I have seven tattoos. The first one I got was a small wave, Hokusai-style, on my inner right ankle, given to me by a Vietnamese-American artist in Manhattan who actually once lived in the refugee camp in Bataan. I then got three from Little Pete, a tattoo artist in Lankenny Place, King’s Cross, Sydney, Australia, a few years apart; two from the late great Subic veteran Tatay Nero Nievo, who held court in Aurora Boulevard, Cubao; and my last, four years ago, the words “Everything is a gift” beside the delicate outline of a flower, tattooed on my inner left forearm by a lovely young lady in Brooklyn, originally an orphan from Seoul, Korea, but adopted by a couple from Connecticut.
And then, there’s an eighth tattoo, one I didn’t want, and which I often forget about, but when I see it, it reminds me of the battle I fought eight years ago. Well, all breast cancer survivors continue to fight a battle—to live meaningfully, to conquer fear of recurrence and of belated side effects, and most important, especially for those of us who help in breast cancer awareness advocacies (especially this October, Breast Cancer Awareness Month), to get other women to take care of themselves and check their breasts regularly, because prevention can save lives.
I was diagnosed with invasive ductal carcinoma, a.k.a. breast cancer, in June 2013, and had a lumpectomy—the growth in my left breast was removed, but the rest of my breast left intact. I did 12 rounds of chemotherapy and 33 rounds of radiotherapy.
I have been declared cancer-free, for which I am grateful every day, but I still undergo annual tests. At least, they were annual, until a breast ultrasound last year revealed unusual activity with some benign fatty tissue around the site of my lumpectomy—thus, my oncologist Dr. Charity Gorospe has put me back on a biannual schedule. That’s the life of a breast cancer survivor, requiring constant vigilance.
Many survivors tell stories of the challenges of chemotherapy, but I was lucky enough to experience few of them. Although I was significantly weakened, I managed to keep working, maintain my appetite, and even do some light exercise. I insisted on staying seated instead of lying in a hospital bed during chemo, even if, towards the last few sessions, my veins were getting harder, the insertions were more painful, and finding a good vein for the infusion because a challenge for the nurses.
Challenges
Maybe I had used up my strength by the time I completed my sessions in January 2014, because although many told me radiation would be easy, that’s when I got the wind knocked out of me. My doctor, Dr. Marti Magsanoc, explained the process to me and warned me ahead of time of challenges because my skin was thin and sensitive, but I guess I didn’t take his warning too seriously.
I was given a couple of months of rest from chemotherapy before I began radiation. In preparation, there were two things done to me which I never knew about.
One, a mold was taken of my breasts using a special kind of plastic that they dipped in hot water, making it pliable, before stretching it over my breasts until it hardened. I would wear this “bra” to keep the puppies in the same position, because apparently, the radiation beams would be so precise that I had to keep still, my arms over my head, and we could not afford to have my rather healthy bosom flapping around, either. In fact, I was rather amused when it took two nurses to get one boob into the proper position.
Two, I got a tattoo. It’s only a dot, placed between my breasts, below my breastbone. I was quite surprised to see the nurse wielding a tattoo needle, which he had to use, apparently, because other options like markers would wash off, and they had to be precise every single time.
Marti explained that radiation physicists actually had to compute such things as angles and dosage of radiation, so it took a while for them to pinpoint exactly where the tattoo should go. I didn’t flinch when I got it—I already had six tattoos at the time, bigger ones that hurt a lot more—but I didn’t realize then that, in a manner of speaking, they needed this dot to continue to cure me.
For the next month and a half, for 33 sessions, I was at St. Luke’s Global City Mondays to Fridays. The time would vary; if I had work, I would come earlier. On some days, it meant a long wait; sometimes, I was done very quickly, since the procedure itself took only about 10 minutes.
I would arrive, and the radiation nurse assigned to me, Jessica, would prep me. I got into a robe that opened in front, and lay down flat as Jessica fastened my “bra” on me. The lights would be aligned with my tattoo, then Jessica would leave the room to avoid exposure. All I heard was the whirring of the machine, as it automatically moved to aim the radiation at my left breast.
‘Cleaning-up operations’
The first week or so of these “cleaning-up operations” to annihilate any cancer cells left, as Marti explained, was uneventful. I would sometimes fall asleep during the treatment. And then, the difficulty began.
As predicted, my skin didn’t like it. From a light pink, the skin turned red and began to burn and even blister. Even the loosest, rattiest of bras hurt, but so did going braless, as movement was painful. I borrowed my brother’s biggest shirts and walked around looking like a rapper with a crew cut. When I looked at my breasts in the mirror, the tiny dot of a tattoo seemed to be overcome by all the chaos going on beside it.
Friends had gifted me with bottles of organic aloe vera, but Marti warned me it wouldn’t be enough. I ended up donating them to the radiation department and buying an expensive French-made cream made specifically for breast radiation.
When that didn’t work, Marti sent me to dermatologist Dr. Issa Cellona, who gave me a collagen cream to apply day and night to speed up healing. It worked—but not before it stung like hell. I would face myself in the mirror every morning and night, bracing myself for the pain as I slathered it on. It was draining.
I felt like I was walking around with a perpetual hot flush; sweat would trickle down my face no matter how strong the air conditioning was, and my entire body felt hot and feverish. Then came the exhaustion and the sleepiness, which seemed to increase by the day. I would often slump over my desk at work, groggy but unable to sleep. Yet, I would toss and turn at night, and be awakened by the pain when I rubbed against my raw breast.
Both Marti and my breast surgeon, Dr. Michelle Uy, were worried about the extent of the burning. I had already had a bit of a setback when I proved allergic to the dye used for my sentinel node biopsy before my lumpectomy. You are injected with a dye that reveals if cancer is present in your lymph nodes. Fortunately for me, my lymph nodes were cancer-free, but the dye turned my boob into a swollen blue grapefruit—yes, I was one of the very small percentage of women who developed a reaction to the dye.
Lifesaver
Thus, my left breast was already a bit beaten up coming into radiation, so it probably couldn’t handle the heat, literally. My lower left armpit area was also burned and discolored, and remains a bit so to this day, eight years after. All I know was, I was very happy when my radiation was over. I got a free overnight hotel stay the Christmas before; I bought another night, and spent three days asleep in the hotel room, with nobody to bother me.
It must have taken three months for the profound, constant fatigue to disappear. Also warned by Marti that, because of the proximity, radiation could have long-term side effects on the heart, I started exercising more actively within a month after my radiation. I drank copious amounts of water, as advised, but it still took a long time to get my full energy back. I still see a cardiologist every January.
Many fellow survivors are sometimes surprised at my story. For them, radiation was a walk in the park next to chemotherapy. I guess no two women really have the same experience, so don’t let this scare you if you’re a survivor with her treatment still ahead of her. Just rest when you have to, be nice to yourself, eat well.
In some cancer cases where chemotherapy cannot be tolerated and a tumor needs to be reduced in size, radiation is often a lifesaver, preparing a patient for more decisive treatment. For some early-stage patients, radiation is all they need to be cured.
For longtime survivors, radiation, whether it was difficult or easy, now remains a distant memory. Still, when I’m giving myself my monthly breast self-exam (which every woman above 20 should be doing) or simply getting dressed, I see that little dot between my breasts. It is certainly less colorful, less flamboyant than my seven other tattoos, which I proudly display. Yet, even if I never wanted it, I have to thank that little hidden dot for the part it played in helping me beat breast cancer, and live to tell this story.