Medicine

When I was a little girl, I hated going to the doctor. The  white cabinet. Doctors with scrubs. The long, never ending corridor, full of people. And its smell. The smell of  a hospital. Disease. Questions. Tears. Fear. An endless  fear. 

Standing in line for more than an hour, my feet cold, and my head  heavy on my shoulders, my grandmother used to tell me, “The  doctors will look at you and prescribe the right medicine to make  you feel better.” The pain will stop. And she was right. It eventually  did. She always used to take me to the hospital whenever I did not  feel good. She was my true medicine. And she still is, until this day. 

But not everyone has their own medicine to take care of them. Some  people wait too long before they are prescribed one. Long enough  before their body sends them the disturbing signals. And you feel  you are not okay. Your body speaks to you in an unfamiliar and  frightening way. 

It is time to go and see a doctor. It is time to take care of  yourself. 

. . .

Breast cancer is the most common cancer in the world. According to  the American Cancer Society, it accounts for 12.5% of all new  annual cancer cases worldwide. It primarily affects women.  However, men can also develop breast cancer. 

Every 20 seconds in the world, a woman is diagnosed with breast cancer. 

In 2020 in Bulgaria, 25% of women with diagnosed cancer have  breast cancer. 

. . . 

Exactly 20 years ago, 30 years-old Rositza Temelkova found  something unusual on her breast. The first,   terrifying signal. She was not okay. She had breast cancer. 

 

“Before that, I did not know anything about breast cancer,”  says Rositza, with her green eyes staring directly at me.

Rositza Temelkova. Photo taken by Simona Simeonova.

Her life was beautifully simple. At 21, Rositza and her husband had their  first and only child, Elina. Four years later, at 25, Rositza successfully  graduated with Bulgarian Philology in Blagoevgrad, and she found herself a  job as a teacher. Every day, she came across the difficulties that we all  encounter in our lives. Problems at work, arguments in the family, small,  insignificant things. The usual and yet, sometimes exhausting, normality. 

“A little before I found out, my sister left for the United States. I was afraid I  was never going to see her again.” Her father was also suffering from an illness at the time of her diagnosis: “I felt stressed all the time. I let my body and  mind relax when things looked better for him.” 

This was when Rositza got sick.

A risk factor is anything that increases a person’s chances of getting a  disease, in this case — breast cancer. There exist three main factors of breast cancer. 

1. Being born female 

2. Getting older 

3. Inheriting specific gene changes passed on from a parent Rositza falls into the first category. She is a woman. 

After going to see a doctor and receiving the news, Rositza’s life became  like a movie. Everything happened too fast, and every second mattered.  Doctors advised her that she needed to get surgery right away. “My husband  is a doctor. He was crying all the way from the hospital in Sofia. I did not feel it was happening to me,” Rositza says. They had to tell their daughter,  which she considers the most challenging thing until today. On the same day  she returned from the hospital, Rositza knew she had no time to waste and  gathered all her girlfriends. 

“I did not know whether I would wake up after the surgery. I was not  aware of what was coming. I was crying.” Everyone thought she was  crying from happiness because she was expecting a second child. Some of  her friends did not want to believe her when she told them the news. Before  leaving the café, Rositza told her friends: “Please go and check yourselves  first thing on Monday.” 

Rositza had an invasive ductal carcinoma (IDC). Invasive means that  cancer has spread into the surrounding breast tissue. Ductal carcinoma is  the most common type of breast cancer. About 80% of all breast cancers are  invasive ductal carcinomas. Depending on how much cancer has grown or  spread, some women’s breasts might have to be removed. Rositza was told  she would wake up from surgery without a breast. Fortunately, only this 

time, the doctors were wrong. It turned out the cancer was smaller  than they were expecting. 

However, this was only the beginning of Rositza’s journey in the fight  against breast cancer. “I had to accept that one can live with cancer. This  experience pushed me out of my comfort zone. My whole life and my  family’s changed.” 

. . . 

The surgery was over. Now was the time for her and her doctors to plan her  treatment which generally has two primary purposes: 

1. Destroy the cancer cells 

2. Reduce the risk of breast cancer coming back in the future (known as  recurrence) 

She started with what are called “traditional therapies.” Rositza went  through chemotherapy and radiation therapy. 

According to the American Cancer Society, chemotherapy is most often  used when referring to medicines or drugs that treat cancer. However, not  all drugs used to treat cancer work in the same way. Traditional  chemotherapy uses cytotoxic drugs. In other words, they can kill tumor  cells. 

Radiation therapy may be used alone or with other treatments, such as  surgery, chemotherapy, and hormones. The therapy itself uses high-energy  particles or waves — x-rays, gamma rays, and electron beams which destroy  or damage cancer cells.

Cells grow and divide to form new cells. However, cancer cells are not like  most normal cells — they grow and divide faster. The idea behind radiation  is to make  small breaks in the DNA inside cells. These breaks make the cells die. 

But when one has cancer, it is not only the body that needs treatment. The  soul is suffering too. Rositza’s friends advised her to go and see a  psychologist. “On the one hand, medicine was taking care of my body, and  the psychologist was looking out for my soul,” Rositza says. 

During this time, there were moments of hardships and many sleepless  nights. 

Rositza has promised her daughter, Elina, that she will stay alive. However,  she could not hide from her the side effects of the disease and the  treatments. 

. . . 

According to breastcancer.org, which provides educational information  written by science writers and health journalists, there exist 84 different  breast cancer side effects. 

Hair loss and vomiting were one of the many that Rositza had to face. This bothered her family a lot, to the point when she had to chase them out of the  room. One day, Elina played out with a friend, who told her it was wrong to have fun while her mother was dying at home. When Rositza found out about that, her response was utterly human. She told Elina, “Tell your friend to talk to her mother and get herself checked.” 

And so, it began. One woman to another.

Rositza wished she could help other women in her condition or who were at  risk of breast cancer. Make them feel like they are not alone. Understood.  Seen. But first, she wanted to get better and, most importantly, look better, 

as she said. “My wish was to return to my natural look and for my hair to  grow. I wanted the women to trust me and not see me as a sick person.” 

And then, little by little, day by day, Rositza was healing. She was winning  the fight against breast cancer. And just like that, one day in 2004, she was  ready to start an association for women with breast cancer in Blagoevgrad.  The important thing for her was to help different women by sharing her  experience and letting them know they were not alone in this fight. And that  it will get better. They joined forces and started working together. 

“I was apprehensive how the women might get to know each other and talk  about their illness,” Rositza shares. However, a couple of minutes after  entering the room, they all talked to each other as if they had been friends  for years. Some women even showed and compared their breast implants.  They all felt comfortable in an environment where they could be around  women going through the same thing. 

Unfortunately, many women from the association have passed away over  the years. Some of them were unimaginably young. Rositza shared an  example of a woman who got sick at 21 and died at 23. 

“Nowadays, more people get sick at an early age. When a person is young,  they do not consider getting regular check-ups or even assume they might  be sick. And that is normal.” 

Breast cancer can sometimes be felt. You can find it and  recognize it as long as you know how. 

According to the American Cancer Society, the following unusual changes  in the breast can be a symptom of breast cancer: 

1. Swelling of all or part of the breast 

2. Skin irritation or dimpling

3. Breast pain 

4. Nipple pain or the nipple turning inward 

5. A lump in the underarm area 

However, many breast cancers do not have any apparent symptoms at all.  Sometimes, a lump is too small for a person to feel or to cause any unusual  changes that one can see on their own. This is the role of the screening  mammogram (or X-ray of the breast) from where the abnormal area  becomes visible. 

Doctors suggest that performing a regular breast self-exam is the best way  for a woman to notice any changes in her breast. 

“It is a matter of health culture,” says Rositza. She shared that her sister,  currently teaching in the US, has to perform all kinds of medical tests to  start the academic year. 

And I wonder why this is not the case in  Bulgaria. 

Why are we not talking about it as much? 

Years back, after starting to love the interaction with the women from the  organization, Rositza became one of the founders of another organization — The Association of Patients With Oncological Diseases (APOZ), with  headquarters in Sofia, Bulgaria. She and her colleagues began to travel  around cities in the country and taught school students how to perform a  physical examination. 

“We had a briefcase inside which we carried silicone models that imitated  female breasts. In several places, the breasts had cancerous formations.” 

The kids were interested, and they were asking questions. They were eager  to learn more. At the end of the day, this was one of the things that made  Rositza happy. She was able to teach others and pass her experience to  them. With the hope that one day, this might save their life. Or someone  else’s life. 

Almost 21 years have passed since Rositza found out she had  breast cancer. 

 

Today, having won the battle with the disease, she is living her life day by  day, appreciating everything she has. “Everything changes when you have cancer. You start seeing the world differently, and your values shift. You  look above things and at life and everything around you.”

Rositza with her daughter Elina. Photo taken by Simona Simeonova.

Today, the association in Blagoevgrad no longer works. Rositza and the  other women could not manage to handle the expenses themselves. But they  keep in touch. “We are sisters by destiny,” Rositza smiles. And most 

importantly, they share their stories. They talk about breast cancer and what  it is like to have breast cancer. The uncomfortable truth. The one we don’t  like hearing. The one that one day might turn out to be your medicine. 

. . . 

I would like to dedicate this story to my grandmother — Iliika Aykova. A special thank you to Rositza Temelkova for telling her story. American University in Bulgaria. Social Issues Journalism 2022.