Monday, May 25, 2015

Just a Footnote

So almost 5 years to the day that I was informed my dad had Stage 5 terminal cancer (and his death within 9 days of the diagnosis), I was gently informed that I have a condition called Ductal Carcinoma (in Situ). April showers bring May cancer diagnoses in my house.

Now before anyone starts to panic, this “cancer” is 100% curable. In fact, there is a better chance I will get hit by a bus on my way to the hospital than that this condition will lead to my ultimate demise. This is a stage 0 form of breast cancer. In some medical circles, it is not even considered cancer at all. Nevertheless, what they don’t know is which women will actually have this condition turn into a full blown invasive form of cancer. This means that once you have found this form of “cancer”, it is treated as though it is an invasive form. So at the ripe age of 37, I have been given the life altering choice of either removing my breast completely, or removing a lump and dealing with radiation. The first choice eliminates the possibility of future cancer in that breast, the latter usually clears out the cancer too, but there is an increased chance of recurrence (15% or so) of either DCIS, or a more aggressive form of cancer.

So, the choices seem like a no brainer, right? Well, as the owner of the breast and lump in question, I have found both choices to be slightly unpalatable. My brain says: “Hell yeah, let’s chop down that tree”, but my heart says “Ummm, let’s just take it easy and remove the rotten apple, we can take the tree down later… it sure is a pretty tree… I am not done with that yet.” My heart is definitely more verbose on the issue. Anyway, the debate goes on, but in general, my brain is usually the winner in these kinds of debate.

The truth is that within 24 hours of learning about a condition called DCIS, I have read multiple medical dissertations, the Master’s thesis of one of my recommended surgeons, and pretty much every breast cancer society webpage within the English speaking Commonwealth. As a known procrastinator, I have mastered the fine art of learning a lot of shit in a very tight period of time so I actually feel quite versed in the details around the condition, the treatment and the outcomes. I learned multiple pathology terms, a hell of a lot of stats, and a bunch of other less medical opinions about what this really means to me. The truth is, I would really appreciate if one of the choices could just be taken out of the equation so I didn’t have to make the decision. Nevertheless, this is just hopeful thinking and I will still be left debating between Mastectomy or Lumpectomy.

To give a little background DCIS, many women are diagnosed after they hit the age of 50 and simply start their yearly mammograms. For me, the conditions were a little different. The first symptom was simply a clear, yellow discharge from my nipple. Embarrassing more than anything… I went back to wearing a nursing pad because it would leak through to my shirt at random moments. I noticed this is January 2015 and mentioned it to my Doctor when I was in with my daughter for a check-up. He did a short exam and was unable to notice anything out of the ordinary so we decided to keep an eye on it. Fast forward about 4 months, I was in the shower and felt a sudden, and sizable lump in that breast. I asked my husband to casually join me in the bathroom, and to “give it a poke”. Well, suffice to say he was quite alarmed and requested I have it checked out right away. He felt his own medical background (i.e. none) was not sufficient for making a diagnosis. It was interesting to see how quickly my clinic got me in or an appointment when I mentioned “lump” and “breast” in the same sentence.  

By the morning of my appointment, I was now noticing the discharge was no longer yellow, but in fact very bloody. At this point, my tiny alarm bells were going off, but let’s be realistic, most lumps in breasts are not cancer (seriously, check the internet, it says it over and over again). I did not get to see my own doctor due to the subtle haste they decided to put on my appointment. I did see a very helpful doctor who confirmed the lump was suspicious and quickly booked a mammogram and ultrasound. With all calmness and honesty, she sent me on my way with the assurance that “most lumps in breasts are not cancer”. No promises, just calm and honest and direct and helpful. She was great.

So, fast forward another week and I find myself at the radiology clinic. I have heard many unsavoury reports on how mammograms feels, and I was certainly trepidatious. Nevertheless, the tech who “handled” me was excellent and professional and the whole thing was much more palatable than I had expected. I immediately went to another tech for the ultrasound and by the end of that process, she assured me everything looked ok, mostly thickened tissue, and there would be no need for a follow up appointment with my doctor. Well… AWESOME! Great news! I texted my darling husband from the parking lot, and we felt a lot better. However, within one hour of arriving home, the radiology clinic called me back to explain that they did in fact want me to have an “aspiration” just to rule out an infection. Infection? Great! Infections can be fixed with antibiotics… let’s do this. Later that evening I received a subsequent call from my doctor. He had just seen the results and wanted to make sure I went in for a biopsy. Biopsy? What? The radiologist said “aspiration”! Biopsies are for cancer! I don’t have cancer… I have an infection. Needless to say, the B word definitely put me a little on edge.

For those of you not familiar with a biopsy, you should actually read a little about the process. While I am generally extremely anal about researching everything about anything, I failed to actually read about the process. When I arrived at the clinic and was given the primer pamphlet I definitely freaked out a little. I had a vision in my head that did not jive with the actual procedure. Either way, the radiologist was very reassuring, and we had a great chat (over my exposed boob) about the changing roles of radiologists and the advancing tech. The giant needle was quite unnerving, but worse was the banging sound it made when it was triggered. In the end, he took four core samples which I can only compare to the drill from the newer JJ Abrams’ “Star Trek”. He wished me luck with my results and sent me on my merry way. I found it odd. “Best of luck with the results”. Weird.

Well, the May long weekend rolled around at this point and we jetted off to Toronto to visit some good friends. On a side note, the pressure bandage I had on was transparent … and quite gross for lack of a better term. I was wildly concerned the damn thing would somehow pop on the flight and I would pretty much bleed to death on the plane. Considering the size of the incision was about 3mm I probably should have been more realistic, but every once in a while even the most logical person can go temporarily insane. Too boot, I have a slight allergy to adhesive so the whole patch was making me exquisitely itchy. It sucked and I think showing my husband may have been traumatizing to him. When I was finally able to remove it, the bruising was quite terrifying – various shades of blue, green, yellow and purple. At this point, I am mostly just thinking, “wow, I feel like we have gone to a lot of trouble for what will eventually be diagnosed as nothing!” At this point, I was also telling my sweet little girls I couldn’t handle hugs against my sore boob. I showed them the bruise and they were very considerate in the way they handled Mommy. In fact, they even told the other kids that Mommy had an owie on her boob and needed a special band aid. They offered to show the other kids, but I admit I denied the request. I wanted to avoid traumatizing other peoples’ children as much as I can. I think there are likely laws preventing that kind of behavior and I am happy to comply.

Long weekend is now over. I return home and first thing on Tuesday morning, my doctor’s office calls to book an appointment… Today. Well, I was at work and busy… I offered other more convenient days… but they offered first thing in the morning the next day. Well, I don’t get these convenient time slots very  often, but I figured he wanted to get me in to alleviate my anxiety and specifically prescribe my anti-biotics for what I had at this point self-diagnosed as chronic mastitis. I had mastitis with my second child and it was terrible. At the worst time, my breast looked like the Eye of Sauron. It was about that hot to the touch too. And I had an adorable baby chewing on that nipple every couple hours. I would literally hold my breath, clench my teeth and close my eyes while I latched her. It took about 10 minutes of searing pain before I would finally feel numb enough to relax. In my logical mind, if I had mastitis 2 years ago from breast feeding, it would make lots of sense for some hidden bit of bacteria to be camped out in there and rear its ugly head at this time. Well, it is a good thing I am not a doctor because my diagnosis was incorrect.

The surreal part of the story actually starts here. This is when my sweet doctor walks in and sits down and says “I have some news that is very difficult to talk about”.

Here is where my heart drops.

Ductal Carcinoma in Situ, pre cancer, stage 0, surgeon, choices, 100% curable.



Curable! That was the word I was waiting for. I managed to finish the meeting with all the grace and dignity I could muster.

When I got home, my darling husband was sitting on the front porch awaiting my arrival. I tried very hard to use the same words the doctor used, but I am sure all he actually heard was “cancer”.  I like to use humour in uncomfortable situations, so I did in this case. I think we handled it well, and so we should. This diagnosis is not about the cancer at all, it is about the breast. And potentially saying goodbye to someone close to your heart (literally).  

So as I mentioned, no need to panic. This is merely a footnote in the lengthy book that is life. Well, it might be a chapter by the end of it all, but it is still just a small part of a big story.

I have not shed a tear (yet), I have not raged, I have not blamed.

I have researched. I have talked. I have waffled and flip flopped on options. I have researched some more, and I have arrived here. I wanted to get my thoughts on paper before they are clouded by time or memory. I am 48 hours since hearing the news, and while I am still quite unclear on the immediate path, decisions will be made and life will go on (and on and on). I have no intention of dying young. I will walk my children down the aisle, I will see my grandchildren, and I darn well better retire with my husband so we can jet set our way around the world.

That is the plan. Let’s get this done. I have already moved on and so should you.
No guilt, no fear, just a summer of uncomfortable healing I am off and running (I probably need a new bra or two). 

To anyone who actually read to the end of this diatribe, ask me anything.

I am an open book, and this is just a footnote.  

No comments:

Post a Comment