Cancer Survivor

I’m getting tired of being a cancer survivor.

Oh, not the survivor part; that’s definitely preferable to the alternative. And in many ways I’ve been very lucky. I have excellent health insurance, awesome doctors who have managed to diagnose me early every time (and that’s not easy with ovarian cancer) and surgeons who were deft enough that all three times I’ve had clean margins on the pathology.

But three times?

This is not a matter of recurrence or metastases. I had breast cancer in 2008, spent most of the summer on chemotherapy and the winter on radiation therapy. No recurrence.

Then last summer I was diagnosed with ovarian cancer. Stage 1c, and I know I was very lucky that my doctor caught it. I had assumed that my difficulty in urination was due to diabetic neuropathy, but my doctor suggested one quick ultrasound test in her office. Two days later I had an appointment at the Women’s Cancer Center in Anchorage. (Keep in mind that problems with urination can be an early symptom of ovarian cancer, which is often symptomless until it is too late.) This tine the chemotherapy (precautionary) was much more severe, and I wound up spending about 18 hours a day sleeping for the third through fifth days after each infusion. Since both cancers were “women’s cancers” I was checked for the BRCA gene, but I have neither of the known dangerous variants.

Except a routine diagnostic mammogram (because of the previous breast cancer) showed up a very small suspicious spot in the other breast, which a biopsy showed was cancerous. I was just getting my hair back from the last time around! Surgery again (partial mastectomy because I wanted minimal impact on my type 1 diabetes) and I just “graduated” from radiation therapy on that one. I’ll be on Herceptin® infusion for most of another year, though my doctor didn’t want to give me any stronger chemotherapy right after the one for the ovarian cancer. I had a port installed (outpatient surgery and they didn’t even knock me out all the way) since I would be getting weekly infusions for a year, and my veins are getting hard to find.

A couple of things I want to say from the viewpoint of someone who’s dealt with cancer:

(1) Keep exercising as much as possible. With my balance so poor, it’s mostly stationary bicycling for me, but I kept up at least an hour or two a day throughout radiation therapy. I really think it helps.

(2) They tell you radiation therapy can produce sunburn-like effects on the skin. Effects, yes, but they’re more like zombie skin. Rotting rather than peeling, and downright painful (and itchy) near the end. So glad that mine’s over and I can put ointment on the skin!

(3) The Herceptin® is a breeze compared with either of the other chemotherapies.

Vitamin D

I know. You’re supposed to get your vitamins and minerals from your food, rather than pills.

But ….

I live in Alaska. The only time I can get really fresh produce is in summer, from my own garden and the farmers’ market. The rest (most) of the year I have to get “fresh” produce that has traveled a loooong way, or frozen food. Being lazy (and suspecting that the frozen stuff may actually be more nutritious than the “fresh” food by the time it gets here) I all too often stick a frozen dinner in the microwave. I doubt seriously that I am getting all the vitamins and minerals I need in my food, so I take a variety of supplements.

Some are subject to a good deal of controversy; some, like Vitamin A, can actually be toxic in large quantities. But I got a surprise on one recently: Vitamin D.

Vitamin D is one that most people can make for themselves if they get enough sunshine on bare skin. Without sunblock. There are foods that have Vitamin D naturally, notably fish and the marine mammals that eat them. This is why the native population, eating a subsistence diet, can survive in Alaska. Believe me, we don’t get much sun on bare skin. Even at the height of summer the sun doesn’t get very high in the sky — about 45°, where I live.

I figured this out years ago. Problem was, at that time vitamin D as a supplement by itself was extremely hard to find. Most often it was combined with vitamin A, as in cod liver oil. Since I eat a lot of carrots I get plenty of vitamin A, and I didn’t want to risk toxicity by taking more — but you wouldn’t believe how hard it was to find vitamin D by itself in those days. I finally found one store that carried it — and it went out of business. Then GNC opened a branch in Fairbanks, and I was able to get vitamin D from them. But the recommended dose was still just enough to prevent rickets.

Now all at once, or so it seems to me, vitamin D is being touted as a miracle pill, needed by the body for a lot of things never heard of in my day. I just knew I wasn’t getting much sunlight, and the light skin of people who’d lived many generations in northern climates was hard to make sense of unless vitamin D was pretty important. But I was still a little worried that my 2000 units a day (possible now without a handful of pills) might be too much.

Apparently it’s not.

Last week I went to the cancer doctor for a follow-up on my breast cancer. The check-up went fine, but he’s had me on Femara for about 4 years now. Apparently one of the possible side effects is reducing bone density, so I got a bone density scan and a blood test of vitamin D (important in keeping bone strong) as part of the check-up. I’ve been taking 2000 units of vitamin D a day for several years now, so I thought my blood vitamin D would be normal to high.

The bone density was a little low, but no lower than it was two years ago. Vitamin D — would you believe at the lowest end of normal? I was actually advised to increase my dose to 4000 units a day, and keep up the calcium supplements and the yogurt and cottage cheese that are a normal part of my diet. So this seems to be a supplement that is needed. Especially for us older folks.