The specialty of Family Medicine allows providers to uniquely experience the lives of their patients from birth to end of life. It is hard to explain the emotions I felt the first time that I delivered a baby. I probably cried as much as the parents. Looking at such an innocent, precious creature enter the world was indeed an amazing moment in time. Likewise, I have also been involved with the other end of life’s spectrum as it relates to death transition. Tears were definitely present at those times as well. I think the hardest situations were those relatively young patients who succumbed to cancer, particularly breast cancer.
October is breast cancer awareness month and it has caused me to do quite a bit of reflection on past patients who left this world way too soon. Their memories live on in my heart and mind and I think about them often. I think about the grandchildren they will never have a chance to spoil. I think about the missed graduations and missed Grandparent’s day celebrations. Breast cancer robbed them of such joy.
One such example was a phenomenal woman of God and friend, who came to me for the first time with a cough. She had previously been treated for breast cancer and had not had any problems of which she was aware. However, she had been coughing for over two months and no one previously had done anything about it. Point number one: if you have a past diagnosis of breast cancer or any other cancer and you have an unexplained cough, see your doctor immediately. I ordered special imaging of her chest and sadly, my hypothesis was true: her cough was due to metastatic breast cancer. The cancer had spread all through her chest.
The remarkable story about this patient was that she chose to live and not die. She accepted that diagnosis with such grace and resilience of which I could only attribute to her unwavering faith in a powerful and omnipotent God. She never complained and never stopped fulfilling her passions of volunteer work and family. Many people never even knew she was battling such a horrific disease. She never missed a party.
Unfortunately, despite the best medical care, her disease continued to progress and spread to her bones and eventually her brain. Again, every time I saw her, she refused to complain and I had to essentially force her to take a prescription for pain. Although this incredible woman was fighting for her own life, she became a resource for other women in similar situations. She witnessed to them and supported them through their journeys. How many times can I say that this woman was awe-inspiring?
Although my patient lost her fight with breast cancer, she left a legacy of tenacity, will, and happiness! She never relinquished her loving spirit and the people around her could only reciprocate the same. She taught her family, friends, and me how to live for this day and appreciate your blessings before too late. In addition, she was a staunch grassroots advocate of breast cancer prevention particularly in African American women.
Most health organizations recommend yearly mammograms (x-ray of the breasts) starting at age 40. These low radiation x-rays can detect small changes, many of whom are benign. The procedure is performed by slightly compressing the breasts between two hard plates; the image is uploaded to a computer, and then read by the radiologist. Pre-medicating with acetaminophen or ibuprofen will help relieve any possible discomfort.
Breast cancer is the most common cancer among American women but second in cancer-related deaths, surpassed by lung cancer. In 2013, the American Cancer Society estimates that there will be approximately 232,340 new cases of breast cancer. However, the chance that breast cancer will be the cause of death is 3 percent, much less than years ago. Early detection is the key!
Too often women wait until there is a problem instead of scheduling annual screening exams. Breast cancers are staged based on whether the cancer has spread out of the breast. Regrettably, this is the case for a lot of women. It is also well known that black women present with breast cancers at much more advanced stages and the cancer tends to be more aggressive.
Therefore, I believe the conversation among women should include not only the latest products for natural hair or the latest app for the iPhone but also information regarding the next mammography van or reminders to our loved ones about their breast exams. Disease is best conquered by prevention!
Yours in Service,
Denise Hooks-Anderson, M.D.
Assistant Professor
SLUCare Family Medicine
yourhealthmatters@stlamerican.com
