Oct 25, 2014

Oh, I'm Aware, Alright: Escarcelle


In France, as in much of the world, October is Breast Cancer Awareness month. I have to say I'm feeling extremely aware because on October 1st -- poetically the first day of what the French call "Octobre Rose" or "Pink October" -- I was diagnosed with breast cancer.

Straying into more personal territory than usual, I first want to give you some of the particulars to put your mind at ease: it is Stage 1 and grade 1 (meaning non-aggressive and very slow growing). If you know more about breast cancer, it is also HER2 negative and hormone positive (estrogen 50% and progesterone 50%), both of which are considered excellent signs for treatability and even curability. This certainly puts my mind at ease, and I can honestly say that I'm not feeling stressed or scared except for the inevitable small blip here and there (and I'll admit the first week, before I knew the scope of it, I was a total mess).

(And by the way, if you are somebody that would have expected to be told privately, please don't be insulted. It's just exhausting, not-fun, and not-great-for-keeping-up-my-positive-attitude to have to keep repeating this and reassuring everybody else that I'll be OK. I'll be OK, really, I promise. It's easier for me to give you the details to support that all in one fell swoop. I'll still be here when I'm 90, unless I'm hit by a truck before then; I'll be the shrunken shriveled old lady with the perky fake boobs of a 25 year old.)

We believe that it hasn't spread to any lymph nodes (although this cannot be confirmed till the surgery itself) and -- if that turns out to be correct -- it looks like I will get away without any radiation or chemotherapy. It's as if there's CANCER, there's cancer, and then there's what I've got -- a boob cold. But if it turns out I do have to have either or both radiation/chemo, well it is what it is. I'll be honest: I wouldn't be happy to lose my hula hair. But I'd rather lose my hula hair than my life, so I'll just make the best of it if it comes down to that. Expect to see me in a lot of crazy wigs; I've always wanted to be a redhead. The girls are not worried about my health, or even the change from squishy mommy boobs to fake ones. And they're not worried for themselves, since they have time, awareness, and scientific advancement on their side. They're mostly worried about me losing my hair. Well, I hope I can oblige them by keeping it.

Also, when we realize that both Anthony and I will both be rehabilitating at the same time (his arm is still in a sling from surgery to fix shoulder tendonitis), we tell the girls that they'll probably have to step up with chores, like washing the dishes and doing laundry. Pippa, in all earnestness, asks, "Can I live with another family during that time?"

I could choose a single lumpectomy, but because of various factors (especially family history and slightly worrisome calcium deposits), I am probably opting for a double mastectomy with reconstruction, which can be done all in one surgery. At my first consultation at the cancer center, I immediately tell the sonogram technician who is checking my lymph nodes, and later the oncologist, that I want the double chop. Good riddance! Both women respond, independently, "You are soooooo American." Evidently, the French are much more conservative about their breasts (except on Côte d'Azur beaches, that is). Prophylactic mastectomy is so unusual that a) if the doctors deem there's not enough medical reason to do so, I would legally have to wait 4 months and b) I am required to see a special psychologist about it. This cracks my mother up: "It's not like you're trying to get a mastectomy for the fun of it. You have cancer. What choice do you have?!"

Given that breast cancer runs strongly in my family -- mother, aunt, maternal grandmother, maternal great-grandmother, and two out of three great-aunts, I think I have good reason. On the other hand, longevity runs through these same women, making it into their 80s and 90s. It's a pretty weird genetic mixture, frankly.

Although the French are less likely to lop off their breasts at the mention of breast cancer, they are -- thanks to the national health system -- much more likely to do sonograms as a mammogram back-up and also biopsies and MRIs. This, plus the fact that my tumor basically feels like a peanut M&M popping up from the surface of my breast, made it easier to identify early. You would think the fact alone that it can be easily felt and even seen from the outside would make it easy to catch, but in fact, it doesn't show up as anything alarming on the mammogram. Because we are in France, however, and they don't need to worry about costs or insurance rules, they immediately do the sonogram and biopsy just based on my family history, for the heck of it. And catching it early obviously helps my diagnosis, treatment options, and prognosis (excellent: with mastectomy, 98-99% chance it won't return).

The MRI I do, for example, costs me 155€, for which our private insurance will reimburse us (and you can see that price has risen 10€ since the poster that I photographed below was printed). That is the full cost of the procedure, not just my portion of the bill, mind you. If I were a French citizen, I wouldn't pay a single cent. In the US, that bill is more like $3,000.

While the cost of care is much lower here in France, the quality is not. As good luck would have it, one of my close friends from college is a breast cancer surgeon and the Director of the Breast Health Center at a major hospital/cancer center in Boston. She's kindly giving me second opinions (so far confirming everything the French doctors have planned) and also has told me that she considers Western Europe to be on par with, and sometimes exceeding, the US in terms of breast cancer research and treatment.

There are some small silver linings. My cancer center and hospital, the Institut Curie, one of the very best in the nation, is a lovely walk through the 5th arrondissement past the Midnight in Paris steps movie location and the Pantheon (currently being renovated), a walk I enjoy very much. And I'm quite proud that I'm able to have all of my discussions in French, comfortably; I have made only one slight gaffe so far, with no horrible repercussions, when I accidentally call the lymph node ("ganglion") a puppet ("guignol").


I know some of you (all of you?) are going to feel concerned for me, especially since many of you have lost loved ones to cancer. But since I always expected to get breast cancer, I genuinely feel very, very lucky with the type/stage I've got, especially since within 48 hours of my own diagnosis, I found out that one of my best friends in the US and my aunt (yes, in that same family line) had also both just been diagnosed, with cases that are a bit more advanced than mine (but still considered curable). My friend calls mine Breast Cancer Lite. I sometimes call it the Breast Cancer of My Dreams. But I'm mostly looking forward to simply calling it Gone.

At first, my surgery was scheduled for Oct 31, and I thought that would certainly be poetic, closing out Octobre Rose. But now it has been re-scheduled for Nov 17, when both the plastic surgeon and cancer surgeon can be there together. Since that is basically the end of my complete/first Year in Fromage, there's a certain symmetry in that, too. I'll be continuing the daily blog until then, as I'm nearing the 365-cheese finish line! Do not expect maudlin cancer-related posts, because I don't feel maudlin. Expect quirky, cheesy observations about life in Paris, because I do feel quirky, and cheesy. I will be continuing the blog after the year mark, though not on a daily basis; I have a hankering to make it to my next milestone: 500 cheeses. But you may notice a little slow-down in mid November, for the obvious reason. I'll be in the hospital for a full week (again: thank you national French health system! And is it wrong that I'm looking forward to a week with absolutely no responsibilities?), and I'll post a little update here once I'm back so that you -- along with my breasts -- are not left hanging.

[Click here to read about the surgery and see the Before & After.]

THE CHEESE: Escarcelle

Escarecelle is a newly created cheese, produced only by one farm in southern France, exclusively for sale at the Laurent Dubois cheese shops. It's actually considered a house specialty cheese, since it was created and is produced under the tutelage of Monsieur Dubois himself. And let me tell you, that man is not named one of the Meilleur Ouvrier de France (master cheese ager) for nothing. It's a raw goats' milk cheese, soft, squishy, creamy, with a delicate toad skin crust. Each little ball is about the size and shape of a fig.

The cheese comes in three versions (with at least two different spellings from my spelling-challenged local cheese shop). The top one is sprinkled with Timut Pepper ("fine acidic and bitter notes"), the lower right is Equinox Pepper (with the very un-French flavoring of cinnamon, along with vanilla and pepper), and the lower left is Serenissima Powder (with cinnamon, ginger, and saffron).

I buy the Poivre de Timut and Poivre Equinoxiale versions, and assume the children will prefer the one flavored with cinnamon and vanilla. But contrary to expectations, everybody strongly prefers the Poivre de Timut, children included. It's not nearly as bitter or acidic as the description would have you believe, and the pepper adds a tang without being spicy. The other one is simply blander and flatter-tasting, and the combination is not as harmonious with the goat cheese. Still, once the Poivre de Timut is gone, the other gets happily eaten as well. It's not that it's bad; we simply have a preference.


For breast cancer awareness, you can't beat a cheese that looks like little boobs and has the word "cell" in it. In the photo below, the Escarcelle, like a Bat-signal casting a shadowy beacon into the night, is sending you and your loved ones the message -- in the form of the letter "B" -- to check your breasts early and often. I'm wishing you all no breast cancer but, if you have to get it, then I'm wishing you my own "Breast Cancer Lite".


  1. I'm wishing it gone for you too. I hope that it is easier to deal with it than what you expect. Thank you for telling your story. Den x

    1. I'm already so happy with how "easy" I've got it, that I can hardly believe it could get much easier. But I certainly appreciate the sentiment and know what you mean: the easier, the better!

  2. Dear Kazz,
    I am sure you will sail through this cancer blip with the grace and sense of humor with which you lead your life. I so enjoy your observations about the French Healthcare system.
    Hugs from the SF Landreville's

  3. Really sorry to hear about this but happy for your lite diagnosis and amazing attitude!

  4. Hi Kazz, our mutual friend Michelle B. connected me with your blog. I'm sorry you have to deal with this upcoming surgery, but I'm delighted to have found your writing.

  5. Kazz-
    This is a great post. Thanks for the information and the diagnosis sounds like the least bad news possible. We're in you're corner and looking forward to seeing you soon.

    --Matt Davis


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