Telling Your Loved Ones You Have Cancer

IMG_6093By Deb Song

I can still remember the day I got the call from Dr. Andrea Madrigrano, my breast surgeon at Rush.

“Deb, I’m so sorry, but it’s not going to be what you want to hear,” she said. “The lumpectomy confirms it is DCIS. You have breast cancer. The good news is, we caught it early, but we recommend a bilateral mastectomy.”

I don’t remember much after that. I tried to stay calm and ask questions on next steps. I’m a doer. Instinctively, I just set out to get this treated. My “let’s do this!” attitude kicked in.

But suddenly I felt my heart racing faster, my breath shorter, and I could not hold back the tears any longer. I started to weep uncontrollably.

I blurted out, “Oh my God. How do I tell my mom? How am I going to tell my parents I have cancer?”

On this Mother’s Day, as I plan a day with my mom, I cannot help but think back to this moment when I was finally diagnosed and staged out for surgery. How do you tell your loved ones you have cancer?

The reality is there is no good way to say it. There is no manual. There are no tips. After my call with my doctor, I turned to Google and Siri and asked, “How to tell your parents you have cancer?”

Not much is there.

‘I don’t want to break my mother’s heart’

At this point, I had kept my screenings, testing, imaging appointments, biopsy procedures, high-risk status a secret from others. I even kept my same-day, lumpectomy surgery a secret from my family, and two dear friends came with me so I could be discharged and took care of me at home. Only a few very close friends and my boyfriend at the time knew and were asked to keep a lid on it because I did not want my family to worry about if I might have cancer. We have a family history and I lost two cousins from breast cancer and am still recovering from the loss.

Then, the mic was dropped. I got the call.

Now, I had to tell my family. I had to tell my mom and dad.

As my wonderful surgeon softly explained to me what I needed to do to save my life, I kept asking questions on how to avoid surgery and treatment even though I already knew the answer from my years of covering breast cancer stories in my work in health care — that I could not avoid the treatment process.

Most of these questions did not only come from fear of my impending battle, but also my fear of how to tell my mom. It’s bad enough I have cancer, but I don’t want to break my mother’s heart in the process.

At that moment, Dr. Madrigrano said to me “Deb, I don’t want to take your boobs. I would do anything to be out of a job and not have to do this, but this will save your life.”

Her kind, honest, heartfelt and direct words snapped me back to my old self even if it was for just a moment to go over next steps and my treatment plan. I set up my appointments to go over details of my surgeries with her and Dr. Anuja Antony, who would be my breast reconstruction surgeon.

Numb

I continued working because it was the perfect distraction.  I had asked if I could take the next day off.

I remember finishing out the day and walking to my car. I felt numb all day, but was like a robot and just kept going.

Finally, when I sat in my car in the parking lot by myself, I lost it. I remember turning on my music loudly to drown out my screaming and sobbing.

I then proceeded to meet my two friends who took me to my lumpectomy surgery so that I could keep it a secret from my parents.

I thought to myself, “Well, consider this practice. I’ll tell them first as though I am telling my mom and dad.”

It didn’t go well. I was a crying, blubbering mess because I can be with my closest girlfriends.

That’s when I realized, there is no manual.  There is no one way or best way to tell your loved ones.

Rehearsal

I set a date to go over to my parents’ house to tell them.

In the meantime, I practiced by telling a handful of my closest friends and my brother.  Each time was different.

The only thing that was the same was how it sucked to hear your closest friends and your big brother cry.

You put on your brave face and smile. You try to use your calmest, most serene voice.

I would say:

“Hey. How have you been? So I’m calling because I have something to tell you. I have breast cancer. But doctors think they caught it early and I am going to be totally fine!  I just need surgery.”

The responses would be:

The initial shock

The questions … What? How? Why?

The tears.

The tears was the hardest part.

I would find myself crying only when I would hear my best friends cry. I felt like someone was tearing my heart out. If I feel like this now, how am I going to tell my mom and dad?

Breaking the news

Surprisingly, it was so different the day I went to tell my mom and dad.

That day, I went to work. Then, took a fitness class and pole dance class. Afterward, I drove straight over to my parents at the designated time I was going to meet them.

The visit started off like any typical visit. I let myself into the house I grew up in. Then, my mom hugged me and asked how work and my workout was. She asked if I ate yet. I told her I was hungry, and she set up some food for me.

As I sat at the kitchen table eating, I thought, “How do I tell them?” I felt myself chickening out.

My dad came down to have tea with me. Our usual routine where we all sit and drink tea and catch up.

As I sat there, I finally mustered up the courage and asked my mom, “So what are you up to in November besides Thanksgiving? Are you free to stay with me for a few weeks to help me out?”

My mom responded, “What’s going on? Why do you need help? Do you need to have surgery again?”

I had a surgery the year before and my mom needed to stay and help me for eight weeks.

“Actually, I do,” I responded calmly.

‘I have breast cancer’

My mom started to become concerned and asked me what I was not telling her.

“I just need to have a couple things removed. That’s all,” I said nonchalantly as I referred to my breasts as a couple of things.

My mom looked at me like she was annoyed and scared.

“What’s wrong? Did the first surgery not take?”

I told her that it had nothing to do with my first surgery and that was OK, and I am doing well from that.

“What is it then?” my mom asked.

“Well, so I have breast cancer, but the doctors caught it early, and I just need to have surgery and no radiation or chemotherapy and I will be fine,” I blurted out calmly.

I couldn’t look up. I didn’t want to see their faces.

It was completely silent.

I finally searched for my mom’s face. I thought she had passed out on the floor. She did not. She had a blank look on her face. My dad began to cry and said, “This is my family’s fault. It is our genes.”

I dug so deeply to put on my best face. I could feel the tears.

Before I could speak, my mom immediately stood up and said, “It’s going to be OK. You’ve got this. We’ve got this. Don’t worry. We will take care of you.”

I tried my best not to cry, but I wept. I think out of relief that I finally told them and that I was no longer keeping it a secret, but also because I know I just cut them so deeply. The two people I love the most in this world.

‘Brave and strong’

She then looked at my dad and said, “We will not cry. The only person allowed to cry is my Debbie, but we will not cry.”

She then hugged me and smiled. She said, “It’s OK my bobae (In Korean bobae means treasure). You at your worst is most people at their best. You are brave and strong. You are the favorite son and the best daughter. You will live and we will put this all behind us.”

I don’t remember much after that.

For the first time, I actually slept.  I woke up without the feeling of fear, devastation and anxiety.  I’m not saying that it just goes away.  For that one moment, I felt a little better.

My mother told me months later that after I left, she fell to the floor sobbing. She cried to all my aunts and uncles. My parents told them all that they ask for forgiveness, but if it would be OK if they call them to cry because they don’t want me to see or hear them cry.

There is no good way of telling your family and loved ones that you have cancer.

I thought I would have insight on how to do it.  The fact is, I probably am not a good example of how to tell your loved ones you have cancer.

What to expect

But I can provide you with insight on how your family and loved ones will react.

There are true emotions. They might not know what you have been going through and what’s going on in your head, but they know it is hard.

Your loved ones will try to be supportive the best they can.

They also need emotional support and will turn to others for it because they want to be strong for you.

It’s OK not to be OK and to feel what you feel whether you are the patient or the caregiver.

It’s OK not to always wear your brave face.

It’s OK to have good days and bad days.

It’s OK to cry.

It’s OK to smile.

It’s OK to talk about your feelings.

The one thing I wish I had done was start off my psychological oncological support during this time. I had waited until after my bilateral mastectomy.

I’m glad I set it up.  It’s never too late to have psychosocial support, but I realize I should have done it at my darkest time, which was during diagnosis.

It really could have helped me in not how to tell my parents, but how to deal with the anxiety, fear and concerns about telling your loved ones.

It also helped me in providing support for my loved ones.  There are programs for caregivers, which helps them too.

So I urge you to get professional psychosocial oncological support. Don’t think you have to go at this alone. The sooner is also the better.

Deb Song is a media relations specialist at Rush. Learn more about For more information about psychosocial oncological support at Rush.

Colonoscopies Can Prevent Colorectal Cancer

By Salina Lee, MD

Despite remarkable advances in detection and treatment of colorectal cancer, it remains the second-largest cause of cancer mortality in the United States. This statistic looms despite the fact that colorectal cancer is one of the most treatable cancers there is because early detection, thus cure, is entirely possible.

What makes this unique among the other cancers for which we have screening tools is that prevention is also possible. This is because we can identify and remove premalignant lesions before they become cancer. So what accounts for the stark contrast between this grim statistic and our known ability to prevent, detect and cure this cancer? Lack of screening. The most common signs and symptoms of early colon cancer are — nothing at all. That’s why we so strongly recommend screening for colorectal cancer.

Current guidelines recommend colorectal cancer screening for adults between the age of 50 and 75.  This may start earlier for those at higher risk (family history of colorectal cancer, chronic inflammatory bowel disease, polyposis syndromes or patients of African-American descent).

After the age of 75, we recommend screening on an individual basis. There are a variety of recommended screening tests. The gold standard is the colonoscopy, which provides both screening and prevention. Not only can it detect early stage cancers, but also precancerous lesions called polyps, can be removed to potentially prevent a cancer from developing.

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Breast Cancer Screening Saved My Life

deb-dog-breast-cancerBy Deb Song

I just want to thank everyone for the overwhelming response to part one of the video series on my cancer journey at Rush.

Testing and diagnosis have been key parts of this wild ride I am currently on.

Like most women, I dreaded the idea of having to take time out of my busy schedule to get a mammogram.

In my career as a media relations expert covering breast cancer stories, I have filmed many mammograms.

They looked uncomfortable and unpleasant.

The doctors and technicians are so nice and make such a huge effort to make it seem less scary, but let’s be real. Who wants to have their breasts examined and squished in a machine? Definitely not me.

Excuses

So, when it was time for me to schedule my first mammogram, I wasn’t really up for it. I could have made every excuse to put it off or ignore it.

I had a good excuse, too! I just had an unrelated major surgery and was recovering from it. I had a huge abdominal scar that hurt and was still healing, and I had just started back at work. Did I really want to be back in the hospital for more tests and procedures? I just wasn’t in the mood to do it, and I didn’t want to take the time off to get a mammogram.

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How Lung Cancer Advances Have Changed My Life

marwaha-feldman-bonomi

Jill Feldman with radiation oncologist Gaurav Marwaha, MD, left, and medical oncologist Philip Bonomi, MD.

By Jill Feldman

I have been fighting lung cancer indirectly, and now directly, for 36 years, and most of it has been an uphill battle. I lost my dad and two grandparents to lung cancer when I was 13, and then my mom and aunt, Dede, died of lung cancer when I was in my 20s. I was shocked and upset that in the 14 years between my dad being diagnosed with lung cancer and my mom being diagnosed, there was not a single advancement in lung cancer treatment, despite it being the No. 1 cancer killer. My family and I felt helpless and hopeless, and while there wasn’t any research on hereditary lung cancer, I knew our familial lung cancer wasn’t just a coincidence.

I did what I could to get educated, be an advocate for myself and my family and to help advance a cause that many were not aware of and/or not interested in. While doing so, in 2009, I was diagnosed with lung cancer at 39 years old. My kids were 6, 8, 10 and 12 — and their only association with the disease was death. They were scared, and my greatest fear was becoming a reality. I was following in my family’s footsteps, and there wasn’t any promising research that convinced me the path would change.

For many years, the only distinction doctors could make was whether a person had small cell or non-small cell lung cancer, and patients had three treatment options: surgery, radiation and chemotherapy. It wasn’t even until the 1990s that combination chemotherapy regimens were  approved. Still, there was debate whether it was even worth treating lung cancer because in many cases, the toxicity was worse than the disease, and the benefits from chemotherapy were marginal.

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A Message of Hope for Lung Cancer

Immunotherapies have changed how we treat the disease

Philip Bonomi, MD

By Philip Bonomi, MD

One of the things I learned early on in medical school is never to forget that it’s a privilege when a patient puts his or her trust in you to take care of them. I have never taken that privilege lightly. My goal has always been to prolong meaningful life and relieve suffering for my patients. That’s been my personal mission statement throughout my career.

And those goals are not always easy when it comes to treating lung cancer. When I started out in medicine, some of the treatments we tried for lung cancer were simply not effective. There were not a lot of options for our patients and often the prognosis was poor.

But through my long career, I have seen that perseverance, believing in an idea and not giving up on it can pay off.

Enter immunotherapies. When I was in medical school in the late 1960s, we had high hopes for immunotherapy. We thought it was going to be very important for treating patients with cancer. But then, we saw one failed study after another over the next few decades.

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Fear Not the Colonoscopy

Doctor's orders reminder for colonoscopy examBy Thurston Hatcher

So if you haven’t heard already, March is Colorectal Cancer Awareness Month. And if you have, you’ve probably also heard a few reminders that it’s time to get that colonoscopy you’ve been dreading.

As an employee of a health care institution, I consider it my professional obligation to inform you that I’ve had one, and it ain’t that bad. Want to hear more? Perhaps not, but I’ll tell you anyway.

Colonoscopies generally are recommended for people age 50 and older, since they account for more than 90 percent of colorectal cancer cases. The procedure, which involves running a thin, tubelike instrument through the colon, helps doctors spot precancerous polyps so they can be removed before they turn into cancer.

As it happens, I wasn’t quite 50 when I had mine, but I had a few minor symptoms that might fall into the “cause for concern” category. My primary care doctor and gastroenterologist weren’t particularly alarmed, but they wanted to play it safe, and they figured I was close enough to my golden years to experience this rite of passage.

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Gina’s Story: Catching Lung Cancer Early

gina-story

Gina meets with medical oncologist Marta Batus, MD, and thoracic surgeon Christopher Seder, MD.

As a lifelong smoker, Gina knew the risks of smoking — but, like many people, she pushed these thoughts out of her mind.

“For years, my very dearest friend and I would sit on the phone together, have coffee and smoke cigarettes,” Gina remembers. “Then she was diagnosed with lung cancer and died from it. Even though I saw what she and her family went through, I was still in denial that anything could happen to me.”

Taking control

Five years ago, at age 70, Gina got a wake-up call to start taking control of her health: She was diagnosed with breast cancer.

She had a mastectomy at Rush and was soon cancer-free. With a new lease on life, she began running, cut down to three cigarettes a day, and started listening to shamanic drum chants and doing positive-thinking exercises. She also continued her regular breast cancer follow-ups at Rush with medical oncologist Melody Cobleigh, MD, and nurse practitioner Teri Dougherty, NP.

Still, Gina’s smoking history and age put her at high risk for lung cancer. So at an appointment last summer, Dougherty talked to Gina about her risk factors and suggested that Gina was a good candidate for a lung cancer screening test — a low-dose CT scan that can detect lung cancer at its earliest stages, before symptoms arise and when it may be most curable.

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