Fat and Flat: On Breast Cancer & Body Love
Content Warnings: Discussion of cancer diagnosis and treatment, death
Note from NAAFA's Executive Director: I met Susan Perez 40 years ago, when we were fifth graders, and she has been one of the most important people in my life. I am sorry to share with our community that Susan died in late July, just a few weeks shy of her 50th birthday.
Representing breast cancer survivors and using what she learned through her healthcare experiences to help support other cancer patients and others with terminal illnesses was incredibly important to her. Susan was really proud that writing this piece for the NAAFA Community Voices Blog might help readers see another way that radical body love and supportive community spaces can change people's lives.
We're sharing Susan's essay again this Breast Cancer Awareness Month in gratitude for her support of NAAFA and in solidarity with all of you whose lives have been impacted by breast cancer. Donations in Susan's memory can be made to one of Susan's favorite breast cancer charities, Metavivor, or to NAAFA for medical advocacy and education.
Susan Perez, a plus-size fortysomething Latina flattie. She is standing in a desert garden in front of a large saguaro cactus. She has short dark hair. She is wearing dark lipstick, dark-framed glasses, paisley pants, and a gray t-shirt with the term FlatAF across the chest in white letters
When I was initially diagnosed with breast cancer in 2005, I was thrust into a whirlwind. I found myself in a medical world where every tool in my toolbox, and some I didn't have yet, were going to be needed.
I became an advocate, an expert, a researcher, and a journalist all at the same time. If each of these roles had an actual hat, picture a mile-high stack on my head. All these new roles were, of course, simultaneous with my daughter, mom, sister, friend, and other everyday roles. I was suddenly faced with so many medical decisions that were ultimately body and life-altering.
I admit my initial choices were more based on saving my life than being a cancer survivor and advocate. I was forced into one of the biggest strength tests of my life. You've probably heard the adage, "You don't know how strong you are until you have no other choice.” Well, I was about to find out.
The best choice medically and to begin treatments quickly was a single mastectomy of the offending breast. So l embarked on my one-year journey as what people in breast cancer patient communities refer to as a uni (unicorn), a single-breasted cancer patient. I had to learn how to style my new body, how to live in it, and eventually how to love and accept it. l was finishing treatment and moving into the prophylactic phase of my healing. Just one year after the first mastectomy, I had a second mastectomy and hysterectomy. These surgeries brought more body changes and a shove into early menopause at 31!
To be honest, some of my acceptance of my new body happened because I just couldn't waste precious energy worrying about what others thought about it. I was busy with treatments, making sure cancer was not going to win. It was my body, after all. Other people could take it or leave it. I was living in it, and it was keeping me alive.
I found gratitude for what my body had done over the years. My breasts had changed the shape of my child-body into that of a young woman. They then served to nurse my son, to nourish and comfort him. After breastfeeding, my breasts were larger than they had ever been and gave me new curves, sexuality, and sensuality I hadn't known before. But they had turned on me, and they had to go.
My now-flat-chested and round-bellied body would serve me going forward. It had done its duty during treatments, tolerating and handling the medicines and other procedures. Now I would learn to love and accept it as the new me.
Learning that new attitude came from being exposed to others who were working to embrace their bodies, especially online. I went to Facebook to find that group, my community. I needed to be around and hear from other flat ladies. I found it, too. Groups with ladies like me, bodies like mine. They taught me the term "flattie" and we owned it. This new term described my body. It was a term made by us, and it was used by us endearingly and for empowerment. It gave a name to my body besides cancer.
I was finding my online home at a time when body positivity was also becoming popular online. I also had friends in the size acceptance movement, and I started to learn more about fat acceptance and, eventually, fat liberation. I always had love and support from my family and friends. I now also had two communities that had my back emotionally and mentally. They understood my struggles with my body like others could not. A unique place to be, to have a place in two uplifting and empowering groups at once– fat and flat.
I was now breastless, which made for a more pronounced mid-section. Hormonal changes rearranged where I carried my belly. My actual weight didn't fluctuate, but the shape and layout of my body did. As I began to try to dress my new body, a lot of that love and acceptance showed up in department store dressing rooms. These shopping trips were where the things I knew and was learning from body positivity and fat liberation helped me continue healing. The daring attitude of trying prints or new styles, plus other tips for dressing your curves that I was learning from my fat advocacy friends, all helped me learn to love my new body.
The acceptance and love I was learning from fat community and flat community guided me as I learned to embrace my new figure. I was able to explore cuts and styles of clothing I hadn't worn before. At times it was hard, and definitely challenged my self-esteem. Other times my shopping trips were a real boost to my confidence and helped me to feel beautiful again. The intermittent boosts eventually led to acceptance of my new body, which was now healed and ready to carry me onto the next chapter of life.
Life did go on. Cancer became just a hurdle in my rearview. I began to excel in my career, was dating some, and even decided to try prosthetic breasts. The prostheses were a part of the path of loving my body. Under clothes, they served their purpose: They looked like breasts, and shopping and trying on clothes was fun again. Clothes fit like they were intended to. My confidence increased. Although the prostheses never felt like a part of me, they were a part of my healing. Wearing them for that short time solidified my not wanting them to be a part of my life permanently. Today, I’m flat AF, and that’s what works for me.
Please don’t misunderstand—none of it was quick or easy. But day by day, I was making peace with my body. Physically, I was feeling like my "before cancer self." Five years quickly passed and I got the official “cancer-free" diagnosis from doctors. No more follow-up appointments, scans, or other maintenance required. The words I wished for, like a green light to make a future.
Then one day a few years later, I ended up in the emergency room after a night of torturous abdominal pain. I had the hysterectomy years ago and my gallbladder had been removed a few months prior. The pain presented as a mystery without these typical organs to blame. After a battery of tests, the ER doctor walked in and announced, "It's back.” I was in utter shock. Gallbladders regenerated?! The confusion on my face registered with the doctor and he explained that "it" was my previous cancer.
My cancer from eight years before was back and had taken up residence in my lungs. When cancer moves from its place of origin, it is referred to as metastatic. So now, the body I was trying so hard to have gratitude for had launched another attack against me.
Once again, I geared up for the fight. This fight, however, was going to be like a marathon—a lifelong one. I began to plan my counterattack with my new oncology team. They quickly explained that this was not a death sentence but a lifelong treatment. I would always be treating my cancer and any side effects. This life hurdle was going to be portable and was always going to be around. The Cancer Center was going to be a place I now visited monthly or more. Once more, my family had my back, and I had my flat and fat communities online as extra doses of love and encouragement.
That was almost 10 years ago. I adjusted to a new schedule of monitoring my health, and my body adjusted to new medications, treatments, and side effects. Eventually, I began to be grateful again for my warrior body for getting me up and carrying me through each day. Not much has changed as far as my body shape, size, or weight.
I still struggle with self-love some days. Where I do not struggle is knowing I am a work in progress. When I struggle, I give myself grace for being human. And my body is the perfect size and shape for ME!
Author’s Note: October is Breast Cancer Awareness Month, aka Pinktober. We are inundated with pink products and pink ribbons everywhere. A large number of companies and organizations change their labels or products to pink for the month. It’s great marketing for them, and customers feel good thinking they are helping support treatment and research. The reality is often that only a small percentage of your Pinktober purchases actually go to breast cancer causes, if any at all. Sometimes companies are “raising awareness” but donating little if anything to the cause. This Pinktober, before buying cute pink ribbons or that pink label, please be sure to know where the money is actually going, and please consider donating directly to a reputable breast cancer charity instead (two of my faves are metivivor.org and desertcanceraz.org). Please also remember that all this pink and ribbons may remind people of the worst time in their lives. The symbol can be inspiring to cancer patients and survivors, but it can also be triggering and offensive to others. Please be thoughtful in how you use it.