66. Another day, another woman with breast cancer

I hear on the grapevine that a fellow choir member has just been diagnosed with breast cancer.

We have sung together for, oh, about 18 years, but I haven't been able to go to rehearsals for months (even in good weeks, I just haven't got enough puff these days), so I haven't seen her for a while.

It occurs to me that, even though I am now a Breast Cancer Patient, I have absolutely no idea what her experience is like for her. We are different people, with different lives and different coping styles. I have also no idea what her story is, and I realise that I want to know the details. All of them.

How did she find out? What kind of cancer? How big? What grade? And - crucially - what is it like for her, to go from Being Fine to Being A Cancer Patient in the time it takes to sit in a doctor's office? The grapevine news didn't stretch that far.

I ring her at once.

This choir friend is, I suspect, not quite as promiscuous with her cancer story as I have been, so I'm not sure how much she welcomes talking about it. But if I have learnt one thing, it is this: not getting in touch is worse than getting in touch (and keeping it brief if needs be).

As it happens, we talk and talk. Nothing like a spot of breast cancer to create a bond.

I still cannot imagine what having breast cancer is like for someone else, but I can relate to the whole hospital rigmarole of being diagnosed.

Unlike mine, Choir Friend's cancer was picked up through a mammogram, part of the routine 3-yearly screening process. I discovered my tiny lump myself and took it to the GP for inspection. She sent me to the one-stop-shop at the hospital (doctor's assessment, mammogram, ultrasound, biopsy), where my cancer turned out to be invisible on the mammogram. It jumped out at us on the ultrasound. They then stuck a needle into it to extract a few cells for the lab.

My cancer diagnosis came a week later, when the surgeon confirmed that it was indeed cancer. In a way, I already knew. My biggest shock was seeing that image on the ultrasound, which didn't look anything like the neatly formed cyst I had expected.

Once diagnosed, I had to wait to have an MRI scan, to see if the cancer had gone anywhere else in my breast. (It hadn't.) Based on those images, the surgeon took the decision that what I needed was a lumpectomy, not a mastectomy. (Hurray, I thought at the time. Alas, events involving microscopes sent me back to the operating table for a mastectomy after all.)

Choir Friend has been to the one-stop-shop, had the biopsy, got the cancer diagnosis, is about to set off for her MRI scan, and will be given The Verdict in due course.

"It's the waiting!" she laments. "Surely there could be a way of putting dates in the diary?"

Ah, yes, the waiting. I remember that. First thing I did, when I suspected that I might have cancer (at the end of the one-stop-shop, a week before my diagnosis), was put my diary onto the surgeon's desk. If it turns out to be cancer, I asked, what happens next? I wanted to know whether and when they would operate. I had no idea. Would I have to stay in hospital straight away? Should I cancel my engagements for the weeks ahead? Look, I'm meant to give a talk next week. Can I?

Don't worry, said the surgeon. Whatever it turns out to be, we will sort it out. It's only small.

Well, yes, I could see that, but what does Sorting it out involve? I had to ask specifically, because I really, really wanted to know these things. I established there and then that surgery wouldn't be until three or four weeks later. (All this, remember, before I was even given my cancer diagnosis.)

This uncertainty was one of the worst things of waiting for Diagnosis Day. So bad, in fact, that during that terrible week of waiting, I arranged to meet up with the hospital's Lead Cancer Nurse (whom I knew, as she had taken part in some of my research). I asked her what I could expect if (a) it was cancer, or (b) it wasn't cancer. She set it all out very clearly over a cup of tea, the entire range of possibilities, and that was one of the most helpful meetings I've had during my career as a cancer patient.

It is good, talking to Choir Friend. Because I can see that, although I do indeed have no idea what her cancer road looks like from her perspective, I am now acutely aware that there is such a thing as a Cancer Road.

(With apologies to the many people who detest words like Road and Journey in the belief that those words should be reserved for a trip to Hull or a holiday in Hawaii. It's just a matter of vocabulary, really. How to find the words to describe what is hard to describe?)

I look back over my shoulder and there they are, receding into the distance, the various stops on my road.

Appointments, scans, surgery, waiting rooms. Medical decisions about surgery, chemotherapy, radiotherapy. (That last one is still to come. Haven't got a date in my diary yet, not even for the so-called "radiotherapy discussion". Does the end of November spell the end of my treatment, or do I carry on into the new year, with daily trips to the radiotherapy rooms? No idea. I've got used, sort of, to not having things in the diary - but it would be better, really, if they were.)

Decisions... Have my planned mastectomy, or stay with my dying mother? To reconstruct or not to reconstruct? 

"Why did you choose not to have a reconstruction?" asks Choir Friend. It's an excellent question and the answer could take up an entire blog post. I talk her through my decision, acknowledging how deeply personal such things are. I am in no position to give anyone advice on such matters.

Family and friends and acquaintances and colleagues, all needing to be told (or do they?). Going back to work, or not? Choir Friend has very recently retired. Does that make it easier or harder?

Shifts in perception. Turning from the one who gives... into the one who receives. Turning from the always-healthy... into the seasoned patient. From cycling to the pool for a 50 length swim, and then cycling on to a full day's work, and then cycling home to cook the dinner before setting off to choir practice... to carefully planning a 15 minute walk around the block because it will take the rest of the day to recover.

I hope Choir Friend will be spared some of these road stops. A lumpectomy followed by a couple of weeks' radiotherapy (as was my initial treatment plan) sounds much more manageable.

But that still leaves the emotional, social and spiritual upheaval of becoming a cancer patient. I don't envy her. But there's a lot of it about.

One in three of us will get cancer at some point.

If that is you, don't expect any advice from me. I don't know how to help anyone cope better with cancer. But I'll be very happy to listen to your story.


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