Dr. P left a message last night on my cell phone: the mass the MRI found in my right breast is benign.
I’m not sure why I didn’t answer the phone when it rang. I think it was really just this overall feeling of exhaustion and a sense that I wasn’t ready to have another conversation about cancer. When she calls me from her home, the caller id says “unknown caller”, so really, I wasn’t even sure, and I kind of knew in my head that I wasn’t prepared to hear my results — even if the results were going to be in my favor.
I’ve been thinking a lot over the last week about the sentinel node biopsy (SNB). The left breast, with all its malignant spots and pre-cancerous spots is without question set up for a SNB. But, Dr. P had told me that if the mass on the right was benign, I would have a choice. I could choose to either leave the lymph nodes on that side alone during surgery, or I could choose to have them tested. The advantage to testing is peace of mind. It’s the only way to know for sure whether the cancer is localized in the breast, or has started to make its move elsewhere. The downside is that anytime lymph nodes are removed, the immune system is compromised and there is an increased risk for lymphedema.
I don’t trust this cancer. The hematologist I met with on Friday told me that from what she could see, my cells are “very busy” mutating. I was referred to her by my primary care doctor to rule out a genetic clotting disorder that runs in my family — because no one wants to find out their blood doesn’t clot properly during an 8-12 hour surgery. I walked in thinking I was getting a blood test, I walked out two and a half hours later, my brain short-circuiting with facts and figures about chemotherapy and mutating cancer cells and post surgery care. I tried to tell her that I was only there for a workup on Von Willebrand factor, but she had this aggressive Long Island you’re-here-you’re-mine bedside manner. She even had me undress so she could examine me.
Here’s the thing: While I didn’t love her delivery, what she said kind of reinforced what I had been thinking. It doesn’t make sense to leave anything alone. I want Dr. P to do whatever it takes, as much as she can, to rid my body of those evil mutating cells. I don’t want to wonder every day for the rest of my life if I made a mistake, if I was aggressive enough, if I could have done more.
On Saturday I celebrated my 53rd birthday. I have to believe I have a lot of years left. I have plans, dreams, so much left undone. I’m not prepared to simply roll the dice here. I have cancer. And I want it gone.
When I was first given my diagnosis, my primary care doctor told me that my cancer was DCIS, which for lack of a better definition is kind of a “good” cancer to have. It’s non-invasive, it hasn’t spread, and it responds beautifully to treatment. But at each subsequent doctor appointment and after all the follow up testing, it turns out that only some of my cancer is DCIS. Dr. P refers to it as invasive, meaning that it has spread beyond my milk ducts. She has fully supported my decision to have a bilateral mastectomy. No one is trying to talk me out of treating this in an aggressive manner. No one has once said to me, “Just do the lumpectomy. You’ll be fine.”
I think doctors are schooled in how to give patients bad news. They don’t dump it on you all at once, they give it to you slowly, in a way that gives you time to adjust and accept what’s happening. In the beginning, it was easy to believe that I had a “good” cancer. But no cancer is good. Cancer can’t be trusted.
When I talk to Dr. P today, this is what I plan to tell her: Do the sentinel node biopsy on both sides. Take as much as you have to because for me there is no choice: I choose peace of mind.