Reflecting on my treatment decision

I ran on the RPAC track today.  Despite doing well on the diet, I had a more energy than the past few running attempts, so that's good. After 1.5 miles though, my lower back was hurting quite a bit - a clear sign that my hamstrings were way too tight. I stopped after 2 miles to stretch and do some ab work for about 20 minutes and then went back to run a third mile and quick-walk a fourth. My miles were 10:47, 10:56, (break),10:52, 15:38.

The diet is going well since I got serious about it, probably Thurs or Fri last week. I'm not that far into it though I've already seen results. The things I'm eating none of include: sweets, white breads, pasta, tortillas, and anything fried. The things I'm eating less often than before: whole grain breads, salad dressing, pria bars, and diet coke. The things I'm eating more often: avocados, fresh spinach, sunflower seeds, oranges, light yogurt, lettuce, tea, and a glass of red wine.

In successful diets in of past, I was much more restrictive in food groups and almost totally cut carbs for at least a couple of weeks and then very, very slowly added them back at one food per week, starting with green beans. It was successful, but I worry it may have contributed to my LCIS becoming ILC. I read something about a researcher looking into a connection between low carb diets and breast cancer, but I don't know of any evidence to support that idea. Regardless of whether diet was a contributing factor, I was okay with that diet when I was a ridiculously healthy person with low cholesterol and good blood pressure - and no cancer and no rehab issues. Unfortunately, I am not that person anymore. Now I need to find a new way to lose and manage my weight while still getting good nutrition. 
 
I haven't written much about cancer/rehab lately because I'm getting on with life right now. I admit that I am reminded often of my plight, however. The other day, I saw a women walking on the RPAC track wearing a bandana and with thin hair peaking out from under it. I created stories about her in my head of course: That she had cancer and endured chemo and is just getting energy back . . . that she had it tougher than I did . . . that she is strong and impressive for beginning the exercising again. Of course, I don't know really know her story. But she reminded me of mine. 
 
As I drove into the parking garage this morning, I heard a teaser on WOSU radio that made me hurry into my office so I could hear the story streaming online before my meeting.  It was about an OSU breast cancer researcher who has found that more women are choosing radical treatments for breast cancer than before.  She went on to say that prophylactic (proactive) mastectomies are being chosen by breast cancer patients who are in Stage 1, younger, highly educated, and often have a history of breast cancer in the family. I'll bet my case was one of the numbers she included from her database research.
 
She is researching this phenomenon because she is concerned these cancer patients (we) might have mis-information from doctors informing our decisions. Since the survival rate is the same for those of us who have lumpectomies vs. mastectomies vs. prophylactic mastectomies, she wonders if too many of us are choosing the radical treatment. She did go on to recognize that we are making these choices because we have a lot of life ahead of us and don't want to deal with breast cancer again. However, she thinks the low instance of recurrence (she quoted 8 to 14% for people who do not have the family gene) does not warrant the high instances of prophylactic mastectomy treatment.
 
I chose to have a mastectomy on the breast with the cancer and a prophylactic mastectomy of the other breast. Since my surgery, I've read about other women with a similar diagnosis (stage 1 ILC and LCIS) who chose the other route that was an option for me, the lumpectomy. I've read about these women (who could be me) enduring chemo and radiation and getting all sorts of other terrible ailments from those treatments. They have longer recovery times and have much less energy for life for months and months. When they are pronounced cancer-free, they start the regimen of taking tamoxifin for 5 years and visit the mammography clinic every 6 months. I know I'm over-generalizing, and everyone has a different treatment plan, but it's not an unrealistic process I describe here. It is very real for many people who were diagnosed with stage 1 ILC and LCIS as I was. And I haven't even mentioned what it is like for the ~1 in 9 women who, despite what sounds like low odds, actually do have a recurrence and start the whole process over again.
 
I'm not saying that the decision I made was right for everyone. It was right for me, though. And I certainly don't want to discount the concerns of the researcher. I am grateful she is doing the work she is doing and thankful she makes a difference in the lives of women who are touched by this disease. However, in this case, I don't share her concerns. I'm not worried that I made the wrong decision with inaccurate data. I know I probably wouldn't have died from this disease within the next 20 years even if I had chosen the lumpectomy. However, what about the following 20 years? And the following 20 after that? I feel like I've been given a gift to have caught it so early and to not be worried about survival. Would I be so lucky the next time?  Next time would it have been stage 2 or worse? Next time would it have gotten into my lymph nodes and required chemo? So I guess I said carpe diem. Besides, there are many more factors than survival at work here.

As tough as the process has been, I've been sidelined for a surprisingly small amount of time. Even in the middle of all this, as I am right now, I am doing pretty much everything I would have been doing if I had not been diagnosed. And I made a major impact on the likelihood that I will not have a recurrence. As the researcher said, I really don't want to go through this again. I no longer have 1 in 10 odds. For me, it's more like 1 in 100 that I'll be diagnosed with breast cancer again.