Dear Readers: As the subtitle says, this week, I bring you episode two of my “My Cancer History.” If you haven’t read every blog article I’ve posted so far, you might want to go back and read I Turned Sideways for episode one of “My Cancer History.” The posting is a little late this week due to scans and minor surgery and treatment changes you can read about at the bottom of the post.
It was May 2013 and I had noticed a lump above my left breast. Dreamboat’s doctor-friend (Dr. Friend) got me an appointment for a mammogram right away. The mammogram revealed that the lump in my breast was suspicious. So, Friday, May 31, I returned to the mammography center for a breast ultrasound and, maybe, a biopsy.
I had found the damn suspicious lump, and I couldn’t un-find it.
Instead of standing at the mammography machine as I had almost every year for decades, on this visit I lay on my back in a dimly-lit examining room, draped in one of those greenish-bluish examining gowns that tie here and there. I was untied here and untied there, with my left breast exposed.
To picture the diagnostic radiologist, first picture a nonna or auntie you know, from the Old Country—the compact, sinewy, vital one—cheerful despite all she’s seen. Subtract a few decades until she’s around 35 or 40 years old. Notice the muscular arms and hands of a woman made for hard work or, in the diagnostic radiologist’s case, for surgical instruments and hours at the gym. Now, take this vision of strength and willfulness and add the speech patterns of a five-year-old talking to her baby-doll. She’s unexpected, but there you have her: Dr. Silvertones.
I don’t call her Silvertones ironically, either. No. In my now six-year relationship with the child-voiced doctor, I’ve found, for gentleness of expression mixed with flat-out honesty, Dr. Silvertones wins the prize over any other doctor I know.
So, in her funny little voice, Dr. Silvertones introduced herself that day, laid a firm hand on my forearm, looked into my eyes, pronounced a few reassurances, and began the ultrasound; its gel warm and sticky-seeming. Her assistant, who had been fairly chatty before Dr. Silvertones stepped in, receded to the shadows behind the machinery, like an all-business security guard.
Dr. Silvertones slid the slick ultrasound wand over my skin, centering on a smaller and smaller area.
“Do you want to see?” she asked.
I assented with a raspy “yes” and the doctor turned her monitor toward me; she drew my attention to what she told me were spicules—arm-like shapes branching from a central area.
“The locus there? That central area?” Dr. Silvertones said, “That’s what I’m looking for. It’s some kind of growth. Not necessarily a tumor.”
“Not necessarily,” I thought. The spicule-arms were thick and long. On the monitor, the thing looked like an octopus made out of the Milky Way. Not a shy octopus clinging to glass walls in a brightly lit aquarium. No, this was the gargantuan beast in an outer space sci-fi movie, the kind that hangs within its zone of cosmos, waiting to attack defenseless spacecraft, like the Starship Dearie’s-Normal-Life.
“If it turns out that you need to have this growth removed,” Dr. Silvertones said, “you could opt for a lumpectomy. But I’d be concerned a lumpectomy might end up being, essentially, a mastectomy. Because each one of these spicules would have to come out, and you can see they’re pretty extensive.”
“Not necessarily a tumor,” I thought. “…need to have this growth removed…” Dr. Silvertones spoke like, if I could handle a little bad news now, it might help prepare me for worse news to come.
Something’s Gotta Give
The ultrasound turned into an ultrasound-guided biopsy and the ultrasound-guided biopsy was a terror. No matter how carefully and confidently Dr. Silvertones explained the procedure, there was no getting around the fact that she was about to make a small incision in my left boob and stick what looked at a glance like an eight-inch needle in there. The needle was hollow and had a grabber inside, Dr. Silvertones explained. She would activate the grabber to get a piece of the lump inside me. She called the whole set-up a biopsy gun. But, aside from the needle, I have no idea what the biopsy gun looked like; I didn’t look at it. I have a toddler’s attitude toward the existence of frightening objects: if I don’t look at them (people dressed in Freddy Krueger Halloween masks, cluttered corners of dim rooms, things that show up on my left breast the day before a two-week vacation to France), they can’t hurt me. Or so I used to think.
So, I never saw the hollow-needled biopsy gun in the radiologist’s hand; I only felt it. Dr. Silvertones had numbed me to pain, but she couldn’t numb the pressure she applied. With one hand, the doc pressed the ultrasound wand against my breast (above my heart) while, with the other hand, she pressed the needle through the incision (near my underarm) and into my breast—still watching the ultrasound monitor, tracking her results. It was slow going. Apparently, I have very dense breasts. Eventually, Dr. Silvertones called her assistant from behind the machinery, asked her to roll up a towel, and told her to hold that against the inner side of my left breast, beside the ultrasound wand. The doctor continued to shove on her needle from the right. I managed to get the fingers of my right hand grasped around the edge of the table I lay upon, not sure if I wanted to be pushing or pulling or just hanging on for dear life.
I thought of the old Sinatra song. (No, I’m not old enough, but yes, I am cool enough, to be a Sinatra fan.)
When an irresistible force such as you
Meets an old immovable object like me
You can bet as sure as you live
Something’s gotta give, something’s gotta give,
Something’s gotta give.
As I understood later, that’s exactly what Dr. Silvertones was worried about: her irresistible needle might meet my immovably dense breast tissue and something unexpected might give—some less-dense pathway in my left breast might open and the biopsy needle go slashing through, to end up in my right breast, my ribcage or, I suppose, the all-business assistant’s face.
Dr. Silvertones managed to force the needle into the lump, and she set off her gun to get the samples she needed. Pang, pang, pang.
On the way out, Dr. Silvertones gave me a hug. A real, wrap-you-up-and-squeeze-you hug, like she was trying to squeeze a little of her gym-built-dense-breast-practiced strength into my ultrasound-and-biopsy-wilted body.
I took that as the worst omen of the day.
Your Breast Cancer Book
It was a Friday. If you read the post, I Turned Sideways, you already know the results. On Monday, June 3, 2013, in the afternoon, Dr. Friend called. In his deep, kind voice, and his goofy lisp, he said, “Dearie, I’m tho thorry to have to tell you thith.”
It was cancer.
But there was more bad news: when, in the following week, I had an MRI to confirm the size and location and, I guess, the cancerousness of the cancer in my left breast, the MRI revealed an additional, nearly hidden, very tiny growth deep inside my right breast. Dr. Silvertones performed a right-breast ultrasound and biopsy. This time there were no spicules, no space-monster octopi. Still, the right breast tissue was as dense as the left. I watched the ultrasound monitor again. There the biopsy needle slid past the right-breast tumor over and over—until Dr. Silvertones speared it—by force of personality.
There was no hug this time; Dr. Silvertones was late for her next appointment. Unceremoniously, the all-business assistant sent me down the hall to an office I hadn’t noticed before: desk at one end, blinds closed against morning sun; a bookcase full of identical, unfamiliar binders; a table piled with paper, pamphlets; and a woman with a droopy face: pudgy cheeks tugged by gravity, corners of eyes and mouth sloping down. The woman opened by saying how sorry she was to see me. Then she handed me one of the binders. It was entitled Your Breast Cancer Book and it was gigantic. Ms. Droopy and I sat down on either side of the desk and she began to demonstrate how the book was set up. “Dividers, labels, pockets,” she said.
My breast cancer book? The thought was a shock. Why would I need Your Breast Cancer Book? Sure, Dr. Friend told me that I had cancer, but… Oh, My God! I had CANCER!
“Pathology, Radiology, Getting Help…” Ms. Droopy continued.
When the next page appeared to have two fresh blotches of water drops on it, the woman came around from her side of the desk and patted my back.
I looked at the tears on the page in front of me. “My husband is in the waiting room,” I said. “I need him.”
Health update: This week, I had a CT scan on Tuesday which confirmed the location of this new-ish tumor in my shoulder. It seems to be dying of its own accord, as tumors will do sometimes when they grow so fast they outgrow their blood supply. The doctors are hoping a change in my chemo treatment will finish off this tumor. So goodbye Eribulin, you virtually side-effects-less old dear. I had hoped we could work together a bit longer. Hello Doxil, you question mark. I had my first Doxil treatment on Friday and feel relatively unscathed so far. My oncologist warned that the side effects from Doxil tend to show up later. I do have a cancerous lymph node in an inconvenient spot outside but near my lungs. The docs are discussing radial surgery to blast that one away. Continued good news: no return of the lung and liver tumors! And more good news: on Wednesday I had minor surgery to place a new port, and Friday they pulled the old PICC line out. I’ll tell you more about PICCs and ports another time, but trust me, this is a delight. It will help to make me a bit more independent in some ways and, eventually, able to pool-jog again!
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