Breast Cancer and Cosmetic Surgeons

Today I’m thinking of my youngest sister Carolyn and the struggle she’s had with breast cancer. It hasn’t been easy for her. For one thing, she had to undergo a (single) mastectomy two years ago that left her with a new body to adapt to. As a man, I cannot imagine what it must be like to have a part of your body removed, especially a part that, for women at least, can be such a focal point in their lives.

I have another sister with cancer. Susan had a form of lung cancer. A smoker for many years, her cancer was discovered seven years ago. While she didn’t have surgery, she went through a heavy cycle of chemo and radiation, forcing immense lifestyle changes. Always a beautiful woman (in restaurants she turns heads), she decided she wasn’t going to go the “chemo bald is beautiful” route, so she went out and bought several eye-catching wigs. After all, when it comes to cancer, it’s all about choice.

I mention choice because after Carolyn’s mastectomy, she was offered chemo and radiation by a bevy of cancer specialists. While chemo and radiation worked for Susan, Carolyn smelled a rat. It just wasn’t her style. She wanted to go the natural route. She and her boyfriend did some research and found a safe drug (from Canada) that pretty much did what chemo did minus the harmful effects. The drug had the approval of her oncologist. It was a controversial move, and a brave one. Carolyn was afraid of “chemo brain” as well as possible weight loss. Bald may be beautiful in old Mr. Clean commercials, but it wasn’t beautiful for her.

Two sisters with cancer is a scary thing, but because Carolyn’s cancer was visible in a way that Susan’s was not, she naturally thought of a breast implant. After some lengthy discussions with her doctor, she went under the plastic surgery knife for breast reconstruction surgery, or a tissue expander. Of course, the surgeon promised her a wonderfully successful implant, a problem-free end result that would very soon have her humming a happy song and shopping at Victoria’s Secret.

“I want my old body back,” Carolyn told me many times. “I’m not about to be stuffing socks in my bra like a two-bit drag queen.”

Happily for her, she has a patient boyfriend who told her, “I love you just the way you are. You really don’t need to do this.” But who can blame her? The surgeon promised Utopia and a bikini-ready body once the tissue expander “settled in.” The future looked bright. Her cancer seemed to have been nipped in the bud and her remaining breast was cancer-free.

After the cosmetic procedure, Carolyn appeared in her new tissue expander, not Mae West or Jayne Mansfield exactly but looking as if she never had a mastectomy at all. Periodic checkups kept her peace of mind intact until the day when she discovered that the expander — the perfect cosmetic implant — was causing an infection.

It was back to the surgeon, who told her, “we can fix this thing, have no fear!” And so, with a dose of antibiotics and a little bit of this and that, Utopia was once again promised her: Bikini-wearing on the beach, and a future of cleavage revealing V-neck sweaters.

The old Broadway musical, Promises, Promises, brings to mind a lot of broken promises along the way. The infection was getting worse, the antibiotics weren’t working, and her surgeon was now saying that the expander had to be removed. This involved another surgery (the fourth!) and a two-week recovery period involving tubes, leakages, etc., all in all a very messy post-surgical experience.

“Can you believe this?” Carolyn said to me. “On the bright side, the surgeon says that a new tissue expander will work. He doesn’t know where the infection came from. Maybe it was a staph infection. He’s not sure.”

Meanwhile in Florida, my sister Susan, who was still dealing with her own cancer, announced that during her latest checkup she was told that her remission looked permanent. She was now working two jobs and enjoying life with her husband, having steak and Chardonnay every Saturday night and enjoying their indoor pool under a canopy of palm trees.

Carolyn prepared for the second tissue expander operation with high hopes, believing that the surgeon would watch this infection business, and that things would go as planned. After all, the good doctor assured her with a kind optimism straight out of a Disney film that this time “things would settle in,” and that “she was a very good candidate for this type of thing.” So, when the dreaded day arrived for yet another hospital visit involving anaesthesia and the “shock” of waking up in the recovery room, she held her head high and told everyone that “this thing is not going to defeat me.”

After the second implant, Carolyn called Susan and announced, “It’s in. It feels okay. The surgeon says it looks good. I think we’re home free.”

In life, I don’t think there’s anything worse than believing that something is going to get better when the opposite is true. Especially when battling an illness that waxes and wanes. There’s nothing quite so secure as certainty or closure (the cliched Oprah moment), rather than bi-polar variables that leave you feeling exhausted.

During a moment of happiness with her boyfriend — a night on her apartment balcony in Roxborough with shrimp grilling nearby and her dog and cat running circles around one other in the living room –Carolyn noticed another burgeoning infection. Yes, it was happening again. I can’t imagine how her emotions must have plummeted just then, all the high hopes she had for a full recovery plunging down into the darkest part of feeling.

She announced the arrival of a new infection at a dinner she was hosting for friends and family. There were no tears, at least publicly. Being family, we saw the troublesome eruption and told her that she needed answers. Why was this happening? Tomorrow, she said, she’d phone the surgeon and go through the rigmarole once again. She couldn’t stand the idea of another trip to the hospital, of falling asleep under anaesthesia and then coming to in the recovery room.

Finally, however, the surgeon did admit that some women are just not able to receive tissue expanders because they’re “chronically” subject to infections. Still, he left the option open for a third go-round. The man was unstoppable. “Maybe next time,” he told Carolyn. “Take six months to heal, and we can try it again if you want.” But Carolyn, feeling like an over-dissected high school biology frog, didn’t fall for the surgeon’s game.

After multiple conferences with family and friends and a prolonged meditation on her balcony overlooking Fairmount Park, she decided against a third slice-and-dice. “How long will these guys just cut, cut and cut? I know the answer to that,” she added. “As long as you let them. Well, I’m not letting them anymore!”

And so, with a song in her heart, she did what any savvy contemporary woman would do: She shopped for “boobs” on the Internet, and found a faux breast from China. “It looks and feels like the real thing,” she says. “It has become … my daily prosthetic!”