Musings on luck and cancer
Luck is a funny thing, often it can be a state of mind. Many people would regard me as horribly unlucky, but I prefer to see myself as incredibly lucky. It's just the way you look at it.
Where I live in Scotland there is a breast screening programme that every woman over the age of 50 is eligible for, providing a mammogram every three years until the age of 70. Screening after that point is on a request basis. I was 50 last year, and could have got called at any point up to my 53rd birthday. I was called at the beginning of April.
I know a number of women who've been called and not gone - they can't be bothered, they're too busy, they're scared at what might turn up, whatever, they didn't go. And yet breast screening saves lives.
It's saved mine.
While I appreciate not everyone lives where they have ready access to breast screening, it is one of the most worthwhile things you can do for your health, because breast cancer is much more common than people think, and the earlier it is treated the better the prognosis. I went because I expected to get validation of what I knew - that everything was OK.
Well it wasn't.
I was recalled for further tests three weeks after my original mammogram. The letter I got was very reassuring, 80% of women who are recalled turn out to have nothing wrong with them, and require nothing more than a few more mammograms and perhaps some ultrasound. I was told when I got to the clinic that there were several areas in one of my breasts that they wanted to investigate, and on the screen one of them looked pretty dodgy even to me. Well they had me at the clinic for nearly four hours, I had six further mammograms (two of which were extremely painful) and two sessions of ultrasound. At they end of it all they did two separate biopsies under local anaesthetic. Then I was given the big explanation. Most of the areas had turned out to be cysts which most women over forty have at least one of. They check them out anyway as while they are usually benign, they can be a bit less so. However, the doctor said there were two areas they felt needed to be biopsied. One they were fairly sure would turn out to be OK but needed properly checking just in case. It was OK in the end.
The other area though, not such good news. The doctor said after looking at the further mammograms and the ultrasound and taking second opinions, she was sure that it was “almost certainly” cancerous. To say that this hit me like a bolt from the blue is an understatement. There was no lump that I could feel (in fact it was some consolation that when the doctor had examined me, she couldn't feel a lump either), I had had no symptoms at all, how was I to know? That really was a horrible day that left me feeling totally shellshocked.
I got the results of the biopsies a week later, and they just confirmed what I already knew - yes it was cancer. That confirmation wasn't as awful as the previous week, probably because I was expecting it. I remember sitting in the waiting room with six other women and their partners, and that was grim - everyone staring at the floor, faces tripping them. However, in my case, while the news was dreadful, it wasn't as bad as it could have been. They caught it early, and the actual tumour was small (about the size of my thumbnail), which is good. Apparently it was also a fairly rare type of cancer; most breast cancer is defined as unspecified, mine was a mucinous carcinoma which accounts for about 2% of cases. This was also good because it has a better prognosis than the more common types. However, mucinous tumours are not solid and tend to be soft, and my tumour was also fairly deep, which means that I would have been most unlikely to have felt it until it was much, much bigger, and hence harder to treat. A mammogram was the only way to pick it up at this stage. See what I mean about being lucky?
The next day I had a pre-op appointment at the local hospital. Here's another area that I'm lucky in. The Western General Hospital in Edinburgh is a centre of excellence in Europe for the treatment of breast cancer. I couldn't have chosen a better place to have cancer! The following Monday I had I had an appointment with my consultant to talk about my treatment, with the op scheduled for two weeks after that, four weeks to the day from my recall appointment. They proposed to give me a lumpectomy to remove the tumour and a bit of tissue round about it, plus a sample of the lymph nodes from under my arm - this is usually the first place that breast cancer will spread to, and while they had looked OK under ultrasound (they had done this at the screening clinic), the only way to be sure was to look under the microscope.
I had the op two weeks ago - I was in and out of hospital in a day - and I am told I have healed beautifully. My breast was also pumped full of radioactive blue dye and it's still a bit off coloured. They do this to see which lymph nodes fluid drains to first, they then take those to see if there are any cancer cells in them, the idea being that if they are clear then the others are likely to be too.
I got the results of the various tests they did on the tumour and my lymph nodes yesterday. Insofar as they can tell, always the proviso, I am clear. No more cancer. All the treatment I get from now on will be aimed at minimising the risk of it coming back. They can never eliminate the risk, however the surgeon told me I have an “excellent prognosis”, and he did use that word, with a low risk of recurrence.
I am so relieved.
So while getting breast cancer could be seen as horribly unlucky, I've been very lucky in terms of when it was picked up (the fact that it was picked up at all, given the type of cancer that I had) in terms of where I have been treated, and in terms of my prognosis. I will always worry about it coming back, but not nearly as much as I would have done if it had been more advanced. Indeed I may be one of the unlucky ones for whom the hormone treatment doesn't work, or who suffers horrible side effects from radiotherapy, but at the moment I prefer to think of myself as incredibly lucky.
Where I live in Scotland there is a breast screening programme that every woman over the age of 50 is eligible for, providing a mammogram every three years until the age of 70. Screening after that point is on a request basis. I was 50 last year, and could have got called at any point up to my 53rd birthday. I was called at the beginning of April.
I know a number of women who've been called and not gone - they can't be bothered, they're too busy, they're scared at what might turn up, whatever, they didn't go. And yet breast screening saves lives.
It's saved mine.
While I appreciate not everyone lives where they have ready access to breast screening, it is one of the most worthwhile things you can do for your health, because breast cancer is much more common than people think, and the earlier it is treated the better the prognosis. I went because I expected to get validation of what I knew - that everything was OK.
Well it wasn't.
I was recalled for further tests three weeks after my original mammogram. The letter I got was very reassuring, 80% of women who are recalled turn out to have nothing wrong with them, and require nothing more than a few more mammograms and perhaps some ultrasound. I was told when I got to the clinic that there were several areas in one of my breasts that they wanted to investigate, and on the screen one of them looked pretty dodgy even to me. Well they had me at the clinic for nearly four hours, I had six further mammograms (two of which were extremely painful) and two sessions of ultrasound. At they end of it all they did two separate biopsies under local anaesthetic. Then I was given the big explanation. Most of the areas had turned out to be cysts which most women over forty have at least one of. They check them out anyway as while they are usually benign, they can be a bit less so. However, the doctor said there were two areas they felt needed to be biopsied. One they were fairly sure would turn out to be OK but needed properly checking just in case. It was OK in the end.
The other area though, not such good news. The doctor said after looking at the further mammograms and the ultrasound and taking second opinions, she was sure that it was “almost certainly” cancerous. To say that this hit me like a bolt from the blue is an understatement. There was no lump that I could feel (in fact it was some consolation that when the doctor had examined me, she couldn't feel a lump either), I had had no symptoms at all, how was I to know? That really was a horrible day that left me feeling totally shellshocked.
I got the results of the biopsies a week later, and they just confirmed what I already knew - yes it was cancer. That confirmation wasn't as awful as the previous week, probably because I was expecting it. I remember sitting in the waiting room with six other women and their partners, and that was grim - everyone staring at the floor, faces tripping them. However, in my case, while the news was dreadful, it wasn't as bad as it could have been. They caught it early, and the actual tumour was small (about the size of my thumbnail), which is good. Apparently it was also a fairly rare type of cancer; most breast cancer is defined as unspecified, mine was a mucinous carcinoma which accounts for about 2% of cases. This was also good because it has a better prognosis than the more common types. However, mucinous tumours are not solid and tend to be soft, and my tumour was also fairly deep, which means that I would have been most unlikely to have felt it until it was much, much bigger, and hence harder to treat. A mammogram was the only way to pick it up at this stage. See what I mean about being lucky?
The next day I had a pre-op appointment at the local hospital. Here's another area that I'm lucky in. The Western General Hospital in Edinburgh is a centre of excellence in Europe for the treatment of breast cancer. I couldn't have chosen a better place to have cancer! The following Monday I had I had an appointment with my consultant to talk about my treatment, with the op scheduled for two weeks after that, four weeks to the day from my recall appointment. They proposed to give me a lumpectomy to remove the tumour and a bit of tissue round about it, plus a sample of the lymph nodes from under my arm - this is usually the first place that breast cancer will spread to, and while they had looked OK under ultrasound (they had done this at the screening clinic), the only way to be sure was to look under the microscope.
I had the op two weeks ago - I was in and out of hospital in a day - and I am told I have healed beautifully. My breast was also pumped full of radioactive blue dye and it's still a bit off coloured. They do this to see which lymph nodes fluid drains to first, they then take those to see if there are any cancer cells in them, the idea being that if they are clear then the others are likely to be too.
I got the results of the various tests they did on the tumour and my lymph nodes yesterday. Insofar as they can tell, always the proviso, I am clear. No more cancer. All the treatment I get from now on will be aimed at minimising the risk of it coming back. They can never eliminate the risk, however the surgeon told me I have an “excellent prognosis”, and he did use that word, with a low risk of recurrence.
I am so relieved.
So while getting breast cancer could be seen as horribly unlucky, I've been very lucky in terms of when it was picked up (the fact that it was picked up at all, given the type of cancer that I had) in terms of where I have been treated, and in terms of my prognosis. I will always worry about it coming back, but not nearly as much as I would have done if it had been more advanced. Indeed I may be one of the unlucky ones for whom the hormone treatment doesn't work, or who suffers horrible side effects from radiotherapy, but at the moment I prefer to think of myself as incredibly lucky.