Planning for my Saplingo Oophorectomy

I just had my first consult with a my oncology gynecologist. Because I have the BRCA1 mutation, I'm at higher risk for ovarian cancer. The recommendation is to remove your ovaries and fallopian tubes before age 40. Because I didn't know I had this mutation until recently, I'll probably miss the mark by a few months, but I'm planning to have the surgery during my implant exchange surgery, which I'll schedule after I'm done with oral chemo (Xeloda). 

The doctor I met with was fantastic and I'm really happy to have found her. My biggest question was whether I would also need a hysterectomy, a procedure that seemingly more BRCA1 patients are doing. Especially because I have a toddler, I'm hesitant to undergo a procedure that will make it difficult to get back to everyday life unless it is medically necessary and has clear benefits. She is on the same page - although there is always some chance of uterine cancer, there is no clear link proven by science and she feels that the risk of removal and an additionally invasive surgery outweighs any benefits. This was a relief for me to hear. Of course, I'll have imaging and a uterine biopsy if necessary, and if anything shows up I would go ahead with the procedure. But for now, if everything looks normal, I'll plan to keep the uterus - I could always get it removed later.

I also asked about hormonal therapy because the doctor at Dana Farber I met with said she would be comfortable with me going on hormone therapy because my cancer is not hormonal. However, the doctor I met with today said she never feels comfortable with hormone replacement in cases where the patient already has breast cancer. I'm totally willing to give it a try without. I'm less concerned about side effects of menopause and more concerned about the long-term health implications of not having estrogen. She's going to refer me to a team who specifically deals with menopause and I'm eager to hear what they have to say about avoiding the health risks of early menopause.

Advice for the Newly Diagnosed

Now that I'm almost a year past my breast cancer diagnosis, I'm thinking about the lessons I've learned and what has been helpful for me. 

1. Stop worrying about the things you can't control (at least, try to)

That biopsy result is not going to change if you stay up all night thinking about it. I went into this with the mantra "I am not going to worry until my doctor tells me I should be worried." Of course it's easy to worry sometimes - just keep remind yourself that it's a useless practice when you can't control the outcome. If you feel like you need to do something, put that energy into small life changes that can make a difference in your outcome, like exercise.

2. Try to keep your life as normal as possible

Treatment can be tough and you should go easy on yourself, but you shouldn't abandon all those things that make your life feel normal - they are a good distraction. During treatment, I worked full time, cooked dinner, went for walks, etc. - just like before. Working from home to avoid germs, I still dressed up every day. Your normal may look different.

3. Do one thing everyday to make yourself laugh, feel happy, or feel calm.

4. Don't feel like you have to share. 

It's okay if you want to keep your diagnosis to yourself. You don't owe anyone an explanation. Talking about cancer is emotional labor. At first I wanted to be an open book, because I truly didn't mind anyone knowing, but after telling a few people I felt like I was doing more work to manage the anxiety MY cancer was causing THEM. I only told a few friends and waited until after chemo and surgery were done to tell a wider circle.

5. Pay attention to your triggers and patterns

For example, I noticed I'd google something cancer-related before bed and then find myself anxious and unable to sleep. So I banned cancer-related reading before bed. This may change during your treatment - sometimes, I found it helpful to see instagram hashtags related to chemo, and then all of a sudden it became a trigger and I really didn't need more of that in my life.

6. Let go of expectations

There are so many treatment options and your situation is not the same as someone else's. Research treatments and surgery options but don't get too attached. This reminds me of being a first time mom - many go in with a 5 page birth plan end up crushed when they have a C section instead of a natural birth, and the disappoinment keeps them from enjoying their new baby. Keep the goal in mind - you want to stay alive and prevent recurrence. You may not be a candidate for a diep flap or nipple sparing (um, speaking from experience) but keep an open mind and you can be happy with your journey.

7. Seek out stories that make you feel hopeful.

Weird confession - usually I hate the word hope and the idea of hoping instead of acting. But when I was diagnosed, the first book I read was Anticancer- A New Way of Life. I found this to be a hopeful book written by someone who refuses to be his diagnosis and instead researches and makes life changes to support his health. I think this shaped my attitude towards diagnosis and treatment. I am currently reading Radical Remission, another good one! 

Video: Does Sugar Feed Cancer?

Just watched this video from the Dana Farber's Dana-Farber’s Zakim Center for Integrative Therapies and Healthy Living. Stephanie Meyers, RD, LDN, CNSD, a nutritionist, answers the question "Does sugar feed cancer?"

Here are my takeaways:

• Cancer cells might use glucose, but eating zero sugar will not prevent the creation of glucose. Your body will make it anyway!
• What you want to avoid is constant repeated spikes in blood sugar, like having a sugary coffee in the morning (sugar beverages are especially bad). 
• The big difference is between processed sugar and naturally occurring sugar. Processed sugar like white sugar, brown sugar, sugar in the raw are basically all the same.
• Naturally occurring sugars are better for you because they are part of a whole food with other components like protein and fiber. They don't spike your blood sugar as quickly and the foods have other benefits.
• New nutrition labels - being phased in with big food manufacturers first - are mandated to display ADDED sugar. This is what you should pay attention to.
• Try to stay under 24g of added sugar a day. This is not a hard and fast rule, just a good goal.
• If you're going to eat something with added sugar, pair it with a balanced meal. Like if you're going to eat a piece of cake, don't eat it alone. Eat it after a balanced meal with salmon and brown rice, for example.