Thursday 26 November, 2020

Touching testimony from a Haitian breast cancer survivor

The person interviewed in this article has given us permission to use her photo, but not her full name. We will therefore call her Miss J.

The person interviewed in this article has given us permission to use her photo, but not her full name. We will therefore call her Miss J.

Breast cancer kills 458,000 people each year, World Health Organisation (WHO) reports. The disease does more damage in low-income countries where patients, because of the lack of information on the subject, are often diagnosed too late.

Although dangerous, breast cancer is curable. In this article, let us discover the testimony of a young Haitian woman living in the United States, who at the age of 39 fought and beat breast cancer. Even if she's now healed, she has not stopped fighting the disease.

“I was sitting on the exam table when the surgeon walked in with the chart and greeted me. He opened the patient chart and read out loud: "You have breast cancer."

"I had a small lump that I discovered about seven to eight years prior with breast self-exam. It was monitored throughout the years, and it was diagnosed as a cyst. In December of 2013, in the course of my yearly gynaecological wellness exam, I brought to the attention of the gynaecologist that the lump that was previously diagnosed as a cyst had increased in size.  The lump could now be seen under my skin.  She referred me for a breast ultrasound, then a fine-needle biopsy. The fine needle biopsy is a procedure where fluid is taken from the cyst for laboratory testing.  Since the doctor could not remove any fluid, he referred me for a core needle biopsy where tissue could be harvested and sent to the lab. That last biopsy is what revealed that the cells were cancerous." 

Loop Haiti: What was your reaction when you received the news?

Miss J: I went to the surgeon's office two days after the biopsy for the results. I was sitting on the exam table when the surgeon walked in with the chart and greeted me. He opened the patient chart and read out loud, "You have breast cancer."

My heart dropped, I felt hot and cold at the same time, and tears started pouring; I was thinking, oh Lord, I can die, I can die very young.  My next thought through the tears was gratefulness. I clearly remember thinking, "better me than my sisters or my friends."  The surgeon sent a female staff to talk to me. She was a survivor of breast cancer as well. They both reassured me and told me that it would be ok.  The surgeon informed me that the surgery could be done Friday of that week.  I told him to give me a few days to take it all in.  In my mind, I already knew that I was not going to delay the surgery.

I was in shock because I did not have a family history of breast cancer nor was I at the age to begin breast cancer screening.  I was 39 years old, and they don’t usually start screening using mammography until after age 40 to diagnosticate breast malignancy.   

The surgeon gave me the option of having a lumpectomy, unilateral mastectomy, or bilateral mastectomy.  I chose the lumpectomy with the understanding of radiation to follow.  

I cried for an entire 24 hours. I cried while talking to my family, to my friends, I cried while at work, I cried while talking to my spiritual counsellor. I cried in the shower. I cried myself to sleep.

I had to work the day that I learned about the diagnosis and I was unable to call in sick.  I worked with my eyes puffy and red and sniffling, but I completed my day of work.  I called my support system to let them know.  They were supportive and strong because I didn't crumble, they cried with me, but they followed my lead. 

Loop Haiti: What type of treatment was proposed by your physician?

Miss J: My surgeon proposed surgery immediately and referred me to an oncologist. He also told me that he would also have to remove a sentinel lymph node, which is a procedure to determine if the cancer had migrated from their site of origin to the lymphatic system.   The lymphatic system is a network of tissue that helps in getting rid of harmful substances, toxins from the body. They would send that tissue to the pathology lab during the surgery if any malignant cells they would be removing more lymph nodes.   If the cells had travelled to the lymphatic system, more lymph nodes would have to be removed, and I would have a drain line after the surgery. 

I remember telling the surgeon, please be very careful I am righthanded and I am a physical therapist, I need my Right upper extremity. I didn’t want any nerve damage to affect my ability to work, therefore my livelihood.

When I woke up after the surgery I look under my armpit and saw that I had no drain lines; I felt so relieved through the pain. I meant that the cancer had stayed at its original site and had not travelled.

After my surgery, the continuation of care was follow up with a breast oncologist that is a specialist in breast cancer. I went to the oncologist, but I didn't feel comfortable. I found another one more in line with my thinking. After multiple tests and looking at the pathology results she recommended chemotherapy followed by radiation.

She offered fertility counselling with options of freezing my eggs in the future event that I would want to have children.  I declined.

Loop Haiti: Can you describe the stages and difficulties of the treatment?

Miss J: I had a meeting with my oncologist to discuss the details of my course of treatment.  Unfortunately, due to the type of cancer, the stage, and the pathology exam, chemotherapy was recommended.

Usually, chemotherapy is given through a vein, depending on the number of cycles through the course of treatment. They may opt for a more central line instead of a peripheral vein due to the causticity of the drug or the length of time of the infusion.  The oncologist might be the one to guide you towards the best option for your treatment delivery.  I was fortunate not to need a port that would have required surgery for insertion and removal.

I had four (4) courses of chemotherapy at three-week intervals. My sessions were usually scheduled on a Tuesday, and the following day after the infusion, Wednesday, I had a shot of an immune booster to help with my blood cells.  As you know, chemotherapy is the injection of toxins in your body to kill all quick-growing cells such as hair cells, the cells of your mouth, the lining of your stomach, bone marrow cells that produces your blood cells.

Blood tests were done prior to the infusion, and the infusion lasted about three hours.  It is a very specific protocol, and I was monitored closely throughout due to the fact that I didn't have a port and that they were using a vein.  They had to be careful that it would not infiltrate and spread the toxin throughout my arm.  At my first treatment, I was accompanied by my sister; I had my comfy blanket, snacks, and books to read.

Between my surgery and my first chemotherapy treatment, I decided to cut my hair shorter to decrease the trauma of seeing big clumps of hair coming off my head.  I sported the hairstyle for a few weeks. The rest of my hair fell off in clumps immediately after the first treatment, so I went to the hairdresser and went for the baldheaded look.

I didn't like the wigs, so I opted for hats and scarves and at home no headwear.

I could feel the toxins as it started to spread in my vein slowly, it is a very strange feeling, as if aliens were invading your body, making you feel numb and alert at the same time.  Following the immune booster shot, I started feeling pain, and everything started to hurt the next day, even my hair hurts; I was in slow motion by Friday. I was nauseous, tired, and weak.  I forced myself to eat as the nurse had suggested every three to four hours some protein and carbs.  I reduce any artificial sugar from my diet.  My go-to snacks were mangoes and starch cookies (bonbon amidon) to cool and soothe my mouth.

My worst days were usually from Thursday night to Sunday. I was literally glued to the bed in so much pain and so weak.

Loop Haiti: What gave you the strength to go through the different stages of this disease?

Miss J: First my faith, my family and my friends. Having a strong faith allowed me to navigate this new endeavour.  I never questioned God. I never asked "why me?" instead, I said that I was okay with the fact that it happened to me instead of my sisters or my close friends.  I did not have children and had a career at that time.  It was easier for me to navigate this tumultuous sea at this stage of my life.  

My diagnosis happened while I was in school to complete my doctorate in Physical Therapy program. And the surgery, chemotherapy, and radiation made it very challenging, at times, to complete the course work for some of these terms. 

I would walk the day after my treatment, Thursday, and the first day that I could drag myself out of bed, which would be Monday.  The physical exercise kept me motivated and cleared my thoughts. 

Loop Haiti: What advice can you give to women or others with breast cancer?

Miss J: My first advice is to any women, know your body, and do breast self-exams monthly.  You most likely will know if something is out of the ordinary, and you could bring to the attention of your medical provider.  Do your women wellness exam yearly or as recommended by your provider.  Early detection is the key!

For my fellow survivors, follow the advice of your provider, be positive, surround yourself with positive people. Cancer is not a death sentence.  With the proper treatments and care and lifestyle changes, we can live productive and long lives.  Get involved in teaching others about early detection and raising money for the cause.

Loop Haiti: What are your projects for breast cancer awareness month (Pink October)?

Miss J: I usually participate and volunteer in two cancer walks during this month to bring awareness to this disease. Still, due to the pandemic, I have been raising money to assist association that help with research and to assist cancer patients.

Interview by Wyddiane Prophète

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