Diane Kulkarni 2595 So.
1200 West Perry City, Utah U.S.A. [email protected]
“Resilience is accepting your new reality, even if it’s less good than the one you had before. You can fight it, you can do nothing but scream about what you’ve lost, or you can accept that and try to put together something that’s good.” – Elizabeth Edwards
I am a breast cancer survivor. Twice. In eleven years. It is my privilege to share my story with you as an encouragement to be your own best advocate by being proactive, doing all you can to take care of yourselves and most of all, nurturing hope along the way.
A few days before a final essay exam in my American Lit class, my professor, Dr. Neila Seshachari from Hyderabad, explained what the exam would cover and how important it was to study for it. She told us, “Run toward the roar.” No one understood what she meant, so she explained.
In Africa, when lions hunt, the group is composed mostly of lionesses and the oldest male lion. The lionesses spread out at one end of a field where the prey are grazing, and the male takes his place at the opposite end. When they are all in place, the male lion roars several times, sending the frightened animals directly into the waiting ambush of lionesses and to their deaths. If they had run toward the roar, the old male would have been powerless to overwhelm even one of them.
This vivid mental picture of the unsuspecting fleeing into the jaws of death has stayed with me throughout my adult life, especially as it applies to my health. You see, my father died after a 10-year battle with leukemia when I was just seven years old. My grandparents as well as other family members also developed various cancers, so I know the probabilities.
During my annual physical examinations and mammograms before my first diagnosis, I always confidently answered questions presented by the radiologist:
1. Do you have a personal or family history of breast cancer? No.
2. If yes personally, what surgery and treatment did you undergo? N/A
3. At what age were you diagnosed? N/A
4. If family history was known, who was diagnosed (paternal or maternal) and at what age were they diagnosed? N/A
5. How many live births did you have? Two
6. At what age was the first child born? 28 and the second at 32
7. Are you taking estrogen and/or progesterone? Yes (HRT: Hormone Replacement Therapy after a complete hysterectomy in 1987)
8. Have you had any breast surgeries or biopsies? Yes, a biopsy that revealed a cyst
9. Are you having any problems? No
10. When was your last mammogram and where did you have it? Last year at this time in the Brigham City Community Hospital.
So that a comparison of any changes could be made, I brought a copy of a mammogram done in a different hospital.
My confidence collapsed in 1996 when I was 50 years old. My mammogram that year revealed that cells clearly had lined up in a milk duct, a condition I learned later was called ductal carcinoma in situ. Like enemy infiltrators, those cells were preparing to break out into the breast to form a tumor. On that particular day, the radiologist gave me a choice. “We can watch this for six months to see if anything changes,” he said, “or we can do a biopsy this week and find out what’s going on.”
I heard the furious roars of intimidation try to overwhelm me and said, “I don’t want to wait! Please do the biopsy as soon as possible!”
The day after the biopsy was done, the surgeon called my husband and me into his office to give me the news that the cells were malignant. Though he spoke in a gentle way, hearing that word shattered me. He reassured us that ductal carcinoma in situ was the earliest possible diagnosis and non-invasive, so my chances were very good. He suggested that I opt for either a lumpectomy or a mastectomy and said if I chose a mastectomy that it was possible to rebuild the breast using skin and tissue from my abdomen.
In shock, I couldn’t comprehend anything he said, but my husband asked questions and took thorough notes. Rebuilding the breast was not an option for me since nine years before I’d had a complete hysterectomy and my abdominal scar would prevent the procedure. We decided to get two more opinions before scheduling a mastectomy.
Back at home, I sought some time alone to try to come to grips with my situation. The words from a favorite author and radio teacher, Elizabeth Eliot came back to me: “Have you had the experience of feeling as if you’ve got far too many burdens to bear, far too many people to take care of, far too many things on your list to do? You just can’t possibly do it, and you get in a panic and you just want to sit down and collapse in a pile and feel sorry for yourself.”
She shared an old Saxon poem that had helped her when she faced an incredible circumstance. The poet urged,“Do it immediately, do it with prayer, do it reliantly, casting all care. Do it with reverence, tracing His hand who placed it before thee with earnest command. Stayed on Omnipotence, safe ‘neath His wing, leave all resultings, do the next thing.”
So I took the poet’s advice and that evening after dinner I did the next thing: I washed the dishes. And before I fell asleep, facing my mortality head-on for the very first time, I surrendered my physical life, my husband and our two daughters, all my hopes and dreams, everything into the hands of my loving Creator, believing as Martin Luther said, “I have held many things in my hands, and I have lost them all; but whatever I have placed in God’s hands, that I still possess.”
The next morning I began an inner spiritual journey for strength by sitting down with a cup of tea, reading my Scriptures, and writing my story in a journal. Daily, as I inscribed how I related to what I was reading, I wrote out my prayers, renewed my commitment, and relished the insights that came to me. This process led me to take courage from those who had suffered and found peace. Dwelling on and receiving truth while thanking God for His presence and gracious help prepared me for the mastectomy three specialists had recommended.
A few days after surgery, my oncologist released me saying that no cancer cells had invaded my lymph system, so I was free to go. I walked out into the summer sunshine a relieved and very grateful woman. Each day became a surprising gift and an adventure with a brand new attitude of gratitude and a desire to encourage other women individually and in small groups with the skills God has given me.
Because I was blessed with friends who had survived breast cancer and were living positive, active lives, I found it very easy to be open about my own journey with other women. This sparked a needed dialogue that soon dispelled any shame or guilt attached to the disease. Though my physical body had been altered, I did not feel less of a woman. I had the full love and support of my husband, family, friends and even the community where I live.
In the summer of 2000, the Utah state governor’s office awarded a medal stamped with the words “Cancer Survivor” to each of those who took part in the American Cancer Society’s Relay for Life. Being cheered on by our loved ones, nearly 100 men and women, wearing our medals, walked around the track at our local city park enjoying the experience of being part of a unique brotherhood and finding hope for our future.
Although it was possible that cancer might return, I determined to nurture hope and be grateful for what I had rather than moan over what I had lost. Odd as it may sound, I was thankful for my cancer diagnosis because it changed me in the most positive ways
The following year, in September of 2001, a few days after the Pentagon was bombed and the World Trade Center in New York City was destroyed by terrorists, I had my annual physical examination. This time, my doctor suggested that I undergo a colonoscopy to rule out colon cancer.
During that procedure, the surgeon discovered a very large polyp that had to be surgically removed because he said, “It could develop into cancer.” In the context of my nation’s vulnerability to sudden terrorism, September 11th was a time when my own body endured a barrage by relentless invaders. The only way to ward them off was by undergoing another radical surgery, trusting in God for the results.
The next day, I found myself being wheeled into the operating room, recovering for several days afterwards, and emerging with a welcome report: the polyp had been benign and the type of polyps I produce do not turn into cancer.
As you can see, it has truly been to my advantage to have my annual physicals and follow my doctor’s instructions. Beginning with a complete hysterectomy in 1987, other major surgeries had saved my life. But six years later, in the spring of 2007, a television interview also proved life-changing.
On the 60 Minutes news program, Elizabeth Edwards, the wife of John Edwards (a candidate for President of the United States) spoke about the return of her breast cancer and how she planned to live the remaining days of life to the fullest. She said she wanted her children and grandchildren to know that “She stood in the storm, and when the wind did not blow her way, she adjusted her sails.”
My sister in-law, Roshni Kulkarni who is a pediatric oncologist living in another state, called to tell me that Elizabeth’s words prompted her to do a self-exam. She found a lump. The next day she had a mammogram that didn’t show anything, but since her doctor also felt the lump, he did a biopsy and then Roshni had an MRI that showed the mass. It was in an early stage.
She called to tell us about her upcoming mastectomy. “You must get an MRI, Diane,” she urged. “You’ve already had breast cancer once, and this will show if anything is there.”
At first I rejected the idea because I was already eleven years beyond my original diagnosis, and I had recently received a clear report on my annual mammogram. But a still small Voice urged me to face the possibility and undergo the test. My doctor agreed. When the results came back, four “hot spots” were clearly visible – the needle biopsy uncovered malignant cells. Again.
Unlike how my life had shattered in 1996 when I first heard that I had cancer and needed a mastectomy, this time, at the age of 61, I was entirely prepared for the eventuality and ready for action. I didn’t think twice about moving forward. I was eager to rid myself of the threat.
My husband and I met with the surgeon who scheduled surgery for the following Monday morning. Three weeks later, when we met with my oncologist, I told her how I had been mentally preparing for a reoccurrence. “Have I done anything to cause this?” I asked her.
“No,” she said. “You didn’t cause this. No one knows why breast cancer occurs.” She was curious why I had thought cancer would return. “I’m sure this is totally unscientific,” I said, “but I had long ago prepared for this possibility because I still had my other breast.”
She evaluated my medical report. The tumors that were present were very small – once again, cancer was caught early. Neither chemo nor radiation was required, but since estrogen feeds breast cancer cells, my oncologist prescribed a five-year dose of Arimidex because it removes estrogen from the body.
Meanwhile, Roshni took chemotherapy as well as Herceptin and Arimidex. Both of us finished our fiveyear course of treatment in June of 2012. Both of us have been released into new life.
My ongoing plan is to continue to do what I have done: be vigilant and totally involved with my health care, willing to do what needs to be done with a positive mental attitude even if cancer shows up again. And I will live each day to the fullest, enjoying my family and friends and the activities that strengthen me and others.
To encourage you in whatever circumstance you may find yourselves, I conclude my story with this quote from Michael Meade, a writer for The Huffington Post: “When faced with great danger in this world, run towards the roaring, go where you fear to go, for only there will you find some safety and a way through danger. Trouble that is faced when it first appears can be the roar that awakens a person’s deepest resources. In times of trouble or tragedy, a person either steps into life more fully or else slips into a diminished life characterized by fear and anxiety.”