I read a series of articles printed in the New York Times recently about the efficacy and merit of breast cancer screening in young women, particularly those in their thirties and forties.  I even saw a few of the articles broadcast across Facebook and I cringed as I followed the know-at-all-banter back and forth by people who commented and agreed.  I assure you, not the article authors, clueless commentators, nor talking heads had to tuck their babies in that night wondering whether they would be alive to share in their future.The gist of what was reported was that yearly mammograms under 50 “only” really save about 4,000 lives a year and thus do not justify their costs (including the tangible cost as well as the intangible stress, unnecessary tests, and inaccuracies).  The reason, they touted, is that breast cancers in young women can essentially be boiled down into two categories [I would argue from what I have learned in the last six months that even this is a grotesque over-generalization]: cancers that are so slow growing or otherwise not aggressive that they either will be cured even if not diagnosed until much later or that would not develop further at all.  The other category represents cancers that are so aggressive that even when diagnosed younger and “early,” will inevitably kill those women anyway.  In the middle are the 4,000.  Women for whom will be blessed with a cure, because of their early diagnosis, despite having a cancer possibly in the later category.  It is a matter of fact that I am one of the 4,000 this year.  My cancer, had it not been diagnosed and treated at its earliest stage, might have killed me.  And long before I might have had that routine mammogram at 50 or had a lump big enough to have felt on self exam.

I saw on the Today show the commentary over a PSA showing a newborn baby sleeping with a butcher knife.  The hosts discussed the controversy about whether the PSA was too harsh (its purpose was to advocate against co-sleeping and highlighting the dangers of a parent accidentally smothering a baby to death).  The pervading thought on TV that morning, was if the PSA saved even a single life, it was “worth it.”  That’s right Matt Lauer!!!  If you can save a life, do it!

Meanwhile, my joy in having beat down chemo was dampened as I learned, not just of another young woman in her forties, diagnosed, but that of one of my best friends in the world.  When I think of our twenty years of friendship I only smile (putting aside the day that my mother sent her to my apartment to be with me when I learned about my dad).  When we stood next to each other under the chupa’s at our respective weddings, I imagined many things and shared experiences in our future – none of them involved going through breast cancer at the same time.

It is a particularly cruel twist for us both.  She is one of a small circle of people with whom I was really honest, day after excruciating day, about how really hard the last six months have been.  Now, not only is she forced to tangle with the terrorist in her own right, but must do so, having a too real idea of what she might endure.  And me, I love her so much, that its feels too much like day one all over again.  Of course, more important than all that is the fact that we both sit in the category of those cured and no doubt, we are lucky to have each other to share all our experiences, good and not so much…  So go ahead and ask, how was she diagnosed?  Thanks to the matter of a routine mammogram at 40.  Oh and this week, I went to an informal luncheon of women from my office who have survived breast cancer today, the facts, you ask?  Six of six women, all under 50 – all diagnosed by routine mammogram.  All had different diseases at different stages at diagnosis.  All alive.

We fight so mightily about the sanctity of life, about the moment life begins, and about a persons right to choose.  I want to be like the baby in the PSA with the butcher knife (the one where you said, if we even save one life…) or the babies you fight over that aren’t even viable.  Today, the call from the head of NTSB was to ban cell phone use while driving.  The mantra…if we save even a single life.  I choose life yet you want to tell me about the economics of whether I matter and am worth saving at all.  I certainly hope that our society fails to become so complacent as to dismiss lives, actual living people, as inconsequential because of economics.  That where once cancer so horrified us, we spoke of it only in hushed whispered tones, referring to it by its slithering looking “c,” we now brazenly debate whether we should use known technology to screen for disease at its earliest and usually curable stage instead of using EVERY possible technology to, in fact, save our lives.  That where our government leaders, pundits, and so-called super-committees fail to reconcile and accomplish much of anything in today’s political arena,  that we can – AT LEAST – cure cancer.  In fact, let’s take the presidential campaign funds away from the candidates and commit those dollars to curing disease.  Please someone get me an audience with those decision makers, so that I might share a more realistic, a human, a real version of the facts.

Sorry for being grumpy…it isn’t usually my way.  But I want a world without cancer and I believe that it is possible, now! I can discuss divergent views on the topic, passionately.  I can even agree to disagree.  But I can’t accept economics driving recommendations against screening for young women.

In other, less big picture, but very, VERY, good news:  Monday I completed my first Herceptin triple dose!!  WOOT!  Other than feeling like I had the flu and then sleeping 13 hours, I felt pretty darn good.  So long as my next cardio work up is unchanged, then I am cleared to switch to the every three week protocol for the duration, for those counting, that would leave 17 more infusions and five years, 11 months, and three weeks of hormone therapy to go.  It would be incredibly liberating for me to be able to get out of a routine that keeps me in the chemo suite that ties my insides up in such knots every single week.  Yesterday I consulted with a radiation oncologist at my request to ask a lot of questions.  And today I met with the oncology surgeon regarding a complete hysterectomy.  Big week!  It was never suggested that I would need radiation but now is question asking time, not later.  Remember what drives a lot of thinking and actions:  that my boys be proud of me and always know I spared nothing to be here to be their mom and wife.  That I didn’t let fear, denial, or hesitation get in the way.  And if a little zapping or radical surgery could make a difference in preventing a recurrence, so be it.  As it turns out, and YES, this part felt great and was very reassuring, the radiation oncologist said that there is nothing about my case that indicates that radiation is necessary or advantageous.  As for the additional surgery, the surgeon thinks I am right to be so aggressive.  It amounts to more cliff diving.  I asked the right questions, I got satisfying answers, and now I have to trust that they are correct as I jump again.  With that, January 24 is the date!  I will have my reconstruction surgery and a total hysterectomy at the same time.  I am very excited to moving forward and believe I am doing the right thing.

Meanwhile, feel free to refer to me as your fuzzy love.  As in the follicle fairies have arrived.  I arguably should have shaved my legs this morning [sorry, TMI], but in an act of solidarity [or laziness] with my head, I refused.  My head, however, is covered, in very blonde fuzz!  Certainly no luscious silky dark strands, but definite fuzz…it is a start.

So that wraps up this update.  Imagine two little girls go off to law school committed to do good in the world.  Both choose government and public service jobs.  Between us there are four children destined for greatness.  Four children who need US to be their moms.  That is a fact.  I hope I matter, that we both do.  That we all do.  That if we get our heads out from our nether regions we can return to referring to cancer in hushed tones, not driven by fear or shame, but because we figured out how to eradicate it permanently.  Now that would make good economic sense, not to mention, save life.  As a matter of fact, it very well could, save all of our lives.

Much love,
jodi alison