Clarity Through Cancer

In March of 2002, I did what many people who are closing in on their 40th birthday do — I took inventory of my life. After a short deliberation, I decided I needed a new home because I felt stifled by the warren-like floor plan and low ceilings of my ranch-style house.

I desperately wanted a third child, feeling like the two healthy children I had were not quite enough to complete a family. My car felt too small and outdated. My garden looked too sparse and dull. And my time too limited.

I was unsatisfied with myself as well. I thought my body was out of shape and considered my face aged and dull. I believed I needed to obtain a graduate degree to validate my intellect and interests, and so on, ad nauseum.

In retrospect, I now realize that I was running a futile relay race, rushing through life pushing an imaginary shopping cart that I was desperately trying to fill — and running that race began to take its toll.

At first, I noticed that I was always exhausted and my eyes ringed with shadows. Sleep was just one more thing I couldn’t seem to get enough of. When I saw pictures of myself or looked in the mirror I was startled. I looked old and tired like a copper penny that had lost its shine. At my annual physical, I mentioned my fatigue to my physician who replied, “You work full time, have two small children and manage a busy life. Of course you are tired.”

But my fatigue remained — a bone-deep, relentless clutch.

Soon after my doctor’s visit I had a vivid and horrifying dream. In my dream I discovered a growth on my torso and went to a hospital to have it removed. An incision revealed a nest of shellfish — mussels and clams — all gripping and ripping at my internal organs. One can imagine my subconscious horror as I tried to yank these parasites from my body.

The dream was so vivid and terrifying that I carried it in my thoughts for the weeks that followed. When I described it to a friend, he noted, “Well you know that Crabs are the astrological sign for Cancer.”

My face has always tattled when my body is sick. When I was twenty-five, I felt run down and I looked pale and unhealthy. At a routine visit my dentist discovered I had an abscessed tooth that was spreading poison throughout my body. The tooth was extracted and when I returned to work a few days later, my co-workers remarked on how much better I looked. And instead of the typical fever, a grey pallor has always been my precursor to the flu.

The July 4th weekend of 2002, I experienced what should have been an idyllic day with my husband and children. We went to the beach, played outside and had picnics. In the evening we went to an outdoor concert to see fireworks, and that’s when I started crying. My tears fell, for no logical reason. Like a rainstorm, they fell fast and furious and continued through to the next day. And just like my unyielding exhaustion, my sadness was inexplicable, powerful and unstoppable.

Two days later, I discovered a lump in my breast. I was reading a book before bedtime, my husband next to me. The fan oscillated soft summer air across the sheets. I was serene, unaware of anything but my entanglement in a novel. Casually, I scratched the area at the base of my left breast. It was a thoughtless movement much like scratching an itch, except I felt something hard and foreign, like a tiny egg resting against my rib cage. Was that my rib?

“I feel a lump,” I stated in a flat voice to my husband.

Looking back, I am surprised how totally devoid of emotion I was. I simply made this life altering statement in an insipid voice. I grabbed his fingers, rubbed them along the ridge of the lump. He felt it. I could tell by his silence.

“Nothing to worry about,” we agreed. “These benign growths appear all the time.”

The following morning, I opened my eyes at 6:00 am to a beautiful summer sunrise, and remembered the lump in my breast, hoping it was an element of a bad dream. I hesitatingly reached for my breast and there it was — a startling reality.

My routine mammogram was coming up in two weeks. I called the hospital and asked if I could come earlier. The mammogram technician asked me where the lump was, felt it, and placed an adhesive strip on the lump so she could locate it again. I breathed through the discomfort of having my breast crushed while over a dozen images were recorded. The technician called me back from the waiting room to tell me that the mammogram did not detect the lump. Evidently, there are places in a woman’s chest that are too difficult for a mammogram to image and they scheduled an immediate ultrasound.

The ultrasound identified a “thick mass” and the on-call physician scheduled a biopsy, “just to be safe.” Two weeks later, as my son’s preschool class ran through the sprinkler in my backyard, their faces colored and sticky from popsicles, my doctor called and told me that the biopsy results were in. In an instant, I transformed from an active Mommy to a cancer patient. He diagnosed breast ductal carcinoma, stage one cancer.

As the news of my cancer filtered out, I received a tremendous outpouring of love and support from friends and family. While I sorted through piles of card, books and phone messages, I wondered what I had done to deserve such care and support. I made an appointment with a prominent surgeon. I was greatly relieved to hear that rather than a mastectomy, a lumpectomy and sentinel node removal, were the recommended treatment. She warned that I would probably need chemotherapy and radiation to follow.

“They will want to treat you aggressively,” she cautioned, “because you are young, strong and can take it.”

I wondered — can I take it? Can I tolerate the whole process and what will be the outcome? I was more frightened by the prospect of surgery than battling cancer. I had never been under anesthetic before, and joked to a friend that I would rather have bamboo forced under my fingernails than have someone “mess with my breathing.” My biggest fear was that I wouldn’t survive and see my children again. Suddenly the only important thing to accomplish in my life was to see my children just one more time.

On August 27th as I entered Boston’s Mass General Hospital at 6:00 am, I felt a strange sense of serenity and purpose, even though I felt like an inmate being marched to the executioner’s chair. My children each made me tiny paper hearts that they had hand colored. I pinned them to my hospital gown feeling a stronger attachment to them than what I had once considered my valuables — my diamond ring and gold necklace. When I woke from surgery, I was so thankful to be alive, that I grabbed the anesthesiologist, pulled him to me and kissed him on the cheek. I was told that I would feel exhausted when I came to in the recovery room, but I felt euphoric instead. I felt empowered having survived the operation and realized a new and deep sense of appreciation for my body, its synergy and strength because it had sustained me.

Weeks later the pathology report offered good news and bad news. When the tumor was removed, the surgeon was able to get clean margins of tissue, which meant the entire cancer growth was gone. However, one of my lymph nodes contained cancer. I was graduated to stage two cancer, just like that. My oncologist recommended a standard chemotherapy regime of four treatments three weeks apart which started in early October 2002. The chemo was compared to guerilla warfare; its objective is to kill any ancillary cancer cells that might have spread.

My oncologist warned me that my hair would fall out — “an inevitable effect of cytoxin and adriamycin.” Surprisingly, I didn’t feel too worried about losing my hair. Instead, I felt a weird sense of curiosity wondering about the shape of my head and what the top of my scalp looked like. To prepare for my hair loss, I made an appointment with my hairdresser and asked her to crop my shoulder length hair, shorter than it’s ever been in my life, close to my head. But before the shearing began, I did as my children asked and had my hairdresser make two thin braids of my hair which my hairdresser snipped off and handed to me so I could give them to my children as keepsakes.

Like many women, I viewed my hair as an accessory to conceal the things I hated most about my face. In my case, I used my long hair to hide my high forehead, ears that stick out a bit too much, and nose that is perhaps too long. But, when I examined myself in the mirror with my new short haircut, I was surprised to note that those perceived imperfections suddenly diminished. I studied my face and started to appreciate it for it’s character and individuality. At my second chemo treatment, my oncology nurses were surprised that I still had hair. “Amazing!” they remarked. I sat in my chair, eyes to the window watching snowflakes dance and lift in the cold November air and felt proud and resilient.

Three hours later, I walked through a myriad of hospital halls, weakened but happy to be liberated from the catheter needle that dripped caustic medicine into my arm. When I reached the door to the parking lot, it swooshed open and I stepped outside. The wind was strong, gusty, the kind that forces you to walk at an angle to overcome it. It felt cold, refreshing on my face, and I lifted my chin to the sky. Then out of the corner of my eye, I watched as strands of my hair flew away with the wind. The raging wind tore at the trees and my hair tore from my scalp. I envisioned my tresses lining bird nests along the nearby Charles River in Cambridge, MA.

Once I got home, I borrowed my husband’s hair clippers and locked myself into the bathroom. I wiped away my fierce tears so I could see my reflection and shave off my hair methodically and completely. A few days later the hair on my body fell out. My eyelashes and eyebrows thinned so severely that I felt lucky to have three eyelashes to apply mascara to on New Years Eve.

The loss of my hair was not the only significant change for me. I was also concerned because my doctors warned me that the chemo affects the ovaries and might force me into early menopause. I was forced to come to terms with the fact that my periods would most likely never return, and I would never experience pregnancy, childbirth and mothering an infant again. I experienced a period of grieving, mourning the loss of those things I considered contingent with my menstrual cycle-fertility, femininity, and my youth.

My radiation treatments started in January after a “mapping session” where I laid bare from the waist up and endured a two hour long CAT scan and the application of six tiny permanent tattoos to indicate where the radiation rays should enter my body. Lying there, cold, naked, bald and tattooed I realized the parallels between being a holocaust survivor and a cancer survivor. I noted that I was considering myself a survivor as opposed to a victim.

My course of radiation took six weeks. I went to the hospital five days a week where I was treated by an incredibly caring team of radiation therapists. I had always been a modest person, but after the second week of baring my breast daily to a score of strangers I began to feel as comfortable greeting strangers topless as I had about offering a handshake in the past.

“When will your hair come back?” my children begged daily.

“In the spring” I replied. “When the grass in our yard starts to grow.”

In March of 2003 during a thaw, my son noticed the flattened grass on my front lawn. “There’s grass!” he exclaimed. “Quick! Take off your cap!” As the frozen earth prepared to birth flowers and grass, we noted that my scalp was sprouting, lovely soft new hair — a metaphor for my second chance at life.

On March 17th I completed my radiation treatments. At my final examination, my nurse, Becky, commented on how well I tolerated the radiation. Usually during radiation treatments women’s breast skin cracks, bubbles or becomes highly irritated. My breast, although red, was evenly colored and did not burn. She attributed my atypical tolerance of the treatment to my positive attitude and willingness to adapt and comply with the treatments. I was highly complimented by Becky because I cannot recall ever considering myself as compliant and adaptable.

But, my metamorphosis to an adaptable creature is just one small indication of who I am now. Cancer has affected and transformed everything about me especially my way of thinking. Recently, a friend congratulated me on completing treatments and said,” Now, that it’s over you can put it all behind you.”

I smiled politely and hid my total disagreement. I will never put this behind me because I am forever changed for having waged this battle against cancer, but I believe changed for the better. Being diagnosed with cancer was like being handed a gift in horrible wrappings. At first I wanted to refuse it, push it away. But I was forced to strip away the exterior all the while overcoming tremendous pain and fear until I reached the core — a gift of inner strength, health and appreciation of everyday life. I used to want more of everything in my life. Thanks to breast cancer, I now know that I always had more than I ever needed.

Karen Koretsky Dillon is a freelance writer and watercolorist who lives in the Boston area with her husband and two children. At this time, her cancer is believed to be in remission. She can be reached at