I teach about paying attention to systems, to the interconnections that are harder to study and learn from. And I have traditionally had doctors that don’t think much about the system because of the way the medical profession works. This is a bummer because breast cancer is a disease that creates confusing overlaps. The cancer is the purview of my oncologist. Estrogen feeds it; my hormones are the purview of my endocrinologist. Ovaries create estrogen; my gynecologist is the one who knows about ovaries. And the system of me? I just get my hot flashes and feel confused and overwhelmed.
Enter my new suite of integrative oncologists, stage left.
Dr. Mark Renneker was the first one to come into my life. My mother, who is the head of my recurrence prevention team, found Mark who is famous for his new approach to medicine. He is a new kind of doctor, part general contractor, part detective, part pioneer. He took my case with a curiosity I haven’t seen from the doctors who walk a more traditional path, and he has ordered a plethora of tests. Right now the pathologist slides from all of my surgeries are at labs all over the world, being re-examined for one thing or another. Breast cancer is so many things; Mark would like to find more about mine.
But looking into the past at the cancer I have had is only a tiny part of what Mark wants to do. More importantly, he wants to look into the present at what my body is doing now. For that, he sent me to his friends, Doctors Penny and Keith Block at the Block Center for Integrative Oncology in suburban Chicago. My day there was unlike any other day I’ve experienced in the medical profession.
First of all, the Block Center is bright and welcoming. It looks less like a medical center and more like the fitness/ spa areas of a nice hotel. The women at the front desk welcomed me and clearly knew about me. They were as warm and light and welcoming as the surroundings.
Secondly, the Blocks don’t believe that cancer is ever going to be controlled by a single silver bullet. They study the many pathways that encourage cancer to grow and try to work to reduce the entire suite of pathways. So my first appointment was with Lisa, an onco-psychologist who talked with me about the five key components of their approach: sleep, movement, nutrition, deep relaxation, and joy and meaning. We talked about the importance of connection, of love, of listening. It’s funny, these are all things I talk to leaders about in the context of their leadership. I have not had that conversation in the context of my cancer before.
Next was Katie, the nutritionist. She is urging me towards a diet that reduces everything cancer likes—which, alas, eliminates many things I like too. Meat is easy to give up (after all, I only started to eat chicken when I thought I couldn’t have soy—but now it turns out soy is good for me). But she wants me on a sugar-free, low fat, vegan diet. No butter! No cheese! Very few eggs! We’ll see how that unfolds.
And then Keith Block himself. Often called the father of integrative oncology, Keith hobbled in, leaning heavily on his cane. But don’t expect an old man here. While Keith and his wife Penny have been running the Block Center for 37 years, Keith was hobbling not because he’s infirm but because he is a long distance runner who hurt his leg. Keith and Mark Renneker are old friends and big wave surfing buddies. They shared a cabin when they were surfing in Antarctica (I didn’t know that was a thing). These guys are unusual in every way.
Keith sat down and talked with me in a way doctors never have before. He was curious about me, about my profession, about my life. He talked with me about medical options other doctors haven’t touched upon, and urged me to a more robust exercise routine than I have had in a long time.
Penny talked about the whole integration of it. She told me about her history and the history of the center, asked me about death and decision making, wondered about who could really listen to me when I was sad and afraid. And at every turn, she and the doctors in the center were empathetic and kind and deeply understanding about what a horror show this thing has been.
Of course, even their kindness can’t dampen the fear of the next steps. The Blocks say that cancer is less like a single traumatic event one gets through and more like a chronic illness like diabetes one learns to live with. To cope with this illness, I’ll need to think in new ways about my diet, my exercise, my meditation, my connections, and the joy and meaning in my life. And I’ll have to bear the ongoing fear of the tests and the news that doctors bring.
In the next weeks, the results from all these tests will come back in and I’ll start to get afraid of my phone again. I’ll find out how many circulating tumour cells I have in my blood (scary number—more than five means my risk of recurrence is high). I’ll find out about the particular pathology of my tumours. I’ll find out what my immune response is like. I’ll have a mammogram and ultrasound (I have passed this set of tests only once without a biopsy—eight times the tests have ended with a needle in one breast or the other).
A month from now I’ll have a clearer treatment path as well as a clearer sense of what my odds are, statistically. The Blocks are quick to remind us that statistics are not about any individual person, and indeed, their treatment approach is well researched and their patients live significantly longer than the average cancer patient.
Still, the truth is that I feel the vague post traumatic stress disorder of more bad news. And I am relieved beyond words to have a team of doctors who can help me cope with whatever the news is. I continue to be grateful for the team of support from those of you who read these words who can help me bear whatever the news might be. I will take whatever positive thoughts and energy you might send my way. In an integrated approach to coping with cancer, the whole system makes a difference. Thanks for being part of my whole system.