An ill defined density – living with cancer
The photo below is of my beautiful friend Heidi who is undergoing chemotherapy for breast cancer. People who have not had breast cancer [or any cancer] tend to misunderstand the illness and see it as one single cancer. As explained here, it is not.
Breast cancer can begin in different areas of the breast — the ducts, the lobules, or in some cases, the tissue in between. In this section, you can learn about the different types of breast cancer, including non-invasive, invasive, recurrent, and metastatic breast cancers
My friend Nicole, also a cancer survivor comments on some of the annoying statements and advice given by people including other cancer survivors when they learn you have been diagnosed.
The assumption that people have that makes them feel comfortable to tell people with cancer about THEIR cancer?—?what they should feel, what treatment to choose or not to choose, what their side effects are or aren’t, and for how long?—?always amazes and annoys me. It isn’t that they don’t know details, but that they don’t know details and still choose to assert ‘what they know’ in conversations with people facing horrors is the central warped part.
My friend’s cancer is specifically ‘Invasive Ductal Carcinoma” which is the commonest type of breast cancer. Hers is an aggressive kind, grade 3 on a scale of 1-3 and is 6cm. The cancer is estrogen receptive and is present in the lymph nodes.
This is the same type of breast cancer as I had in 2000 but with some significant differences. Mine was 4cm [T2N1] grade 3 with cancer in the lymph nodes. My treatment began with surgery — a two stage procedure starting with the removal of 1/3 of my breast with the hope that was all that was necessary. It was not and so I had to have the whole breast removed followed by chemotherapy. I declined radiation therapy. My cancer was not estrogen receptive meaning I could not take post chemo hormone therapy.
Heidi’s treatment is sequentially different to mine. Not only is she is starting with chemotherapy, the drugs are different and the aim is different. In her case, her doctors hope the chemo will shrink the tumour and I assume kill off any cancer cells nearby. She will then have surgery depending on the size of the tumour. Finally, she will have radiation therapy followed by years of hormone therapy.
The similarities most often rest in the side effects of the steroids: insomnia, tiredness, and generally feeling crap for most of the time. But even here there are differences. For example, not every chemo drug results in hair loss and there is a range of other side effects. To say the illness is complex and misunderstood is an understatement.
Last Wednesday I had a two-stage procedure to remove a benign tumor [on the day the radiologist discovered a second one, hopefully also benign] in my left breast. The operation was the last stage in a series of tests over the past four months, mammograms, ultrasounds, and biopsy. The tumors are tiny at 4mm and probably would not have been removed without my history of breast cancer. What is interesting is that in 2002 I had a mammogram through the NHS [UK’s free at the point of access health service for all] which showed
an ill defined density centrally placed which was seen on earlier films [July2000]. It was investigated previously with ultrasound and further views, when no focal abnormality was seen. It is therefore unlikely that the appearances are significant.
The question is, and I will probably never know the answer, is there a connection between the ‘ill-defined density’ of 2000 and the two tumors removed on Wednesday especially given they were centrally located? If they had not been removed would they go on to change form and become malignant and aggressive? As my friend Nicole says, trying to fathom what caused our cancer — was it something we did or were exposed to, and could we have prevented it — is mostly futile but we still wonder, still ask.
The reality is once you have cancer and survive, you live with it forever. It might not be a central part of your consciousness at all times but it lingers on in the recesses of the mind. The other reality is the event in our lives called death is unavoidable. Death also has different meanings and we experience the inevitability in different ways. For me, in many ways, death is a release so much so that at times I find myself looking forward to it. I am not religious in the conventional sense so no heaven or hell for me. I will rest in the place of my paternal ancestors as that is where I locate my living self. Not to digress to far from this post, but I do believe there are a few people who know the secret of death. Imagine if we all knew this secret what chaos would ensue.
For Nicole death means the acceptance of the lack of control we have. We can’t always tell what is going on inside of us until it is too late. We can’t control our environment and habits/behavior enough to be secure in the sense that a cancer patient knows that, faces that, in ways many others happily disregard or simply don’t have to think much about because the strain of it is so abusive to daily function.
It is worth taking the time occasionally to contemplate our inevitable end — at least in the form we all know. Cancer provides this unwelcome opportunity. Heidi explains,
I’ve been thinking that acceptance of death might be a good process for me to go through. I’m not saying I’m giving up on positive thinking. I actually think it might be an extension of that. To fully accept the thing we can’t change and be free of the anxiety related to it. Not that I intend to die soon. But we all die. So it could be a good investment for my healing now as well as for the inevitable future event.
Heidi has just completed her chemo treatment and will soon move to the next stage which is surgery to remove the lump which has hopefully shrunk and lymph nodes. She documents her experience with cancer on her blog “Heidi’s Bosom Buddies”
October update. Heidi’s tumor was shrunk and removed but required two surgeries. She is now undergoing radiotherapy.