So a lot has happened since my last update, as seems to have been the way of things since my surgery in May. Life has been something of a rollercoaster and a couple of weeks ago we were plunged down another descent. Just as I was smugly congratulating myself on avoiding a mastectomy and admiring my new radiotherapy tattoos, a call at 5pm one evening from my breast-care nurse threw everything into uncertainty again. My latest CT Scan, while clear everywhere else, had shown up some ‘areas of concern’ in the same breast we thought we’d just rid of cancer. I was called in to see the surgeon – radiotherapy was put on hold - and I was sent for an ultrasound to have biopsies taken. The radiologist thought it looked like post-operative inflammation so we were in two minds about how worried to be over the weekend. We went back in to get the results on the Monday. I love a game of ‘guess the results from the medic’s demeanour’ (I like to be a few seconds ahead of the curve on these things) …my breast-care nurse hugged me on the way in and the surgeon had on her ‘bad news head-tilt’. Bugger. One of the biopsies just showed inflammation. The other showed more cancer, in a new area of the breast. That mastectomy I thought I’d so cleverly avoided was actually needed. Not for the reason they’d originally thought but still, someone up there wants this boob gone.
There followed some more anxious waiting while I had a special, very detailed PET-CT scan – ‘just to be sure’ and an MRI ‘to check the other side’. I believe they call it ‘scanxiety’. Every time my phone rang I’d near enough have a heart attack. The thought of the cancer having sneaked off somewhere else in my body while we were busy celebrating seeing the back of it was just too much to take on board. Thankfully, aside from the right breast, nothing untoward showed up on the PET, which goes down to a molecular level and can show up disease at the earliest stages. So, we breathed a huge sigh of relief there.
Exactly what has been going on in my body in unclear. Has this new cancer sprung up during and post chemotherapy? Or was it always there and just missed because I didn’t have the right scans? I have dense breast tissue which can hide areas of disease on mammograms and ultrasound. The tumour never even showed up on a mammogram in the beginning despite being obvious on ultrasound. I choose to believe in this ‘hidden on scan’ theory, which would also explain why the area of cancer that was taken out in my lumpectomy was twice the size that had showed up on the ultrasound scan. It feels more comforting to think it was always just hiding out there rather than that this is a rampaging crazily aggressive cancer that is growing at a biologically unfeasible rate, even during chemotherapy. We’ll never know for sure as I was never given an MRI scan at the start to properly image what was going on.
The waters had become so muddied I rather lost faith in the process so went for a second opinion. I decided to switch doctors and hospitals as the doctor/patient relationship can’t really function without full trust.
All this has led us to the door of a mastectomy which happens tomorrow.
Good news/Bad news
Before I get you all concerned for my future let’s assess the good and bad news here. On the good side, I’ve now had a PET Scan, CT Scan and bone scan and they have all come back clear so we can be as certain as medical technology allows that the cancer has not got anywhere else. I had a partial response to chemo - the midway ultrasound scan (and my daily checks!) showed the tumour had shrunk by more than a third. The aim of chemo is really to mop up any sneaky cells that have got away and any tumour shrinkage is a bonus so let’s presume any errant little cells have been stamped on. I’ve had all my lymph nodes under my arm taken out so the cancer has been cut off at the pass from getting out of the breast anytime soon. It was lucky that I had that CT Scan or I would have been merrily cruising on through radiotherapy with this other area of cancer dividing and multiplying away with abandon.
On the down side the emotional turmoil of the uncertainty and the twists and turns in the treatment plan have been pretty tough to take. Oh, and I have to lose the boob after all. I’ve likely not had enough time to really process it yet but right now I just feel I’ll be glad to see the back of it. It feels - like one of the doctors described - that it’s just ‘gone bad’. I was never against having a mastectomy, I just didn’t want one unnecessarily. If it’s got to go, it’s got to go.
One small fly in the ointment is that the area they’re concerned about is quite big, so the surgeon thinks he’ll have to take quite a bit of tissue away. That means my hoped for immediate reconstruction is unlikely, though he won’t be able to make a call until I’m ‘on the table’ as it were. So I’ll be waking up from surgery tomorrow hoping to have had an expander implant but not really expecting to. If it’s not possible then I’ll need what’s called a flap reconstruction, sometime next year. But…swings and roundabouts…that might mean a free tummy tuck!
Goodbye to the boob
It will undoubtedly be most odd saying goodbye to my right boob tomorrow. But if that’s what needs to go for me to be able to stick around and see my Fred off to university one day then I will gladly give it up to the cause.
After the incredibly tough time of the last few weeks I feel strangely positive. The 3 different scans that have come back clear for distant metastases give me confidence we’re getting on top of this. A bit more surgery is a pain but just a few weeks more recovery, then radiotherapy to tick off and I’ll feel we’ve hurled cancer out of our lives, chucking its scabby shoes and coat behind it. There is light at the end of the tunnel again.
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