Cancer Journal 3: Stuck on the Breast Cancer Roller Coaster Ride
I was diagnosed with breast cancer September 11th. I quickly learned that being told you have the disease really tells you nothing. I never realized before that there are many, many TYPES of breast cancer, and your treatment depends heavily on the various characteristics of your tumor as well as your gene mutation status.
After my heinous, insanely painful biopsy, my breast tissue was sent to a pathologist and analyzed. I got the results back a week later. I found out my tumor was hormone positive, and HE2 negative. What this means is that my tumor feeds on my estrogen and progesterin, and that it doesn’t have these special proteins that makes it aggressive and fast-growing. My surgeon got my insurance to pay for me to get a genetic test (apparently this is no mean feat in these days of stingy insurance coverage), and the results came back negative, all across the board.
Not only did they test me for BRCA 1 and BRCA 2 — the main genetic markers that increase a woman’s risk of breast cancer signficantly — but many other genetic mutations as well. They even checked to see if I had an increased risk of colon cancer. (By the way, BRCA 1/2 testing is what led Angelina Jolie to get a pre-emptive mastectomy and have her ovaries removed. Here’s a clip of my surgeon discussing Jolie’s famous decision.) I got nothing that would increase my risk of any type of cancer, apparently. I was a bit shocked by this, since I actually have a sister who also had breast cancer and got treated with a lumpectomy and radiation, the same treatment my surgeon recommended given my early stage status and the small size of my tumor.
In any case, I felt like I had won the breast cancer lottery. Because my tumor was hormone positive, it was likely I wouldn’t have to suffer through chemotherapy but could just take hormone suppressing drugs like Tamoxifen to cut off my cancer’s food supply. And ER+/PR+ tumors have a better prognosis, apparently.
Since I didn’t have the genetic markers, there was less worry about recurrence. My risk of subsequent tumors was no higher than that of the general population, and I didn’t feel pressured to consider a bilateral mastectomy instead of just a simple tumor removal. So I’d been feeling pretty optimistic and positive about my chances with this awful disease.
But then I had the MRI…
I’m grateful my surgeon pushed my insurance to approve it. Breast MRIs are way more accurate than mammograms, and another thing I’ve learned through this process is that I have particularly dense breast tissue, which means tumors can be missed by traditional detection methods.
MRIs really don’t miss a thing, especially when you use contrast dye, which clings to any breast tissue abnormality and really highlights it in the image.
The MRI was uncomfortable, especially since I had to tolerate an IV pumping contrast dye into my vein while my poor breasts, which had already been through the ringer of mammogram/ultrasound/biopsy hell, were smooshed together between these cold, hard plates. I also had to focus on remaining totally still, face down, while being forced to listen to nonstop annoying cranks and beeps. I tried not to get claustrophobic and freak out that I was stuck in a giant tube for half an hour. Afterwards, my right arm swelled up like somebody injected me with a giant grape, and it was tender for a week. But I’ll take that MRI over Dr. Mengele’s biopsy, any day.
Today I was anticipating that my surgeon would say “oh, your MRI is just fine,” because prior to today, every diagnostic test had produced as positive results as possible, given my diagnosis..and that we’d set a date for the surgery. I’d go into the hospital within the week; she’d cut me open and drag out that offensive tumor; sew me back up like new, and 3–4 days later, I’d be back to my old grind. Just like it never happened.
But what I’m learning is that cancer couldn’t give a shit about conforming to what you expect.
I go into my meeting with my surgeon, all happy and ready to jump to the end phase of this mess. She, on the other hand, looked somewhat grim as she explained what she saw on the MRI.
The MRI revealed two new areas of concern — one in my LEFT breast and another in my right breast, where the cancerous tumor was discovered. “Given your MRI results, I cannot recommend that we proceed with breast conserving surgery. I also can’t tell you to go ahead with a bilateral mastectomy at this point, either, because we don’t know what we’re dealing with,” she said.
She explained that breast MRIs often flag things that aren’t cancerous, and there’s no way to know for sure without..YOU GUESSED IT..a BIOPSY.
Just when I thought I was done with that shit..
“We’ll have you come back in and get ultrasound images on the areas the MRI contrast highlighted. If the ultrasound looks suspicious, we’ll go ahead and biopsy both those areas right there. You’ll get the biopsy results back in a day.”
I explained to her that the previous surgeon poked me 5 times with Novocaine, and despite the fact that this failed to induce the proper amount of numbness, barreled in and biopsied me anyway. And that it hurt for 3 weeks afterwards.
She didn’t seem too sympathetic. I guess because I needed to realize that I was trading short-term pain for long-term survival. I know I should be very very grateful that I had the insurance to even be able to GET an MRI (thanks, Obama!) — had we proceeded with the lumpectomy without checking for other tumors, I could have ended up with undetected cancer that could have metastasized down the road, and nobody wants that.
And I understand that if those 2 areas ARE cancerous..it’s way more preferable to lose my boobs than lose my life. But, dammit, they’re NICE BOOBS. I like them. Even though I’m sure my surgeon could replace them with very nice implants..it’s just not the same. I was really convinced we’d just zap, bang, bam! grab that tumor out and my boob would still look great, and I’d be healthy and take my Tamoxifen..and never worry about cancer again. Now I have to face that I may need a bilateral mastectomy, after all.
I guess there actually IS no cancer “lottery.” Cancer just sucks, no matter how “positive” your tumor is, or your genetic tests turn out. It’s more like a roller coaster ride with extreme ups and downs that jerk you around until your head snaps.
Copyright 2017 S. Wade