Reflections on Pregnancy and Breast-feeding After Cancer

This was a guest blog post I wrote for Living Beyond Breast Cancer for their recent “Pregnancy After Breast Cancer: What you Need to Know” initiative, about having my daughter after breast cancer.

You can read the original post here

Rebecca Pine 8 months pregnant

I was diagnosed with breast cancer and learned that I carry the BRCA1 gene mutation a month before getting married and moving to a new state. I was 33, and strove to keep things as normal as possible for our newly blended family of five. My husband and I wanted to have another child. This newlywed dream was pushed aside as days became filled with countless doctors’ appointments and evenings of late-night research. I had six “second” opinions. All were urging me to have a double mastectomy. I couldn’t wrap my head around the concept of removing my unaffected breast at that time, and ended up deciding to have a unilateral mastectomy. Maintaining this seed of hope — that we would one day be able to conceive a child and that I would be able to breast-feed — gave me courage as I moved toward decisions about surgery and treatment options.

After the whirlwind of breast cancer subsided, my husband and I broached the question of pregnancy with my doctor. My medical team met with the tumor board to discuss my case. We were not sure what to expect. Having a baby post-breast cancer is a controversial topic, and the information I pored over at the library and online seemed inconclusive, if not bleak. I was discouraged. My breast cancer had been highly estrogen receptor-positive, and all of the young women I met through a support group had been told they could not or should not have more children.

Maintaining this seed of hope — that we would one day be able to conceive a child and that I would be able to breast-feed — gave me courage as I moved toward decisions about surgery and treatment options.

My husband and I were delighted to hear that recent studies appeared more favorable. My doctors were not aware of any clear data on the risk of BRCA mutation-positive survivors and pregnancy. We were advised of my high lifetime risk of breast and ovarian cancer, and told that if we wished to proceed we should waste no time. If all went well, the plan was to have a baby and breast-feed, then remove my remaining breast and ovaries afterward to further reduce the chances of additional hereditary cancers.

We weighed the risks against our hopes, and decided to try to have a baby. It was not long before I became pregnant, and our whole family was filled with excitement.  However, near the end of my first trimester, I miscarried. It was a difficult and uncertain time, which required physical and emotional healing before we were ready to try again.

When we were able to conceive again, my belly swelled — and along with it, my singular breast grew two cup sizes! Through a referral to the local “breast fairy,” (certified fitter of mastectomy products) I obtained a prosthetic, which could be slipped inside my bra whenever I felt the need to be symmetrical. Would you believe there is no such thing as a pregnancy mastectomy swimsuit? I learned that it’s possible to stitch “do it yourself” mastectomy pockets out of stretchy nylon fabric.

After 9 months of anxiously waiting, we were blessed with a baby girl. I was able to nurse her with my remaining breast. It was not easy at first. She did not take to breast-feeding naturally, as my son (born before my diagnosis) had. My daughter initially had difficulty latching on and suckling properly. It was discouraging. Thankfully, I was referred to a lactation consultant who guided me through the process of building milk supply and helped my little one and I learn to nurse more effectively.

There also appears to be no such thing as a mastectomy nursing bra. With no time to sew stretchy nylon pockets while juggling a newborn, I would tuck my breast form inside of my nursing bra. My little one would regularly pull it out, before I could even realize she was grabbing for it. Times like this call for a sense of humor … and it felt good to welcome the laughter.

I was able to nurse my daughter exclusively for 6-and-a-half months and regularly for 2 years. There was something about coming face-to-face with my own mortality that made these “ordinary miracles” of birth and breast-feeding especially extraordinary. I shed many tears of gratitude as I sat rocking my little one to sleep, knowing how truly blessed we were. I know that other survivors have had children after breast cancer, but these are not commonly told tales. I had heard of only two such women while I was doing my research, and it gave me such hope. I’m grateful that today there are resources such as LBBC, where women can learn about the latest data and read stories of others who have had these experiences before them.

© Rebecca Pine


Rebecca Pine was diagnosed with breast cancer in 2009. She is a writer and workshop facilitator for The Breast and the Sea, which she has co-founded with photographer Miana Jun. The Breast and the Sea is a written and photographic project that empowers those faced with breast cancer in the process of emotional healing through personal interviews, photographic witnessing, community support, and reflective, nature-based movement workshops. The above photos of Rebecca and her young daughter are from The Breast and the Sea. You can follow Rebecca’s blog at 4kids1breastreadyornot.

I am not a Skiier

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I am not a skier. My husband and our older children ski for the sense of adventure and thrill of the trails. I love being in nature and am a strong believer in positive family activities. Yet I find myself lurking behind on even the simplest trails, nervous about other skiers or snowboarders, and convinced that trees are going to jump out at me. I somehow muddled through years of ski vacations before I discovered snowshoeing, after our youngest daughter was born. It was the perfect fit for me. I was finally able to hike along in the snow, enjoying the outdoors and moving along at what could be a strenuous, yet safer-feeling speed.

I had just gotten my snowshoes secured and my little one bundled up in my carrier backpack—a small feat in and of itself—when she began saying, “milk, milk!” I settled down on the ground with my daughter in my arms and began to nurse. It was a beautiful, clear day. I noticed scattered people wearing pink. The numbers grew quickly: dozens and soon hundreds of men and women—mostly women—clad in all shades of pink. Many were wearing tutus, fluffy boas, or wild and crazy pink hats. I watched a particularly pink group of young women pose for a picture. One said, “say titties!” and they all tittered, echoing her words joyously. Their snowshoeing fundraiser had just ended.

I found myself longing to run right up and join them—after dashing into the nearest phone booth and pulling a pink tutu of my own out of thin air! I felt such a need to join in their camaraderie, their sisterhood. I was filled with gratitude for each and every one of them. I have one breast—and scars where the other one used to be, before my journey with breast cancer.

I go to the woods for solitude. To connect with the beauty of the land and to regain a sense of self. For renewal. Yet this day, amidst the stands of beech and hemlock trees, I was also filled with a strong and unexpected sense of community. I normally take the most solitary, least-trodden trail whenever I hike or snowshoe. On this day, however, I found myself drawn to follow the pink multitude that had gone before me. I pictured them all snowshoeing just ahead of me: their conversations and laughter faintly echoed in the crunch of my snowshoes upon the Earth.

In my county, there is a breast cancer fundraising walk every year by the beach. This was the fourth year that my family participated. It has been nearly four years since my cancer diagnosis. The breast cancer walk is always a strange time for me. Most people in my day-to-day life, outside of our family, don’t know that I am a survivor. It’s not that I am secretive about it. It just generally doesn’t come up. That’s one of the things about breast cancer—most of the world never sees your scars. Whether or not a woman chooses reconstruction, most women decide to be or at least appear to be symmetrical to the outside world … and so grows the assumption that we are. Once a year, at the breast cancer walk, I wear a pink t-shirt that says “survivor” on the back in big letters. I feel awkward wearing it. Some people in the crowd cheer for those with “survivor” shirts. It makes me shrink back, wanting to blend in. Yet on this day I wished to be bold.   Part of me yearned for a feeling of recognition; for a medal or a pink tutu of my own to behold.

The next day, while snowshoeing again, I continued thinking about the women in pink. As I meandered through trails of birch and maple, my thoughts drifted. Where do I fit in? Not with other young mothers, when thoughts of my mortality are often lurking in the back (and sometimes the foreground) of my mind. After losing one part of my body in order to preserve the longevity of the whole, my breast was replaced by a looming shadow of fear. Would the cancer return? Might it be fiercer than before, throwing my life in an even greater tailspin?

Yet, when I am among other survivors, I feel out of place too. I am often the youngest, dealing with different issues than middle-aged or older survivors deal with. Even in the company of survivors who are in my age bracket, I feel I remain an outsider. I am the only one I know that has had a child after recovery and been able to breastfeed. There is great uneasiness, even in the medical world, about such choices. Each person and situation is unique. There is no one right decision for all of us. I learned through research and advice from my medical team that there were risks involved with conceiving and carrying a child. I also discovered recent studies, which indicated that hormones released during pregnancy and lactation can actually help prevent breast cancer recurrence. My doctors knew how much we wanted another child. We were advised to conceive as soon as possible following my treatment. We were blessed with a healthy baby girl. Despite some early complications (unrelated to milk supply), I have been successfully and happily breast-feeding my daughter with one breast.

As I trekked through the woods, I thought about my future plan to remove my other breast once my daughter has weaned.   The BRCA-1 genetic mutation runs in my family—I am hereditarily predisposed to breast and ovarian cancer. In the quiet space around me, I considered my options: reconstruction with implants, my own transplanted tissue, or nothing—flat scars across my chest. I thought of my husband recently asking if we should have one more child…

Uncertain of my future, I continued my ascent across the mountain trail. My daughter was lulled to sleep by the rhythmic sway of my steps and crunch of the snow. Filled with gratitude, I paused to kiss her lightly on the head. She is my pink tutu. My silver lining.

 

© Rebecca Pine 2012

I Choose Hope…

img_9573We must hold tight to hope. Today, more than ever. For, it is hope alone that will carry us through the darkest times. We cannot control the external circumstances in our lives. It is only ourselves that we can change.

The world around us is suffering deeply. In recent months, we have seen a tremendous outpouring of kindness and transmutation. There has also been a disappointing display of ignorance and deception. While we must certainly mourn our losses in our own way, let us not lose sight of hope. Hope is the gateway for tremendous courage.   It is that courage, which facilitates true change.

Let us remember that we are not alone. In our togetherness, we find strength—especially when we gather in circles of women, as women have been gathering since the beginning of time. The knowledge of the power of community is in our blood, and in our bones. I speak of women because there is something special that lies deep within each of us, that knows how to nurture and carry life. Our bodies hold the wisdom of how to labor and deliver our young. We have an innate sense to protect our children, and to band together to take a stand for what is right. When we quiet our minds, we have access to that same higher self that guided our bodies through the process of childbirth, illness, famine, or oppression—whatever difficulties each of us has had to endure. True power is a balance between the masculine and the feminine natures. May we strive to embrace, support, and accept one another each and every day.

Regardless of what happens next, I urge us all to choose compassion—even when we find ourselves face to face with hate. May we remember that we always have a choice about how we react. Let us take the time to pause, and to breathe. Hatred breeds more hatred. Violence triggers more violence. Shaming others only isolates both sides. Let’s look honestly at what the world needs most right now, and examine our choices with every new situation that presents itself. If we choose to lower ourselves to respond to negativity with negativity, we only contribute to the problem.

I believe the solution lies—much as it always has—with living our lives with integrity; striving to do the best we can with what we’ve got. When we focus on stretching, growth, and togetherness, we are met with a strength that far exceeds our own. That is not to say that this will always change our outer reality… society around us shifts at its own rate. We are most affective at altering the outside world through our own inner work. When we empower ourselves to rise up in the face of adversity and take a stand peacefully for what we know and believe in our hearts to be true, there is nothing that can take us down. Even in the face of violence or oppression, maintaining compassion and peace ensures that we cannot lose. Dignity and grace are allies that no one can take away from us.

When we rise up in this way, embracing our truth, we can only win. In uniting together, we create a powerful force of change that cannot ultimately be ignored. In choosing kindness over bitterness, we make the greatest difference. Responding to hatred with compassion and education leads to eventual understanding. May we keep our heads held high, continue to open our hearts and our hands to those around us, and carry on loving and nurturing our families. Only in holding tightly to love and to hope will we be victorious.

With love,

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© Rebecca Pine

May we all “Think Before we Pink!”

img_9987It’s October. Leaves are beginning to change color. It’s the season of hot apple cider, pumpkin spice lattés… and everything PINK! While there are certainly breast cancer survivors who embrace and enjoy the focus on “breast cancer awareness month,” there are many of us who dread it. Breast Cancer Action has coined the term “Pinktober,” and urges us all to “Think Before You Pink.”

FACT- Unless you are living alone in a cave somewhere, or on a solitary, drifting iceberg, there is no need for “breast cancer awareness.” We are aware about breast cancer. That’s not the issue.

FACT- Buying everything pink (including items with pink ribbon designs) does not guarantee that these companies will contribute to breast cancer organizations. It is often a gimmick that is used to attract sales. Read the fine print on labels and ask questions! Find out where the money goes from your purchase.

FACT- When these pink purchases actually do contribute a portion of their sales toward breast cancer organizations, it often goes to large companies that use most of their donated funds to go toward “awareness.” Many of these organizations raise large amounts of money through breast cancer walks, and most people have no idea that they are raising money for “awareness” and not a cure. If you want to make a difference, research how a company spends donated funds.

FACT-If you truly want to do something useful to help stamp out breast cancer once and for all, please make a donation to one of the few companies where 100% of your donation goes toward funding research for metastatic breast cancer—the only breast cancer that takes lives. 30% of all who are diagnosed with breast cancer become metastatic. There is no cure for metastatic disease. It is estimated that only 2% of all money raised for breast cancer research goes toward finding a cure for metastasis. Shocking as it is, most research funding is still earmarked for early stage breast cancer.

If you want to make a difference this October or any time of year, these are two organizations that I completely endorse:

Stand Up For Suzanne—Local Long Island, NY organization that funds cutting edge breast cancer research at Cold Spring Harbor Laboratories.  http://www.standupforsuzanne.org

About CSHL research: http://www.cshl.edu/Research/Breast-Cancer.html

Metavivor—An organization run almost entirely by those with stage IV, metastatic breast cancer patients, or “lifers.” They are dedicated to raising the important public awareness about living with metastatic breast cancer.  http://metavivor.org

About research Metavivor funds: http://www.metavivor.org/research/grants-awarded/

For more information on “Pinkwashing:”

http://bcaction.org/site-content/uploads/2012/02/2012-Think-Before-You-Pink-Toolkit.pdf

© Rebecca Pine