Guest post by Stephanie @ Bah! to Cancer
I found a lump in my right breast towards the end of September 2008.
Now, let's get off on the right foot here. The sentence above implies that I have some kind of breast-examination regime in the manner of a proper grown up, but that's not the case; I am the kind of person who, after buying shoes reduced from £100 to £50 in a sale, thinks that she has £50 to spend. At 37, I had only just got round to starting a pension. Sparkly things fundamentally, thoroughly thrill me. The reason I found the lump was that I could see it. I was walking past the mirror on my way to the shower, the light caught a distended area at the top of my right breast, and I thought ‘Hmph! That spoils my line’ and had a bit of a feel. There was definitely something there. I consulted Alan, my husband, who was happy to do a bit of feeling, but less happy to confirm my findings, and so off I went to my GP.
Dr Adeyemi asked me about family history (no) and other risk factors (no, no, no) It was a cheery consultation, and we agreed that the lump was probably a cyst, but he referred me to the Breast Unit at St George's Hospital in Tooting just to be on the safe side. This seemed sensible to me and I was happy to go along.
Dr Adeyemi asked me about family history (no) and other risk factors (no, no, no) It was a cheery consultation, and we agreed that the lump was probably a cyst, but he referred me to the Breast Unit at St George's Hospital in Tooting just to be on the safe side. This seemed sensible to me and I was happy to go along.
Less than a week later, the nurse practitioner at St George's also agreed that it was probably a cyst or a ‘fatty deposit’ (nice) but sent me for an ultrasound scan and mammogram anyway, and then stabbed me with a needle (it's called a fine needle biopsy apparently, took about 5 seconds and didn't hurt a bit).
A week or so after that I got a letter, slightly less cheery in tone, saying that although we all still agreed the lump was probably nothing to worry about, we think it might be worth having an ultrasound-guided biopsy just in case. (Nobody said just in case what yet, but we all knew. I started to get a bit antsy at this point.) The biopsy would also take in an irregular area in the left breast identified by the ultrasound.
The ultrasound-guided biopsy was where I started to suspect that the cheeriness had turned to kindness and compassion in the face of The Word No-one Had Yet Mentioned. First of all, as well as the radiographer, there was a nurse there whose job seemed to be to hold my hand. This set of biopsies was a bit more involved than the earlier brief stabbing. First, it involved local anesthetic (numb breasts - that's so weird). Then the radiographer made some incisions – they are very good at distracting you from looking down at yourself once the anaesthetic has gone in, but I was aware of a bit of mopping of blood. Then there were 4 goes each side with a spring-loaded hollow needle. The part of me that enjoys medical documentaries found this quite interesting. Once the radiographer has found the area to take a sample from (there was some shoving to get to that point), there is a loud click, which is the sound of the spring-loaded part of the needle popping out and in again and taking a cylinder of tissue with it. The tissue then goes into a little basket and can go to the lab to be sliced and examined. Once all of the samples had been taken, the incisions were covered up with steri-strips and I was swathed in dressings and sent off before the anaesthetic wore off. (Very clever, hospital people.) By the time I got home, the bruising and aching were kicking in, and the whole of the afternoon was pretty miserable. I think I watched TV, which I would never normally do during the day, although as it happened, this was good training for what was to come.
The reason that that afternoon was so wretched (quality of TV programming aside) was that this was the time that I started to seriously contemplate the idea that I might actually have cancer. Not the cyst or the fatty lump, but the cancer. Not the amusing dinner party story about how my breasts were almost entirely purple and yellow after the ultrasound guided biopsies, but the cancer. Not the evening of relieved phone calls to the few people who knew about the tests, but a much bigger round of much more difficult conversations. At this point, I wasn’t even think about the bigger implications. These little ones were enough to make me a blubbering wreck by the time Alan came home.
The ultrasound-guided biopsy was where I started to suspect that the cheeriness had turned to kindness and compassion in the face of The Word No-one Had Yet Mentioned. First of all, as well as the radiographer, there was a nurse there whose job seemed to be to hold my hand. This set of biopsies was a bit more involved than the earlier brief stabbing. First, it involved local anesthetic (numb breasts - that's so weird). Then the radiographer made some incisions – they are very good at distracting you from looking down at yourself once the anaesthetic has gone in, but I was aware of a bit of mopping of blood. Then there were 4 goes each side with a spring-loaded hollow needle. The part of me that enjoys medical documentaries found this quite interesting. Once the radiographer has found the area to take a sample from (there was some shoving to get to that point), there is a loud click, which is the sound of the spring-loaded part of the needle popping out and in again and taking a cylinder of tissue with it. The tissue then goes into a little basket and can go to the lab to be sliced and examined. Once all of the samples had been taken, the incisions were covered up with steri-strips and I was swathed in dressings and sent off before the anaesthetic wore off. (Very clever, hospital people.) By the time I got home, the bruising and aching were kicking in, and the whole of the afternoon was pretty miserable. I think I watched TV, which I would never normally do during the day, although as it happened, this was good training for what was to come.
The reason that that afternoon was so wretched (quality of TV programming aside) was that this was the time that I started to seriously contemplate the idea that I might actually have cancer. Not the cyst or the fatty lump, but the cancer. Not the amusing dinner party story about how my breasts were almost entirely purple and yellow after the ultrasound guided biopsies, but the cancer. Not the evening of relieved phone calls to the few people who knew about the tests, but a much bigger round of much more difficult conversations. At this point, I wasn’t even think about the bigger implications. These little ones were enough to make me a blubbering wreck by the time Alan came home.
A fortnight later, and it was back to Breast Clinic for the results. Alan was meeting me at the hospital, and as I walked down the road, I had a moment of absolute clarity that I was going to be told that this was a cancer, and I was shaky and afraid. I met Alan, and as we headed in to the clinic, I noticed something that looked like ‘pre-operative’ highlighted next to my name on the receptionist’s sheet.
Alan and I waited, and I counted how many women were wearing hats indoors. (Lots. And not many with hair sticking out from underneath.)
We didn’t have to wait long. Joe, the nurse practitioner, called me and I went into a consulting room. Alan stayed in the waiting area. I’m not sure why. Maybe we were just obedient in the face of institutionalization – he wasn’t called. Maybe it was the last part of me grasping at a quick in-and-out ‘that’s all fine, Mrs Butland, nothing to worry about’ type consultation. Anyway. It all got a bit Pinteresque at this point, so here’s the script.
[STEPHANIE enters a small, almost windowless, stuffy office, with a door from the clinic waiting area and two other doors adjoining consulting rooms within. JOE, the nurse practitioner, is already is in the room. There’s a box of tissues and a fat blue file on the desk.]
JOE
(Kindly, looking me straight in the eye) We have your results, Stephanie, and there is a cancer in your right breast.
ME
OK. Right. (I look down at my breast, as if for confirmation; a sort of cheery ‘hi, it is me after all’ from the lump)
(Mr MOKBEL enters from one of the side rooms and sits behind the desk.)
JOE
This is Mr Mokbel, one of our consultant surgeons. [To MR MOKBEL] I’ve just told Stephanie that there is a cancer in her right breast. (To STEPHANIE) I’m so sorry. I really thought it was nothing.
ME
Shall I get my husband in?
JOE
Of course.
[ALAN enters and sits down. General greetings and introductions.]
ME (to ALAN)
I do have a cancer in my right breast. (to JOE) Which presumably means that the left side is OK?
(JOE and MR MOKBEL exchange a look)
JOE
Well..
MR MOKBEL
We know there is a cancer in your right breast. We think it is quite small and we have caught it early. We need to remove the lump.
ME
Not the breast?
MR MOKBEL
The lump only. And at the same time we will examine the lymph nodes under your arm to see whether the cancer is there. If it is, we will take out the nodes.
ME
(holding ALAN’s hand, probably quite tightly) Not the breast?
MR MOKBEL
Not the breast. (A small part of my brain hangs up some bunting. I have been bosomy for 25 years or so and am not ready to stop now.)
ME
Good. That’s something.
MR MOKBEL
On the left side, there is a small group of cells that don’t look normal, but may not be cancerous. We would like to take them out so we can examine them properly.
ME:
(crying a little)
[Everyone makes sympathetic noises, including CHARMAINE, the MacMillan nurse, who has come in unnoticed at some point.]
No, it’s not that, it’s just that.. my Mum will be so upset.
MR MOKBEL
The prognosis is excellent, We have caught this very early, and you are young and in good health.
(Someone asks about what happens next. I’d like it to have been ALAN as he doesn’t seem to have said anything yet, although he was doing stalwart hand holding and eye contact.)
It all goes a bit blurry after that. Alan and I were ushered off to talk to Charmaine about what would happen in more detail. We talked about who to tell, how to tell them, and the possibilities of what the treatment would be like (which turned out, by and large, to be much worse than they actually were). We came away with a whole lot of leaflets.
We agreed, on the way home, that this was not the end of the world. We agreed that it was ‘a cancer’ rather than Cancer and we would encourage everyone else to think of it that way. We told the people who knew that I was going to get the news that afternoon. Then we decided we needed a drink, and as the only thing chilled in the fridge was a bottle of champagne, we drank that.
Very nice it was too.
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