Yucky news from my oncologist: serious post

Matroyshka dolls: layer upon layer of the face we prepare to meet the faces that we meet… (http://step2loveblog.com/?p=1265)

Matroyshka dolls: layer upon layer of the face we prepare to meet the faces that we meet… (http://step2loveblog.com/?p=1265)

When I got my diagnosis of triple negative breast cancer with no primary site, I had two things to worry about: a cancer that was only 15% of all breast cancers, very aggressive and with very limited treatment options (one option); no primary site, so nowhere to target with removal or radiation. When the surgeon said “remove the whole breast,” my oncologist said “we think it’s in the tail of the breast, so a lumpectomy should work.” I was happy with the oncologist’s opinion, and put all thoughts of a mastectomy out of my mind.

Last Tuesday, chemo #7, I had a big appointment with my oncologist. She’d been away for the previous week at the the 9th European Breast Cancer Conference 2014 in Glasgow Scotland. We started with a question of mine:

“With no primary site, and five lymph nodes with cancer, do I have metastatic cancer?”


I was shocked.

“But I thought that was just called regional spread?”

“It’s the same thing.”

Wow. All of a sudden I was one of the women I’d been feeling so much compassion for. When I saw “metastatic” on a blog, or article, I actually thought to myself, “I’m doing everything I can. I won’t go metastatic.” So my appointment started off poorly, and was about to get a lot worse.

Without a blow-by-blow accounting, the gist of it was that my doctor had reconsidered, and was now recommending a bilateral—both sides—mastectomy, and recommending it “110%.” This triple negative cancer is aggressive, and we want to get rid of it once and for all, and with no primary, the safest thing to do is remove all breast tissue. You can consider reconstructive surgery, and it can be done immediately. It will require a number of revisions, since it is a work in progress when you use your own tissue, as opposed to saline implants. They will be large scars. It’s no walk in the park….”

I have been quietly freaking out for four days with this news. When I was trying to think of a visual to accompany this post, I thought of Russian matroschka dolls. The outside one, the largest, protects the others. Inside is the next one, slightly smaller, but still protecting the rest, and so on. The larger one is the me everyone sees. The next, the one that acquaintances see, the next, the one that, say, the neighbours see, then the me the kids’ teachers see, and so on, through the me my friends see, my relatives, my sisters, my children, my man, down to the tiny, unprotected and raw me. And that is how I feel. This diagnosis, not an estrogen-positive breast cancer, Stage III with a tumour on the mammogram that can be measured and staged, but a vicious. aggressive cancer with a tumour lurking somewhere out of sight. I feel so alone.

There is no doubt that I will undergo the operation. I understand the rationale. I don’t want my breasts if they harbour a cancer that can strike back again in six months or a year or two. I want the bast chance to escape this cancer, and if this is the way, so be it.

But the thought of the surgery, or surgeries, since there will be three, makes my stomach heave and my heart jump and my throat close. I feel my shoulders burn and my arms shake. I’ve had many things happen in my life that people have said “I don’t know how you do it.” Well, this time, I don’t know how I will.