Janus 13

Yesterday as my daughter was driving me to the hospital to get the results of my breast biopsies, she said, “How are you feeling? What are you expecting to hear?”

It seemed an unnecessary question because many times before I had said that I felt that it was cancer, mainly due to the way I was treated by the staff during the procedures 10 days before, but since she had brought up the subject, I asked, “What did you see when you were with me watching the procedures last week?”

“Well,”she said, “there is no doubt that there is something there.  And you know cancer comes from the word crab, and your whatever was dark and flat but with lots of rough edges sort of like a crab might have.” 

“So you think it is cancer too,” I said.

“I’m afraid so.”

And then the consultant made three of us who thought that.  She was young, tall and thin, and rather cold.  She was abrupt in her questions, and not very comforting in her comments.

“The scan showed you have a 40 mm grade 2 invasive lobular carcinoma. It is hormone positive, Her 2 negative, K 67 10%.”

Luckily my daughter is a scientist so she understood more than I what those words and numbers meant.  

“The usual first course of treatment would be surgery,” she went on.  “It is of a size where you probably would be given a mastectomy, but might be able to have a lumpectomy but if she had that, you would have to have five days of radiotherapy. If you had a mastectomy you wouldn’t need any other treatment.”

“But I am expecting to be treated with chemotherapy for my colon cancer,” I said. “Do you mean I need to have this surgery before that, or might the chemo help with the breast cancer too?”

“Well chemo isn’t really of much effect on breast cancer.  It would not be our first choice of therapy, but as you are going to be having the chemo anyway, I think we might postpone the surgery until after you have had it.  But in the meantime, I think we will give you a drug called letrozole which will block your body’s uptake of oestrogen.  You will take one tablet a day, and it just might shrink your tumour down so that only a lumpectomy will be necessary.”

“What are the side effects of that drug?” I asked.

“The usual side effects of menopause - mood swings, hot flushes, things like that.”

Then she asked me to strip and palpated my right breast.  When she had finished, she said, abruptly, “Well, which do you choose - mastectomy or lumpectomy?”

“Mastectomy,” I said, because I felt it was what she wanted me to say.

So that was it.  We were taken by a nurse who was our personal contact from this hospital to liaise with us and answer any questions.  She gave us loads of booklets and went through the basics again.  Because all big medical decisions go through a team meeting, they had to discuss the potential treatment plan with my surgeon from the other hospital and so the next trip would be to confirm what the joint treatment would be, and to prescribe me with the Letrozole.  The appointment was made for 3 weeks time.

“So the cancer will continue to grow without treatment, “ I said.  “No problem,” she replied, “because it is a very slow growing cancer. You probably have had it for the last five years and it is only now got to the stage where it was recognisable.”

So now we know.  But despite having the two most common types of cancer for women, I somehow am pleased that both of them are rarer than other types within in same category.  For instance 80% of breast cancer  is called ductal where the cells are within the milk  ducts. My 20% is lobular. In the booklet, the picture of the two of them, show the ductal type being on the branch  part of a sort of tree shape with the trunk of the tree being the nipple The lobular cancer is like a flower (or weed more likely) on the very end of the leaves of the tree. 

So now we know.  I can’t say I am devastated. It would have been nice to have a benign tumour, but I guess that is the downside of living a long time.