Thursday, 26 June 2014

6. Good news?

Yesterday was Results Day.

There are people whose job it is to slice up my right breast and lymph nodes, nice and thin, and look at it all through a microscope. My surgeon will tell us what the tissue looked like. 

Will I need a tissue?

Making my way to the hospital, I have no idea what to hope or fear. What is good news? What is bad news? It is my profession to know these things. I even know the definition of bad news. I’ve quoted it in my very own book, on page 29.

“Bad news is any news that drastically and negatively alters the patient’s view of her future.”

Perhaps that is why I am not nervous. I know that whatever the microscope threw up, it cannot make my future any more difficult. Even if every single slice of breast and all my lymph nodes showed further cancer cells, the outcome would be the same.

A period of chemotherapy, trying to mop up any adventurous cancer cells that might have made their way beyond the breast and the lymph nodes. Radiotherapy, perhaps. (In for a penny, in for a pound.) Years of hormone treatment, to stop my left breast getting similar cancerous ideas.

And then, that will be that. Cured. This is my view of the future: six months of my life taken over by cancer – perhaps a  year – and then I’ll be merrily cycling off into the distance, leaving the cancer firmly behind.

Bad news would be the discovery of aforementioned adventurous cancer cells, but if they exist, they are safely out of reach of this month’s microscope.

There is another aspect to my lack of nervousness. It feels as if I’ve become inured to an onslaught of bad news. My lack of control over life events is not easy for me, but I am trying to see it this way…

There is nothing I can do to change what is happening in my life. The only thing I can try to change is my response to it.

I’ve been trying.

So, what did the surgeon tell us?

She was smiling this time, so I think it can be classified as Good News.

All the breast slices were fine. No sign of cancer cells, or even pre-cancer cells, anywhere else.
Of the 17 under-the-arm lymph nodes that were taken out, three turned out to have cancer in them.

It could be worse.

What’s next?

The surgeon will now hand me over to the Oncology Team. (Note how good I have become at being a patient: I am putting my life in the hands of others, who take me on, sort me out, pass me over to the next expert. I do not resist. I am grateful, even, that there are people who know what to do with me and my cancer).

My surgeon and Owl with his amputated breast wing

It was a bittersweet parting, because this surgeon has been brilliant in every way. She even sent one of her junior doctors off to fetch an operating outfit, so she could have her picture taken with Owl. (Photographic evidence of his surgery was missing in his album.)

My dear surgeon, if you are reading this: I salute you.

I will meet with the oncologist in a month's time. She will talk me through the proposed chemotherapy treatment. This is likely to involve a dose of poison pumped into my veins every three weeks, giving me just enough time to feel utterly miserable and crawl back to relative normality before the next dose is due. I expect this to start, roughly, at the beginning of August; it will last, roughly, until Christmas.

So that’s 2014 sorted.

I came home carrying yet another cancer booklet, this time on chemotherapy treatment. (If this barrage of information continues, I will soon need to build a new bookshelf). I read it, cover to cover, lying under the tree in the garden.

The chapter on side effects runs to 20 pages. There is all manner of excitement to look forward to. (“Possible” side effects, the booklet is keen to point out, so let me be accurate here: “possible” excitement). 

There is the promise of another booklet for each of these possible side effects, so yes, I'd better start putting up that bookshelf.

Some of the "possibilities" come as no surprise.
There will be hair loss ("Yes, there will," said the breast care nurse).
Nausea (“No there won’t”, said the breast care nurse, “they have drugs for that these days” – let’s hope she is right. I am not a pleasant companion if nauseous; pregnancy was bad enough).
Bowel changes (won’t go there, it will put you off your morning coffee).

These I knew about.

But on the 19th page I spot a side effect that I intend to make full use of, even if I don’t get it. “Doctors sometimes call this mild cognitive impairment (MCI)”, the booklet explains. “But it’s more usually known as ‘chemo-brain’.”

The problems with memory or concentration can last until well after the treatment. I am looking forward to having an ongoing excuse and a fancy name, at last, for not remembering people’s names, where I put my purse, or when my daughter is meant to bring a packed lunch to school. Although I fear the suggested “useful way of managing it” is not going to be much good, because it involves putting reminders on your mobile phone.

Problem is, where did I put my mobile phone?

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