Hidden Scars from Breast Cancer

Yes there are lots of hidden scars in breast cancer. I have discussed the emotional side a lot - which boils down to PTSD for some. But there is also the physical side. Every time you look at your body and see your cancer scars, you are reminded of  your cancer misadventure. Its only a scar that will fade over time but its still there.

Back in 1984, I found my first breast lump. Due to the limitations of surgery at the time, I had to have an excisional biopsy. And because of my medical history (three years after thyroid cancer) they had to be sure. (And if you are trying to calculate my age, I am still only 37). So I had a lumpectomy (aka excisional biopsy). And it was benign which was good. But it left me with a scar. A big fat red scar.

After surgery, I realized I had a bigger problem than normal in bathing suit shopping. I had this giant scar, 2" long, on the outside of my left breast that ran horizontally across toward my armpit. Bathing suit shopping is bad enough with the unflattering fluorescent lighting, holding your stomach in while you are trying to decide if it will fit when you really do lose those 10 pounds by June. Then you have to add in - will my scar show?

Seriously, it took me a good 10 years for the scar to fade and for me to stop worrying if  someone might see it sticking out the side of my bathing suit. It was a bit of vanity for me. But I already had a scar on my neck from thyroid cancer surgery that could not be covered up in a bathing suit. I really didn't need a second visible scar.

Now surgery is catching up to my bit of vanity. At Beth Israel Deaconess Medical Center in Boston, they have pioneered breast cancer surgery with hidden scars.

"Traditionally, the procedure would place an incision directly over the tumor, making it very visible. But Beth Israel Deaconness Medical Center now offers another option.

"The more we can make the scar smaller, or put it in a place that can't be seen, the better for the patient," said Dr. Ted James, chief of breast surgical oncology at the hospital.

He started offering hidden scar surgery here last year.

"What the hidden scar surgery tries to do is to place the incision in a less obvious or visible location. Under the breast is one location. You can also make it around the areola, that's another place where you can hide a scar, and if the incision is very high on the outer portion, we've actually gone through the armpit," James said."

"Hidden scar surgery can take a bit longer than traditional procedures, but recovery time is about the same."

A lot of progress has been made in treatment of breast and other cancers but I really do like the idea of taking into account the fact that the surgical scars can be a less prominent reminder of our cancers each time we look at our bodies.

More on cancer costs

A few days ago, I blogged about the costs of cancer. But there are lots more costs of cancer that are not just financial.

There are physical costs that include surgical scars, damage to your body from treatments, and more.
The emotional costs are things like PTSD which takes a lot to get through. Neither of these can ever really go away. You just end up covered in scars inside and out.

So well-intentioned people do things like give free trips and events for those who were diagnosed with cancer. These are the people who offer trips to us cancer people.

If you have been diagnosed with cancer, you can go to events like the Stowe Weekend of Hope for free the first year. Then you get an incredibly discounted rate for future years. Don't get me wrong, the Stowe Weekend of Hope is a wonderful event with so many resources for those with cancer. But I just wish I didn't have the medical history which allows me to go so cheaply.

So as we dig deep in our financial pockets we also have to cope with all the other costs and you can't just declare bankruptcy and walk away from your emotional and physical costs.

Thyroid cancer facts

The Huffington Post brings us Thyroid  Cancer: The Five Things You Really Need to Know. One little factoid jumps out: UP 274 percent since 1997. That would make it the fastest growing cancer in the country. But it affects a relatively insignificant number of people - around 60,000 this year - so it doesn't get a lot of attention.

Number one to know is it is not the good cancer. There is no good cancer. The term is derogatory and misleading.


Number two is that taking a pill every day is not that easy. You need to replace the vital thyroid hormone but if they give you too much you will be hyper and if they give you too little you will be hypo - too much or too little does not do the body good. And the doctors try to keep your levels low to prevent that lovely possibility of recurrence.

Number three is there is no new normal. I hate that term. After both cancers I was supposed to reach a new normal. If I was nineteen at my first normal and now I am on my third normal. What is normal for me?

Number four is that oh so subtle scar across the front of your neck. It fades with time but it never goes away. Stop staring!

Finally, you are not alone with thyroid cancer, you just have to look a little further to find support because it is still rare. I can count on my fingers the number of people I know with thyroid cancer. This includes the pharmacist at the local Walgreens, Ria the painter, Yumi from Japan, Lesley in Texas, the other woman I cant remember her name who also had both breast and thyroid cancer, and a few others online. (I know I am forgetting someone but after cancer twice the brain is the first to go.) But I probably know hundreds of women with breast cancer - literally.

So if you know someone with thyroid cancer send them to thyca.org or bitemecancer.org.

Appearance counts too

As anyone who knows me can tell you I am not a fashionista. I mean I wear something that is clean and relatively unwrinkled (I don't iron) add some perfume (the most important thing) am ready to hit the door. I usually remember to brush my hair again just before going out the door. Make up is a slim possibility and periodically is visible. But that's on the outside.

There are other issues. I have had 8 surgeries. Most of them have minor scars and my body has returned to normal. But my breast cancer surgeries who were almost immediately exposed to radiation, are the most disfiguring (I think that's the right word). We'll just say I am reshaped in certain areas... I also have a nice set of internal scar tissue that quit easily mimics an unwanted recurrence.... Lots of lumps and bumps. No one told me I would end up this way. Maybe if I had known, I would have looked at other options in a brighter light.

Evidently I am not alone. There has been (yet another) study that says many women who were treated for early stage breast cancer are unhappy with their cosmetic appearance post treatment. They never tell you this part. They tell you about lymphedema. They tell you about staging. They tell you about chemo and radiation and nausea and going bald.... But they don't tell you that you will look different afterward. That's a big fat oops! But at least I am not alone.

We count too!

Yoo hoo! We are here! Don't forget about us and how we feel and how we are treated! Doctors are just starting to realize that the patient experience is part of the equation. Well maybe not just starting to realize this but more like acknowledging that how we are dealing with results and side effects are important too.

I will say doctors are human beings who are caring enough to enter the field of medicine and study for so many years to learn to heal people. But there is science involved in medicine where they are trained to read the pathology reports on cells and look for clear yes/no replied. Not, 'well, I felt pretty crappy after two days on that new medication so I stopped taking it'. Well how is 'pretty crappy' defined. Were you throwing up non stop or did you feel like you wanted to lie down for a bit?

I talk to my doctors and they suggest different things to me - procedures, surgery, prescriptions, etc. - at different times. My next upcoming discussion is with the ankle surgeon. I badly sprained my ankle in the summer of 2009. A little bone chip, a little tendon tear, and little cartilage chip (in a moment of stupidity I tried to look over my shoulder while walking - the danger of multi tasking). I have had x-rays and an MRI and tried PT, exercises, balancing, etc. I have been told if it is still problematic in December, I can have a 'cleaning out' surgery as opposed to a 'repairing' surgery.

My ankle is not better. I have been told it is 'chronic' (what a lovely word). I am really not looking forward to surgery (it would be my ninth - how many surgeries and then do you stop keeping count?) but my ankle is still not better. It is achy, etc. But if I had surgery, I know there would be a rehab period. Would it ever end up being better than it is now? How long will it take to stop being achy?

When you have a procedure/surgery/medical (mis)adventure, its not just the process of what happens when they do it but also, what are the long term effects. Will I have scar tissue that causes problems in moving my arm for the rest of my life? If you take out all those lymph nodes, will I have to worry about lymphedema for the rest of my life? What about underarm shaving?

For my next surgery, I want to know, not just what it will be like if I don't have it (I already know that part), but if I do have it, what are long term expectations, when will it feel better? Will it ever feel better than it does now? What about long term susceptibility to other injury with the surgery vs. without the surgery.

Some of my other surgeries have had more significant consequences if I didn't have them. When they say they are taking out the nasty cancer cells, you sort of shrug and say 'go right ahead' and don't worry about the long term results. I am sure they did give me a piece of paper before each surgery that had fine print to tell me about side effects. I have them somewhere... But maybe I should have paid a bit more attention to some of them.

I guess my point here is that we, as patients, need to educate ourselves on, not just the what happens if I don't have the procedure but what happens if I do. And then learn to speak up and tell our doctors about the problems afterward.