Friday, Dec 14, 2018

My life matters

Cherise Evans Saunders says decision to remove both breasts in hindsight wasn’t so tough to make
Cherise Evans Saunders, one year after a preventative double mastectomy, on Sunday, October 21. CHERISE EVANS SAUNDERS

It’s a tough decision to make to remove one’s breasts, but after you go ahead and do it, and you think about the reason why you did it – to prolong your life – you would say to yourself, job well done, according to Cherise Evans Saunders who yesterday recognized the one-year anniversary of her preventative double mastectomy.

Today she says undergoing the life-saving surgery was a blessing and that she thanks God daily for allowing her to be here, because she didn’t have to be.

“Everything was found out accidentally, and [God] provided the way for [doctors] to find out, so I thank him every day for being here,” said Evans Saunders, who since her surgery has said breasts are overrated.

Today, Evans Saunders said she’s in a better place.

“A year ago, I was still dealing with the removal of the breasts to tell you the truth, and still dealing with public reaction to seeing me without breasts. It was a shock to me when I first got up that morning and saw myself without breasts, so it was a shock to a lot of people when they actually saw me without breasts. I had to get used to all of that and put it all at the back of my mind and say public opinion [doesn’t] matter. My life was what mattered. It’s no longer a shock.”

She was supposed to have reconstruction surgery at the end of this year, but with two months left in the year, she’s decided against it. It’s a decision she said is both financial and the fact that it doesn’t really matter to her to have it done.

“I do have insurance, so insurance might kick in for it, but it really doesn’t matter to me right now. And it really doesn’t matter to anybody who means anything in my life right now, so it’s no hurry.”

She has a prosthetic which she wears. When she’s at home she goes without, and sometimes if she has to dash out to the shop she finds herself reaching for it and then opting not to put it on and she goes as she is. Evans Saunders says the prosthetic is heavy, and she really feels freer without breasts.

“Removing the breasts allowed me to see me. You get to see your whole body. You can see all your imperfections without breasts. If you have a stomach, you get to see just how big your stomach is without your breasts, because breasts hide everything.”

She also said she’s grown in the last year.

“I was just speaking with somebody and telling them how [friend and fellow breast cancer survivor] Shantell Cox-Hutchinson knew how I could become withdrawn and she pushed me to do the interview with you last year and because of that interview it has opened up so many doors for me to tell my story.”

Evans Saunders was one of nine cancer survivors recognized by fashion designer Gillian Curry-Williams through her Remilda Rose Designs presents “Celebrating Life Through the Fabric of Hope” show, a fundraiser from which proceeds go to the Cancer Society of The Bahamas (CSOB). She was also a part of a news special for women who tested positive for the BRCA 1 gene.

Evans Saunders tested positive for the BRCA 1 gene in October 2016. That positive test increased her chance of getting breast cancer. She had a decision to be proactive or reactive to avoid a future breast cancer diagnosis because doctors told her that it was not a matter of if she would develop breast cancer, but when.

An introvert naturally, Evans Saunders said it was hard talking about undergoing surgery, but she’s glad she did it and hopes her story has helped someone else make the decision to go ahead and do what they need to do to save their life. She says she would be there to support anybody who has to go through it, as support is vital.

“If you don’t have that strong support team, you will get depressed. And my support team [Lillith Bostwick, Tanya Pinder-Carey, Inez Cox, and breast cancer survivors Marsha Sands, and Shantell Cox-Hutchinson] did a lot with me. We went to dinner. I got a call every day from every one of them just to make sure I was alright – if I needed anything … it got to the point where they didn’t want me to even move. You have to have that support. If you don’t have that support behind you, I don’t know how people would make it.”

And she’s been through a lot more than a double mastectomy. Evans Saunders had to endure eight rounds of chemotherapy and two surgeries to fight stage three ovarian cancer which was discovered while she was in hospital for a hysterectomy. A routine surgery that should have taken two to three hours meant she remained in surgery for eight hours as the doctors dealt with the cancer they found and removed it.

Evans Saunders has had two aunts die from cancer – once from breast cancer, and another from ovarian cancer.

The results of a years-long breast cancer research released in 2011 showed The Bahamas with a high incidence of early onset breast cancer with six distinct BRCA 1 mutations found in patients from cancer families in the country. The study was of 214 Bahamian women with invasive cancer, unselected for age or family history of cancer. They were screened for six mutation in the BRCA 1 gene that had previously been reported in cancer patients from The Bahamas.

The team – Talia Donenberg and Judith Hurley (Sylvester Comprehensive Cancer Center, University of Miami); John Lunn (Doctors Hospital); DuVaughn Curling and Theodore Turnquest (Princess Margaret Hospital); Elisa Krill-Jackson (Mount Sinai Comprehensive Cancer Center, Miami); and Robert Royer and Steven A. Narod (Women’s College Research Institute, Toronto, Canada) – found that a mutation was identified in 49 of the breast cancer patients (23 percent). They found the mutation frequency was particularly high in women diagnosed before age 50 (33 percent) in women with a first-degree relative with breast cancer or ovarian cancer (41 percent) and in women with bilateral breast cancer (58 percent).

The study showed approximately 23 percent of unselected cases of breast cancer in the Bahamian population attributable to a founder mutation in the BRCA1 gene – the highest reported mutation prevalence for any country studied to date. The result of the study was that genetic testing for the mutations was advised for all women diagnosed with breast cancer in The Bahamas.

Age, being female, obesity, and prolonged periods of oral contraceptive usage increases risk factors that can’t be changed, and pre-disposes a person to breast cancer.

“As you age the risk increases that you can develop breast cancer,” Medical oncologist Dr. Tracy Roberts-Halkitis, told The Nassau Guardian in an earlier interview. “The fact that you’re female, and you start having your periods younger and having menopause later, so younger than 12 years and older than 55, you increase your risk because you have a longer period of time where you’re exposed to estrogen. Obesity is a factor, and our population’s BMI [body mass index] is high. In terms of fat, regardless of where it is … specifically after menopause, becomes a risk factor for breast cancer, because wherever you have fat, you still produce estrogen, not in levels high enough like when you had your periods, but you still have fat, so you make some. And if your breast cancer is driven by estrogen it can stimulate your breast tissue to grow. Then there is the use of oral contraceptive pills for an extended period of time – five … 10 years is long, and it’s the estrogen component of them that’s a risk factor.”

Roberts-Halkitis said women should know their family history and be doing their monthly breast exams after their period. She said they should know what their normal breasts feel like.

The gold standard in testing remains the mammogram.

The American Cancer Society recommends women between ages 40 and 44 having the option to start screening with a mammogram every year; women 45 to 54 getting mammograms every year; women 55 and older can switch to a mammogram every other year, or they can choose to continue yearly mammograms, and that screening should continue as long as a woman is in good health and is expected to live 10 more years or longer.

The doctor also encouraged trying to eat as healthy as possible, and recommended a diet consisting of lots of fresh fruits and vegetables – foods with lots of color that she said has antioxidants and qualities that help with free radicals.

She also encouraged physical activity, that people reduce smoking if they do, and decrease their alcohol intake.

October is recognized globally as Breast Cancer Awareness Month.

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