I sit in the doctor’s office in a boxy blue paper gown, waiting. My heart is bouncing in my chest. What I find out today will shape my life for months -- years, even. I’m here to learn more about the breast cancer that wormed its way into my body when I wasn’t looking.
"Were my margins clear?" I ask the oncologist when he finally appears and explains that he’ll be sending my tumor cells to a lab in California for a test that will measure the chance of a recurrence.
"We wouldn’t be having this conversation if they weren’t," he says.
My margins were clear! I sigh in relief.
A month ago, I would have seen clear margins as a sign of a feeble mind. As a retired college professor, I still find it impossible to read without a pencil. My book margins are littered with notes.
A month ago, I belonged to the land of the healthy. I was on the giving end of sympathy, a much easier place to be than where I am now.
A month ago, just 120 days after my last (negative) mammogram, I felt a twinge in my right breast and detected a tiny lump. "Whatever it is, it’s not cancer," my gynecologist said, and I felt every muscle in my body relax. But "just to be sure," she sent me for a second opinion. I submitted to more mammograms that were clear and an ultrasound that wasn’t. A biopsy confirmed the cancer the following week.
No fair! I wanted to scream. I ate spinach and broccoli. I took fish oil and drank green tea. I exercised regularly, didn’t smoke, wasn’t overweight, had no family history. There must have been some mistake -- or ...
Maybe it was the nightly glass of wine with dinner.
Maybe it was the estrogen cream that sustained my waning sex life.
Maybe it was chalk dust from all those words scribbled on blackboards.
Endless thoughts ran through my head.
The surgeon had been the one to deliver the news. "It’s curable," he said. "Think of this as a glitch. I suggest a lumpectomy. Unless you’re mad at your breast, in which case I could remove it completely."
I thought at first that this was an attempt at levity, but he was unsmiling. Why would I be mad at my breast? I don’t get mad at my brain when I have a headache, do I? I quickly agreed to the lumpectomy and a date was set. This was one area of my life I had no desire to downsize.
Five days later, the 0.6 cm lump was snipped out, and with it some 15 lymph nodes. Cancer had been found only in the Sentinel node.
Fast forward another two weeks to today, my first appointment with the oncologist, the one where I'd hoped to learn which of the barbaric treatments I'd have to endure. I knew that radiation targeted the breast itself, in case any cancer cells were still floating around, whereas chemotherapy and hormone therapy were "systemic meds," the first out on a search-and-destroy mission in the whole body, the second out to starve my cells of cancer-causing estrogen.
"Were the cells differentiated or undifferentiated?" I ask.
I know that’s the good answer, because it means the cells hadn’t gone totally crazy. But if they were differentiated, i.e., more or less well-behaved, and the margins were clear, how did those little devils get out of the tumor and into the Sentinel node? And had they stayed put once they got there?
Not necessarily, I’m told. The cells could get out through tiny blood vessels. Even as we’re speaking, I imagine a whole school of those feisty things swimming through my blood vessels, exploring other body parts to infect.
"It’ll take two weeks for the results to come back," the doctor is saying. "Then we’ll know whether you’re a candidate for chemo."
Seeing the fear in my eyes, he says sympathetically, "We hate putting patients on chemo."
I observe sadly that he doesn’t seem to have the same hesitation in putting patients on estrogen-blocking drugs for five years, drugs that turn your bones to mush and give you hot flashes. Handing me the prescription, he asks, "Do you have any more questions?"
Do I! My mind is flooded with all sorts of things I can’t articulate. They’re actually sending my tumor across the country -- they didn’t flush it down the toilet? Are the cells still dividing? Do they give it a number? A name? My name? The thought of a blob of cancer cells with my name rankles me. I picture the UPS man in his khakis delivering a box packed with ice to a lab. Inside, a slide. On the slide an expanding gelatinous mass with the name I’ve answered to since I was married in 1968. What if the lab technician knows me? I have lots of friends in California. "So that’s what became of her after she retired," the technician would think.
"No," I reply. "No questions."
Have you or anyone close to you ever had to deal with a breast cancer diagnosis, even though you were otherwise very healthy? How did you handle it?
Image via spakattacks/Flickr
This post was written by Mary Donaldson-Evans