Given the seriousness of the disease, “Cancer” and the enormous emotional upheaval with which a woman is faced when the word ‘Cancer’ is prefaced by the word ‘Breast’ everything seems to be over and done with so quickly at this stage anyway, but my mind still reels from it all.
Yesterday was the appointed day to visit the surgeon in Lower Hutt again and have the results of the pathology on the tissue removed from my breast – there, I’ve had to admit it and lose the word ‘boob’ – and from the Node Biopsy. After Peter and I had had breakfast I fiddled with the packet of things I had received from the Cancer Society which has now become intermingled with the material I received in the Cancer Pack from Boulcott Clinic. There is one booklet in there which I have not been able to face. Its called ‘After Breast Cancer Surgery – Looking Ahead’. I’ve had several attempts at reading it and the only part of it I can read without tears welling up as I try to read, is the part on Radiotherapy.
It’s an Australian Cancer Society publication I can’t fathom why I can’t face this booklet but even as I prepared to go to the post-op appointment I still couldn’t read it without great big tears rolling down my face and dripping onto my clothes. I had thought that the feeling of relief I felt after the surgery might have translated into a bit more self assuredness and a lot less of the tears and tissues. But no. I had to give up on it again and just go do something else to while away the time before we left to go to Lower Hutt. I had thought that I wasn’t even too worried or anxious about the visit but the tears and tissues might have indicated otherwise.
When we arrived at the Boulcott Clinic we were ushered into to see Carl Dowle after a short wait. Straight down to business, he told us that the tissue removed from my breast had about 2mm of clear tissue all around it and that the node biopsy had shown no evidence of Cancer cells. Hooray for something. It should have been a great relief, but it wasn’t, because in that message he also told us that he had, unknowingly, removed three tumours!! The biggest one, the frozen pea that grew into a chick pea, the one I knew about, was 18mm in diameter. But there were two others, one of 11mm and one of 2mm. I can easily see how one would miss removing something only 2mm in size and I can understand that it would have been easy to miss seeing it on one of the numerous mammograms I had had prior to the surgery. But what absolutely amazes me and frightens me is the fact that the mammogram machine and the surgeon both managed to miss the fact that there was another malignant tumour 11mm wide growing in there, when there had been all that kerfuffle about the two areas of calcification which turned out to be benign.
So while all that is running round in my brain the surgeon has moved on to the statistical probabilities of my likely survival with a 6 week course of radiotherapy and whether that should be followed up by Hormone therapy, and if so, which one. The favourable results in the pathology report rule out any necessity to consider chemotherapy as a treatment. I had expected that to be the case once I heard the results of the report but the relief I thought I might feel never eventuated. Those other two tumours are really bugging me.
Apparently I shouldn’t be worried. It’s gone now. Is there another rogue frozen pea growing somewhere else in my breast?
Cancer brain, all the logical and illogical thoughts that race unbidden into one’s consciousness. But am I being illogical? I don’t know. I guess I’ll have to find out in the 5 years of checks which will follow my completed treatment.
For the statistical analysis he used something called Adjuvant Online, a website to help health professionals and patients with early cancer discuss the risks and benefits of getting additional therapy (adjuvant therapy: usually chemotherapy, hormone therapy, or both) after surgery. (I’m learning so many new words throughout all of this. Adjuvant wasn’t ever something my limited vocabulary had come across before.) He entered data into the site on the size of the tumour, but only the biggest one because it’s most unusual, unheard of, not recorded for anyone to have three tumours, the grade and it was a Grade 2 tumour, and various other statistics from the pathology report that elude me now. The website throws back at him that I have a 78% chance of still being here in 10 years time. But of that other 22%, 14% will die from something else, other than Cancer. 7% will have a recurrence of Breast Cancer. My chances of sticking around a bit longer are enhanced by a measly 2% if I undertake 5 years of hormone therapy to repress the production of oestrogen which fuels the growth of the cancer cells, even though the radiotherapy is supposed to kill off anything and everything around the site of your recently removed cancer/s to prevent just that very thing. Yet 7% of women have a recurrence.
He discussed the options of Tamoxifen versus Aromatase inhibitors – more new words. Both of them have some pretty nasty side effects. If I choose to have the hormone therapy and he seemed to be angling towards the aromatase inhibitor treatment, mostly on the basis that the side effects were not quite as severe, but one of the effects is to weaken your bones and become more susceptible to Osteoporosis. Oh my goodness, that’s also something which can be a side effect of Coeliac Disease. I have already had one bone density scan, about 1 year after my Coeliac diagnosis. While I was in the next room having the dressings removed from my wounds by Robyn, Carl was picking up the results of that bone density scan from 4 years ago on his computer. I am stunned that all my records seem to be so readily available. But that was fleeting compared to everything else going on.
I had thought that removing the dressings would reveal the true shape of the new me, but all it really revealed was more sticky tape beneath. The only sutures I have are soluble internal ones. The two wounds on my breast are all held together with steri-strips, one long one on each wound with several more at right angles along the length. The wound where the excision took place is about 10cm long and begins to show that my shape will never be the same without re-constructive surgery, and over the node biopsy the wound is about 8cm long. Not a pretty sight, even covered up with steri-strips. Everything is still swollen and there is a lot of bruising too, but most of the swelling appears to be where the biopsy took place, strangely enough.
So back to the Bone Density Scan. Four years ago it was pretty good for a person of my age, but I have an appointment for another one in two weeks time. A copy will also be sent to the radiologist to consider in planning my radiotherapy. When the appointment with the radiologist will be is a bit in the lap of the Gods as the Christmas Holiday period intervenes in the normal sequence that it should be conducted. Carl, or someone, will also consider it, I guess, when the decision is made about the hormone therapy.
So armed with more information and another load of inner turmoil, well, on my part anyway, we left Lower Hutt and off we went to Wellington where I was to have the second fitting for my Mother of the Bride dress. It looks as if it will be lovely. Zowie had a mock up of the dress for me to try on and for her to tweak where necessary. As I looked at myself in the mirror, all I could think of was whether or not anyone would notice that some of my top half was missing. Its fairly detailed with ruching on the bodice and is a princess line style, so probably will hide the worst, but then when she came to the tweaking it needed pulling in under the bust. She’s about to emphasise what is now my least desirable feature I was thinking. Despite the lovely colour and lovely fabric I feel diffident about wearing it before it’s even made.
The Wellington skies had leaky eye syndrome when I emerged from the fitting. Peter had been off at Animates buying more supplies for the feline inhabitants of our home. Fortunately there was a shop verandah to wait under, but I didn’t have long to wait.
From there we went to the Office Christmas lunch at a pub near the office in Karori, which, last time I had seen it was called The Quiet Lady. Now it’s the Pickle Jar. And was I in a pickle. For the first time I had to confront my workmates with bits missing. Of course, nobody was crass enough to comment. Maybe they didn’t even notice. But I felt as if I had gone to lunch with a bunch of strangers. I don’t feel I am the same person any more, physically or mentally.