Not ‘Just a cyst’

As promised, I am going to write about my journey with Breast Cancer so far to fill you in on how I got to where I am not.  The title gives you an idea of how this all evolved.

As mentioned in my last post, in October, 2014 I found a lump in my right breast randomly in the shower one day.  I didn’t think much of it and figured it was ‘just a cyst’ and went about my day.  After working out, I was getting into the shower to get ready to go back to work and happened to glance down and noticed some green discharge leaking from my right nipple.  I gave a little squeeze and more discharge came out–but this time green, amber, and black.  That scared me enough to do to the medical clinic to ask them to check me out.  Thank goodness I did!

At the clinic, I could tell they were concerned but they made a point of saying it could be any number of things from a cyst to something called a ‘Pappilioma’.  They referred me to get an ultrasound as at my age mammograms tends not to show much because breast tissue is too dense.  It took 2 weeks to get in for an ultrasound, and in the meantime, I actually competed in Toronto, Ontario, since there really was nothing I could do but wait. At the time, other than my supervisor and assistant, I had only told my dance instructor what was going on (and only then because we were going to be competing and I was distracted).

When I got to my ultrasound, they did a mammogram as well, just to be thorough, but I knew there was a problem when the ultrasound tech told me to wait while she got the radiologist and mentioned he might want to do a biopsy.  When the radiologist came in, he told me they were seeing not one, but two lumps and that he was going to biopsy both.  Then he said words that ran my blood cold–‘At this point, we aren’t looking anymore to see if you have cancer, we are looking to see what type of cancer you have.’

I was floored because a) I didn’t know there were different types of cancers and b) I was 35, had no family history of breast cancer, and I was still working on the theory it was ‘just a cysts’.

Seeing my reaction, the radiologist amended to say ‘But it could still be just an abnormal presentation of a pappilioma….but it doesn’t really look like that’.

What followed were the longest 10 days of my life.  I stayed busy with work and dance (even did a showcase), but came down with a horrific bout of the flu on November 19th.  I remember the date exactly because after being sent home on sick leave, my doctor, surprised my biopsy results weren’t back, tracked them down and called me to tell me that the biopsy was positive for Invasive Ductal Carcinoma–the most common type of breast cancer.  She told me she was referring me right away to a surgeon to have it removed.  I still had the flu, which for some reason struck me as funny.

When I was first diagnosed, I was told it should be as simple as removing the tumours, some radiation, then some hormone therapy and that would be all.  There was mention of the possibility of chemo therapy, but based on what they had seen, they didn’t think it would be necessary, but all would depend on the results from my surgery.

My surgery was December 9th, 2014.  The plan was to do a ‘lumpectomy’ or ‘partial mastectomy’ to remove the tumours and a Sentinel lymph node biopsy to remove and check the first line of lymph nodes (basically the lymph nodes that are first to receive fluid and tissue, like cancer, from other areas of the body).  The preparation for the surgery involved placing a wire in the smaller tumour using the ultrasound as a guide so the surgeon would know where to cut.  This is when things started to change for the worse.

When placing the wire, the radiologist told me that he needed to place not one, but two wires because there were numerous new ‘spots’ showing up on the ultrasound.  He couldn’t really say what those ‘spots’ might be, but considering my recent history, I had a pretty good guess.

The surgery went very well, but I could tell something had changed when the surgeon visited me in recovery.  Suddenly it wasn’t ‘IF’ I needed chemo, it was ‘When’.  The surgeon told me she had to remove a lot more than she expected and that I was being referred to the cancer agency to a medical oncologist.  It would be another 10 days before I would have the pathology reports from the surgery that would say if the surgery had been successful, what they had found and that plus my age would determine what happened next.

In the end, the surgery was only a partial success.  The original two tumours found on my first ultrasound sprouted 18 babies (those were the ‘spots’) in the time between the ultrasound and my surgery.  In addition, all of the invasive tumours were discovered to be surrounded by another less invasive type of cancer called DCIS–Ductal Carcinoma In-Situ–which never showed up on any scans or tests prior to surgery.  They also removed two lymph nodes from under my right arm, one of which also had a tumour–which thankfully was ‘encapsulated’ meaning it was contained and not spreading cancer cells throughout my body.  My surgeon removed as much of the cancerous breast tissue as she could, but while there was ‘clear’ tissue around the cancerous tissue they like to have borders of 2 mm all the way around for the surgery to be considered a success.  Most of my borders were less than 1 mm.

Being a little overly passionate about dance, I decided to do a competition between my surgery and starting chemo.  Why? a) it was on my birthday and I didn’t want to spend my birthday starting chemotherapy and b) I wanted to do something for me before I gave myself over to the treatments.  I had my doctor’s blessings and it actually didn’t delay anything as it worked out that I would have started chemo the following week regardless due to scheduling.

All of this added up to my needing a cancer treatment plan that includes 6 months of chemotherapy (started January 23, 2015), 6 weeks of radiation (still waiting to confirm the exact date for that–should be in August), and at minimum a full mastectomy on the right side (I have chosen to do a double mastectomy with reconstruction, which I will talk about in a different post that will probably take place in August).

I am currently coming up on 20 weeks of 24 weeks of 16 chemotherapy treatments.  I started with 4 treatments of ‘AC’, which is referred to as the ‘red devil’ because of it’s toxicity and side effects once every 3 weeks and, after a brief visit in the hospital with a respiratory infection that resulted in a 1 week delay, switched to weekly treatments of a drug called ‘taxol’, which I have 4 left.  July 10th is my last treatment and I cannot wait!

Some basic questions you might have–yes, I lost my hair, but it is growing back now slowly.  Yes, I have been sick with side effects, but I have been very very lucky to not have extreme versions of them.  All of my doctor’s are encouraging me to keep dancing through my treatments–within reason. Being active helps keep me positive, helps keep the side effects at bay, and helps me from gaining too much weight from the large amounts of steroids that come with Chemo to help manage the side effects.

I hope I haven’t written too much, and that you don’t find it difficult to follow.  I want to set the background before I move forward.

I want to leave by saying that I am incredibly blessed and lucky that I went to the medical clinic and started the diagnosis process when I did.  Even delaying a week could have changed a ‘stage II’ diagnosis which I have to a ‘stage IV’ diagnosis which as much much graver consequences.  Even with my small ‘margins’, all of the treatment I am undergoing right now is focused on lowering the chances I will face cancer again–the point is to make sure there are not microscopic cancer cells hiding in my breasts or lymph nodes or anywhere in my body by aggressively attacking and killing any that might be hanging around.

There is no reason to think that after my surgery in October I won’t hear the words ‘you are now in remission’, and I look forward to hearing that and dancing my way into the future.

If you find a lump in your breast–even if you are not sure–don’t dismiss it! 80% of breast lumps are harmless and benign, but only by testing can you be sure it is ‘just a cyst’.

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