissonance at the same time.

Since November, I have been wondering about the messages we’re given after our diagnosis:

  • If you undergo these tests, we can tell you what’s wrong with you.
  • You can beat this with the right regimen. Hey, chemo sucks! But it will heal you.
  • You can beat this if you stay positive. Negativity and anger are toxic. Forgive!

Why is cancer so personal? Why is cancer all about what I do? What if I’m not a positive person? What if I’m a pessimist? All of us know pessimists. Clearly, not all of them have died.

The only solution, for me, is to be grateful for the health I’ve had and the help I received and to assist others by researching the politics of cancer treatment. There’s something creepy about Amgen paying for almost all the cost of my pricey Neulasta shot. There is also something creepy about pharmaceutical companies funding National Breast Cancer Awareness Month. Why is so little attention paid to the causes of cancer, such as the toxins we absorb from conception on? Why work so hard to defeat something when it could be prevented?

Note: This post was inspired, in part, by Andi O’Conor’s tales of rebuilding her house, which burned down in the Four Mile Canyon Fire in 2010, especially “Life on the Edge.”

Art and Exercise

I just returned from working out at La Familia Rec Center, near Dailey Park in Denver. It’s a few blocks from our apartment.

During this cycle of chemo (the third), I was a little later getting to the rec center than last cycle. I took some walks and did some yoga and Pilates, but I didn’t get to the rec center until last Thursday and then Saturday. I did a workout at home in between, and by Saturday I was pretty tired.

I’ve been trying to maintain my strength throughout chemo, but today was the first day I managed to ride the recumbent bike for 30 minutes, and that was only on level 3. Now, I’ve never ridden the bike at a level higher than 5, but 3 seems pretty wimpy. After about 15 minutes, I went down to level 2 because my legs were tired. I tried to keep my heart rate around 140.

Afterward, I did some resistance training: sitting row, hip abduction and adduction, leg extension. I would have done 3 sets of dead lifts at 40 pounds (including the bar), but there were too many people in the weight room. Maybe I can do those next time. I think they’re good for my back.

After my workout, I stretched in the basketball gym while a man practiced 3-point shots. Then I walked closer to the murals at the back of the gym. According to the woman at the front desk, the athletes in the mural were modeled after various people from the community in 1979. I wonder if they were excited to see themselves immortalized that way. She said the mural had never been touched up, and it looks great (except for the football player who’s positioned so as to kick the boxer in the crotch).

There’s another mural in the pool area, which includes a couple of figures and various solar bodies. It’s a different style than the mural in the gym, but apparently two of the artists were the same.

The Chemo-Chemical Complex

The post I wrote yesterday about chemo was so reasoned, so calm. But later that night, after watching Bright Star by Jane Campion, my true feelings came out.

First of all, I have to explain that it’s been very difficult for me to cry about this diagnosis. At times I would have liked to sob for a few hours, just to release some tension, but it doesn’t happen. Except, I guess, when I watch sad love stories.

And, of course, in Bright Star, John Keats is dying of tuberculosis, a loathsome disease. (That same disease has just been found in a school in Longmont, by the way.)

I started thinking about the disgusting nature of chemotherapy. How it follows this insidious path in my body. How the effects make me feel less than human and certainly not female anymore. Something more like a test case. I’m not sure why the weakness, the stomach upset, the hair loss, and the brain fog produce this reaction. It’s just that they all feel so wrong for a person who prided herself on her health and her ability to get by without medicine.

When I was a teenager, I did a few drugs. I smoked cigarettes, I drank a lot of coffee with milk and sugar, I smoked pot, and I did mushrooms once. In the 1980s, I did coke a few times. Finally, in my thirties, I realized what should have been obvious: I don’t like being drunk or stoned. I don’t like smoking. I don’t really like altering my body’s natural functioning at all.

And now I’m on these drugs, supposedly to save my life, that are trashing my body, far worse than the cancer has until this point. Setting aside the certainty of what cancer would have done in the long run, I want to talk about the perverse nature of chemotherapy. Why is it that the medical establishment chose this route to cure cancer instead of a more natural approach?

I think it happened because of the postwar mindset. Because we were high on creating new chemicals that could fix our world for us, solve all our conflicts with nature.

Have you ever noticed that since World War II, poisons have worked themselves into every corner of our lives, thanks to corporations? Some 80,000 new chemicals have been created since that time. They’re used in agriculture and industry and cosmetics. But are the pharmaceuticals in use today part of that group of 80,000 chemicals? After a very small amount of surfing, I would say that chemo drugs are in those ranks.

Here’s the quote I love best from the second link: “With advances in technology that improved the ability to detect and quantify these chemicals, we can now begin to identify what effects, if any, these chemicals have on human and environmental health.”

Yep, I am a guinea pig. And so are you and your kids. Because most of these new chemicals haven’t been tested. Why? Because it’s just not important to the US government to understand the health effects of all those chemicals. That might restrict corporations’ ability to sell them.

I’ve spent the last 15 years of my life trying to avoid chemicals. I cleaned my house without them. I managed without bleach (yes, chlorine is a poison). I ate organic food. And so on. My main lapse was to use Roundup on my yard, but even that involved using smaller amounts of chemicals than if I’d used Weed and Feed every season.

And still I got cancer. For all I know, it may have been caused by smoking in high school. Or by not having children. But the presence of 80,000 new chemicals in the world, mixing together in our bodies in ways we don’t understand, certainly does raise hard questions.

And now I’m using more chemicals to clean up the mess in my body.

It’s insidious, don’t you see?

So here’s my pledge: I am never doing this again. If my cancer recurs (and triple-negative breast cancer is more likely to recur than other subtypes), I won’t do chemo again. I hate it.

That Old Familiar Road

This week I’m not sure that “adventure” is the right word to describe chemotherapy for triple-negative breast cancer. “Endurance trial” seems wrong too, since my symptoms have been milder than those of many women undergoing treatment. What I find strange is how the cycles of chemotherapy are all so similar, and yet they change all the time.

Last Friday I had my third infusion out of six. The needle hurt going in, and I’m beginning to suspect it has something to do with the nurse who installs it. Perhaps a little less vigor next time?

I ate lunch, as usual. Afterward we went to the Pearl Street Mall to visit the chocolate store opened by a former yoga teacher of ours.

One thing that surprised me about the second cycle was how quickly my sweet cravings came back. Every day for 12 days, I had donuts or ice cream or chocolate or something similar. It was a little eerie, watching it happen. Then on the Wednesday before chemo, I went to a potluck with members of Boulder Media Women, and Linda Spangle gave me 100 Days of Weight Loss: The Secret to Being Successful on Any Diet Plan. She said she takes a copy of one of her books to gatherings and always finds someone who needs it. And she was right—I do need a book like that. I’m planning to use it this cycle to avoid acting like such a sweets addict.

The very first daily motivator goes this way: “I used to be that way, but now I’m different!”

If I could just convince myself of that—convince myself that I don’t need to eat every sugary thang that crosses my path—it would do wonders for my health and self-esteem.

But, when I have a sour stomach, desserts do sound good. Although I should be grateful I have only a “sour stomach” instead of nausea and vomiting, I’m not. I just want it to go away.

In two or three days, it will subside. I know that, so I’m trying to distract myself by keeping busy.

During the second chemo cycle, a new symptom emerged—muscle twitches, coldness, and weakness—and it’s back, in my face and arms and legs. The nurse practitioner suggested I take L-glutamine and alpha-lipoic acid, which I haven’t yet bought, and a friend suggested acupuncture. So tomorrow Todd will take me to the walk-in acupuncture clinic in Boulder, and I’ll see if that does anything.

At times I rejoice that I’ve made it through 3 cycles, but then at other times the remaining 3 sound so endless.

The tumor in my right armpit is disappearing. It’s just a little nubbin now.

And there is the new book, which gives me hope that one day I won’t be a slave to sugar.

It’s warm and sunny outside. I think I’ll go for a walk before tomorrow’s cold descends.

 

Woman at the Barbershop

Once I started chemotherapy for triple-negative breast cancer, I became obsessed with having my hair buzzed at a barbershop before chemo could take it from me.

Not that losing hair is new to me. My hair has been falling out for fifteen years (Thanks, Grandpa!), and I got a buzz cut last year just to see how I liked it. I have to say, it wasn’t my favorite ’do—I didn’t like the look of the top, which was longer than the rest—but I could live with it. Especially in places like Seattle or Portland, where I saw a lot of women walking around with extremely short hair.

Todd was nonplussed by my insistence on a barbershop. He didn’t understand my desire for a haircut involving hot towels and a straight razor. For a while, I considered going to Proper Barbershop in Denver, but then I decided that a cold PBR and vintage Playboys weren’t that important to me. Neither was gender integration of that particular haven for men. I left it to the boys this time.

Instead I chose Al’s Barbershop, which has a location on the Hill in Boulder convenient to my appointment with the oncologist late that afternoon. The first thing I noticed upon my entrance was that all the pictures of fabulous hair featured men. Judith, my certified barber (Al won’t let you use a straight razor on customers until you’re certified), decided she would use scissors and a comb to shorten my hair, instead of a trimmer. So she divided it into sections and got to work. Al's Barbershop Boulder, women and barbers

She was amazingly quick. In no time at all, I was under half an inch all over my head. It was relaxing to have the comb scraped (gently) up and down my scalp. Then came the real treat: hot foam and a neck shave. 

Judith didn’t have any reason to use hot towels on me, but she did promise I could come back when my hair got patchy and have my head properly shaved. Then, she said, she would use hot towels and polish my scalp until it shone.

I’m still not sure if I want that.

My foolish week

I took Cancer Vixen literally. After reading it, I thought the first couple of days after chemo would be easy. The steroids would keep me pumped until Sunday, at least.

Maybe Prednisone works that way, but the Dexamethasone didn’t do it for me. It’s prescribed primarily to stave off side effects, and I will say that I had very low levels of nausea over the weekend.

I went in Friday, January 13, met with my doctor, and had chemo for several hours. First the nurse stabbed me in the chest with a wicked-looking needle that has a slight curve. That hurt, but only when she stabbed me. (Having this port in my chest freaks me out.) After the anti-nausea drugs and more steroids, she pushed Adriamycin in over 10 minutes, and when she was done, she hooked me up to the Cytoxan, I think, and let it drip. The Taxotere came last. Or maybe it was the other way around.

When I unplugged my chemo dispenser and dragged it to the bathroom, I discovered the Adriamycin had turned my urine pink. That lasted for a couple of days.

Todd and I ran errands in Broomfield after we finished chemo and then headed back to Boulder, where we were staying with a friend. I had to get a Neulasta shot on Saturday morning to support my body’s production of neutrophils (a type of white blood cell), so it was best to spend the night in Boulder instead of driving back and forth to Denver on Saturday.

Todd and I had made plans to attend a banked-track roller derby bout in Colorado Springs. We had lunch first with friends, and then I fell asleep on the way to the venue—a sign of things to come. After we arrived, Todd ran around doing video things, and I edited photographs, but the brain fog and light sensitivity that had crept up the night before got worse. I slept through the second half of the bout and all the way home to Denver. Todd said I took 4 naps on Sunday. I don’t remember.

On Monday night, we went to watch a movie with some friends. I was feeling very uncomfortable in any position, and my jeans seemed to bind my knees. It occurred to me the next day that I was experiencing the achiness associated with Neulasta, and I should have taken Claritin the day of the shot and the next day. I made it through the movie Monday night, but it was a physical struggle.

As I said, I had very little nausea, probably because I took Compazine (Prochlorperazine) until Monday or so. But it made my head feel swollen. I kept wanting to massage my temples, and the drug seemed to thicken the fog that surrounded me. I tried to do productive things, but the most I could manage was to edit a few photographs.

On Tuesday, I felt much less tired, but I needed to figure out how to manage my heartburn. I didn’t want to take more Compazine, but when I got up in the morning, feeling hungry, and ate something, my stomach hurt. I took a nurse’s advice and tried Prilosec, but so far it hasn’t helped all that much.

My tendency to eat when my stomach bothers me didn’t help matters. I couldn’t resist a frozen dinner with Salisbury steak and mashed potatoes for lunch, but the first bite fell into my stomach like a rock. Saltines helped calm things down, but then I allowed Todd to persuade me to eat at Go Fish, where I avoided raw fish and ate gyoza and tempura vegetables. I began to feel my GI tract was a distant galaxy where stars were forming. I started taking a Senna laxative, but because I took only 1 at a time, at first I felt more discomfort.

Wednesday was the worst day for stomach problems, and something was waking me up at night, so I wasn’t getting much sleep. I walked to K-Mart to buy pajamas, and my stomach was tender. Once I got home, Saltines came to my rescue. I felt so good that I agreed to meet a friend for dinner, where we ate cheese and a light pasta dish and drank wine. It was great food—especially the Gouda with nettles—and great company, but my stomach winced at each new bite.

Lessons learned:

  • Take Claritin before and after Neulasta, and take two Senna each night, starting the night of chemo.
  • Stop taking Compazine as soon as possible and switch to Prilosec or something else that reduces stomach acid.
  • Drink lots of broth and eat lots of bread. Tame the mouth monster that wants constant stimulation, and feed the body instead.
  • Avoid social engagements until the fifth day after chemo (and the period will get longer as I get to the later treatments).
  • Be aware that as my stomach begins to feel better, my white blood cell counts are dropping. Stay away from crowded places where I might pick up an infection.
  • Save the restaurants for the 10-day mark or later.

Tonight I’m taking Ativan (Lorazepam) to help me sleep. Maybe it will soothe my stomach as well.

***

Slept like a baby, and woke up to spotting. I think chemo-induced menopause has begun.

 

Hard to port

I had a port inserted today so that I can receive chemotherapy (and have blood drawn) through the port instead of through a vein in my hand or arm. The left side of my chest is a little sore now, and I can’t really turn my head to the left. I have to turn my body.

When I was doing my third year at the University of Sussex, I got such a major crick in my neck that I walked around for at least a day with my head tilted to the side. One of my professors wanted to know why I was holding my head that way. I felt that way today, talking to a friend who stopped by to drop off baked ziti and salad and bread. (I think it’s about time for a second serving.)

It was a comedy of errors this morning at the Department of Interventional Radiology. When I was in the pre/post room, being attended to by three different nurses, a handsome young man with bed head approached me. I asked if he was the surgeon, and he replied, “I’m one of them.” (UCH is a teaching hospital, after all.) He said they were going to put the port on the right side."two by two, hands of blue", port surgery, chemo port, breast cancer

“The same side as the tumor?” I asked. “Shouldn’t it be on the other side?” I knew there was a good reason for my question, though I was far too sleepy to think of it. He said they would discuss it in the OR, explained the procedure, and left.

Once in the OR, I was hooked up to various machines. There was a bank of 8 monitors, 6 of which had my name on them. I found that life-affirming, or at least ego-affirming.

The man with the goatee set up a tray for the surgery and then had to redo it because he hadn’t realized I was allergic to latex. (I’m not sure I really am allergic to latex, for that matter. After one dive trip, I got a rash that lasted for a few days. I attributed it to wearing my latex dive suit for 4 days straight, but who knows? It could have been anything.)

The next step was to help me get my right arm out of the gown so he could clean my shoulder. By this time, I had asked two or three people whether the port should be on the left side. He explained to me that it’s easier to put the port on the right because the vein into which the tube is inserted makes a little jog on the left side.

Then he swabbed my shoulder with an icy substance that left a blue residue and proceeded to cover me artistically with blue drapes. (Does anyone else think “Two by two, hands of blue” from Firefly/Serenity when they see those new hospital gloves? Creepy. Can’t get it out of my head.)

Just as I was almost tented in, a woman whose name/rank/serial number I never caught snuck under the drapes and informed me that, yes, the port should be on the left. If they put it on the right side, it would make post-surgery radiation more difficult. This was the “Time Out” that I had been told would happen, so they could make sure they got everything right.

Right arm back in the gown. Left shoulder out. Icy wash again. I hoped I didn’t flash the man with the goatee, but I didn’t really care either. Tenting on the other side, and all I could think was, “Are they going to recycle all that plastic? Reuse it?”

I asked the man with the goatee if he was doing all right. I thought he was frustrated because he had to keep redoing all his prep work. I hope it didn’t come across as snotty, because I didn’t really mean it that way. It might have been his fault that he didn’t catch my so-called allergy, but it certainly wasn’t his problem that the doctors hadn’t “done rounds” and didn’t know where my port should go. Especially since I had brought it up with one of them almost an hour before I went to the OR.

The last thing I remembered before surgery was the (fourth) nurse telling me she was giving me sedatives now. When I woke up, someone on the other side of the blue drape was tugging at my chest. I think it was one of the surgeons finishing the sutures.port surgery, chemo port

For the rest of the day, all I did was get crabby with Todd about all the traffic on Colfax (which he controls because he has his own galaxy) and lie around and, finally, eat a real meal. Now I’m having blueberries for dessert.

How appropriate.

Photos courtesy of Todd Bradley and his iPhone.

How Cancer Distorts the English Language

I’m an impatient person who is getting lots of lessons in patience lately. My life seems like a film shoot: wait, wait—a flurry of activity—and then more waiting.

I just got the results from the biopsy of the mass in my right breast. Now I officially have breast cancer. Not that there was much doubt after the biopsy of the lymph nodes in November, but, as one doctor said, “It’s always a little disappointing when it comes true.” I’ve chosen a surgeon in Denver and an oncologist in Boulder, from different groups. I sometimes ask myself, “Beth, why can’t you do things the easy way? Pick one group or another?” But I didn’t. I picked the doctors who talked to me in a way I could understand. And I picked the surgeon, especially, because she was the only one of three who mentioned that she tries to minimize the trauma under the arm, where the lymph nodes are removed.

But now the holidays have come down like a pack of Dementors, and it’s cold and everyone is trying to get away. (Can you tell I’ve been watching Harry Potter movies?)

I knew I should have taken that 700-page editing job! Then I would have something to keep me busy, something other than looking for a place to live, editing the thousands of photos I took in the last 6 months during 12 Cities, 1 Year, or starting a photography business.

The truth is, the only thing I want to be busy at right now is treatment. But it’s not happening yet.

Cancer has made me into a patient, but it will never make me patient.

Sentences like that one make people hate to learn English.

What I Forgot

Two days after moving into the basement of another friend’s house, I unpacked some of the items in our camping box. I wanted the blue polyester napkins I’d had since graduate school and a couple of glass storage containers. When I opened one of the containers so that I could wash it, out fell a ball of twine, neatly secured with rubber bands.

What an adventure I had planned to go on in 12 Cities, 1 Year. I wanted to have everything with me, everything we could possibly need. No matter that bringing along all this stuff contradicted the spirit of the digital nomad lifestyle. I was going to protect myself with balls of twine (I think there are two in there) and dried sweet onions and a glove for getting things out of the oven. No telling when I might have to pick up something hot.

Yet I always knew I would forget something essential on this trip. And I realized what it was on November 21, three days before Thanksgiving.

That evening I learned I had cancer. I was standing on a sidewalk in San Francisco outside Ramen Dojo, talking to my gynecologist about the results of a biopsy. “It’s not good news,” she said. And it wasn’t. In a way I pitied her. It can’t be fun to spend your evenings calling patients about breast cancer.

And if I could think about her, then I didn’t have to think about myself.

I went back inside the crowded restaurant and told my husband we would talk about it later. Then we ate our garlic ramen, wonderfully rich but a little too spicy. I couldn’t finish mine, but the diagnosis didn’t stop me. I was able to eat mochi for dessert, after all.

We turned down the sidewalk toward our car. I wanted to speak. I breathed carefully. I wanted to tell him, but we walked a block before the words came out of my mouth. “I have cancer,” I said. I often find it difficult to say what I have to say, but this time the words seemed to be pulling up so much fear with them.

That evening I remembered what I forgot to bring on our 12 Cities, 1 Year trip: my health. I was so accustomed to my health, so used to having it with me, that I didn’t think to bring any extra.

Doing things makes me feel better. So I went back to our hotel room in San Francisco, and wrote out an email to my friends and family. I’m not that fond of talking on the phone. I’m much more comfortable with email. And the kind, loving responses started rolling in: sorrow, comfort, recommendations for doctors, offers to help.

The first time I talked about my diagnosis to someone besides Todd, in person, I felt so cold and tight inside. I thought I might start shivering, right there at the Thanksgiving table, over chocolate cake and pumpkin pie. I worried that I might be giving the cancer more power by admitting to it, as if it were some kind of cellular Lord Voldemort.

Every time I talk about the cancer, or listen to a surgeon tell me which body parts I’ll lose, it both relieves and exhausts me. Having a clinical discussion about cancer is easier than crying about it, but both let that cold fear rise a little closer to the surface.

The other night, I watched Harry Potter and the Prisoner of Azkaban, in which Professor Lupin compliments Harry on being more afraid of the Dementors than of Voldemort. It shows, Lupin said, that Harry was afraid of being afraid. Lupin thought that wise.

I hate being afraid. Thinking about this cancer is like looking over the edge of a pit. There’s a staircase twirling down into it, one of those black metal dealies that you can see through, all the way to the bottom. I dislike heights, and I know that I’ll be terrified walking all the way down that staircase, and all the way back up.

But I also hate waiting. If I stop looking and step down, at least I’ll be doing something.