It’s been my flattest week since my diagnosis.
I’ve read my pathology report a couple of times. Know your enemy.
Way back when all of this started there were some problems with the lab that did my initial report, including the fact that they specified the wrong breast! I think part of my was holding on to the possibility that I really didn’t have such an aggressive cancer. I was hoping for a lot of red-faced apologies. “Sorry, Meg, it’s actually a much less serious cancer than we originally suspected.”
Cancer gets graded based on how aggressive it is. They look at the microscopic features of the cancer including how similar it is to healthy cells. Less similar means more aggressive. They give three aspects of the cancer a score and then add these up. Grade 1 is the least aggressive and grade 3 is the most aggressive. Like my father before me, mine is a grade 3 cancer.
I was also hoping for a full pathological response. This would mean that the chemotherapy had completely killed all of the cancer cells. It would have greatly improved my survival odds.
Part of my problem was riding the wave of optimism generated by my doctors. My oncologist told me she was pretty confident we were going to see a full pathological response and my surgeon, on the day after surgery, also told me things were looking good. While the chemotherapy has certainly killed three tumours, the primary tumour still had islands of active invasive cancer spread throughout the dead tissue. So nearly dead but not quite. On the plus side, the whole of the tumour was removed with clear margins.
I was less than thrilled to learn that one of my lymph nodes also showed signs of having been attacked by the cancer. It’s dead now, but the fact that it was there at all is unsettling. On the positive side, if these cells were evidence of it moving out into my body then the chemotherapy would have attacked it and, hopefully, killed it.
The big shock is the presence of DCIS (ductal carcinoma in situ) under the tumour and extending all the way to the bottom of the incision. This hasn’t come away cleanly.
The trouble with a doctor’s appointment is that you’re time limited. I know my surgeon said something about going all the way to the chest wall but I didn’t hear ‘DCIS’ and so the pathology report was another shock. From my own research I know that DCIS is a pre-cancerous condition and that many people have it for years without it becoming cancer, but mine is still grade 3 and I’ve just had a surgeon cut into it.
I’m reassured that the multidisciplinary team that meet to discuss every patient have concluded that radiation is the best option for me now.
Of course, the whole point of radiation therapy is to ‘mop up’ any remaining cancer cells so it’s just as well I’m booked in for that. Unfortunately it can’t start until my wound heals. Now I have a month of living with the possibility of a grade 3 cancer growing or spreading in the absence of any treatment.
I have no choice. The only other option was more surgery and they’ve decided against that. I’ve left a message for my surgeon to call me so I can be clear about why we’re not doing this. I know she’ll have a good answer. I’d just like to know what it is.
When I asked my surgeon what the chances were of this cancer killing me, she said, “Ask me in two and a half years.” In other words, she doesn’t want to speculate but the statistics say that if I can make it to three years after my diagnosis then my chances improve dramatically.
Now that’s what I call a long wait.
Welcome to cancer land.
I spent a week after surgery feeling so well and so positive it was hard to believe I’d had surgery. This week I landed with a thump.
Day by day I’ve been pulling myself back up again. I’m greatly assisted by my wonderful friends and family, particularly my husband. I’m putting together a be-as-well-as-I-can strategy as a way of feeling more in control between now and radiation therapy. Because of my pathology my surgeon has asked that my radiation oncologist include the centre of my chest as well as my left breast. Who would have thought I’d be so keen to get into that great big machine and to expose my body to radiation, but suddenly I’m very, very keen.
Head down and bum up. Keep moving.
Fuck you cancer!