Thursday, July 31, 2014


Yesterday I got a bit of a reality check when I went in for my third radiation treatment.  There were a few people in the sitting room, so I plopped down, hoping to strike up a conversation with at least one of my fellow radiation-ers.  It didn’t quite work that way.

The man sitting next to me looked so frail and haggard that I kept wondering if I should hold a mirror under his nose.  He didn’t respond when I greeted him, didn’t acknowledge when I sat down on the couch next to him, and seemed to be looking right through the television.  (In his defense, that Talk show with Sharon Osborne was on, so one could hardly blame him for not actually seeing anything.)  I quickly gave up on him as my hopes started to tank.

Just when I was about to set my sights on another guy in the room, he started chatting to someone else.  His voice was loud and nasal and since the room is open, there’s no way to avoid overhearing.  He was sharing his story, of feeling some weakness in one of his arms, tolerating it for a few months, and then finally having it checked out.  He spoke of a couple of perplexed doctors who couldn’t find any reason for the nerve pain they were certain he was experiencing, until they did some sort of MRI and discovered his lung cancer.  The tumor was somehow pinching a nerve that was causing pain up and down his arm.  He spoke about the type of tumor it is, how it’s the “best” kind of lung cancer you can have, and how he’s hopeful for the future.  The woman he was speaking with said all the encouraging things you would expect in such a situation, but her eyes were telling a completely different story.  She looked at him with a combination of pity and embarrassment – she clearly thought his optimism was naïve and had all but written him off.  I wondered if he could see it as easily as I could.

While the previously immobile guy next to me lit up an e-cigarette (what in the hell ARE those things, anyway?  I understand e-mail.  I even mostly understand e-Harmony.  But an e-cigarette??) and I pretended to be fascinated by a coffee table book on rural Italy, I started thinking about my own situation, my own version of the “best” kind of breast cancer, my own random discovery.

In my case, I didn’t feel anything wrong.  Nobody did.  The danger of having dense breast tissue like mine is that it’s harder to feel lumps and harder to see them in mammograms.  There are lots of studies out there examining the link between density and mortality; it’s scary stuff.  In my case, I simply realized one day that it had been more than a year since my last mammogram, which had also been my first.  I had gone in for a baseline, sometime after I turned 40, at the urging of my nurse practitioner.  Because of how dense my breast tissue is, she said, it would make sense to get some images on the record as a point of comparison.  I had the mammogram, then got called in for a second mammogram, and then got called in for an ultrasound on my right breast.  There were some sort of calcifications, which they ended up declaring benign cysts.  It was a frightening process, but when I was sent home with a clean bill of health, I was also told to expect more of this in the following years.

So I wasn’t concerned when it happened again.  I had my regular mammogram, at which I explained the glorious nature of Groupons to this very sweet tech who apologized every time she squished my boobs between the chilly plastic plates.  I fully expected to be called in for a second set of images, which is exactly what happened.  But it was different this second time.  This time, as I waited with all the other women in hospital gowns self-consciously crossing our arms over our unbound chests, my name was called again.  And instead of just taking me back into the changing room and whispering that everything was find and that I should come back in a year, they took me into quiet little room with a computer and a few professional looking chairs.  A doctor and a nurse navigator were waiting for me.  Obviously, this was going to be a different type of conversation.

They didn’t tell me I had breast cancer, though.  They told me they found something suspicious, and that I needed to have a needle biopsy to have it studied and identified.  They didn’t diagnose me.  They didn’t spell out any doomsday scenarios for me.  But it was another step, beyond the second set of images, beyond the ultrasound.

The needle biopsy was one of the weirdest and most painful experiences of my life.  I had to lie face down on a table with a hole in it.  My breast hung down through the hole, the table was raised up, and the medical team worked on what looked like pedicure chairs below me.  I felt like a Chevy getting an oil change.  The Groupon tech held my hand and rubbed my back and basically acted like my own personal Florence Nightingale, trying desperately and unsuccessfully to get me to relax my shoulders and not fight against the process.  I ended up bruised and punctured and glad it was all over.

(Oh, and they showed me the calcifications that had been removed from my breast.  I’m not sure why, but I had assumed they would look like tiny little golf balls or something, white and round, almost like flakes of laundry soap.  Instead I was confronted with a vial of what can only be described as tiny little beige worms.  I was assured that this is what all calcifications look like, not just mine, but even so, I swear I will never eat chow main noodles ever again.)

But it turns out it still wasn’t quite all over.  The results of the needle biopsy suggested DCIS, Ductal Carcinoma In Situ.  DCIS means there is a malignancy in a milk duct, one that thankfully hasn’t burst through the duct, and is therefore the safest of all breast cancer findings.  But it’s still cancer, and it still needs to go.   I had an incisional biopsy performed on May 29th.  The surgery was quick and relatively painless, and the recovery was just a few days of laying low.  I figured I was in the clear, despite the total Bride-of-Frankenstein lookin’ scar on my breast.  

But the DCIS diagnosis was confirmed by the surgical biopsy, and so here I am, in a radiation suite, 5 days a week for 6 weeks.   I’m aware of how extremely fortunate I am.  My cancer was found when it was absolutely tiny (between 4-5mm, about the size of the tip of a pencil), it hadn’t moved beyond the duct, the surgery removed all the malignancy and showed clean margins, I don’t have to undergo chemotherapy… it could be so, so much worse.  Just like the guy who got the “best” sort of lung cancer, I got the “best” sort of breast cancer.  Whatever that means.  

And while I have certainly had the notions of context and relativity drilled into my head throughout this experience, I have also learned that it’s vitally important for me to still honor my experience, exactly as it is, exactly what it is.  Yes, it could be so, so much worse.  I am likely to sit in these waiting rooms with people having last-ditch radiation, treatment that will be designed to possibly prolong their lives by weeks or months, but not even years.  My prognosis is excellent: while I am a relatively high risk of re-occurrences, I’m expected to finish treatment and then basically pick up where I left off.  

But none of that means I’m not still scared.  None of it means I don’t still feel cheated and angry and more than a bit disgruntled.  None of it means I didn’t have cancer removed from my body.  And while I may never understand e-cigarettes, I do understand that.  I DO understand that.  

 3 of 30, in the bank.

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