Finding A Renewed Purpose After Cancer
- Veteran author Judy Blume, 84, is known for many titles, including “Tales of a Fourth Grade Nothing” and “Forever.” Despite retiring from authoring her own books after 50 years, Blume found a newfound passion for writing book recommendations. Blume is also a two-time cancer survivor, having beat cervical and breast cancer.
- Blume was diagnosed with early-stage breast cancer. She underwent a mastectomy (removal of the breast) and breast reconstruction for treatment without needing chemotherapy.
- Cervical cancer begins in the cells lining the cervix, the lower part of the womb (uterus). It usually develops slowly, however, before cancer presents itself. Vaginal bleeding or pelvic pain are common symptoms.
- A pap smear can be used to detect cervical cancer or changes in cervical cells that suggest a woman is at risk of developing cervical cancer.
- More than 70% of cases of cervical cancer are caused by the human papillomavirus (HPV). More than 90% of HPV-related cancers, including cervical cancer, are preventable in people who get the HPV vaccine that is recommended for all preteens (both girls and boys) 11 to 12 years old.
- The human papillomavirus, or HPV, is a group of more than 200 related viruses, some of which are spread through vaginal, anal, or oral sex, according to the National Cancer Institute. It can cause a handful of cancers, including cervical and throat cancers.
Acclaimed author Judy Blume, 84, was one of the more well read authors for a generation of young Americans, with books such as “Tales of a Fourth Grade Nothing,” “Are You There God? It’s Me, Margaret,” and “Blubber.” Amid Blume’s lifelong record of accomplishments, she is also a two-time cancer survivor, having beat breast and cervical cancer.
Blume says that after 50 years of writing, she’s closing that chapter in her life.
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“I think back to the moment I said, ‘That’s it. Fifty years. I don’t want to write anymore.’ And then this opportunity came up. So how lucky am I, suddenly able to get up in the morning excited about what I’m going to do, how I’m going to spend my day,” Blume said.
Helping Patients Cope with a Breast Cancer Diagnosis
Blume’s Summer Vacation Was Interrupted By Cancer Diagnosis
Amid Blume’s storied career in literature, she also faced two bouts with cancer.
In September 2012, Blue shared details of her cancer experiences in a blog post that outlined her breast cancer diagnosis and her cervical cancer battle.
Blume said she had plans to spend the summer of 2012 in Italy in part to complete her book “A Castle!” However, in June of that year, she underwent routine breast cancer screening, which changed her summer plans.
“A visit to the radiologist on June 12 for a routine ultrasound (dense breast tissue) led to a core biopsy,” Blume said.
Her biopsy results revealed ductal carcinoma, also known as stage 0 breast cancer.
“Wait – me? There’s no breast cancer in my family,” Blume said.
“I haven’t eaten red meat in more than 30 years. I’ve never smoked, I exercise every day, forget alcohol – it’s bad for my reflux – I’ve been the same weight my whole adult life. How is this possible?” Blue added, conveying her shock.
After accepting her new reality, she quickly transitioned her mindset to treatment.
“Taking charge (or thinking I was taking charge made me feel better),” Blume said.
After consulting two doctors she was comfortable with, Blume landed on getting a mastectomy and breast reconstruction for initial treatment.
“The idea of a mastectomy wasn’t a difficult emotional decision for me. Maybe because my breasts have never defined my sexuality,” Blume said.
When a woman decides to have a mastectomy, several factors go into that decision. Among things to consider is whether to have breast-conserving surgery such as a lumpectomy. These decisions should be made alongside your doctor by openly and candidly discussing risks vs. benefits.
Other factors that weigh into the decision to get a mastectomy are the size and features of the tumor and your family history. However, the gravity of your decision comes into full view, especially if you choose to get a mastectomy and remove both of your breasts.
WATCH: Regaining your sense of self after reconstruction.
Some women decide to have their breasts reconstructed and have implants put in right after the mastectomy, while others don’t have reconstruction at all.
Dr. Elisa Port is a surgeon who specializes in the care and treatment of patients with breast cancer at Mount Sinai Health System. She added that most women opt to have some reconstruction. The length of these surgeries can vary greatly. When implants are used, the procedure can take two to three hours (so the total surgery time would be around five hours). There is also the option to take one’s own tissue (usually from the belly area) and transfer it into the breast area during reconstruction.
“When it comes to reconstruction, there are more decisions to make – implants or autologous? If implants, saline or silicone? By then, I was so tired of having to make decisions I went with whatever would make the surgery easiest on me,” Blume said.
Help Coping With a Breast Cancer Diagnosis
If you are facing a breast cancer diagnosis, your emotions are likely to run high, which is completely normal. Psychiatrist Dr. Lori Plutchik says emotions are often fluid when coping with a diagnosis.
“The patient or person going through the stressful event should accept that emotions will be fluid. You may feel fine one day and then feel a massive wave of stress the next. It’s also important for those you look to for support, whether that’s a therapist, friends, and family, or both, to understand the fluidity of stress-related emotions,” Dr. Plutchik said.
If a stressful event affects how you think and feel, it may be time to seek mental health treatment. This could mean traditional talk therapy, medication, changing lifestyle habits (like exercise and diet), seeking a support group, or many other approaches.
Dr. Comen has some helpful tips for women needing a little extra help coping with a breast cancer diagnosis.
- Let your family and close friends know and let them help. So many cancer survivors tell us they want and need support but are often too preoccupied to make specific requests. Urge those close to you to jump in with whatever practical help they can offer.
- Keep a journal. It can be highly cathartic to let those feelings loose on paper. Grab a pen and a lovely journal and chronicle your thoughts throughout the day.
- Join a cancer support group. Groups are available in nearly every community and offer opportunities to connect with others going through a similar journey. You’ll learn constructive insight from others who can tell you what to expect and how to stay strong on tough days.
- Consider seeing a therapist. Ask your doctor to refer you to a therapist so you can discuss your fears and concerns in a safe space. Often, vocalizing your thoughts and feelings rather than internalizing them can provide relief.
Blume’s Cervical Cancer Diagnosis, It’s Connection to HPV
Blue also said she was diagnosed with cervical cancer that was caused by the human papillomavirus (HPV) in 1995. She underwent a hysterectomy for treatment.
“We didn’t know it was cervical cancer before the surgery, but we knew something was going on. Caught it just in time, extensive but still in situ (very early stages).” Blume explained.
Cervical cancer begins in the cells lining the cervix, the lower part of the womb (uterus). It usually develops slowly, however, before cancer presents itself. Vaginal bleeding or pelvic pain are common symptoms.
Cervical cancer, which has been linked to the human papillomavirus (HPV), is curable when discovered early through routine screening, which is done through Pap Smears or HPV tests. A pap smear can be used to detect cervical cancer or changes in cervical cells that suggest a woman is at risk of developing cervical cancer.
Blume credits her family and friends who offered her support while undergoing cancer treatment.
Helping You Better Understand Cervical Cancer
Cervical cancer forms in the cells of the cervix, the lower, narrow end of the uterus (womb), which connects the uterus to the vagina, the National Cancer Institute (NCI) explains.
“Cervical cancer usually develops slowly over time. Before cancer appears in the cervix, the cells of the cervix go through changes known as dysplasia, in which abnormal cells begin to appear in the cervical tissue,” the NCI explains.
“Over time, if not destroyed or removed, the abnormal cells may become cancer cells and start to grow and spread more deeply into the cervix and surrounding areas.”
While symptoms tend to be difficult to detect during cervical cancer’s early stages, some signs can still indicate something is amiss and needs a closer look.
The NCI explains that symptoms of early-stage cervical cancer may include:
- vaginal bleeding after sex
- vaginal bleeding after menopause
- vaginal bleeding between periods or periods that are heavier or longer than normal
- vaginal discharge that is watery and has a strong odor or that contains blood
- pelvic pain or pain during sex
Cervical Cancer and HPV
Cervical cancer starts in the cervix, and more than 70% of cases are caused by the human papillomavirus (HPV). More than 90% of HPV-related cancers, including cervical cancer, are preventable in people who get the HPV vaccine that is recommended for all preteens (both girls and boys) 11 to 12 years old in two doses administered between six and 12 months apart. The shots can also be started as early as nine years old.
“The key with the vaccine is that you received the vaccine before you ever reach sexual debut or have sexual encounters. So that’s why these vaccines are approved for young children ages 9, 10, 11 years old, up to 26,” Dr. Jessica Geiger, a medical oncologist at Cleveland Clinic Cancer, told SurvivorNet.
The American Cancer Society recommends cervical cancer screenings begin at age 25, and HPV screening is recommended every five years after that.
Understanding HPV
The human papillomavirus (HPV) is “a group of more than 200 related viruses, some of which are spread through vaginal, anal or oral sex,” the National Cancer Institute says.
HPV infection is linked to multiple cancers, and the majority of sexually active people will get the disease at some point in their lives.
Although nearly all cases of cervical cancer are indeed caused by HPV, people should also be aware that HPV puts both men and women at risk of developing several other cancers, such as oral cancer and cancers of the vagina, penis, anus, and throat.
Overall, HPV is believed to be the cause of 90% of anal and cervical cancers, approximately 70% of vaginal and vulvar cancers, and 60% of penile cancers.
“There are no screening guidelines for throat cancer, unlike cervical cancer with pap smears,” says Dr. Jessica Geiger, a medical oncologist at Cleveland Clinic Cancer Center who previously told SurvivorNet. There are no standard tests to determine if you harbor the virus.”
On the plus side, HPV-related throat cancers are generally very responsive to a combination of radiation and chemotherapy treatments, according to Dr. Geiger.
“The cure rates for people who have HPV-related disease are a lot higher than those who have tobacco-related throat cancer,” she said.
WATCH: HPV’s link to cancer.
Protecting Against HPV
Nearly 80 million Americans have HPV today, according to the Centers for Disease Control and Prevention. It impacts men and women and won’t cause problems for most people.
However, in a small percentage of cases, it can lead to cancer.
The HPV vaccine is recommended to protect against HPV and, therefore, HPV-related cancers.
Gardasil 9 is an HPV vaccine that offers protection against “nine HPV types: the two low-risk HPV types that cause most genital warts, plus seven high-risk HPV types that cause most HPV-related cancer,” according to the National Cancer Institute.
The vaccine creates an immune response to HPV 16, the primary cause of 92% of head and neck cancers. Once children are vaccinated, they cannot be infected with that strain. For parents, the HPV vaccine enables them to protect their children from developing cancer in the future.
“The key with the vaccine is that you receive it before you have sexual encounters,” says Dr. Geiger. “So that’s why these vaccines are approved for young children … ages 9, 10, 11 years old, up to age 26.”
According to the CDC, the HPV vaccine is recommended for all male and female preteens 11 to 12 years old, and it is given in two doses between six and 12 months.
The series of shots can also start as young as nine.
The CDC also notes that teens and young adults through age 26 who didn’t start or finish the HPV vaccine series also need the vaccine.
Additionally, people with weakened immune systems or teens and young adults between 15 and 26 who started the series should get three doses instead of two.
Although adults up to 45 can still receive the vaccine, it’s not recommended for everyone older than 26. Still, a person older than 26 could choose to get vaccinated after talking to their doctor about possible benefits, even despite it being less effective in this age range, as more people have already been exposed to HPV by this point.
WATCH: Should children get the HPV Vaccine?
Vaccine hesitancy can impede people from getting the vaccine. The concern may come from parents who may feel the vaccine paves the way for early sexual activity. For this reason, some health practitioners educate the public differently about the vaccine.
“I think rebranding the vaccine as a cancer vaccine, rather than an STD vaccine, is critically important,” says Dr. Ted Teknos, a head and neck cancer surgeon and scientific director of University Hospital’s Seidman Cancer Center.
Dr. Teknos believes concerted efforts to “change the mindset around the vaccine” can make a difference.
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