Images of the breast-cancer patient held under the reins of scrutinizing medical devices had a profound impact on me during my visit to the Centre de Cultura Contemporania de Barcelona in December 2005. The patient was the artist whose work was part of exhibition at the center. The exhibition was a visual documentation of the artist’s journey through life from the time she was diagnosed with breast cancer to her last days when she finally succumbed to the disease. She was young, and her serene face haunted me. For a moment, I vaguely felt the artist’s pain, anxiety, as well as her spirit as if I were sharing her experience. I went back to the hotel and examined my own breasts. On my left breast, I felt two small lumps: one in the lower part and the other right underneath the nipple. They were of the size of a grain of rice.

I immediately visited my doctor upon my return to California. The doctor ordered a mammogram which turned out to be normal. However, the mammogram did not capture the details around the nipple. The doctor then ordered an ultrasound to be performed, but only around the nipple and not for the entire breast. The test revealed a small cyst. The lump at the lower part of my breast was never detected.

I was called in to discuss the result and was advised not to be worried. ""They only found a cyst of fluid. Your doctor will call you to drain it if he thinks it’s necessary."" No one called me. I thus thought that everything was fine.

In June 2007, I began to feel a pulsating and stinging sensation on my left breast. I examined my breast and was shocked to find out that that tiny lump had grown into a mass of the size of a large marble. I immediately called my health-care provider for an appointment. The doctor who examined me was the same doctor who did not call me to drain the cyst. I anxiously studied his facial expressions while he was touching my breasts. He smiled cringingly. ""Nah, it’s not cancerous. It’s round and not spiky and is probably a cyst. But, I’ll order a mammogram for you. Someone will call you within a week.""

I asked him if I could have a biopsy at that time. He shook his head. ""It’s too small for me to do that."" Again, he told me to go home and not to worry about it.

A week passed, and I heard nothing. I called and asked about the mammogram appointment. The person who answered the phone told me that since this was a routine appointment, I would need to wait for some time. ""What do you mean routine? I have a lump of the size of a ball."" She apologized but said the doctor did not order it under the stat category, meaning urgent. She read what the doctor put in the record and told me that my next mammogram would not be until 2008. I pleaded with her over the phone and she finally scheduled a mammogram for me on July 24, a month away.

Another week went by as I waited in anxiety. My left breast continued to bother me now and then with that pulsating and stinging sensation. I complained to a friend who was a doctor in Stockton. He happened to work for the same HMO that provided coverage for me. He said if I was willing to drive to Stockton, he would help me speed things up. I was ready to drive any distance to find out about the lump. He arranged for me to undergo a series of tests consisting of a mammogram, ultrasound and biopsy, all in the same day. Again, the mammogram was negative but the ultrasound told another story.

As I looked at the face of the ultrasound technician, I knew I was in trouble. I asked her to let me look at the monitor. She hesitated for a moment then turned the screen toward me. I was thus introduced to my tumor. It had the shape of America’s map. I could see Florida. I called my husband later and told him, ""I have America in my breast!""

The biopsy confirmed that the tumor was malignant. I asked the surgeon at the Stockton facility if the tumor was too small to perform a biopsy. She said it was big enough for anything. She immediately scheduled me for surgery in the next few days. But as I did not want to have the surgery so far from home, I asked to be transferred back to San Jose. I later learned that the Stockton surgeon made many calls to the facility in Santa Clara begging for people with authority to call her back so that she could arrange for the transfer. No one called her. She even called the customer care department and complained but nothing worked. My friend the doctor decided to take a day off and showed up at the Santa Clara facility searching for a surgeon who would take my case. He managed to find me a good surgeon.

On the day of the surgery, I was put under general anesthesia in time for the 8 a.m. procedure. At noon, the nurse woke me up and asked me to move to the wheel chair. I tried to find out what happened to me. ""Did I lose all my lymph nodes? Were they positive?"" I murmured. I soon fell into a state of half awake and half asleep, but I could hear the nurses fighting about me. ""She needs to leave."" ""My patient is not ready yet."" ""But we need the bed…""

I was discharged around 2 p.m. It took me great effort to leave the bed and get into the car. I found out that the surgeon performed a lumpectomy on me and removed 15 lymph nodes. I also learned that the sentinel node was tested positive. The cancer had spread. I was wheeled out of the hospital disoriented and confused.

Ever since I was diagnosed with cancer, I began to learn that many women I knew well or am related to have had breast cancer. Yet no one had told me about their experience with this disease, especially my Vietnamese American friends. I was shocked to find out that six of my former co-workers who worked with me at a building on North King Road had breast cancer. Everywhere I turned to, I would run into someone who was affected by this disease. But why did everyone suffer in silence?

I felt somewhat cheated going through the entire ordeal. If I had been somewhat exposed to the many issues that a breast-cancer patient has to deal with including the choice between lumpectomy or mastectomy, the treatment procedures and their side effects, the probability of recurrence, the proper diet regimens, etc., I would have been better prepared to make those decisions that might affect my future. It would certainly help to know that Asians did not respond well to mammograms and that the ultrasound test would often be a better diagnostic alternative.

One day, I complained about my situation to a friend who was much involved in humanitarian works. She was a doctor and also a breast-cancer survivor who had spent years in Vi?t Nam taking care of the needy. I told her that my heart went out to those women who suffered in silence in our community. She sighed and said that ""at least they have beds to lie on, available treatment to receive, and a chance to survive."" She told me that after she completed chemotherapy, she visited the Breast Cancer Institute (Vi?n Ung Thu Vú) in Sài Gòn and was shocked to witness the sufferings of Vietnamese cancer patients. Most of them sleep on the floor on spread-out newspapers waiting to die. Generally, women in Vietnam only begin to seek for treatment when they feel pain or big lumps in their breasts. They are not diagnosed with the disease until they have reached Stage IV, when the cancer cells have metastasized. The concept of self-examination is foreign to these women, and if they feel something wrong with their breasts, they will need to wait long before they can undergo a mammography. The statistics show that there is one mammography device for every 2 million Vietnamese. If a person is tested positive, she may not be able to afford the costs of the needed surgery. Furthermore, her chance of infection after surgery are very high.

Chemotherapy, radiation and hormone therapy are available but only wealthy patients can pay for their costs. These patients constitute less than 10 percent of the population.

I am now a cancer patient. Even though I could have avoided running this gauntlet of cancer treatment if my doctor had diagnosed me properly in 2005, I am now in peace with myself. In many ways, I am much luckier than those cancer patients in Vieät Nam whose days are numbered. There is no doubt that cancer patients in many other parts of the world are going through the same experience. I hope I will survive.

But survival is no longer my final destination. I want to send a message to people around me asking them to help those women who are languishing in the dark corners of the world afflicted by this terrible disease. We need to light a small candle to erase their surrounding darkness, to give them some hope, albeit small. We need to tell them that their lives are worth fighting for, and they need not lose hope.

Ever since I found out I had cancer, I had received the overwhelming support from my family and friends. Never before did I realize I was so much loved. I now feel this deep sense of gratitude toward others, and from there I rediscover my appreciation of life. I now observe a newly self-imposed exercise regimen. I am determined to become an athlete. Who knows, Jenny  Ð? may one day become a top athlete. Like Lance Armstrong.

Nah!

In the garden of misfortunes, flowers continue to bloom.

My journey of a breast cancer patient has only just begun. Whatever remains of my life will certainly have its share of splendor.