Short version; it’s not as great as I had hoped but it’s still good news.
Long version; The tissue sample still had some islands of active cancer amongst the dead tissue but the margins are clear (meaning they’re pretty sure they’ve got it all). One of my removed lymph nodes had evidence of dead cancer cells and the other four were clear.
Thanks to the decision to have chemotherapy first I’ve avoided a mastectomy, avoided ‘full clearance’ of my lymph nodes from under my arm and avoided all of the complications that can come with that treatment.
I’m remembering how lucky I was to have this cancer detected in the first place. If it hadn’t been for a letter from Breastscreen I would be dead, or very very sick by now.
I’m remembering how lucky I was to have someone recommend Kylie Snook and the Mater Hospital. Then to have Kylie refer me to Rachel Dear as my oncologist. If I’d been treated locally then having surgery first would have been my only option. I would be recovering from a mastectomy, coping with all of the complications of having no lymph nodes down my left side and around about now I’d be finishing chemotherapy. The difference is that I would have no idea if the chemotherapy was working because the tumours would have already been cut out. It’s possible that I could have already developed more tumours, particularly if the chemotherapy protocol turned out to be something that didn’t work on my particular type of cancer.
I’m remembering how lucky I’ve been to have had a response to chemotherapy. Kylie talked to me today about the patients she’s seen whose tumours dig in and either grow or hold stable in spite of everything they throw at them. There’s no guarantees with any cancer treatment. Everyone is certainly doing the best job they can with what they have but sometimes the cancer is too aggressive.
I’m counting my blessings.
I’m also saying ‘fuck’.
Fuck fuck fuck fuck fuck.
It’s a good word to say when you don’t get the news you really wanted. I really wanted to hear ‘full pathological response.’ The reason I wanted this is because it would have improved my survival odds considerably. A full pathological response pushes triple negative breast cancer patients into the same statistical bracket as other breast cancers. 86% of them are still alive after five years. Nearly 90%. In simple terms that means one in ten will die. Nine in ten will still be with us.
Not getting a full pathological response leaves me in the triple negative survival rate statistics. That’s 75%. Essentially that means I have one chance in four of dying in the next five years. Fuck. But also three chances in four of still being here! Which is so much better than being 100% dead. Which is what I could have been if my cancer wasn’t detected or if I hadn’t had chemotherapy.
This is life with cancer.
There’s what you want and then there’s what you get. The challenge is to experience the disappointment without letting it get me down. Fortunately I’m very good at that. I start from here; even if I only have three years left I’m sure going to make the most of them. I’m not going to waste them sitting around feeling sorry for myself.
Next step; While it’s possible this cancer could come back there is no point worrying about that until and unless it happens. Apart from anything else, worry isn’t good for me and probably messes with my immune system, so worrying about cancer can make its return a self-fulfilling prophecy.
Next step; There’s a lot I can do to improve my odds. I can eat well, watch my weight and make sure I enjoy regular exercise. I can focus on making sure I have the best quality of life that it’s possible to have. My surgeon thinks that quality of life is the most important thing when it comes to beating cancer.
I also need to spend just a little bit of time being sad about the result. I would have liked nine chances in ten instead of three chances in four. I didn’t get them. I’m probably going to have some entirely appropriate tears about that.
Then I’m going to remember that three chances in four is still really great odds. I’m going to remember that I’m feeling strong and healthy and looking forward to getting back to yoga class and going walking regularly with Graham. I’m going to go to lunch with my beautiful daughter and hear all about her plans for moving out and starting her next degree. I’m going to take a picnic blanket out into the yard and get Graham to read Douglas Adams aloud to me. I’m going to have my friends over for pizza, or organic grass fed barbecued meat or afternoon tea. I’m going to go op shopping with my Mum and listen to her funny stories about the retirement village.
The best thing about my pathology result is that I don’t need any more chemotherapy or surgery. We’re moving right along to radiation therapy and now we’re including the lymph nodes down the centre of my chest. This is because of the evidence of cancer in one of the removed nodes and the fact that my surgeon decided to leave a major node in my chest rather than break my ribs to get it out. (And for this I am also grateful!). She’s happy that it’s already been zapped by chemotherapy and that radiation will mop up any remaining nasty cells.
I’m going to take a few days to process all of this but I know I’m going to be well and strong and happy once I have.
I’m going to live.