Bonnie Annis is a breast cancer survivor, diagnosed in 2014 with stage 2b invasive ductal carcinoma with metastasis to the lymph nodes. She is an avid photographer, freelance writer/blogger, wife, mother and grandmother.

Bonnie Annis

Bonnie Annis is a breast cancer survivor, diagnosed in 2014 with stage 2b invasive ductal carcinoma with metastasis to the lymph nodes.

Americans like to eat and it’s no wonder that they do. Every single time we turn on the television, commercials prod us to try the newest food products. Many advertisements found on cable or streaming services focus on unhealthy foods like sweets and fast foods. Those tantalizing marketing ads make us salivate.

During the summer, I start to become more aware of the excess weight I’m carrying. Being physically active is more challenging when the temperatures soar and every extra pound seems heavier than normal.

Today, I was helping my husband with some yard work. It was 90 degrees outside, I was “sweating like a pig” and felt yucky. Over the course of a few years, as I’ve gotten older, I’ve become more sedentary, and the pounds have slowly crept on. I hadn’t realized it during the cooler months but today was a different story. I knew I had to do something about it. Not only was I concerned about feeling better, but I was also concerned about the possibility of excess weight contributing to a recurrence of breast cancer. After 11 years of living cancer free, I never want to risk having it come back into my life.

I remember reading several medical articles about studies done on postmenopausal women, particularly those who were overweight or obese. Since I fell into the postmenopausal category and I’d packed on a few pounds, I paid more attention. Studies revealed that when those factors were combined with cancers fed by estrogen (ER+), it got even more dicey. Apparently excess body fat led to more production of the hormone estrogen and that could feed cancer cells, causing them to grow.

What could I do to give myself better odds? It wasn’t hard to figure out. I needed to work on my diet and exercise. If I cut out processed foods and sweets, focusing more on healthy options like lean meats, fresh vegetables and fruits, I’d probably start to feel better. Coupling that with daily exercise, like walking, I’d burn unnecessary calories.

Women don’t like to talk about their weight but during the summer months, we often become more conscious of how we look. When it’s time to pull out the bathing suits and shorts, there’s not a lot of leeway for camouflaging those “jelly rolls.”

For many years, physicians have encouraged patients to eat healthily, exercise often and maintain a healthy weight; however, attempting to do those things isn’t always as easy as one may think. Will power requires determination but if controlling what goes in our bodies can help keep cancer at bay, shouldn’t we want to do it?

No one wants to face a cancer recurrence, but as a breast cancer survivor, I know it’s a real possibility if I don’t stay on top of things.

A recurrence of breast cancer can occur at any time to someone, but studies indicate patients who are postmenopausal and carry excess weight may be at a higher risk. If you fall into that category, like I do, I hope you’ll choose to do something about it before it’s too late. Health is really such a valuable asset. Ask any cancer survivor, we know.

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Maintaining a healthy lifestyle is crucial for postmenopausal women, particularly those who are overweight, to reduce the risk of breast cancer recurrence. Excess body fat can increase estrogen production, potentially fueling estrogen receptor-positive (ER+) cancer growth. Adopting a balanced diet and regular exercise can help manage weight and improve overall health. Despite the challenges of willpower, the benefits of controlling diet and physical activity are significant in preventing cancer recurrence. Awareness of one's health, especially during summer, can motivate positive lifestyle changes.

After years of survivorship, I’m realizing that shedding extra pounds may do more than improve comfort — it could reduce my risk of recurrence.

Could Shedding a Few Pounds Prevent a Breast Cancer Recurrence? 

It’s been almost 11 years since I had surgery to remove breast cancer. Some days feel like it was a lifetime ago, and others feel like it was just yesterday. It’s taken time to accept my body the way it is now. The scars are no longer fresh and raw. They’re still visible but have almost faded into the same shade as the skin on my chest wall. I’ve worked hard to look at them as evidence of survival, but sometimes they still cause me pain.

Recently, on a visit to the emergency room following unrelated cancer surgery, I had to remove my shirt so staff could perform an EKG. At that time, the nurse on call was a male. I felt awkward removing my shirt in front of him, even though my husband was with me and felt like I needed to give him a heads up as to what he’d see. In the past, nurses at other medical visits have expressed disgust, sadness, or shock when I’ve had to remove my shirt. After seeing their reactions, I decided it would always be best to warn someone before freaking them out with my breastlessness.

The guy did his best to be professional, but I watched his face. I could tell he hadn’t seen a breastless woman before, and it was making him uncomfortable. I gave him a nutshell version of my cancer story while he hooked the electrodes to my body, and he seemed to relax, but after leaving the room, I heard him talking with another staff member in the hall. He told that person he’d just witnessed something odd.

The other staff member asked what he was talking about, and he said, “A woman with no boobs.” Then they started laughing. Tears welled in my eyes, and my husband reached to hold my hand. When I returned home from that ER visit, I was sent a patient questionnaire by the hospital asking me to rate the visit. They had a place for comments after the survey questions were complete, and I gave them details about what had happened to me. I hope they reprimanded the staff member. I’d noticed his name on his hospital ID and had made sure to include it in my comments. That experience was extremely unprofessional and insensitive.

Then, on Mother’s Day, my son came to visit. He has an odd sense of humor and seems to find joy in shocking others with it. We were talking after lunch, and he said, “Hey, look at this TikTok video.” He held his phone out to me, and I saw a person filming a topless, breastless woman dancing. As the camera zoomed in on her, I could see familiar scars. She’d had a double mastectomy, like me. She was swaying to some soft jazz music. My son was laughing and said, “You could do that!” I was taken aback. I know he meant it to be funny and lighthearted, but I felt deeply wounded. I didn’t like feeling like I was a freak, something to be made fun of, and especially by one of my own children.

My oldest daughter sent me a GIF last night. It was a white bra filled with bright pink petunias. Someone had hung it on a garden wall. She texted, “Hey, Mom, you could do something like this with all of your old bras.” At first, I didn’t think anything about it. She knows I enjoy crafting and probably thought I’d find it funny, but I didn’t. Once again, my feelings were hurt, and I wondered how it was so easy for people to laugh and joke about a person losing part of their body.

Maybe I’m making a mountain out of a molehill, but I don’t think so. I’m not an overly sensitive person. I’ve done my best to roll with the punches through all facets of my cancer journey, but sometimes, it’s hard.

I’ve even thought perhaps something was seriously wrong with me. Maybe I need to see a therapist to discuss unresolved issues from having both breasts removed. Shouldn’t I be at peace with my decision now? How much longer will little things like this affect me?

As I try to self-analyze, I realize I miss my breasts. It sounds odd to say they were part of who I was, but it’s true. I felt whole with them. I don’t feel whole without them.

Summer is here, and it’s going to be very hot. We usually go to the beach and, while there, do some swimming. It’s gotten to the point where I hate summer. Not only because I’m flat-chested, but because swim prostheses never stay put in the special swimsuit I bought for women with mastectomies.

I do my best to camouflage my chest with pretty patterns or shirts with pockets, but still, I feel like people notice when I don’t wear prostheses. Wearing them in the summer is a challenge. The silicone ones are heavy and hot against my skin, and camisoles with built-in breast forms aren’t much better because it’s like wearing 2 shirts instead of one.

I’m not trying to complain, but it would be nice if people were more sensitive to those of us who’ve had to have our breasts removed. And yes, I could have chosen reconstruction and may not have dealt with any of these issues, but I didn’t want to go through another painful surgery.

When I was growing up, my mother used to tell me, “If you can’t say something nice, don’t say anything at all.” That euphemism has stuck with me all these years. I’m sure some people don’t mean to be insensitive toward those who’ve experienced breast cancer; it would be nice if they’d be more understanding. Perhaps if they’d try to imagine how it would feel if the “shoe were on the other foot,” they’d listen more and speak less.

Mastectomies do more than disfigure the body; they wound the spirit, too. I wish doctors would prepare patients for that, but sadly, they don’t.

The narrative reflects on the emotional and psychological challenges faced by a breast cancer survivor post-mastectomy. Despite the passage of time, the individual grapples with societal insensitivity and personal discomfort, particularly in medical settings and interactions with family. The story highlights the enduring impact of mastectomy on self-image and the need for greater empathy and understanding from others. It underscores the importance of preparing patients for the emotional aftermath of such surgeries, advocating for sensitivity and awareness in both personal and professional environments.

Breast cancer surgery can disfigure the body in some way, and often the scars are more than skin deep, which may worsen by the actions of others.

Dealing with Insensitivity After Breast Cancer Surgery

This year has been flying by! As I turn to the new month on my calendar, I see several medical appointments jotted in red. Most of those are routine visits, but there’s one I’m dreading — my annual visit to the cancer treatment center. This will be my 11th visit, and since I’ve been going there, I’ve had four different oncologists. Each time I’d get familiar with one, they’d transfer to another medical facility. It was challenging and often left me feeling unsure about my care, but the center is well-staffed, and I knew they’d assign me to another great doctor, so I didn’t worry much. This time I’ll meet another new doctor. Hopefully, she’ll stick around for a while!

Throughout the year, I barely give a thought to cancer except in the month of October when breast cancer awareness is prevalent due to all the commercialism. During the other months, I go about my life doing the things I enjoy, but sometimes, especially when I have an odd pain, a little thought pops into my head, “What if it’s cancer?” Most recently, this happened during a follow-up visit for hiatal hernia repair surgery. During an endoscopy, the doctor told me he found several growths in my stomach and wanted to biopsy them. The first emotion I felt was fear. I’d never known anyone with stomach cancer before; what if it was cancer? I couldn’t help wondering what I’d do if the biopsies came back positive. I wondered, “Would I take chemotherapy this time?” “Would I survive another cancer?” As those thoughts kept bombarding my brain, I had to give myself a reality check. I needed to be present instead of worrying about the future. I started to have a conversation with myself — a little positive self-talk — “You’ll be okay! There’s no reason to worry about what might be. Worrying doesn’t change anything.” Telling myself those things helped me get past that moment of fear, and I was glad.

Fear of recurrence is normal for cancer survivors. Living past diagnosis allows a person to experience hope, but there are those who will experience anxiety due to the trauma of the first bout with cancer.

I always thought I could trust my body. It had never let me down for any length of time before cancer. Oh, I had some small surgeries and illnesses but knew those weren’t life-threatening. Cancer was vastly different. When I was told I had cancer, instantly I knew it was serious, and I could die.

The first year or two after diagnosis, I felt I was walking on eggshells. I thought any moment; I’d get news that the cancer hadn’t been irradicated by surgery and radiation. I prepared for the worst but hoped for the best. Then, when I passed the five-year mark, I started to relax and breathe a little. I’d heard 5 was the magic number for breast cancer survivors. If you made it that far, chances were you’d be okay. I didn’t quite believe that though. I knew someone who’d been cancer-free for twenty-two years before her cancer came back, and I couldn’t help but think how devastating that would be.

When I passed the 10-year mark, I really let out a sigh. I told my husband and my children I was cured. Saying it out loud helped me believe it to be so. I wanted it to be true, with all my heart, I wanted it. And that’s when I began to wonder…if I’ve been cancer-free for eleven years now, why do I have to keep going back for annual checkups? Will I ever be completely discharged from care?

On my most recent visit to the endocrinologist, she told me I was due for another bone scan. I’m getting close to 70, and she likes me to have one every few years because of severe osteoporosis. She asked when I’d be going back to the cancer treatment center, and I told her I had an upcoming appointment. She asked me if the oncologist didn’t order a DEXA scan to let her know, and she’d order it. The concern in her voice triggered me. Once again, I began to wonder how I’d react to hearing the news that cancer had returned. As I left her office, I told my husband about her statement. He told me not to worry about it. “Just take one day at a time,” he said. “You can’t worry about tomorrow.” And I know he’s right.

Hopefully, when I step into the cancer treatment center on Wednesday, I won’t freak out. Normally, when I walk down the halls and see scores of people in various forms of treatment, I get triggered. I don’t like seeing bald, gaunt women holding on to IV poles as they shuffle slowly past. I feel guilty when our eyes meet, and I see the “I wish I was as healthy as you” look in their eyes. When that happens, I do my best to offer the sweetest smile I can muster and say something kind to them.

Sometimes I think cancer has caused me to hyperfocus on my body. Any new ache or pain can bring about thoughts of recurrence. I don’t know if I have it or if it even exists, but I assume I have a form of medical PTSD thanks to cancer. At least I’m more aware of that possibility now, and I try to find things that occupy my mind. Art has become my go-to when I feel anxious or concerned about the possibility of recurrence. Doing something special for me each day helps push negative thoughts away.

Thoughts of recurrence have waned over the years, but every now and then, they’ll pop up, especially when I hear of a friend who’s been newly diagnosed or when I see some commercial on TV about a new cancer drug. Maybe one of these days, I won’t pay attention to cancer at all. I’d sure like that day to come, and I know many others would, too.

There are so many things in our lives we can’t control. I’m learning to accept that I can’t control my body any more than I can control time. I can control my attitude, though, and I’ve chosen to look for the positive in the negative. By doing that, I feel a little stronger each day.

Cancer survivors often grapple with the fear of recurrence, a common anxiety stemming from their initial diagnosis and treatment experiences. This fear can be triggered by routine medical appointments, new symptoms, or reminders of cancer in daily life. Survivors may experience a form of medical PTSD, leading to hyperawareness of bodily changes. Coping strategies, such as positive self-talk and engaging in hobbies, can help manage these anxieties. Ultimately, survivors strive to focus on the present and maintain a positive outlook, despite the uncertainties surrounding their health.

Even after many cancer-free years, the fear of recurrence still lingers, and many long-term survivors struggle to keep those thoughts at bay. 

Survivors of Breast Cancer May Still Struggle with Fear of Recurrence

Bonnie Annis is a breast cancer survivor, diagnosed in 2014 with stage 2b invasive ductal carcinoma with metastasis to the lymph nodes. Catch up on 

The year is flying by and soon Summer will be here. In the South, that means scorching temperatures. Those warm days can cause challenges for those with lymphedema. In this article, read how Bonnie Annis prepares each year to beat the heat and reduce lymphatic swelling.

I live in the deep South and have for my entire life. When I was a child, Summers never bothered me. I ran around in sleeveless tops, shorts, and rarely wore shoes. I even grew up without air conditioning, which was a challenge, especially in the evenings when I was exhausted and longed for a comfortable sleep. An attic fan and open windows helped cool down our house some, but not enough.

As I grew older, I learned the best times to be outdoors during the Summer months. I’d rise early and get my work done. During the hottest parts of the day, I’d stay indoors in the wonderful air conditioning. As they day ended, and the temperatures lowered, I could venture outdoors to do some gardening or other outdoor chores.

When I was diagnosed with breast cancer, Summer had just begun. The stifling Georgia heat was just cranking up. I spent the first month after surgery either in a doctor’s well air-conditioned office, or at home resting in my own cool home. Nothing seemed to bother me until about a month after surgery.

About midday, I noticed some swelling. Reaching out to the doctor who’d performed my surgery, I explained my concerns. She asked me to come in for a post-surgical checkup and after examining me said I’d developed lymphedema. Although I’d heard of it before, I wasn’t quite sure what it meant. I asked questions and she gladly answered them before recommending I see a therapist certified in manual lymphatic drainage. She said when she’d removed lymph nodes from my arms after removing both my breasts, my lymphatic system had suffered.

I saw the therapist for 6 weeks. On each visit, she’d massage my arms for about an hour, working on one and then the other. She explained the massage would encourage excess fluid to flow upwards toward my heart if she started at my fingertips first. Then, it would travel through the “railway like” lymphatic system where it could be expelled. After the massages, she’d wrap my arms with compression bandages. I’d go home looking like a mummy, but admittedly, my arms felt better.

When my insurance coverage for these treatments expired, the doctor prescribed compression sleeves to help with the swelling. They were expensive, but insurance covered a good portion of the cost and allowed me to get 4 pairs a year. I found an online company that offered pretty patterns and bought the sleeves, but they were challenging to put on because they were so tight. I was told to put them on first thing in the morning and leave them on all day. They did keep the swelling down but as Summer progressed and temperatures soared, I found them uncomfortable to wear. Sweating was not something I enjoyed, and those tight Spandex sleeves made me sweat a lot! I looked for alternative ways of managing the swelling.

I started dry brushing in the shower. I bought a soft bristle body brush and would gently use it to push the fluid up toward my heart like the therapist had shown me. Then, I’d take a lukewarm shower. Hot showers could exacerbate the swelling, I had been told. Next, I’d use body lotion and beginning at the fingers, I’d gently move up my arm. Those things were great, but I had to do more if I was going to be outside.

While visiting the lymphatic massage therapist, I’d been warned about protecting my arms from injury. That included small wounds like bug bites, burns, or even sunburn. When I questioned the information, I was told wounds to my damaged limbs could cause cellulitis, a dangerous infection that can quickly escalate and sometimes require surgery. That scared me.

Now when Summer comes, and I plan to be outdoors, I wear thin long-sleeved shirts when I can. I’ve found several sporting goods stores that offer these type shirts with built in sun blockers. When it’s too hot to wear long sleeves, I spray myself with insect repellant. Normally I choose a product with DEET but lately I have opted for more natural sprays that don’t contain that chemical.

I also make sure to layer on sunscreen if I’ll be out for extended periods of time. I don’t want to risk a painful sunburn. And when I’m cooking at the grill, I wear long silicone mitts made especially for outdoor use. That way I’m sure my arms are protected from excessive heat.

Lymphedema isn’t something that can be cured. As a secondary complication from breast cancer surgery, the best thing I can do is manage it by protecting myself. When my arms begin to feel tight and uncomfortable, I’ll use my electric compression pump designed specifically for those who suffer from lymphedema and when I can’t do that, I’ll elevate my arms.

Summer seems to aggravate my symptoms. During cooler months, I don’t notice the lymphedema as much, but it’s still there. I guess it’s a small price to pay for surviving breast cancer and I’m willing to do whatever necessary to keep myself well and comfortable.

Managing lymphedema during the hot Southern summers poses significant challenges, especially for those who have undergone breast cancer surgery. Effective strategies include early morning activities, staying indoors during peak heat, and using air conditioning. Manual lymphatic drainage therapy and compression sleeves help manage swelling, though they can be uncomfortable in the heat. Additional measures include dry brushing, using insect repellent, wearing protective clothing, and applying sunscreen to prevent injuries and infections. While lymphedema is incurable, these strategies help manage symptoms and maintain comfort.

Summer heat can worsen my lymphedema, but I’ve learned simple ways to stay cool, reduce swelling and protect my arms — here’s what helps me most.

Bonnie Annis

Could Shedding a Few Pounds Prevent a Breast Cancer Recurrence?

Dealing with Insensitivity After Breast Cancer Surgery

Survivors of Breast Cancer May Still Struggle with Fear of Recurrence

Lymphedema Makes Summer Preparations Challenging After Breast Cancer

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