The Memory of My Cancer Diagnosis Will Stay With Me Forever
Several years ago, I was diagnosed with bilateral breast cancer. I was lucky, and made it through to the other side. But years later, I can still recall the shock and trauma of hearing those dreaded words, “I’m very sorry to tell you….”
I’d put off seeing my GP for weeks. Though I knew the lump was there, a large swelling on the inner side of my left breast, and had noticed it was growing at an alarming rate, I kept telling myself it was probably just an odd, but entirely benign cyst. At 38 years old, I was convinced I was too young to get breast cancer and, besides, apart from one great Aunt who died of the disease back in the late 1970s, there was no family history. No, I was just being paranoid, I decided. There was no way I wanted to risk showing up at my local GP surgery and being dismissed by the doctor as a silly, time-wasting hypochondriac.
When I started having terrifyingly vivid nightmares about dying on an operating table in my local hospital, I knew I had to have the lump investigated, or else I’d never get a decent night’s sleep. When I arrived at work that morning, I snuck into a quiet room and called the surgery, who scheduled an appointment for me the following day. That night, I had another nightmare, this time involving Terry Jones from Monty Python dressed in a comedy nurse’s costume and slowly cutting off my left breast with a pair of nail-scissors. As an avid Python fan since childhood, I didn’t really know whether to laugh or to scream.
As I’m sure you have already surmised, the doctor did not dismiss me as paranoid malingerer. (And, let’s be honest, how many of us have ever really been laughed out of a doctor’s office for simply asking, “Should I be worried about this thing, doc?” That’s what doctors are there for- to answer our health questions, reassure us if there’ nothing to be alarmed about, or investigate further if there is something unusual happening. The moral of the story; don’t let embarassment or shame delay you from seeing your doctor if you notice anything irregular going on.) Instead, as she performed a breast exam while I nattered away nervously, I watched her expression grow slightly darker as she said, “I am actually a bit concerned about this lump. I’m going to make an urgent referral for further investigations.”
I can still remember leaving the surgery and walking to the train station to make my way, belatedly, into work. I recall it was a beautiful sunny day in early March, with bright blue skies and the happy yellow bulbs of the daffodils waving in the slight breeze. I remember feeling dazed, and a little bit angry that the world could have the cruel audacity to suddenly look so beautiful when I was facing the possibility of not being in it for very much longer. As the train trundled its way through the pictureque fields of Hertfordshire and into London, I fantasized about going for a long stroll out in nature with my (long-deceased) pet dogs, petting the long muzzles of the horses in those paddocks and looking into their dark but comforting eyes, murmuring, “I think I could be dying, horsey, and even though I hate my life sometimes, I don’t think I’m ready to leave it just yet…”
When I got to work, I gave my manager the heads-up about the situation, as attending the necessary appointment/s would necessitate me being out of the office and, as she was not just my manager but a good friend, I didn’t want to lie to her about where I was going. I was (or was trying to be, at least) very calm and light-hearted about it- “I’ve got this stupid lump in my breast, oh, I’m sure it’ll turn out to be nothing but the doctor says I need to get it checked out just to be on the safe side”- but inside, I was spinning. She looked at me with her mouth slightly ajar and tears welling in her eyes as she assured me that whatever time I needed to take off for appointments would be 100% okay, and that if I wanted to take some time off work for “personal reasons”, I need only to ask and it would be granted. She asked me how I was doing and, whilst trying desperately not to burst into tears, I responded with the same lie I would end up repeating ad nauseum for the next ten months and beyond; “I’m fine.”
Two weeks later, I found myself sitting in an outpatient Breast Clinic with many other women and a couple of men (yes- though it’s more rare, men can get breast cancer, too), each at different stages of their “cancer journey” (makes it sound like a scenic package-cruise along the Nile, doesn’t it?). There were elderly women in their 70s or 80s, some looked to be in their 50’s, and there were people there who were younger than me. I had never realised just how prevalent the disease was in the community, and how age, race, class-status, and even sex is no protection against developing breast cancer. Indeed, according to the World Cancer Research Fund (WCRF), breast cancer is second-most prevalent type of cancer globally, second only to cancer of the lung.
When the breast cancer consultant examined me she, like my GP, frowned and said, in as reassuring a voice as possible, “I may be wrong, and I don’t mean to alarm you, but I‘m very worried about this.” Oh. Shit. I was asked to return to the waiting room where I would soon be called into another room for an ultrasound scan of the breast and a core-needle biopsy.
I waited for hours, with the “Astral Weeks” album by Van Morrison playing quietly on my earphones. I still can’t hear “Slim Slow Slider”, with its closing refrain “I know you’re dying baby, and I know you know it too”, without my mind being pulled back into that brightly-lit clinic where I sat in a hospital gown staring dazedly at a display case full of information and support pamphlets, awaiting my turn to be pulled, prodded and pierced, and feeling so afraid and so alone.
By the time it was all done, the ultrasound performed and the biopsy taken (the punch of the biopsy needle being hammered through my breast and into the lump that was soon to be re-branded as “The Tumour” made me feel like a vampire being staked through the heart), the business day was drawing to a close and I had been in the clinic for nearly six hours. Though I’m sure many readers will think me incredibly foolish and irresponsible for thinking it at this of all times, all I could focus on at this point was how desperately I wanted to get outside for a cigarette. I was called in to speak to the consultant again one final time, told that an appointment had been made for the same time the following week to get the results, and finally allowed to put my bra and my shirt back on as I prepared to head back out into natural light once more.
I texted my manager to let her know I’d only just got out of the clinic and I was going to head straight home to take some paracetemol (for the ache in my boob from the biopsy) and have a lie down. Of course, she told me that was fine, and assured me that I could take the following day off, too, if I needed/wanted to do so. Honestly, though, I needed the distraction of work to keep my mind from being consumed by fear and anxiety, and for the next seven days, I did everything in my power to keep busy and to avoid thinking about what was coming.
The following week, I found myself back in the waiting room of the Breast Clinic and preparing myself for whatever I was about to be told. Weirdly, despite the fact that it seemed to me a foregone conclusion at this point that the news was going to be bad (after all, every medical professional I had encountered so far, from my GP, to the breast cancer consultant, to the imaging team that had scanned and biopsied the lump, had made the same tight-lipped face when they saw the very large growth on the side of my breast, and that couldn’t be a good sign, could it?) it was still a shock when the same consultant I had seen the previous week said, “I’m so sorry, X [my real name], but it is cancer.”
I think I said, “Oh, fuck”, then “sorry for my language.”
She went through some of the technicalities; the type of tumour it was (mucinous carcinoma), the prognosis, the next steps, then invited the Cancer Nurse Specialist (or CNS, also called Clinical Nurse Specialists) in to join our conversation. To be honest, I didn’t take much of the information in, because the diagnosis was still repeating inside my head over and over again, as if my brain were a vinyl record and the news had caused a sudden imperfection in one of its grooves that was causing the stylus to jump:
“I’m so sorry, [X], but it is cancer” click “I’m so sorry, [X], but it is cancer” click “I’m so sorry, [X], but it is cancer” click “I’m so sorry, [X], but it is cancer”….
I guess any medical professionals that have to break bad news to people on a regular basis are used to this kind of numb, shocked and uncomprehending reaction from their patients, as they explained that I could go and grab a coffee or get some air (you may not be surprised to learn that my fresh air was not quite so fresh and was heavily laden with tobacco smoke and nicotine) and that I should come back for a meeting with the CNS in half an hour, where she would go through everything again, give me a load of information about breast cancer, support and counselling services. When I broke the news to my sister that night and, over a couple of bottles of chilled rosé and some fancy biscuits from M&S Food, the two of us went through the literal box of information and resource materials the CNS gave me, we referred to it as my “Breast Cancer Welcome Pack”, laughing through our tears just as we have done since we were kids.
Telling my sister and then, that weekend, Mum and Dad (over a long-distance phone call, as they were living on the other side of the world), made it all so real. When I told my sister, it was the first time I had said the words “I have breast cancer” out loud, and I burst into tears as soon as the sentence came out of my mouth. The following day at work, I told two more people; managers further up the food chain, who would need to be aware of the situation and the fact that I was going to be requiring a lot of time of work.
Though I swore them to secrecy for the time being, I knew that I couldn’t keep my diagnosis a secret forever. Even if I chose to play my cards close to my chest, and even if my repeated early departures from the office to attend clinic appointments and CT and MRI scans failed to raise my collagues’ eyebrows, I would require a few weeks off post-surgery and, if I ended up needing chemotherapy (at this stage, the jury, or more accurately, the multidisciplinary team, was still undecided), that was going to be impossible to keep hidden.
But, I didn’t want people to worry about me, I didn’t want to answer their inevitable questions, I didn’t feel comfortable being the focus of people’s attention and, more than anything, I couldn’t deal with the looks of pity and, sometimes, tears that ensued as I gradually came clean. Though of course, I was touched by their care and their kindness, I’m an introvert (which may surprise you if you’ve ever visited my blog!), I don’t know how to cope with being seen and, at the time, I (wrongly) equated being ill with being a failure.
Subsequent investigations revealed that my cancer was bilateral, meaning that it was in both breasts. However, I was incredibly lucky (and pretty unusual) in that my multiple tumours were not the result of metastatic cancer (cancer from one primary tumour that has travelled into the lymph nodes and is spreading through the rest of the body) but of three individual primary tumours. I went through two separate surgeries, in between which I had an investigative procedure known as an MRI biopsy on one of the tumours, that was so painful and unpleasant that as I sat in Kings Cross Station waiting for the train home, I made an international call to my Mum, time-difference be damned, and bawled. She told me later, “I knew it must have been absolutely dreadful, because for you to ever admit that you were hurting, it could only mean it was sheer hell.” How well she knew me…
In the end, I was incredibly lucky, and I didn’t require a double mastectomy. Instead, I underwent two lumpectomies, known more commonly in the UK as wide-local excisions, the three-pronged adjuvant cancer treatment regimen of chemotherapy (for me, it was six sessions of FEC chemotherapy), radiotherapy, and endocrine therapy.
My endocrine treatment drug was Tamoxifen, but I only took it for two and a half years (when I started, five years was standard, but doctors now recommend ten years) before stopping the medication (following discussion with my doctors). This was due to the side-effects of severe brain-fog and my propensity to grow uterine fibroids whilst taking the drug, which lead to an excruciating gynaecological procedure called a hysteroscopy which, for reasons too complicated to go into here, I had to undergo whilst awake, despite the gynaecologist’s suggestions. It was horrendous!
My breast cancer treatment is behind me now (touch wood) and I was finally discharged from the outpatient Breast Clinic in 2018. I am incredibly fortunate to be one of the estimated 600,000 people in the UK still alive after a diagnosis of breast cancer. With improvements in screening, earlier detection and advances in cancer treatments, this is predicted to rise to 1.2 million in 2030.
It was a life-changing experience, and I will never be quite the same person as I was before breast cancer, in ways both good and bad. I learned a lot about my resilience and my coping skills, and with the passage of time, the memories of my cancer experience have started to lose their sharper edges. But the initial discovery of the lump, and the shock and trauma of my breast cancer diagnosis will remain with me forever, a vivid recollection of the time when life suddenly grabbed me by the throat and forced me to confront my own mortality.
Dedicated with love and strength to everyone going through their own cancer journey.
Enquiries and comments are always welcome. You can also find me on Twitter @GrantJupiter