Category Archives: Breast Cancer
Survival can be summed up in three words – never give up. That’s the heart of it really. Just keep trying. -Bear Grylls
I will go before thee, and make the crooked places straight: I will break in pieces the gates of brass, and cut in sunder the bars of iron – Isaiah 45:2
Cancer Statistics Don’t Mean What You Think They Mean
If you are on the journey of cancer yourself, or you love someone who is on the journey you are bound to catch yourself looking at “survival prognosis statistics,” and they will scare you to death.
In 1974 my mother was told that the survival prognosis for her breast cancer was 5 years post diagnosis. She lived 4 years and 11 months.
Today they still define the life prognosis of cancer patients in terms of 5 year survival rates. So when they say, “You have a 90% five-year-survival rate,” it appears to say that 90% of the people with your type of cancer only live 5 years.”
It appears to say 90% of the people diagnosed with that type of cancer this year will need to have their estate in order within 5 years from the date they were diagnosed.
It appears to say that more people are making it to 5 years, but we still can’t seem to get past 5 years for most of them.
If that was accurate, it would mean that despite 32 years of research, cancer treatment is not helping patients actually live any longer post diagnosis than it did 32 years ago.
If that was accurate, I wouldn’t bother with cancer treatment at all. If I only have 5 years, I’m not wasting 3 of them in a doctor’s waiting room.
Fortunately that isn’t accurate. The statistic is misleading, and the news is better than that!
The Five Year Survival Rates means 90% live “at least” 5 years post diagnosis. It does not mean “only” five years.
Even better news
The 10-year survival rate for all people diagnosed with breast cancer is only 6% lower than the 5 year survival rate for all people diagnosed with breast cancer.
Or in other words approximately 84% of all breast cancer patients will live at least 10 years post diagnosis.
The 15-year survival rate is only 5% lower than the 10-year rate.
At least 79% of all breast cancer patients will live at least 15 years post diagnosis.
79 out of every 100 breast cancer patients have made it at least 15 years.
I have friends who have made it a lot longer than that, they were diagnosed at stage 3. I plan to follow in their footsteps.
Other Things to Consider That May Ease Your Mind
The people who don’t make it often have other health issues that complicate the situation. Those who are elderly and/or already in fragile health in general always have a harder fight than the healthy. That is a very sad reality of the world. Some are the people fall into those categories where it was already in an advanced stage and in distant parts of the body before it was discovered, some suspected or feared it was there and tried to ignore it and hoped it would go away, and by the time they officially diagnosed it, it was in major organs. So, don’t avoid it, meet it head on and deal with it .
Don’t Give Up –
Even if you are one of the people whose breast cancer was not discovered until it was at a highly advanced stage, and had already spread to other parts of your body and invaded major organs of your body, don’t give you. Approximately 26% of people in that situation live “at least” five years. Not “only”. That means over 1/4th of people diagnosed with the most depressing ratings in regards to cancer still beat it. Never think of it as five year as “only”. Think of it as “at least.” If you can beat that 5 year mark, maybe you can beat that 10 year mark, and maybe that 15 year mark.
Every day, month, year you make it, is a day, month, year the research has improved.
Never Give Up!
Never Forget They Mean “at Least” not “Only”!
Good things are coming down the road. Just don’t stop walking.” –
Robert Warren Painter, Jr.
Whoever said patience is a virtue never had cancer:
I am a person that likes to take life challenges head on with a plan in place. I don’t do the unknown future thing very well. So one of the hardest parts of this journey for me has been not being able to see around the next bend in the road.
Deep down, I know that my doctors are doing the best thing by doing things one step at a time. However, a huge part of me is screaming, “I’ve been to the doctor eight times, spent a lot of money in co-payments, have had mammograms, sonograms, MRI’s, and consultation after consultation, after consultation, and have known about this cancer for almost a whole month, and I still don’t know anything!
So far I have seen my general practitioner (numerous times), a radiologist, a surgeon, an MRI specialist, and an oncologist. Every single one of them has handed me a larger stack of paperwork to fill out than the one before. They all start with the same questions about name, age, date of birth, address, contact numbers, contact emails, emergency contacts, have I been given the privacy notices, will I pay for what insurance doesn’t pay, what meds am I on, what am I allergic to, what surgeries have I had, who am I related to that has had cancer.
OVER and OVER and OVER.
I keep wondering why they don’t just share the information!
When I arrived at the Joe Arrington Cancer Center (JACC if you want to be cool), I got more paperwork to fill out than I’ve ever received before. Page after page after page after page after page of paperwork. I was still doing it when a nice woman in pink showed up and told me she was my “breast health navigator.”
The Breast Health Navigator
God has a sense of humor. I chose to compare cancer to a road, and the first person they send me at the cancer center identifies herself as my navigator. It is a nice reminder that God is still with me in this journey.
My navigator’s name is Tiffany, (I admit, I got a giggle out of a pink clad Tiffany too), and she was my favorite person today, outside of my daughter who arranged a baby sitter and drove the hour from her home in a small town near me to stay with me through this.
Tiffany had looked at the reports from all the doctors, and came in to explain to me a lot of the details that she suspected doctors and nurses might not explain clearly when they spoke to me. She did an amazing job of explaining things, and I learned the details of my diagnosis from her. Though the doctor was amazing at explaining everything, Tiffany was equally as amazing.
My cancer is:
- An Invasive Ductal Cancer (not great news)
- It is Estrogen Receptor (ER) positive (actually good news)
- It is Progesterone Receptor (PR) positive (actually good news)
- It is HER2 negative (really good news)
Keep in mind, what follows is my interpretation of what I’ve learned in this journey, and I’m not a doctor. I am an informed patient who knows medical terminology, and I read science journals for fun, and I drive my friends who are doctors and nurses and research scientists insane with questions, but I am not a doctor or a nurse.
This is my understanding of things, without all the scientific jargon.
Cancer cells are, in the words of Mel Brooke’s Igor, “Abby Normal,” cells. Normal cells are like well behaved children. They stay where they belong most of the time, they generally only grow and reproduce when the body needs them to do so, and they listen to the signals from the body, and when they grow up they have a specialization. Cancer cells are the brats of the cell world. They have a will of their own. They reproduce without any concern for others, and they push around the normal cells, and they ignore the orders to stop what they are doing.
Ductal means it started in the milk duct. Apparently 80% of all breast cancer is ductal.
Invasive does not mean my cancer is running a blitzkrieg on my body. It means that some cancer cells made their way outside of the milk duct into the normal breast tissue. I imagine an over-energetic toddler who climbed out of the playpen when you weren’t looking and woke up all the other kids. They might not do any serious damage if you get to them quickly enough, but you better grab them fast, and get a better playpen.
Estrogen (or oestrogen for your Brits who read this) and Progesterone are common female hormones. They send signals to certain normal cell protein receptors and basically turn the cells on and off like a chemical light switch. They tend to be buddies who like to hang out together. In regards to cancer, ER and PR are buddies that keep each other out of trouble they would get into if they were alone.
ER Positive Facts
- Approximately 2 out of every 3 breast cancers are ER positive.
- ER Positive cancers respond well to hormone therapy. Tiffany described hormone therapy as starving the cancer cells.
- ER positive cancers have a 10% higher survival rate than ER negative cancers.
How I think of Estrogen Receptors
They are brats that use estrogen to flip a computer switch they shouldn’t be messing with. This tells the cancer cells to come on, reproduce, divide, etc., and not to stop. I like think of it as telling a computer to find pi to the very last number. You don’t want to do that if you need the computer any time in the near future.
PR Positive Facts
- 65% of ER positive cancers are also PR positive.
- Approximately 2 out of every 3 breast cancers are PR positive.
ER Positive and PR Positive Facts (I am double positive)
- These cancers usually grow more slowly than other breast cancers
- They respond very well to hormone therapy
- Per a British study, these people have the highest survival chances.
HER2 (I am negative and that is good)
- This is the human epidermal growth factor receptor 2 gene.
- High levels of HER2 tend to appear with faster growing tumors
- High levels of HER2 tend to appear with tumors that come back.
- Being negative for HER2 is a good thing.
Then came the doctor and the reports
I do like the oncologist.
I like most things about the Joe Arrington Cancer Center.
They do some things very, very well, like Tiffany, and free valet parking for patients, and volunteers who walk you to the doctor’s office.
What I didn’t like about the medical part of this journey
Constantly Changing Opinions
Remember- I started out this whole journey with a mammogram that resulted in the official reports that it was a “2 cm tumor in the right breast, one lymph node affected, not in the left breast, not on the chest wall, stage 2.”I loved those results. I was very happy with those results. I wanted to keep those results.
Then I was sent to a surgeon who said they didn’t test enough to know what the left is like, and they can’t guarantee it isn’t on the chest wall, it is not 2 cm it is 2 cm by 4 cm, but still probably still a stage 2, possibly a 3 though, we need more tests.” I wasn’t as crazy about that news, but it was still okay. So off to the MRI I went.
Then I was told, “MRI says you have a busy left breast, we need another sonogram, and a biopsy.” I wasn’t happy to hear about a “busy left breast,” that needed more investigation.
Then I was told the MRI and second sonogram cleared the chest wall, cleared the left breast, looked like it was still just in the one lymph and right breast, but there was something that might be a benign cyst in the liver, they’d look at that later. Later, to me, said, “don’t worry about it.”
Then the Biopsy was done. That was the least traumatic experience I’ve had so far.
Then I got the biopsy results via a phone call. Left is good. Wall is good. An aggressive malignant cancer, but still a stage 2 and it looks like it was caught early enough to be treatable. Off to the oncologist. This was both bad and good news. It was good in that I expected it to be worse news. It was bad in that it confirmed it definitely is a malignant cancer.
TODAY IT CHANGED AGAIN
Today Tiffany said “5 cm”, not 2, not 3, not 4. She said 5. Five is that line they draw between “be optimistic with good reason,” and “okay, this is very bad news, but don’t give up hope.” If you cross that line to anything over 5 your doctors stop talking “when” you beat it to “if” we beat it. They stop talking about “some people” making it past 5 years.
Today the Oncologist said “2 cm by 3 cm by 4.5 or 5 cm”. I liked 4, because 4 was 1 cm away from that nasty “do not cross” line down the middle of 5.
They are reading the same report all the others have read, and coming up with a larger tumor size. By all the others, I mean the General Practitioner, the surgeon, and several pathologists who read such things as MRI’s and sonograms and biopsies. They didn’t get some “new test results”. They aren’t reading different results. They are all just reading it differently. Frankly, this shakes my confidence in their reading comprehension skills. Maybe they are like those teachers we all have who have to change at least one thing on every paper they touch, just so they can say they changed one thing on every paper they touch.
Fortunately, they gave me a copy of the final biopsy report. It says the left breast and wall really are clear. It took a very round about way of saying it, but I used to work at the Health Science Center, and I know that doctors love that round about way of speaking so I stayed calm as I wandered through it all, and the bottom line is they said the left looks good and the wall looks good.
ALL of that is good news – but….. Ah yes, but … but I have a “hypointense lesion” on the liver and so they want to do a PET Scan.
IF.. they had asked, I could tell them that for awhile I was taking too much aspirin, because I didn’t know aspirin was dangerous like Tylenol is.
IF… they had asked, I could point out that I had Rheumatic fever in college. A very serious case of it in fact.
Nothing on any of that huge stack of paperwork asked about things like that though!
They would still do a PET Scan, but I wouldn’t be scared to death by their attention to the liver. Now, I get to spend something like 7 to 10 days wondering if this cancer has spread already. That is 7 to 10 days thinking, “They’ve had an ENTIRE month to look at it and STILL HAVEN’T started a treatment!” They have given cancer an extra month to plan its attack. They are saying, “it probably hasn’t,” and “we expect to find nothing,” but “we really need to look at this.”
The Oncologist also marked the report as “at least a stage 2,” not “a stage 2,” but “at least” a stage 2. The difference is percentages of 5 year survival rates. I want my stage 2 to be a firm stage 2. Right now, statistics show that 93% of women with a stage 2 breast cancer live “at least” 5 years after the diagnosis. Statistics show that 72% of women with a stage 3 breast cancer live “at least” 5 years after the diagnosis. I want my extra 21%. I want my low A, not a low C. FORTUNATELY, I know that the “5 year survival rate,” doesn’t mean “you are going to die in 5 years.” A lot of people do NOT know that. A lot of people are walking out of doctors offices today and doing just like my grandfather did when he was told he had cancer. He went from the doctor to the funeral home and planned his own funeral because he thought he had 6 months to live. See my next blog post about statistics.
BE CAREFUL WHO YOU TALK TO
I paid over $112 today to have a woman talk me into taking a test I didn’t want to take.
Note: that is not the price of the test. That is what they charged me to listen to someone talk me into taking a test I did not want to take. The actual test might run as high as $475 out of pocket.
The doctor suggested I consider genetic testing because it would help him know how aggressively he should approach my treatment. I don’t like the idea of genetic testing. I am well aware of my family history, but if the doctor thought it would help I would consider it. He told his nurse to page the genetic counselor. I assumed to explain the process to us.
I had no idea that this was an official, billable consultation, until she walked me up to a desk afterwards and told them to bill me. Until that moment I had no idea I owed her a dime. As it turned out, I owed her $112 worth of dimes.
As I said earlier, the actual test could end up costing up to $475 out of my pocket. I know this because during the consultation the woman told us that “if the company calls you and says you owe more than $475 after insurance, tell them not to do the test, and to call me, because I know I can get it for you for just $475.00.” You would think she might have mentioned, “Oh, and talking to me right now is costing you $112.”
She spent a great deal of time trying to talk me and my daughter into genetic testing. I don’t like the idea at all. I am not trying to talk anyone out of it. I am only stating my own personal feelings in relation to myself. I know all the things they say, I’ve heard them a thousand times, but the fact is, knowing I probably have some kind of genetic predisposition to cancer is not news to me. I figured that one out on my own long ago.
I always said until they can tell me how knowing that I have that gene improves my survival rate I’m not doing it. She spent a long time trying to convince us it will improve survival rates (and by the way, never did convince me, but I do want my doctor to know whatever HE thinks he needs to know).
She told us that this will cause them to be more proactive in following me or my children if we do test positive for the gene. Well, I heard that all of my life, and I followed that most of my life. I have had a lot of false alarms, based, largely, on the fact that my mother had cancer. Anything even remotely not like 99% of the people in the world that showed up on some medical exam instantly resulted in “you probably have cancer,” and “we need these very expensive tests,” and “we don’t want to scare you, but you need to be terrified,” conversations.
The bottom line of that is that the panic over my mother’s death by breast cancer that doctors had resulted in a negative affect behavior on my part. The medical overreaction started when I was in my 20’s, and I got sick enough of the overreaction that I started avoiding all medical testing. Period. I don’t recommend that. It was childish on my part, but I was so tired of being scared to death needlessly and it was affecting my ability to trust doctors.
I used to faithfully do mammograms, pap-smears, full blood workups, all the proper testing, every year, just like they wanted. But time after time after time I had some doctor or pathologist go into a panic over something minor on some test, demand lots of other tests, and just generally stress me out after costing me and my insurance company thousands I didn’t have, and then going, “Oh, heh, heh, there was nothing wrong after all. Our mistake. Go home, be happy.” Eventually I decided the stress from the tests and from the cost of the tests had to be worse than cancer itself. I did my self-exams, but I was sick and tired of the panic because my mother had cancer.
Today, after the $112 consult just to tell me, “we like genetic testing” I’m less trustful of talking to anyone at the cancer center if I haven’t expected to be asked to talk to them. advance. I am actually wondering if I’ll get some kind of bill for my “navigator” now. I may start greeting people with, “Hello, my name is Sharon, what is talking to you going to cost me? Do you bill by the hour or visit?”
WHAT IS A LIFE REALLY WORTH?
The bill to see my oncologist was the mere $40 co-pay my insurance requests. I find it ironic that I paid $40 to the man who will be responsible for saving my life, and $112 to the woman who talked me into a test I didn’t want.
THE VAMPIRES ARE BACK
Next on the agenda was the blood draw. They are running the usual complete blood tests that you generally get at any annual physical exam, plus a blood test that tends to help detect liver cancer, and one that tends to help detect lung cancer, and the genetic test is a blood test. She said they can do a saliva test, but it is less accurate. The doctor was careful to tell me he doesn’t expect me to have either liver or lung cancer. He is just covering the bases. All in all, they took 5 vials of blood today.
NO WONDER THEY GAVE ME AN ADMISSION TAG
When I first checked in at the desk today, they gave me an admission bracelet like hospitals do when you are an in-patient. In fact, it says, “date admitted” on it. I wondered why they did that since as far as I knew, they hadn’t planned any procedures for the day.
I walked into the center at approximately 9:30 a.m. My daughter and I walked out at approximately 2:45. I understand the admission tag.
Total I paid in co-pay today: $152.00
Total information I learned today? It is invasive (knew that) ductal (didn’t know that) cancer (knew that) , and it is ER/PR positive, and HR2 negative (didn’t know that). They want to do a PET/Scan “sometime” (knew that).
Appointment scheduled for PET Scan – Not yet. They’ll call me.
Plan of action for treatment – They’ll let me know after the PET Scan.
Frustration level – High.
Level of gratitude that God, my family and my friends are still with me – Higher than the highest mountain.
This is post 2 regarding my journey with breast cancer. I share it in hopes that others as new to this experience as I am now, can read it and know they aren’t alone, and maybe realize what to expect if they are a little newer to this journey than I am.
The MRI was scheduled for Tuesday, October 18th The biopsy was scheduled for Friday, October 21st.
No one could tell me what to expect to be done on that Friday, financially speaking or medically speaking.
So I waited. Cancer is a lot of hurry up to wait.
I was sent to a wonderful center for women that was set up by a former breast cancer patient, who happens to also be a medical doctor. The center founder went out of her way to make the experience as non-traumatic for patients as she could and I am grateful. The technician was sweet and carefully explained the whole process, though it wasn’t my first MRI.
For those who may be reading this who have never had an MRI and are afraid of it. Please don’t be afraid. There is nothing painful about it.
It involves the use of magnetic power, so remove anything metal, and if you have pacemakers or anything metal on or in your body be sure the MRI tech knows. The machine I was placed on was built especially for breast exams. You lay on your stomach, your breasts hang down into little cups built into a table, your legs are positioned slightly up behind you, you’re given ear plugs and ear phones (with music if you want), and told not to move. It is open on both ends, to ease that closed in feeling. I am claustrophobic, but this didn’t bother me at all. They didn’t strap me down. I was only warned that moving would mean having to start over.
The machine makes a lot of funny noises, and they vary in volume and type. Some of it sounds like loud church bells, some of it sounds like a jack hammer, some of it just sounds like a motor running. The music didn’t drown it out totally, but it did help a lot.
Some older places may still use the lay-on-your-back-and-get-moved-into-a-tube form of an MRI, but again, nothing painful to them at all.
MRI RESULTS – I have no clue what the MRI results are.
My MRI was late in the afternoon on a Tuesday. The MRI was meant to provide more info to my surgeon before my biopsy that was scheduled for the first thing Friday morning. However, I was told the MRI results would probably arrive on Thursday or Friday afternoon. I reminded them that the doctor wanted them before he did the biopsy, and they thanked me and said they’d get them to rush the reading.
Thursday I got a call that they had not received the official, full MRI results yet, but that from what they had seen my left breast looked “very busy,” and that they were concerned it looked “very busy,” and that they were going to need to do an ultrasound on the left side the same day as the biopsy. I asked, “Are you telling me the cancer is in the left?” They replied, “Well, we can’t say that of course, but it looks very busy, there is a lot of activity in there, it doesn’t look like what we would expect a normal breast to look like, so we want to do an ultrasound on the left breast on Friday, just to make sure.” Make sure of what?! I never got an answer to the what.
I was asked if I had taken any aspirin. I responded that I hadn’t. Remember that. It matters later.
Plan of Action for Friday – Arrive at 8 AM, do a biopsy of the right breast, wait while they took in another patient, do a sonogram of the left breast. At this point, I still didn’t know if they meant to do a biopsy and lumpectomy or just a needle biopsy or what.
Financial Plan for Friday –
When I asked how much money I needed for Friday I heard, “We don’t know.” That was the official answer, though a little more wordy. “We don’t know what the biopsy will cost up front, but you’ll have to pay $100 + 20% for the sonogram.” To which I replied, “Well, how much is that?” To which they replied, “We don’t know.”
My family had helped me with the first round of expenses on this journey, and my daughter set up a GoFundMe campaign to help pay for more of it. People were kind and generous, and amazing, and wonderful, but it takes days to transfer money around, and we didn’t know if it would make it into the accounts by Friday or not. So, our family plan of action was, if they asked for more up front than we had Friday we would simply reply, “You should have told us what to plan for when we asked the first four times.” I still like that plan actually.
Son, daughter and son-in-law meet me in the lobby, and so does the technician who is going to do the ultrasound. She says we have a new plan. We’ll do the left sonogram that very morning, and good news, the MRI is in, but no one has had time to read it yet.
She does the sonogram, marks a ‘cyst’ that concerns her in the left, and says it is “just a cyst,” though it looks suspicious. I’m not sure how to take that, but decide the surgeon will know.
The Biopsy Itself
My surgeon is very professional, but also very charming, and he carefully explained every step of the process as he prepared for each step, from the first rubbing of alcohol on the area where the local anesthetic would be applied, to the last moment.
He asked me again if I had taken any aspirin, and I told him, “No,” because I hadn’t taken any for several days.
I was prepared for incredible pain from the insertion of the needle to administer the local anesthetic, and was joyfully surprised. I’ve had shots, cat scratches, iv’s, and blood draws that really sting. I cannot bear a pain killing shot at the dentist office, but this felt like a very light, pinch. Nothing more.
He warned me there might be a feeling of pressure. There was, but no pain. None.
An aspirin a day might not keep the doctor away.
I was not in pain, but I was bleeding a little more than my doctor expected so he asked me about aspirin again, and I told him that I hadn’t taken any since Monday. He chuckled and looked at his technician with a brow lifted and she said, “I asked if she had taken any. I didn’t ask if she had taken any this week.” I had no idea aspirin has a blood thinning capability for over a week. Now I know.
He made her redo the dressing on the biopsy sight, and asked for a pressure bandage, but she was out, so he told me to put pressure on it, watch it, not to do any reaching or lifting, or anything with that arm.
Then they sent me out to the lobby to sit and wait a bit, and as I was talking to my family my daughter noticed I had blood on my sweater. I thought she meant “a few dots of blood.” She meant, “a lot of blood.”
My daughter scooted me off to the lady’s room and we discovered I was trailing blood all over the lady’s room, and looked like I had bathed in cranberry juice. I was perfectly dressed for a Halloween horror film.
There was no pain, but a lot of blood.
My daughter calmly called the nurses and they packed it off, and fetched the doctor again. He pondered putting a stitch in, and they all decided that a better bandage, and more pressure probably would do the job. When they had it under control the doctor joked that the good new is everyone stops bleeding… eventually, and then he joked about leaving to go make a blood donation in my name. That reassured me and let me know that he wasn’t worried. He did tell me to call if I got home and was concerned. The nurses fussed over me longer, taped me up like a mummy and waited to see if it seemed to have stopped.
Preliminary, unofficial MRI results
While everyone was watching my little “Jason” scene, they told me that they hadn’t officially read the MRI report yet, but they did “skim read,” the results of the MRI and Sonogram, and the preliminary results looked good in that department.
When they felt the bleeding was under control they sent me home.
Aspirin really is a great blood thinner. A really great one.
Apparently, handling my old truck was enough of the reaching to start it going again, but I didn’t notice that until I started to wash the sweater and realized I had already bled through the new dressing. Looking down, I also saw that the top and side of my washing machine had blood all over it. It looked like someone had committed murder in my laundry room. The blood stains below are where I bled on the washer, while I was standing beside it.
I let the kids know the situation, just in case. If I bled to death that night I didn’t want anyone arrested because I took an aspirin 4 days ago. I also called the doctor’s office and received instructions to lay down, apply pressure, monitor and if necessary go to an ER. It wasn’t necessary.
On a side note. I’ve sworn off aspirin for awhile.
If you are wondering, I haven’t felt a single bit of pain from the biopsy procedure. I kept expecting things to hurt after the local wore off. They never hurt.
More waiting. The biopsy was Friday morning. They told me it would be “a couple of days.” So I tried to mentally prepare for as late as Wednesday. I knew weekends didn’t count.
Saturday – Fine
A little worried about what the results might show, and still wondering what “busy” meant.
Sunday – Fine
My youngest grandson’s birthday party was at a local park on Sunday evening, and I had a wonderful time. I was relaxed. I was able to answer questions and talk about everything with full confidence it was all going to be fine.
Monday – Full Blown Panic Attack
I have no idea what triggered it, but suddenly, on Monday, I was terrified of the results, terrified of long term survival chances, terrified of finances all over again, and convinced they were going to tell me it was a stage 4 cancer. I have no idea why this happened that day. Maybe I was tired, maybe I let my spiritual guard down, maybe I’d just had one too many people remind me of the doctor they knew that had been wrong. (Some very well meaning people did that, with the best of intentions over the weekend, though must were equally on board with reasons to be optimistic).
Tuesday – The results Are In
I talked to my daughter on Tuesday, and confessed to the panic attack. She eased my mind. I spent some time talking to my best friend at work about the whole situation, and she also eased my mind. I was going nuts wondering what the results were, but telling myself I’d hear Wednesday, and not to give into the urge to call and nag the doctor’s office.
I’d made my favorite stew in a crock pot and realized I was out of cracker, so I decided to swing by the store during my lunch hour to grab lunch. The call came while I was standing in the middle of the cracker aisle at United Market Street at 19th and Quaker Ave.
My doctor was kind as he delivered the news, having no idea that I was not in the privacy of my office or home. He told me he had the results, and that it wasn’t good news. I braced myself, expecting the words that followed to be stage 4, spread everywhere kind of news. He quietly explained that the pathology reports comes in 2 parts. The initial result and the detailed result. The detailed report would come in a few days, but at this point they knew the following:
It is an aggressive, malignant cancer, that is probably estrogen based.
The lymph node is confirmed to be cancerous as well.
I asked, “Just that one, or more?”
He said, “Just one.”
I asked, “Is the left breast clear?”
He said, “Yes, it is.”
I asked, “Is it attached to the chest wall?”
He said, “No, it isn’t.”
I asked, “Do you think it has spread beyond that node and the breast itself?”
He said, “We did find a cyst in the liver, and may want to biopsy that some day to find out why it is there, but at this point, we do not believe it has spread beyond that lymph node.”
I said, “I know that you can’t really stage it until you get the full report, but based on what you know so far, from all the tests, am I looking at a stage 3 or a stage 4?”
He said, “Oh, you are definitely a stage 2.”
TWO! Not 4! Not even 3!
So, I asked him what he recommended for treatment, he told me that he wants me to see the radiologist/oncologist before I decide anything. He feels I need input from the man who has to fight the battle against the cancer cells themselves, but he said generally it will probably come down to choices of doing something to shrink it first, then doing some form of surgery (lumpectomy or mastectomy) to cut out the cancer, or doing some surgery and then radiation and chemo. I asked him, “If I was in your family, what would you tell me?” He said, “Exactly what I just told you. If you were my wife, or my child, or my sibling, I would tell you that you have to decide what you can bear to live with. Some women choose to try to save as much of the breast tissue as they can, some want to get rid of it all so they can avoid radiation and chemo and never have to think about this again.”
I said, “But they’re wrong aren’t they? Medically? My mother had 2 radicals, and still died of breast cancer. You don’t get to just cut them off and forget them do you?”
He said, “No, you don’t. There will always need to be some treatment post surgery, and cutting them off won’t guarantee you’re free for the rest of your life. It doesn’t work that way.”
I said, “If I opt for a lumpectomy, can you get it all?”
He said, “I have to know the margins.”
I asked, “What do you mean?”
He explained that to me. I won’t explain it here, because I might explain it incorrectly, but what he said sounded totally logical to me, and the answer to the margin question will be in the final biopsy report.
The next part of the journey
I saw my general practitioner just an hour after the surgeon called. This was due to an insurance requirement related to referrals. They wouldn’t let the referral to the oncologist come from anyone other than the primary care physician, but he also wanted to make sure I understood things.
I appreciated that. He is a wonderful Christian man, and he was very optimistic. He used the phrase that it was a good thing we caught it early. I told him I didn’t feel like we had, and that I felt like a fool for not having had a mammogram more recently than I had. He smiled and said, “It is stage 2. I have lost patients in their 30’s because they found what you found, and chose to try to pretend it wasn’t there. By the time they admitted it might be cancer, it was too late to help them. You are a stage 2, and your oncologist and your surgeon are not just two of the best in the entire state, they work together as a team better than any team I’ve seen. They care about their patients. They want them to survive. They invest in making them survive, and so do I.”
So, today. I’m at peace. Impatient, but at peace.
My next doctor visit is to meet this amazing oncologist. Our appointment is next Wednesday.
On a side note. I used to work at the Health Science Center, and I still work at the university. I know a lot of brilliant scientists and brilliant doctors, and brilliant researchers. They all love my doctors’ plan. Those who know my doctors and the centers all say I’m in great hands.
One day at a time, the road winds, but that’s okay. I’m still traveling.