By: Tammy McCarus, M.D.

I’m not sure how and I’m not sure why, but sometime after giving birth to my first child in 1997, I developed an overwhelming feeling that I was going to get cancer. Not just any cancer, but specifically breast cancer. And not just breast cancer, but specifically cancer of the right breast. I had never had any problems with my breasts. I had always received a normal result on my mammograms and I had no family history of the disease or other risk factors. As an OB/GYN, I am extremely practical when it comes to health and I could not fit this inner voice into my logic and science-based approach to medicine, but it persisted.

Seven years passed and something told me not to doubt that little message in my head. I used it to motivate me (even physicians need a little extra push sometimes) to perform self-breast examinations and to have mammograms. Gradually, I began to realize that this was a time when my patient’s experiences might help guide me through any resistance to careful self care. After years in the doctor’s chair, I had the feeling that I was about to experience what so many of my patients felt from time to time. In the process, I learned volumes about the connection between my relationship with myself, my body, and my ability to heal.

I also recalled the heartbreaking story of a former patient, Kaye. I thought back to the day that Kaye, a wife and mom in her early 50s, sat in my office with an obvious abnormality but she was in denial. She did her best to chat about another, unrelated gynecological issue for most of her visit until I finally interrupted her and said Kaye, what is going on with your chest? She had a huge abnormal protrusion from her chest that was so big it rested on her lap. She then burst into tears, admitting that something was obviously wrong. An examination revealed that her right breast was 10 times its natural size, flaming red and hot to the touch yet she had managed to ignore her condition for months out of fear. She was terrified of extensive treatment, the possible changes that might come with a major illness, or even losing her life.

Sadly, tests showed that Kaye had a very advanced case of breast cancer that took her life five months later. Perhaps the most tragic part of Kaye’s story was the fact that her breast could not have changed so radically in a short period of time. It was clear that she had delayed treatment for several months because she was terrified of knowing the truth. She’d refused to listen to her body and her own inner voice, and yet that terror had put her at risk.

As fate would have it, while in Las Vegas, celebrating my 44th birthday and 10th wedding anniversary, I said to my husband, “I think I’ve found a small lump.”
He is also an OB/GYN so I valued his opinion. This lump was in my right breast, in an area just under my skin and felt to be the size of a gun pellet. It was hard, smooth, round, mobile and not causing any skin changes or enlarged nodes in my underarm. It was not painful. I wondered if this was finally it, the thing I dreaded but knew in my heart was coming.

Being sensible OB/GYNs, my husband and I decided to watch the lump for one menstrual cycle, hoping that if it were a cyst, it would simply go away. We waited. It didn’t budge. After a series of mammograms, other tests and a biopsy, I was diagnosed with invasive cancer. But thanks to my vigilant exams, it was found while it was extremely small (6mm). Once again, my inner voice told me that the best course was a complete bilateral mastectomy (the removal of both breasts).

Even though I am a surgeon, I was just like anyone else who gets a diagnosis of cancer. I feared for my life and for the future of my two beautiful sons. What could be worse for children than to lose their mother while they were young? This was a sickening thought and I had to try to
forget it. I focused all of my energy on finding the right doctors and getting well. I had no intention of letting this horrible invader take my life, threaten my children’s happiness or take me from my husband. Today, I also understand that I am lucky. I am healthy, but not every breast cancer survivor’s story ends like mine.

Still when all was said and done I thought about my patients, and women everywhere: How many of us, I wondered, stay connected to our inner voice? We spend so much time and energy taking care of everyone else that we fail to take the best care of ourselves. We forget we cannot have the relationships we desire with the people we love if we are not healthy and whole.

You may not think you have an audible, determined inner voice as I did, but when your body experiences symptoms and show signs of illness, trust me, that voice is there. Make sure you allow yourself to hear all that it has to say. In most cases, breast cancer, when caught in the very early diagnostic stages, is always treatable and almost always curable. That’s why mammograms, self exams and being sensitive to your body can save your life. It’s even more important if women in your immediate family, such as your mom or siblings have the disease because you’re at higher risk. The next time your body tells you something is not right, listen carefully. It’s not hard science, it’s common sense.

Tammy McCarus, M. D., is an obstetrician and gynecologist in private practice in Orlando, Fla. She is also the president of the Florida OB/GYN Society.