Excerpts from the breast cancer novel: Soft Tissue
[1]…The air hostess made her first round to make sure all seats were upright and the seat belts were fastened. Her next round was to offer snacks and drinks. Beverages were offered at cost. Roxy ordered a Heineken while James ordered a scotch on the rocks. The time lapse before the drinks were served broke the ice of silence for both Roxy and James.
“My name is Roxy Adams, a fourth year Law student in San Francisco.”
Roxy introduced herself by extending her right hand to James, a matter of courtesy.
“I am James Ugo, a scientist at The Bi-Cell Pharmaceuticals, in Palo Alto.” James responded.
“I am going on vacation with the other ladies to Egypt to visit the Pyramids and so on.”
“Lucky you. I am going to a conference at the Cairo University. I am presenting a paper on breast cancer. For me it’s all work, no vacation.”
The drinks were served and both were taking sips of their drinks now, somewhat relaxed. Roxy was beginning to unfold the blankets to cover her legs from the cold, a combination of the effect of the plane’s altitude and the air conditioning.
“James, did you say breast cancer?”
“Yes.”
“Egypt of all places. I can imagine skin cancer because it’s so hot down there. I don’t know about breast cancer.” The surprise in Roxy’s voice was quite evident.
“You’ll be surprised.”
“About what?”
“Do you realize that the oldest recorded breast cancer was in Egypt around 1600 B.C. The physicians recorded eight cases of breast tumors which they referred to as ‘bulging tumors of breast’. Roxy you don’t want to know about the brutal surgery that followed in the absence of anesthesia.”
“I can only imagine, yak.”
“I mean it was surgical excision without any pain reliever, and the drugs included arsenic compound. Talk about medieval medicine and murder.”
Roxy could not hide the smile on her face as she concentrated on James’ facial expression of disdain. [Page 14]
[2]…“James you’re not kidding. Are you?”
“Dead serious.”
“Amazing. You know my grandmother was diagnosed with some type of cancer. I’m not sure exactly what type but it was not serious. They gave her medications and that was it. No other members of my family have been diagnosed with cancer since then.” She took another gulp of her beer, looked towards the window, which by now was covered by the blind. She turned to James and popped the question “What are the causes of breast cancer?”
James took a deep breath, stirred his scotch on the rocks and took a sip. He turned to Roxy. Both of them were more or less eyeballing themselves but were hardly noticeable in the dim coach lights. “Nobody really knows exactly, but there are certain facts we know. It is a combination of genetic, environmental and lifestyle factors. Doctors have identified the abnormal genes, BRCA1 and BRCA2, referred to as “high-risk” genes that contribute to an increased chance of developing breast cancer. Over 20% of breast cancer is caused by an inherited gene. Recently a set of “low-risk” genes, CHEK2, and the faulty version of the gene, CHEK2*1100delC, have been identified in women diagnosed with breast cancer than in healthy women.
Women with mutations in BRCA1 and BRCA2 genes have a 50-80% chance of developing breast cancer. More than half of breast cancers affect women over 65. Those women who either had children late in life or have no children, whose periods started when they were young or whose menopause occurred late and some women who take the contraceptive pill have a high risk of developing cancer. Women taking combinations of estrogen and progesterone seem to have greater risk than women taking estrogen alone. Less than 1 in 20 breast cancers are inherited. 1 in 1000 people carries the genes responsible.”
“That’s quite helpful James. Did you say contraceptive pills?”
“Yes. Oral contraceptive pills have been linked to breast cancer for quite some time now.”
“Interesting.”
“What are the side effects of Oral Contraceptives?” Roxy continued her enquiry.
“There are four main side effects namely: blood clots, stroke, heart attacks, and breast cancer. Every woman regardless of age should practice ‘breast awareness’. This means in other words, to know your breasts, what they usually look and feel like so that they can recognize any changes.”
A message on the intercom interrupted their discussion. “This is the captain speaking. We are going through a short period of turbulence. Make sure your seat belts are fastened, your seats are upright, and your overhead lights are turned off.”
“That’s a consoling message.” Roxy soliloquized as she straightened up her seat. [Page 15]
[3]…They like to party, and occasionally spend the weekends dancing at the “Sahara-Caribbean” joint in Burlingame, next door to the airport. Elaine knew about most of Roxy’s dates and Roxy knew about most of Elaine’s dates. They were not ready to have babies yet so they talked a lot about contraceptives (pills) as method of birth control and other alternatives. They were truly playing the field.
“Roxy, why do most of you consume so much alcohol? I mean law students and lawyers. Is that part of your curriculum?” Elaine asked, completely amazed at Roxy’s ability to drink alcohol.
Roxy laughed the question off. “There is a lot of pressure in law school.”
She responded. When Roxy initiated the idea of travelling to Africa it was easy to come up with a “foursome”, willing participants, namely: Elaine West, the nurse; Ifeoma Stalin, the pharmacist; Beatrice Shunt, Ifeoma’s friend and a microbiologist; and Roxy. They were good social mixers. So, during this flight back from Luxor to Cairo it was easy for Elaine to notice that something was bordering her friend, Roxy. She slowly approached Roxy’s seat and sat beside her. Roxy was seating by the window and starring outside at the vast, endless white and blue clouds while actually recognizing nothing. Her mind was fixed on how to connect with James. She was not sure whether he had decided to fly back to San Francisco after their conference, which had just ended. Roxy turned around to recognize her friend, Elaine, sitting next to her, then gave her the familiar welcoming smile.
“What is it?” Elaine asked, her eyes probing Roxy’s face and radiant with smiles. “Is it James?”
Roxy smiled broadly, turned her head towards the window again in a shy retreat, stared briefly, and then turned back to Elaine,
“How do you know?” she asked jokingly.
“I am Elaine remember, your very good friend.”
Both friends laughed and giggled together, relaxed abit, and held hands.
“He is very handsome, with bright piercing eyes and a scientist too.” Elaine volunteered.
“He is smooth and gentle.” Roxy added.
“Smooth James.” Elaine confirmed
“I didn’t know scientists are this young and handsome. His suit is sharp and clean. He acts so conservative, speaks well, clear and understandable English. You will think that he went to school in Oxford University or somewhere in London.” Roxy reflected as Elaine relaxed with her head tilted back in her seat.
“No. Roxy, the guy is a good USA graduate. One of us. A black elite. Check that out.” Elaine appeared even more pleased than Roxy.
[4]…“But why am I thinking about him?” Roxy queried almost in bewilderment and a certain air of resignation.
“Because the guy got it. He is good and you can’t argue with success. I bet he is also losing sleep thinking about you.” Elaine responded trying to reinforce Roxy’s feelings and at the same time encourage her to make the move when next they meet.
“He probably has tons of girlfriends. That’s if he is not already married.”
“He is very single I bet. Doesn’t look married to me. There is no ring on his finger.”
“Ok, we’ll see.” Roxy responded almost trying to change the topic. After a brief pause Roxy continued, “I am kind of surprised. I have this image that most scientists look weird, old, absent-minded, with uncombed hair, own only one shirt, khaki pants and jeans, hardly any suits, maybe one.”
“Yeah, mad scientists.” Elaine suggested.
“Elaine you work around them daily in the hospital. What do you think?” Roxy asked somewhat ignorantly.
“They are not as neurotic as lawyers if that’s what you’re asking.” Elaine clarified. Both burst out in laughter.
Elaine continued, “Some of those doctors are young, conceited and arrogant, most of them have girlfriends who are ready to kill if you get close to them, and a good many of them are married. Yes, a high percentage is middle age to old. On the average the younger ones are well dressed.”
“I am impressed with James.” Roxy replied, looked into Elaine’s eyes, and waited for her sarcasm in return.
“That’s an understatement Roxy. I haven’t seen you in this state for awhile. Most guys aren’t worth your time, I thought.” Elaine pushed the button on her seat and it stretched out so that she stretched her legs and back, now fully relaxed.” She continued,
“Both of you were chatting non-stop during our flight from SFO to Cairo. What were you guys talking about?” Elaine enquired.
“He was explaining some of his research related to cancer, breast cancer in particular. I understood him up to a point, and dismissed the rest as mumbo jumbo. Sort of who cares?, However, I remember his mentioning that their conference ended yesterday and he might fly back to America soon after the meeting.” Roxy elaborated.
“Did you get his phone number?” Elaine quickly interjected.
“No, I did not.” Roxy answered as if it was no big deal.
“I’ll be damn. How did I know you wouldn’t?” Elaine responded with disappointment. She always wanted the best for her friend, and looks out for her. [Page 21to 23]
[5]…Denise was a very beautiful, elegant white lady, now in her late forties. She took pride in her appearance, her figure and wanted nothing more than to look youthful. Anything money can buy to keep looking youthful including beauty treatments and/or cosmetic surgery. Eventually her doctor would put her on hormone replacement therapy (HRT) so that she can maintain that youthful, buoyant movie star looks as she jets around the world. Denise looked in the mirror one day as she was dressing up and putting on her makeup to fly off to one her high power business meetings, and felt different.
I think I have to consult my doctor about my skin, especially my facial skin. I feel that I am getting old. She soliloquized.
She finished putting on her makeup, looking everyway as a powerful attractive executive, and on her way out she turned to her secretary, Laura Mill, and ordered. “Laura, get me an appointment with my doctor. I’ll like to see him tomorrow evening when I return from my trip to Los Angeles, California.”
Her chauffeur drove her to the private terminal where all the Gulfstream Z555 jets, Lear jets and the like were packed. These corporate jets belonged to several corporations and individual.
Denise operates from her headquarters in Orlando. She got out of the limo and walked through the mini terminal corridors with the air of authority.
Most people recognized her and paid their respect through winks and faint hand waiving. The courtesy van whisked her off to her jet, which has been serviced and ready for take off.
As soon as she got into the plane, the doors were pulled shot. She walked all the way to the rear where her office was. The seats were soft, and expensive. The wood was of shining polished mahogany. Right next to the cockpit was the bar and kitchen. This was simply an enviable luxury. The only passengers were the three staff members of her company, the stewardess, company attorney and the secretary.
The jet was guided into the runway. In a few minutes the jet was speeding down the runway, the lift off. While in the air, Denise worried about her looks.
Laura called Dr. Bill Smith’s office to schedule an appointment for Denise.
“Hello, Dr. Smith’s office.” The receptionist answered.
“This is Laura, Denise Shunt’s secretary. I’ll like to schedule an appointment for her to consult with Dr. Smith tomorrow evening.”
“Just a minute please I’ll check his schedule for tomorrow.” She quickly checked with the doctor and was cleared to add her to the appointment list.”
She returned to her desk. “You are set for 4.30 p.m tomorrow, Thursday.”
A patient of the caliber of Denise, the Executive Director of Richards, Inc., will always have preference in the doctor’s schedule. She was a preferred customer.
“That’s great. My boss will see you at 4.30 P.M. tomorrow, Thursday.” Laura reiterated for confirmation.
Denise completed her business meetings in Los Angeles in good time to rush back the next day for her doctor’s visit.
“We’re heading straight to Dr. Smith’s office.” Denise instructed her chauffeur.
It was a short drive to the doctor’s office, and for that period she sat, comfortably, in the back seat reviewing her previous day’s meeting. The driver pulled into the visitor’s parking lot just in time for Denise to make her appointment on time.
“Hello Director. I haven’t seen you in quite awhile. Nice to see you. You are looking great. How is business?” Dr. Smith liked to address her as ‘Director’. He was all smiles and friendly to her.
Denise returned the cordiality. “All is well doctor. Business is just fine, always busy and demanding, meetings and all. Overall there is nothing unusual which is good news.”
“Director how can I be of help today?”
“It’s about my face. I think I’m getting old. I love my youthful look doctor.”
“Director, we’re all getting old. You are looking great and much younger than your age.”
“Well I want to look younger.”
“Of course Director, if you insist. Have you considered Hormone Replacement Therapy (HRT)?”
“Doctor Smith, that’s exactly why I’m here now. I have heard a lot about HRT so I need your advice. I want my youthful look to stay as it is or younger.” Denise responded.
“Director I will give you a short explanation to help you make the decision. Human growth hormone (HGH), in your case as a female, estrogen and progesterone decline as we age. For women, the estrogen and progesterone as easier to detect because women reach menopause and exhibit premenopausal symptoms. Estrogen is not a single hormone rather a group of several different hormones that are related and perform the ‘estrogen function’.”
“How do you measure this thing?”
“Director we measure your levels of pituitary hormones and the messenger hormones. For HGH, we measure IGF-1 (somatomedin C). For sex steroids, we measure sex hormone binding globulin, estradiol, estrone, and progesterone. We also measure levels of DHEA(dehyroepiandrosterone), and pregnenolone, sometimes cortisol and prolactin levels depending on the symptoms and signs.”
