cancer

Bad hair days are back again

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Chemo gives a wide range of side effects, most of which are highly unpleasant and there is nothing on this planet that can make them fun and there is nothing positive in them.

Strike that. All but one are unpleasant and negative. And I’m one of the few people who probably regards even that one as positive.

But for me, alopecia has never been an issue. I have been looking forward to it. It gave me an excuse to chop my long hair off and colour it bright pink, and I doubt if it’s been bleached this often since I was at UKC and changed my hair colour every week or so. I loved that barber shop downtown and with easy access to Directions hair dyes I had a blast!

I bought a whole bunch of wigs in different colours, lengths and styles and have been having fun wearing them all winter. After all, what’s the point of having wigs if you can’t use them? Wearing a wig means never having a bad hair day, after all. And seeing as people are used to my changing colours and hair styles on a regular basis (at least I used to) some haven’t really noticed that they’re wigs!

My hair has started growing back and I am constantly having bad hair days. Not just because I’m a heavy sleeper but it’s winter so I have to wear hats. My scalp has been fuzzy for weeks – not cute kitten kinda soft fuzz, but fortnight old lambs. The hairs have been growing at 1 mm per month rate. But now they’ve gone all anarchistic on me, so some are growing a lot faster.

And I mean a LOT faster.

Some hairs are several inches long whilst most of it is short. I’ve given up hope that my “cancer hair” will be rainbow coloured and there is no glitter in sight. Nor is there any sign of curls.

It’s just grey on grey on grey.

And bad hair days.

And because it’s growing at different rates and I’m having those hot flashes again, I can’t wear my wigs for long periods cos I get all sweaty and itchy (no, the wig doesn’t itch but having sweaty hair that bends different ways itches).

The big question now isn’t whether I will colour my hair again, it’s how long I can stand this grey-on-grey and/or if I get the hair trimmer out first. If I do, it’ll probably grow at the same rate but it will take a long time before I can colour it – but I might grow completely bonkers looking like this.

Look good, feel better aka grown-up make up!!!

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I’ve never learnt how to do my make up. Not properly. Words like foundation, blush, rouge, day/night cream, brow liner, lip liner scare me. I’ve always made do with lipstick, mascara, eye liner and eye shadow. That’s it. No mess, no fuss.

But when oncology has a quarterly make up course for breast cancer patients and you know you’re probably going to lose eye lashes and brow, of course you sign up for it! It’ll be fun, of course it will, and you might actually learn how to do proper grown-up make up.

Look good feel better is a non-medical, brand-neutral public service program that teaches beauty techniques to people with cancer to help them manage the appearance-related side effects of cancer treatment. The program includes lessons on skin and nail care, cosmetics, wigs and turbans, accessories and styling, helping people with cancer to find some normalcy in a life that is by no means normal.

There are affiliates in 25 countries and in Norway, there are make up courses quarterly at the 7 largest hospitals. If you are a female cancer patient at any of these hospitals I would highly recommend attending one of these courses!

We were a dozen or so women of all ages and make up levels, and the only thing we had in common was our lack of hair. We all got an amazing goodie bag filled with stuff I have never ever owned before in my entire life, which was fun, and we got a great step-by-step demonstration on how to do facials and keep the skin hydrated and look good even when cancer makes you all pasty and bloated and white.

I discovered that my upper lashes have mostly stayed put whilst my lower ones were kinda missing. I can see that my brows are sorely lacking in colour and mass so good to learn the curvature of the brow so one can pencil them in!

 

The goodies are from a variety of companies, thank you to KLF (The Norwegian Cosmetics Association) for make up and thank you to the volunteers who make it possible!

Unfortunately no pics of me made up, cos my flatigue was pretty bad and I didn’t really think about it, but I truly enjoyed myself. I think we all did – in the midst of hardcore treatment and a horrific illness, these little snippets of joy are what keep us going!

Hormonal bitch, anyone?

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I’ve always had hormonal issues, which is why my GP put me on Diane/Dianette som 20-odd years ago. It’s an estrogen emitter which has somewhat alleviated my androgen hormonal issues.

But even taking estradiol on a daily basis, my estradiol levels have always been extremely low. Looking at my blood work for the past decade I’ve always had 0.1-0.2 when my levels should have been >1.0.

According to Dr. A-hole (more of him in a blog to come) my tumour was probably mostly progesterone sensitive rather than feeding on estrogen, which makes sense – why would I get a humongous tumour that feeds off a hormone I hardly produce?

I’m taking tamoxifen now, and will be taking it for the next ten years. Tamoxifen (if you read those older posts) inhibits the production of estrogen thereby reducing the risk of a new estrogen-sensitive tumour, which is great! If your tumour fed off of estrogen to start off with.

In men, tamoxifen can be used against infertility and increases testosterone production.

Women treated with tamoxifen have been found to develop primary tumours elsewhere in their body (though a link has not been found – though I doubt if anyone has done much to look for it).

After starting on tamoxifen in December, I’ve been growing a beard. That hair is growing much faster and better than anywhere else on my body. Stressing as I was after talking to Dr. A-hole, I asked my nurse about this. She checked with an oncologist and could tell me that this was a perfectly normal side effect of tamoxifen.

So basically, my hormonally crazy body which has always produced too many androgenous hormones (progesterone and testosterone) is now producing even more of them.

Guess what. “However, PR action in breast cancer is grossly understudied and remains controversial.” (PR: progesterone receptors). “women with high testosterone serum levels appear to be at a significantly increased risk to have or to develop breast cancer within a few years”

“Premenopausal concentrations of testosterone and free testosterone are associated with breast cancer risk.”

Am I scaring you yet? I’m certainly scaring myself here.

Basically, I had a hormone-sensitive tumour which most likely wasn’t estrogen-sensitive but rather androgen-sensitive because my stupid body has always produced loads more androgen hormones. I am currently on a medication (that I am to take for the next ten years) that decreases estrogen production (a virtually non-existent production to start off with) and increases androgen production (if hirsutism is a common side effect, then increased production of androgens is the cause and therefore another side effect).

I am on a medication that is increasing the hormone imbalance in my body, the very same imbalance that gave me the darned cancer to start off with.

I’m no doctor, but that sounds more like they’re increasing the probability of me getting breast cancer again – or cervical cancer (which is a well-known side effect of tamoxifen).

I have my first set of check-ups in June. Unless I freak out completely before that and demand a full blood screen and appointment long before. At least I have sufficient grounds to demand a mastectomy of my so-called healthy breast. I don’t believe for one second that it is, or that I won’t find a tumour there in a year or two…

Stress levels and heart rate rising – AGAIN – here’s some stress-relieving, comfort music:

One-tit wonder

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It’s now been three weeks since my mastectomy and tomorrow I will be getting the results from pathology. They found cancer cells in the sentinel lymph nodes, so they removed a whole chunk of lymph node tissue from under my arm as well. If the cancer has spread into that as well … 2018 could be even more interesting that I wanted.

But that’s tomorrow. And because I am so far behind on my blogging, let’s just revisit some good music.

We all know what a one-hit wonder is although we tend to disagree on the definition.

A friend of mine had this as one of the songs in his funeral:

For some of us, Chumbawamba are far from a one-hit wonder but this was their only commercial success:

Great band. I had the pleasure of interviewing them at UKC a million years ago, for KRED, and seen them a number of times.

Fear Factory

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Some questions should never be asked.

Of a person who has just been given the cancer diagnosis, “Aren’t you terrified?” is one of them.

It’s probably one of the stupidest questions on earth.

Most people who are facing cancer treatment are scared. Being asked it is about as useless as “Are you alive?” or “Are you human?”, and worst case scenario, you end up scaring the person even more.

I’ve never been afraid of my own cancer, but I was talking to a very dear friend who had cancer for the first time at age 22 (a few years and couple of cancer rounds ago) who said “I am terrified every single day of cancer” and she’s not alone in that.

Waiting for bad news is terrifying, this is standard human behaviour.

Finding that damned tumour is terrifying. Waiting for the results of pathological testing is terrifying. Waiting to start cancer treatment is terrifying. Going through treatment is terrifying. Waiting to find out if the treatment works is terrifying. Waiting and hoping for the “cancer-free” message is terrifying.

If you’ve survived cancer you will always be terrified of cancer, for the rest of your life, because the probability that you will have cancer more than once is highly probable. Breast cancer survivors are more likely to have skin cancer (due to radiation treatment), gynaecological cancers and a second round of breast cancer.

Cancer strikes the fear of God into even the strictest agnostic.

And no, that fear is not understandable if you haven’t been there. If enough people ask if you’re afraid, you will become afraid.

But the people I don’t understand are those who fear cancer testing. Mammograms, ultrasounds and smear tests are uncomfortable. There isn’t a woman I know who doesn’t dread a visit to her ob-gyn, but seriously.

Ten minutes of discomfort yearly are a small price to pay to not have to undergo chemo that knocks your body well out of shape. Having to look at your sagging breasts in the mirror once a week may be a sad reminder that we are long past the perky tits of our twenties, but looking at two healthy tits is a whole lot better than having to see one missing.

This is the most important meme in the world and I will keep sharing it forever. These signs and symptoms may come months before you feel that darned lump!

A twentysomething once told me that she was more concerned about the potential side effects of the HPV vaccine than getting cancer. I’ve hardly seen her since I was diagnosed so I think she might be under the impression that it’s contagious. Misinformation kills!

If you have genetic cancer in your family, please make sure you have regular check-ups. Get your genes tested – I know that knowing that you have a disease gene is bloody terrifying, but even if you have one or more of the dreaded genes it doesn’t mean you’ll get cancer. You are predisposed and should have yearly checkups, but it also means that the probability of it being found early on, getting appropriate treatment and becoming cancer-free is much greater than not having the gene, sticking your head in the sand and dying cos you thought “It won’t happen to me”.

I don’t have any cancer genes. My body’s lack of estrogen production should have ensured that I didn’t get an estrophile tumour. Yet I did – shit happens.

Having one or more of the breast cancer genes also means you can get a double mastectomy, get silicone implants, and guess what – no mammary glands, no breast cancer. No uterus, no gynaecological cancers.

And if you do find a lump in your breast – DO NOT GOOGLE! Another dear friend of mine found a lump just before Christmas. I must admit that I have been terrified on her behalf. If I knew a year ago what I have learned about breast cancer over the past year, I would probably have been shitting bricks for myself. Turns out she has the same as me *phew* which was an enormous relief.

There are so many different types of breast cancer, some are more easily treatable than others, and the one I have – though it had an extremely aggressive growth rate – is the one that’s easiest to treat and survive.

Cancer is a fear factory. You will wake up every single goddamned day for the rest of your life wondering “Is this the day I get cancer again?”. It’s up to you to decide how much that fear is going to ru(i)n your life. Not that you can make the fear go away, but if you let it paralyze you, it will.

Then again, you can get hit by a truck tomorrow.

My silver anniversary was spent offline…

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In October I had a silver anniversary.

Internet and I have been connected more or less full time for 25 years.

That’s a long time.

It all started with sb13@ukc.ac.uk, has been through numerous email accounts (including several anons in Finland), a dozen computers/terminals and most OSes. I started my online career with mail, cat, jove, vi, irc, tetris, text-based rpgs and vms.

I’ve agonized over slow modems and trying to get the TCP/IP adjustments correct. Plug and play did not exist in those days. I can remember the very first days of Netscape and playing Doom on the office intranet.

In other words, I was at one time at the peak of technology.

My N95s, from left to right: 2008-14 and is used for charging as the screen is kinda wonky 2014-? is my current phone The last one is for when the current phone dies…

No longer. I am now very happy to have my faithful N95, and although it was first generation smart phones, it now has very limited options: I can make calls, send messages, take awesome pictures, and play on facebook.

That’s it. So what with neuropathy, flatigue, muscular pain, acute tendonitis in both arms, a resting bpm over 120 and loose nails on both fingers and toes, I have been more or less offline since the end of September.

Which is probably the longest time I’ve spent offline even through the early 90s (I was allowed to sneak in to UiOs servers and log on to my anon email accounts).

Apologies to all who have sent me emails or awaited updates here, there are a gazillion blogs coming but they are not pubishable from my N95.

And no, I can’t use a touchscreen thingamajig cos my tendonitis flares up.

Soooo…. I’m afraid you’ll have to stay patient a while longer. My finger nails are threatening to fall off. Sorry.

 

The downward spiral

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1

Day 27 after last chemo.

27 days of complete and utter flatigue and an insane heart rate.

Every time I have made a movement, my body has perceived it as having finished a marathon. My entire body has gone all wobbly, heart rate has sky rocketed, and I’ve collapsed onto the closest chair-like object. Regaining control of my body has generally taken shorter time than decreasing my heart rate to something that can vaguely be called ‘normal’.

Life for the past 27 days has mostly been dragging myself from bed to the sofa, watching ancient reruns of Bones, Friends, NCIS and Master Chef (Junior). It’s also been numerous crappy reality shows (pawn shows, designer competitions etc) and Border Security: Australia’s Front Line which is actually kinda interesting/entertaining.

I can’t say how annoyed I was when I – last Sunday, ie day 20 – remembered that I have the dvd box sets of both Buffy and Angel. Coulda binged on them for three weeks instead of crappy daytime tv. At least I now have something fun to watch, as it doesn’t seem as if this flatigue is leaving anytime soon.

My concern has been my heart. An increased HR after exercise is normal – but this has been as far from normal as can be. I yawned and my HR spiked past 140 and stayed there for ten minutes. My normal HR at the hospital has been ca 65. The good thing is that once it passes 130, you don’t actually need to search for a pulse to check – cos your entire body is pounding with blood so you can sit still, close your eyes and just count. Dead easy.

The tricky part is falling asleep when you can feel your heart beating, hard, rhythmically, wondering if this is ever going to end. After a couple of hours of 120+ one tends to give in and take a sleeping pill. It’s weird how the rhythmical noise in a MRI/CT machine sends me to sleep, but my heart making the same kind of noise doesn’t – maybe because something in me is worried for chronic heart problems?

The irony in my mother dying of heart failure when she was 49 – and me now having massive heart problems at 44 – has not escaped me.

The skin on my feet is disintegrating so I got an electric foot file. I can actually pull off large pieces of 3-4 mm thick skin that has just loosened – I know, sounds disgusting – but between removing dead skin, filing, and lathering in massive amounts of lotion, we’re hopefully soon back to something resembling normal.

At least my nails haven’t loosened yet but my eyes are still running.

Massi is back on the road (yay!) so we had an enjoyable trip to the hospital for my next scheduled chemo. I can drive. It’s just the walking to and from car, getting in and out of car, and all that stuff that sends my ticker into a frenzy. At the moment I have three options for getting to the hospital: drive myself, take public transport (out of the question for my immunocompromised body), or be at the mercy of Pasientreiser. Seeing as the early shift take great pleasure in changing orders and sending out cars an hour early, that is no longer an option.

It was when I could shower & get ready in ten minutes. I now need an hour just for showering. So – we drive. The fact that it’s a good 300 m walk from the car park to the hospital should be interesting. Seeing as I normally can manage 10-15 m before collapsing, this will not only be a marathon for me, it’ll be an ultramarathon.

Speaking of which. Chemo brain has run out of power even if heart is pounding on at 130. I love my fake-life. tbc…

Round 5 – running out of steam

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It’s been a week since my last chemo and if it wasn’t so exhausting, I would want to quit.

Cumulative sucks.

Onset of fatigue on the evening of chemo. Flatigue set in good and hard on Wednesday. There was no effect of the corticosteroids (apart from night sweats). Heart palpitations en masse (pulse: 115-130) repeatedly throughout the day. Fungal infection but this time I was ready for it – after 6 days of Nystimex, the worst was over.

For some reason, very light neuropathy (just tingling in my finger tips) which is a relief. Or maybe I’m just so flatigued that I’m not registering any pain? I am certainly not complaining.

There are a couple of blogs in the pipeline – if I can just get enough strength to sit at the computer for more than ten minutes at a time.

But yes, still hanging in there, still enjoying the sun through the window.

Word of the day: cumulative

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Yesterday I had my fifth round of taxotere. I can safely say I’m over half-way through chemo! Onco was very happy, MR last week showed a reduction and his physical exam did the same. According to his measurements, it’s now 3*4,5 cm. We had a long chat about side effects and I got a new regime (Lyrica for the neuropathy and Nystimex for the fungal infection – it’s the same as Mycostatin but sugar-free, so should be trigger-free in regards to my perio).

I got the window chair this time! Orchid was dead, but who cares, my stuff is colourful enough. And I have finally found the Perfect Cup – haven’t spilt a drop in a long time with this one!

I also discussed my concerns in regards to Neurontin having such a great effect the first time but none whatsoever the second time (pain management and “head buzz”) and he told me that our bodies react differently in regards to meds and that this is totally normal. Nice to know. I also asked about the fungal infection and whether he thought it originated in my gut or mouth, and he was unsure. He’d also never used Nystimex, so we ended up with a nice microbiological talk about microflora of the mouth.

Stats were good, my white blood cell (WBC, leukocyte) levels are increasing but CRP was at 4 (very low), blood plates and % were normal, good to go for another round. We had a small talk about number of rounds of chemo and the op – we are in agreement that the more chemo I can push into this silly body, the better, and he also agreed that Boxing Day might not be the best day for surgery, but we are now deciding on chemo one round at a time.

Unless I manage 8, in which case there will be 9 and op the second week of January.

Five rounds of chemo means that I am getting cumulative problems. Increased WBC levels (normal levels are 3,5 to 10 but normal for me over the past 6 years has been 11-15). Last week they were at 12, this week 18. It’s the Neulasta injection that increases these levels so we’re still within an acceptable range, as long as the rest of my blood work is acceptable, but definitely a value that shouldn’t increase too much.

My nurse gave me a saline solution to rinse my eyes with. There is a slight possibility that the epiphora may be due to chemo coursing through my system and that rinsing my eyes whenever they start watering may alleviate it slightly. I got several 10 ml syringes. First try this morning – you know how syringes can be really hard to push down and then it just goes BOOM? Left eye not exactly happy with having 1 ml shot in at great speed.

And I am noticing cumulative side effects. The hydrocortisone pills I’m taking no longer give me two energy-packed days after chemo. I started folding and clearing away laundry and managed half an hour before body said “naaaaaaaaaaaaah, much better to write a blog”.

I did start on the Nystimex last night, hoping that it might prevent a complete fungal explosion, although I have stocked up on vanilla and chocolate protein puddings, chicken breasts and yogurt. Apparently one of the protein puddings tastes horrible but as I’ll only be eating them if/when my mouth gets really bad – I’ll use my olfactory memory to remember the best chocolate and/or vanilla puddings I’ve ever eaten!

I shall now try to fold some more clothes. Actually, no, that’s a fib. I shall try to sort clothes into their appropriate drawers and fold them some other day – if and when I have the energy – at the moment I’ll be happy to get all the clean clothes from the hamper into correct drawers…

The book in the photo is “Stien tilbake til Livet” by Long Litt Woon. Unfortunately, only in Norwegian as we speak but it has been sold to many countries and it is highly recommendable! Information, facebook page and a good book review (both in Norwegian).

Breast cancer is a gift for life. And death.

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It’s October, which means it’s Pink Ribbon Month, Breast Cancer Awareness Month (for your national wesite, check out NO, UK, US). In Norway the focus this year has been on long-term effects of cancer treatment. Guess what – a large percentage of women who have undergone breast cancer treatment never return to the work force.

And guess what else? The number of cases are under-reported and most of these women feel shame because they are unable to return to the activity levels of their previous job & personal life.

The Norwegian Directorate of Health/Helsedirektoratet have made a nice report of potential long-term side effects which can be found here (downloadable pdf); it’s in Norwegian.

Not because they don’t want to, but because somewhere along the line, they got some unpleasant side effects that turned out to be irreversible. I’ve already mentioned CIPN. CIPN can actually appear up to two years after end of treatment, can appear in women who weren’t bothered by neuropathic pain during treatment, and can be completely debilitating.

F(l)atigue can also turn chronic. Fatigue sufferers often find themselves ridiculed as lazy. They often receive little or no understanding for lying on the couch or in bed all day.

If you’re one of those people who call fatigue sufferers lazy, please read my blogs about it again. And again. And again. Until you realise that no, we’re not lazy. We would feel like we’re dying inside except that requires thinking which again requires energy which WE DON’T HAVE.

I’m not even going to venture into the psychological hell that a (single/double) mastectomy can send any woman into. Or chronic alopecia. Me, I don’t care. It’s not the first time I’m a skinhead and I’m loving having an arsenal of wigs to play around with – but that’s me. Permanent baldness is still a taboo.

I almost forgot about chemo brain. It is an actual diagnosis, can start long before you actually have chemo, can last for years, and is a mental fog that just won’t let go.

“Doctors and researchers call chemo brain many things, such as cancer treatment-related cognitive impairment, cancer-therapy associated cognitive change, or post-chemotherapy cognitive impairment. Most define it as a decrease in mental “sharpness” – being unable to remember certain things and having trouble finishing tasks or learning new skills” (American Cancer Society)

If the tumour is hormone-sensitive and you get anti-hormonal treatment, menopause may set in prematurely. It’ll probably be worse than natural menopause (due to it happening much faster on drugs) and you probably won’t be allowed to get hormone treatment to lessen the symptoms. Even if the tumour isn’t hormone sensitive, you may experience early menopause.

Osteoporosis is also a common long-term effect but as it is a well-known effect, bone density is usually monitored.

These symptoms are diagnosible and are, at least medically, accepted as such. Docs may not know of any treatment that can help, but at least they can give you a black-on-white diagnosis to help with insurance and/or benefits.

But not all women get easy diagnoses. Some of them get a mixture. Light fatigue, enough to make looking after your grand kids a nightmare, not enough to make you connect the dots. Aches and pains all over the system. Complaining to friends and family doesn’t really help cos they think you’re lazy. You need to work out more, exercise more, get out more, it’s your own fault.

So you go for power walks four days a week and go to the gym four days a week and you just feel weaker, but everybody’s saying that you’re just lazy and need to up the ante, power walks seven days a week and the gym five days and you just feel more and more tired. Only thing is – aching muscles and joints is another long-term side effect, and no amount of exercise or bad-mouthing is going to fix it.

Oh, and make sure you have a good dentist and get a full check-up before treatment, during and after. Many women end up having to draw several teeth and that’s expensive if you can’t prove that it was due to chemo.

A common side effect of taxanes is having your nails loosen and fall off. Yes, that is a thing. They shrivel and fall off. They can keep falling off for at least a couple of years and it is as painful and uncomfortable as it sounds. The exact mechanisms are unknown, but using nail hardener and dark nail polish, just not on the part furthest down where the nail “breathes” may help. Or not. The problem with not knowing the mechanisms is that one can only assume that it helps – statistically, who knows. At least iut’s a good excuse to wear lots of fun nail polish!

After a mastectomy there’s also a really big chance that you will experience a lymphedema and/or reduced mobility in the shoulder/arm of the op. Physical therapy can help with the mobility issues – but some patients will never regain full mobility.

There’s also the probability that you’ll find a lump in your remaining, so-called healthy breast. It’s probably just a cyst or benign tumour, but you’ll most likely have to wait days or weeks to get it checked out – thousands of minutes in hell waiting to find out if it’s malignant or not.

If you’re unlucky enough that the tumour is in your left breast and you need radiation over your heart, you may be at risk of cardiovascular problems.

And there is a large risk of getting cancer again. Just cos you’re cancer-free doesn’t mean it’ll stay that way always. The meds may cause cervical cancer and/or endometriosis so annual pap smears and ultrasounds are a good idea. Radiation will make you more prone to skin cancer, so you’ll have to take extra care whilst sun-bathing and never ever use a tanning salon/solarium again.

Oncologists no longer say that you’re healthy even if they’ve removed every cancerous cell from your body. If you’ve had breast cancer, it’s a bit like being an alcoholic – you might not have touched a drop in 50 years, you’re still an alcoholic. You’re temporarily cancer free, and you will never feel safe from cancer ever again.

“Breast cancer can come back or metastasize (spread) in three general areas:

  • the breast area where the cancer was originally diagnosed; this is called local recurrence
  • the lymph nodes in the armpit or collarbone area near where the cancer was originally diagnosed; this is called regional recurrence
  • another part of the body such as the lungs, bones, or brain; rarely, the opposite breast; this is called metastatic or distant recurrence” (breastcancer.org)

25% of all women who have breast cancer will experience recurring cancer (cervical cancer or skin cancer as a nasty, long-term side effect aren’t “recurring” so those cases are in addition to the 25%). The good news is that we now have a lot of drugs and treatment regimes so even with metastatic spread, chances are quite good that you can live for many years with chronic cancer.

The bad news is that recurring cancer can appear many years after you were treated and labeled cancer-free.

The really bad news is that metastatic cancer can be difficult to catch, even with yearly check-ups, and the longer the cancer can spread, the greater the risk for it being terminal and not chronic.

Five year survival rate for primary breast cancer is 89% (Norway, 2006-10). The same rate for metastatic cancer is 20%.

So … early detection is important. Use the lemon chart and visit knowyourlemons.com as there is a lot of great info there. See your doc if you’re in doubt. Don’t think “It won’t happen to me” cos it can. Cancer doesn’t discriminate and it doesn’t matter how rich, smart, beautiful, funny, young or amazing you are – you still might get it.