Weeks 4 & 5 A.D.
Pathology results from the biopsy were due any day now. The doctor said three to five days, and Monday was now day three. Thankfully, work consumed the day and kept me distracted because I didn’t get a call that day.
It was Tuesday when the doctor called with the results.
“There is malignancy.”
It’s official. I have invasive ductal carcinoma.
It’s not like I thought the results would be benign, but to be honest, there was a little tiny shred of hope that I had held on to. As the doctor named the cancer, I felt that little bit of hope slowly dimming inside of me. It was like being at that first mammogram appointment all over again.
“It’s low grade and it’s not aggressive,” she said. “No one wants cancer, but if you have it, this is the kind you want. It’s highly treatable.”
I should be assured by that. But my anxiety is telling me to expect the worst from “treatable” – losing my breasts, scars, terrible radiation, sickly chemotherapy, hair loss, weakness, and worse. What does “treatable” mean?
Before hanging up, she informed me that I’d receive another call to get oncology and surgery appointments scheduled. The treatment planning would now begin.
I texted the news to my husband, sisters, in-laws and oldest friends from high school. My mind was a foggy blur, not at all conducive to being productive at work – which is why I was so grateful that I had a lunch scheduled with a former teammate that afternoon anyway.
On the drive to lunch, I kept thinking about this journey. Should I share this [cancer news] with others? I had only told people in my very closest “circle of trust”, as we call it in my work. Is this something you just tell people? Like when people ask “how are you!”, I just blurt out, “I have cancer”. Should I be this open about it or is this a private matter? But, what is so private about it anyway? I’m going to have to go through treatment. I’m going to be a mess, at least emotionally anyway. Plus, and the biggest plus of all. If cancer can impact anyone, and it does, then keeping quiet about it gives it the power to sneak up on others.
That lunch was just what I needed. It was great to catch up with an old friend. As we swapped updates on the going’s-on of each others’ lives, it was a good reminder, for us both, that you just never know what someone is going through. Along with the joys of life, we all have shit going on too. And it’s really important to talk to others because you never know who you could help, or who might be able to help you. That’s what true community is — a concept that is often devalued or forgotten in today’s society. I know I’m guilty of it. I often opt to not make my problems somebody else’s, I don’t want to burden others. I almost always respond to challenges with “I’ve got it”, “I’ll figure it out”, or “it’s not your problem, you don’t need to worry about it.” Leaning on others is hard for me.
After lunch, and a bit of texting with one of my friends, who is a two-time breast cancer survivor herself, I realized there’s is so much I don’t know about what I’m about to embark on. When the Nurse Navigator called later that afternoon to schedule appointments, I had a list of questions ready.
Q: What is the hormone receptor status?
A: Estrogen positive at 95% & progesterone positive at 92%, HER2 negative. Which is good. (I’d later learn why and what this even means)
Q: What grade is the tumor?
A: Grade 1. The cells are slow growing.
Q: What is the growth rate?
A: The Ki-67 is at 8%, so it is very slow growing.
My oncology appointment was set for the day after Christmas and my appointment with surgery was on New Year’s Eve. These appointments would determine my treatment plan.
It was good news. Or, as good as cancer news can be. But as an empath, I began feeling…guilty. Maybe, just maybe, I will be one of the lucky ones. But it was hard to stop thinking about the women who didn’t get the same call I did, and are facing more aggressive cancer or types that are harder to treat. I felt for all of them. I cried for them.
I also imagined what treatment might look like for me. I’ve heard lumpectomy mentioned a few times but I didn’t want to get my heart set on that. The idea of a mastectomy terrified me. Like actually brings me to tears. I don’t want the scarred remains of my what were my breasts to remind me every single day, that I had cancer.
I mastered the art of distraction that weekend. I had started painting a wooden nutcracker the week before at a holiday crafting team building, that I was determined to finish before Christmas. I put every ounce of intricate, detail into that thing, from the lightly pinked cheeks to the gold fringed epaulettes on the wooden soldier’s jacket. I decided that I didn’t want to let cancer steal the joy of my Christmas. I would use this project to commemorate the time I made it through the Christmas season with a cancer diagnosis. I added little bits of hope into it in the form of light pink ribbons on the Christmas tree my nutcracker held.
Outside of the nutcracker, I also buried myself in sourdough, a new hobby I found this year. I baked an obscene amount of bread. My mindset was “bake it to fake it till you make it.”
I just needed to enjoy Christmas with my family and try to focus of the positives. So, when Christmas came, I set out to really enjoy every single moment. I savored my time in Iowa with my sisters and their families. I didn’t rush through Christmas Eve. I relished every single moment of Christmas morning, going through stockings with the kids, opening gifts, walking next door for breakfast (and more gifts) with in-laws. At the time, the day seemed to go in slow motion, as I appreciated every minute as it passed. It was how it should be.
Then it was Thursday, oncology day. Back to KU at the Westwood location. Zach held all my things while I changed into a pink kimono shirt, open in the front, of course. The first thing I noticed about my doctor was his soft bedside manner. He was careful…no, thoughtful in the words he chose. He explained that my cancer feeds off my estrogen and progesterone hormones, so if we’ll treat it by blocking off its “food source”. HER2 proteins are not present in my cancer cells, which is good, because those cause rapid growth and spread.
He got out a treatment plan document and began crossing things off and circling other things. He explained that for my cancer, I’ll should go on hormone blocking treatment for five to seven years, for best results. It would be in the form of a pill to block hormones created by my organs and probably injections to block hormones created by my ovaries. Since I’m still young, after the seven years, there’s still a possibility I could go through natural menopause. So, I could be the winner of two menopauses. Dear Lord! But, since the cancer does not appear aggressive, I should not need chemotherapy.
YESSSSSSS!!!!!!!!!
But. Big BUT. This plan will depend on surgery and pathology results from the removed cancer. Chemo is not 100% ruled out. Radiation may also be on the docket, but that also depends on surgery outcomes. He noted that the surgeon ordered an MRI for January 12. That could also alter the treatment plan.
We talked about additional service and support that might benefit me — Oncology Psychology is a common care service for patients. I think I said “yes, please” before he even finished his sentence. Then we discussed genetic testing. I agreed that taking a genetic blood test to see if I am at risk for other mutations would be smart since I am considered young, and have breast cancer in my family. The results would take two to three weeks and could also impact my care plan going forward as well.
Basically, there is a plan. It’s just jammed with dependencies.
Plan A: Remove the tumor. Block hormones.
Dependencies: Genetic blood test, MRI, pathology from surgery.
Next up: meet the surgeon.
Midlife Mamacita 