I will always remember the phone call from my friend: “I’ve got cancer.” Was she joking? No, not with that taut tone of voice.
Marianna and I were friends who happened to be nurses. Before that phone call, we’d joke that any of our abnormal symptoms—bleeding, headache, constipation—was cancer. We didn’t mean it, but it was a flip way to diffuse our concern.
She clarified she had breast cancer, Ductal Carcinoma In Situ. At the time she was diagnosed in 1997, and until recently, DCIS was seen as a cancer and was treated aggressively. Now, by contrast, in a controversial change of view, the medical establishment is seeing DCIS as a precancer and, depending on “grades,” is suggesting only ‘active surveillance.”
With this change, Marianna, and many other women, may not have had to undergo disfiguring surgeries and painful follow-ups.
Aside from Marianna’s blog post, I’ve heard only a quick announcement on the evening news about this change. I could not help but think how this news was affecting persons with DCIS who received aggressive treatment. And how it was affecting me as Marianna’s friend.
When I first heard her news, I instantly felt a deep, dark chasm between us. We had never been wordless together, but I could find no words. And, with little experience with breast cancer, I felt I could never know exactly how she felt or exactly what her journey entailed.
Feeling wordless led to feeling helpless. We lived in separate states. I was teaching full-time, and I could not be near her.
I would have liked to have hung out at her bedside. We would talk about “nurse” things, the guts and blood, the details, of the patient experience. Was the doctor empathic? What was her state of mind? What was she doing to prepare for surgery? How did she deal with her family’s fears? What was it like being a patient rather than the nurse? How did she feel waking up from the surgery? What did she feel like during the first dressing change?
Details that only come up after a length of time together, details not likely to be revealed in a phone call.
Then I felt guilt. Why did Marianna get cancer and not me? Especially since we’d joked so many times about it. With the reality that she had cancer for real, her diagnosis hit me like a cruel stab in the heart and ensured we would never again make light of having cancer. In the years following, my guilt resurfaced when she’d email about participating in annual breast cancer walks.Why wasn’t I moved to do the same?
Our long-distance friendship has survived this crisis period. When I look for good that came out of this experience for me, I easily find our commitment to actively tend our friendship—via frequent emails, serendipitous phone calls, yearly face-to-face visits. And through dreaming up and following through on writing, alongside each other, the stories from our nursing careers, hers as a nurse practitioner and mine as a nurse educator.
But, now with the controversy surrounding the treatment of DCIS, I feel like my heart is shattering once again. I know medical advances are always in a state of flux, and I’m happy other women will not have to go through Marianna’s journey, but I’m mad that she had to go through it. I’m mad that she’s had to dread mammograms for years.
I’m mad about the physical and emotional trauma inherent with a cancer diagnosis that might not have been necessary for my friend.
Have you been touched by this controversy? If so, share your story!
- When Cancer Is Not Cancer (nursingstories.org) (Read Marianna’s story here.)
- What If What You ‘Survived’ Wasn’t Cancer? – Bloomberg (bloomberg.com)
Marianna Crane said:
Thanks, Lois, for bringing this discrepancy in the DCIS diagnosis to light. It doesn’t need to have a traumatic and disfiguring treatment process. Yet, many women aren’t given options.
And yes, out of distress can come clear realizations like the importance of friendship in our lives. Thanks for your support and friendship over all these many years.
Lois Roelofs said:
You are more than welcome. It’s not everyday that one finds a friendship that is long-lasting and reciprocal like ours!