A Delicate Balance

My great aunt used to read tea leaves. She would make you a cup with loose tea , and when you got to the bottom, take a look at the leaves as they were arrayed after the last sip, and tell you something about your future. My grandmother pooh-poohed it, asked her not to do it, tried her best to ignore it, but her sister persisted.

Now, I wish she was alive to read my tea leaves. You see, there is a fundamental paradox built into the cancer equation that I still struggle with, and maybe the tea leaves would help.

When I was diagnosed, one of my first reactions was why me? I take care of myself. I eat a Mediterranean diet, exercise daily, never smoked. So why should I get cancer when someone who smokes three packs a day and eats to excess can live to his 90s and die peacefully in his sleep? It’s not fair. But life isn’t fair, or so my mother always said.

My doctor assured me that it wasn’t my fault. There was no genetic or lifestyle cause, my cancer was random, and we would never know what caused it. Cells mutate all the time, he said. Most often, our immune systems catch the errant cells and dispose of them before they do any harm. But sometimes one slips through the cracks and sets up camp. Maybe the immune system was overwhelmed at the time, or maybe the mutation wore a clever disguise. (Yes, cancer cells can do that.)

But if cancer is so capricious, does it matter how much I exercise and take care of myself? Current research suggests it does—that exercise, diet and possibly stress reduction can reduce the likelihood of recurrence, maybe even of original disease. So how can I not feel responsible for “giving myself cancer” but take responsibility for making sure it doesn’t come back?

I wrestle with that paradox, just as I wrestled with the emotional fallout of being raped when I was 17. Was that my fault? Could I have done anything to prevent it? Could I admit to existing as a sexual being without having to claim responsibility for my own assault? That took 12 years of therapy and a loving husband to resolve, hopefully the cancer conundrum will be a little easier to deal with.

The odds of getting cancer are high—nearly 40% of us will be diagnosed in our lifetimes, and until I hit the magical 5-year mark, the likelihood of a recurrence is even greater than the risk of a new cancer. So, what’s a girl to do?

The way I see it, I can’t prevent a drunk driver from slamming into my car, but I can avoid driving on New Year’s Eve, stay alert for cars that appear out of control and always wear my seat belt to reduce the odds and minimize the potential harm, should such a fate befall me.

There are no guarantees with cancer, either. I can’t stop cells from mutating, but I can help myself along as much as possible. I can avoid toxins that encourage mutations, like smoke and chemical carcinogens. I can strengthen my immune system by exercising and eating right. I can try to de-stress my life to help ensure my immune system is not overwhelmed when it needs to fight, finding a daily moment of Zen in yoga class or a desk-side meditation. And I can be vigilant, making sure I get those regular screening tests and follow-up exams that are recommended.

But, where do I draw the line? Should I give up red meat because higher levels of consumption are associated with higher levels of colon cancer? Is it okay to have a nightly glass of wine given that alcohol is a known toxin? Should I eat only organic food? Avoid all plastic products? Move out of the city?

Just as I don’t let concerns about getting hit by an intoxicated motorman keep me locked inside, I won’t let fear of cancer keep me from enjoying life. We live with uncertainty every day, make choices based on limited information, reevaluate our assumptions and make mid-course corrections all the time. I’ll keep asking questions about cancer and its prevention, following advice, and, who knows, maybe in a couple of years I’ll feel differently. I don’t know if I have found the right balance yet, but in the absence of Auntie Anna’s tea leaves, or some other inside information, it feels like this is the best I can do.

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