Breast Cancer Blog - Episode 20: Buy One Get One Free

So I have now been diagnosed with cervical cancer as well as breast cancer. Why have one cancer when you can have two, right? Sorry for the brash intro, but I’m so utterly wall-punchingly pissed off with this now. I'm a medical miracle, whoopdifuckingdoop.


Here’s the fact check:


It’s currently assessed at stage 2, which means it’s just started to go beyond the wall of the cervix, so hysterectomy isn’t an option. I now have to have a CT scan to see if it’s gone any further, via lymph nodes (not the armpit/breast ones, a whole new set), after which the stage might change (i.e. get worse). Then they’ll decide what the treatment is, but it’ll almost certainly be radiotherapy and chemotherapy, or radiochemotherapy, or chemoradiation, which are all slightly different, fuck knows.


Here’s how it played out:


We go into the appointment and there’s a doctor, a nurse and some other woman who is never introduced or mentioned. The nurse introduces herself, and it turns out she’s the one I had the difficult conversation with the other day. Great vibe so far, huh?


The doctor asks me how I am. The irony is so immense that I let out a laugh. I tell him I’m feeling anxious, anxious to hear what he has to tell me. He does this thing where he looks at his notes like he’s a bit part actor checking his lines, then fixes his face into a ‘concerned’ frown. He says “it’s not good news at all”. There’s this pause where I think I’m supposed to gasp or something, but I don’t, so he carries on. “It is cancer”. Again, the dramatic pause. The three of them look at me like the doof doofs are sounding at the end of Eastenders, but instead of falling to the floor weeping, I say “OK”, and nod encouragingly. I hold his eye contact. He wrinkles his brow.


He looks a little baffled by this change to the expected play-out, but he rallies. He says they don’t have all the information yet, so I will need to have an CT scan to tell them more. He says they will book one in and then they’ll be in touch. And I think that’s it. I think I’m actually expected to take that pathetic excuse for a consultation and just get up and go home. It’s been three minutes. Three minutes.


Plot Twist

The script probably says that at this point, the nurse gently takes the hand of the sobbing woman and leads her to the room with the flowers, where she gives her some leaflets and tissues and sends her on her way to let it ‘sink in’. But this crew seem to have forgotten to read the memo which tells them that I’ve seen this episode before, and, if it’s okay, I’ve got a couple of questions about the plot line.


I say I’m a little confused, as I thought the MRI was going to determine the size and spread of any tumour, and the pathology report would determine the grade of cancer. He flinches and turns to his screen:


“Ah, well, the MRI told us some things, but we need to know more”

“What did it tell you?

“It showed some cancer, but not enough detail”

“But doesn't the MRI give you the details that the biopsy and ultrasound didn’t?”

“It is very complicated and whilst it showed some evidence'...I interrupt

“So did the pathology show the grade of cancer?

He checks his notes, he hasn’t a clue. He looks to the nurse for help.

She says “um, the pathology report hasn’t come back yet, and we only got the results of the MRI scan yesterday”

I say “so okay, but if the results had come back earlier would they have given more information?”

“No”, I swear she actually sighs, “but we now need to do the CT scan as soon as possible and the team will then review it and decide on a treatment plan”. She’s trying to wrap the conversation up now, we all know it, but I’m not quite done yet.

“So what are the likely treatment options?” I ask, trying to look as wide eyed and innocent as I can, which probably isn't very. I’m not sure who to address the question to, as the Doc seems to have given up and the nurse is giving me a very tense smile.


The Doc decides to pick up the baton, he has a pre-prepared line for this. He puts his bad news face back on.


“You will need a combination of (a beat for dramatic effect) chemotherapy and (another beat, possibly for a cymbal clash) radiotherapy.

I shrug, stomping all over his dramatic centrepiece and say “OK. I'm already having them both for the breast cancer so I guess it’ll be a question of finding a treatment programme that works for both then? What might that look like?” I’m not supposed to be saying this, These aren’t my lines, these are theirs, this isn’t in the script. They are both floundering.


Nurse steps up.

“Gynae Oncology is not as straightforward as breast cancer, It’s a lot more complex”. I nod, and make a note-to-self to now add capital letters when referring to the ‘very complex’ area of fanny cancer. Breast cancer is clearly for beginners. But I'm kind of OK with big, complicated words, so I'm not terribly afraid of "complex", as it happens. And I really, really don't like being patronised.


Backstory

I’m wondering what the backstory is here. This is the 3rd time she’s told me that breast cancer is second fiddle to gynae. Maybe she applied for a job in the breast team and got turned down. Maybe she had a fling with a breast Onco and got rejected. Maybe she’s just a bit less kind than the breast nurse and she knows it. Hey, maybe the breast team nicked all the good pink stuff and the cervical guys got left with teal ribbons. I mean teal, it's not the stuff of marketing unicorns and cupcake fundraisers, is it? Either way, she and I aren’t hitting it off.


At this point Mr G steps out of the shadows, like the surprise long lost relative who comes to smooth the troubled seas and bring peace to the duelling factions. He knows me far too well and can sense that my hackles are up. He sums up what we’ve been told, and says that we’ll wait to hear from them then, as soon as possible. He stands up and I follow his lead, tacitly accepting that further conversation is useless at this point. We leave the room and head off towards the corridor.


The Sideroom Scene

But then all of a sudden she’s next to me, the nurse, touching me on the arm and suggesting we go into a sideroom to talk. I’d forgotten completely about the side room scene. I’m hesitant, and ready to continue walking out, but Mr G steps into the room and my fate is sealed. Looks like we’re doing the pastoral bit after all.


She perches on a chair and hands me an information pack. I put it straight in my bag, I’ve already read everything in it, and a great deal more. She says she doesn’t want me to go away confused or frustrated. Ha! Too late, but perhaps she’s worried about the customer feedback form. Cynical? Moi? I tell her that I need to have a clearer understanding of the results of the MRI, the reasons for the CT scan, the difference between the two and what we do actually know so far.


And suddenly something shifts. She drops the ‘cotton wool at all costs’ approach and realises that I don’t need the aftershock care that a first time cancer diagnosis usually needs. I’m already 3 months ahead of the curve, unshocked, unschockable, and ready to hear the medical facts. And so she gives me them. I gain more from the next 4 minutes of conversation than I did in the whole of the appointment that just happened. She gives me the facts and the next steps. I thank her, and finally I’m clear on where we’re at. It’s as I said at the start, definite cancer, stage 2, might have gone further, need to see lymph nodes and other areas (chest, lungs etc). Bladder, bowel, kidneys and liver looked clear on the MRI, but CT scan will confirm and check the places that don't show up on MRI scans. Got it.


We head off home, pissed off and sad. But not shocked, not struck down with terror and with all the tissues we started with. Eyeliner in tact, mascara perfect. Mr G is stoic, pragmatic and strong, ‘Whatever it is, we’ll deal with it. It’ll be fine’, he says.


I smile and nod. I agree with the first part. Whatever it is, we have no option but to deal with it, but I’m mentally calculating my odds and I know they just got a whole lot worse. Fucksake.





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