Next month will mark two years since my doctor found a lump in my breast during a routine exam. Given that I had a clean mammogram and sonogram 9 months before, exercise vigorously nearly every day, am not overweight, eat tons of fruits and vegetables and have no family history of breast cancer, the revelation was stunning. Duh. When isn’t it?
I’ve since learned that my maternal grandfather’s prostate cancer (a form of hormonal cancer, like breast cancer) may have elevated my risk. Having particularly dense breast tissue, not having children and taking birth control pills also may have played a role. Other studies show that women with vitamin D and Folic acid deficiencies and women who drink more than 2-3 alcoholic drinks a week can also up their chances. But since it is estimated that one out of every 7 women will get breast cancer, pretty much just being a woman is a risk. Sorry to be such a downer. But there is good news, as I’m sure you’ve heard. There is a much higher success rate in detecting and treating the disease than ever before. And I know this is due in no small part to the magnificent (and I mean truly magnificent) Evelyn Lauder and her tireless and phenomenal work with the Breast Cancer Research Foundation. And how's this for making lemonade out of lemons: With so many women experiencing it, there is now a treasure-trove of info. to help us get through the ordeal with more dignity, comfort, and peace of mind than was previously imaginable.
So in honor of Breast Cancer Awareness Month, here are the tips, tricks and products that made breast cancer slightly less of a pain in the ass for me, plus one that didn’t.
Best Advice: Don’t surf the net after diagnosis
Boy, did my surgeon have my number (I guess I’m not all that unique). After we discussed my course of treatment and probable outcome, she strongly advised me to steer clear of the internet and most books written about breast cancer. The reason? Many sites and books paint the worst-case scenarios, which can provoke crippling fear and anxiety. Like I didn’t have enough already? She did give me a big binder of of explanations, resources and tips compiled by California Pacific Medical Center, where I got my treatment. I chose not to look at it. And I have to say, that as crazy, neurotic and anxious as I am, I experienced far less emotional turmoil than some of my more investigative friends. Granted, my diagnosis and proposed treatments were very straightforward—pretty much the norm for stage 1 breast cancer with a low risk of recurrence and negative tests for BRCA genes. My agreed plan of attack was a lumpectomy, sentinel lymph node biopsy, two months of five days a week radiation and a five-year course of Tamoxifen—standard operating procedure. If things had been more complicated and extreme, I would have definitely done more research and gotten second opinions.
Most Important Part of Recovery: Acupuncture
I’ve written before about how acupuncture gave me my life back in terms of helping me finally recover from the aftermath of radiation (extreme fatigue, lethargy, depression, pain and swelling (aka lymphedema) for over a year after I concluded treatment) and managing my side effects from Tamoxifen (extreme fatigue, lethargy, depression, leg and feet cramps, weight gain and insomnia, to name a few). Acupuncture helped with all these symptoms, even mitigating my advanced arthritis, and I think made me slightly less neurotic, though my husband might argue that point.
Unfortunately, the Tamoxifen is so toxic to my system, I need to be stuck with needles every other week to maintain and hopefully advance acupuncture’s salubrious effects. And I simply loathe it. The other patients are on beds in other parts of the room thinking serene thoughts or blissfully snoring away. Meanwhile, I’m lying on the table hating their guts trying to soothe myself with the Allman Brothers Band on my IPOD so I don’t jump off the table and murder at least one of them. How Zen. But believe it or not, my one regret is that I didn’t start treatment sooner. A friend of mine who basically sailed through radiation did acupuncture concurrently. She might have had that outcome anyway—everyone responds differently to cancer and cancer treatments. And this is a great tidbit so I’ll repeat it, “Everyone responds differently to cancer and cancer treatments.” But given the myriad benefits acupuncture seems to impart, I can’t help but believe it might have made radiation a less grueling experience.
Most Flattering Sports Bra: Anita Maximum Control Momentum Wire-Free Sports Bra, $69 (barenecessities.com).
Typically, I’m a Champion Powersleek Sportsbra girl, $46 (champion.com). It’s a heavy duty number that can withstand high-impact activity with an adjustable back and straps —crucial features for small-across-the-back, large-across-the-front me. And these bras, which are rather roomy and customizable, were fabulous post-surgery at accommodating my dressing and swelling without adding to my discomfort. They’re also great at fitting compression pads, which I need at night as a result of the lymphedema. But these bras are completely unglamorous and bulky under clothes. So when the swelling went down and the dressing was gone, but the prospect of my regular underwire bras sent waves of terror down my spine, I switched to the more streamlined, also adjustable Anita style. It’s sleek, virtually invisible and gives a terrific shape.
Magic Tricks: Coping With Needles
Given how traumatized I am by acupuncture, it probably won’t surprise you that getting my blood drawn used to totally freak me out. And it doesn’t help that I have crappy veins. (I know. I know. I am such a baby!) Now that I am an old hat at it, it’s certainly less scary than it used to be, and I credit a super-kind phlebotomist for making the process almost a snap. He suggested drinking a lot of water and staying really warm prior to the test to help optimize circulation. Dehydration and being cold can all impede it. He noted that the better circulation is, the easier it is to find a vein and actually get blood from it. He also introduced me to the Butterfly Needle, a smaller, thinner number that works better on veins that like to roll over when they’re poked than the standard variety. When he’s not my guy, I always ask for that needle specifically and it makes a huge difference.
Dumbest Move: Hopping on the Lifecycle two days post surgery
A well-meaning friend told my husband that it was really important that I get moving as soon as possible after surgery. And exercise bulimic that I am (“I’m not going to lie around and get fat just because I’m recovering from breast cancer surgery”), I seized upon this advice and went to the gym to peddle furiously on the bike for 45 minutes. The result? I felt faint, nauseous and experienced excruciating pain in my breast. I actually almost passed out in the shower afterwards. From what I understand, there are several types of surgeries where the experts like you to walk and maybe even get on a treadmill almost immediately following surgery. Walking, not intense cycling, being the operative directive here. But breast cancer surgery, at least in my case, is not one of those instances. In fact, when my surgeon called me later that day to check in and deliver my pathology report and I told her of my athletic adventures, her response was, “Really, Cara? I mean, really? I think I’ve been crediting you with having far more IQ points than you actually have.” Ouch.
Not to sound superficia, but what the heck? To me, one of the biggest bummers about cancer is that you just don’t look like yourself for what seems like an interminable amount of time. And I didn’t even have chemo so I can only imagine how one feels going through those dramatic changes and acute side-effects, which are typically far more extreme than anything I experienced. I realize what a lucky girl I am. But even without it, I was just shocked to see the reflection staring back at me in the mirror. And even two years later, I don’t really feel like I’m “back.” Perhaps, because of the Tamoxifen? No one can really ‘splain it to me. Anyhow, here are some products that really seem to make a difference.
Aveeno Skin Relief Moisturizing Lotion, Fragrance Free, $9.49 (ulta.com): I found it to be the least greasy, fastest absorbing, least stinky and most comfortable lotion to combat the “sunburn,” and extreme flaking from radiation. My radiologist recommend Aquaphor, which I love for my lips but it was just too unctuous for such a large area and under clothes.
Vaniqa, $90 (by prescription): A godsend for Tamoxifen-induced chin hairs, http://www.carakagan.com/post/2012/07/10/Vaniqa-It-isnt-sexy-But-it-works.aspx
Nioxin Hair System: Successfully manages Tamoxifen-caused hair-thinning, $37.50,(sleekhair.com), http://www.carakagan.com/post/2012/04/16/Hair-There-and-Everywhere.aspx.
Bobbi Brown Extra SPF 25 Tinted Moisturizing Balm, $52 (bobbibrowncosmetics.com): Lightweight yet luscious and emollient, this imperceptible cream foundation evens out skin tone and adds just a little bit of a glow.
MAC Fast Response Eye Cream, $30, (nordstrom.com): The only de-puffing eye cream I know that doesn’t dehydrate skin and emphasize crows’ feet.
Nars Bronzer in Laguna, $34; Nars Blush in Amour, $28 (sephora.com): This brownish bronzer shot with gold shimmer topped with the peachy pink blush really enliven the complexion, imparting a fresh, healthy color and radiance.
Nars Matte Velvet Lip Pencil, $24 and Nars Lip Gloss, $24, both in Dolce Vida (sephora.com): The pencil delivers a precise, comfortable application of stay-put color with just the right amount of coverage—not too sheer, not too opaque. The gloss lends extra moisture and a sexy sheen. Dolce Vida, a medium-bright dusty rose, looks like my natural lip color turned up a notch or too. Pretty.
Dr. Dennis Gross Age Erase Recovery Mask, $48 (dgskincare.com): This mask is messy, drips and tastes terrible when it gets into your mouth, which it almost always does. But it’s well worth it. No matter how drawn, pale, exhausted and miserable I look, this mask always makes me look better. Always.
Ciao for now my friends. Stay happy and healthy and get your mammogram!
Years ago, Marie Claire invented a fabulous column called Splurge vs. Steal that showed delicious, drool-worthy designer products paired with their far more realistically priced doppelgangers. And it was genius! Everyone and their brother knocked it off. (Lust vs. Must, anyone?) No one had ever had the balls to say, “There is cheap stuff that looks just like the expensive-as-hell-stuff. And here it is.” Talk about pissing off high-end advertisers. But somehow it worked, and I don’t think there were too many casualties. Some people, though, didn’t get it. I remember one grande dame in the PR industry saying to me, “I think that column is ridiculous, why would anyone buy the expensive version when they can have the cheaper one? They should call the column, Smart vs. Stupid. I mean, no one is that stupid.”
OK--truth time: I am that “stupid.” I not only prefer to make the “stupid” choice, I revel in it. I just happen to like (ok love) designer and expensive. With beauty products (and don’t get me started on shoes and handbags), the packaging is always more gorgeous, the makeup pigment richer, the textures more luscious, the moisturizers more moisturizing, the fragrances finer and the effects more profound. I know these thoughts aren’t rational because there are tons of mass market beauty products that are really, really good—probably, great, even. I just don’t get the same rush slogging my way through poorly-stocked and disarrayed drugstore aisles or even Target (sacrilege I know) as I do blissfully strolling the beauty floor of Bergdorf Goodman. And I have a love/hate relationship with Sephora. Even though it has fabulous products, the place is always a mess, badly-stocked, crowded, noisy and deplorably lit. I feel like I am doing battle every time I go in there, unless I am meeting my star beauty advisor Zoe at the Powell Street store in SF.
But my allegiance to all things expensive is no longer feasible now that the cosmetics companies aren’t sending me all of their latest and greatest products (and my daily staples) for free. So here Notorious NYCK sits—a girl with champagne tastes on a beer budget. But with a little digging and a whole lot of resolve, I’ve found a few reasonably priced versions of my extravagantly-priced addictions. And while they don’t elicit the same passion, these cheaper products do get the job done--and I am only suffering slightly as a result of the substitutions. I know, I know, everyone should have such problems!
Splurge: Clarins Water Comfort One-Step Cleanser with Peach Essential Water : $32.50 (clarins.com)
This is a beautiful cleanser. It’s fast, gentle, thorough and moisturizing. And Its heavenly peach fragrance makes it a pure pleasure to use.
Steal: Sephora Collection Triple Action Cleansing Water: $14
The only drawback to making this switch is missing out on the sublime scent of the Clarins version. This cleanser is every bit as good. Promise.
Splurge: Dior Snow UV Shield SPF 50: $50 (dior.com)
I’d like to pause and just take a moment to worship at the temple of Dior. I am obsessed with its beauty products; they are just beyond gorgeous. This sunscreen is silky, moisturizing, non-irritating, applies like a dream and is completely imperceptible on skin. Plus, its sleek white tube with black accents is perfectly portable and incredibly chic. And while it does contain some chemical sunscreen, Snow UV Shield’s key defensive ingredient is zinc oxide, which is great for sensitive skin. An added bonus is that natural sunscreens like zinc and titanium dioxide provide immediate protection against the sun since, they are physical blocks. With chemical sunscreens, you need to wait at least 30 minutes before their protective powers kick in.
Steal: Neutrogena Healthy Defense Daily Moisturizer Pure Screen SPF 50: $11.99 (Neutrogena.com)
The tube is nothing to write home about and the consistency a little less velvety than Dior’s, but this product is a good, daily 100% natural sunscreen with moisturizing properties that blends well and doesn’t leave a preternaturally white sheen on skin like 100% natural sunscreens can.
Splurge: Nars Monoi Body Glow II: $59 (nars.com)
God I love Nars. It is impossibly glamorous. If I could eat it, I would. I first got turned on to the tinted version of this product (Body Glow) by this young gorgeous European couple who used to summer next door to us on Fire Island. Both he and she would frolic in the sand and surf in low SPFs and tiny bathing suits. At the end of the day, they would anoint each other’s sun-kissed skin with this divinely-scented, shimmery cocoa-colored oil. (This act was only a little less pornographic than it sounds.) They looked so golden and gleaming, I had to try this magic elixir myself. What I got for my efforts were brown streaks (I am glow-in-the-dark pale so the color didn’t blend) and stained clothes. I am also impatient and not interested in “drying time.” But I am obsessed with the clear version of this product. It makes skin crazy soft, lends a subtle shimmer and imparts a flowery coconutty scent.
Steal: Monoi Tipanie (tahiti-iti.com, $7.98):
I am pretty darn proud of myself for finding this bargain-priced version. It looks, smells and feels just as good as the Nars product. And while the packaging is less chic, it’s sort of retro and kitschy with a Gauguin-style Tahitian woman on the label, so you can’t help but smile every time you use it. Monoi oil was originally created in Tahiti, BTW. It’s comprised of pure coconut extract macerated with the bud of the tiare flower (Tahitian gardenia), which supposedly infuses the oil with nutrients as well as a delicate, fragrance. The Tahiti-iti (God, don’t you just love that name?) website offers several different scents of Monoi oil, but the one that most closely resembles the Nars product is the Tipanie, or Frangipani variation.
Ciao for now my friends. Stay happy and healthy.