A week is a long time to ponder a cancer diagnosis. Luckily, we were away celebrating our first wedding anniversary so had ample distraction in the form of the city of Bath and a handful of dead Romans.
It’s very hard to block out a potentially terminal illness. It plays with your mind. Mixing it with some overthinking and a hunk of red wine doesn’t make for a great Saturday afternoon. However, we celebrated, spa’d, and enjoyed a more sober Sunday and Monday. Ate a lot of great food, I discovered Steak! And we were ready to return for the key meeting.
My formal diagnosis meeting was with Mr Young, my consultant.
Keith had spent the week holding onto the 10%. He was confident we were due the luck. He struggled to accept the possibility of cancer more than me. He said he’d rather have it twice than have me repeat his year. I was confident that telling someone they had cancer when they didn’t went against the medical oath ‘do no harm’.
Let’s make it official
In the waiting room, it dawned on Keith that had the tests come back benign we’d not be sitting there. That they’d have made a simple, and much cheaper, phone call. When a Breast Cancer Care nurse called my name we had the answer. You don’t get a ‘team’ meeting if you’re cancer free.
Mr Young, my consultant, taught Dr Elder most of what he knows. I know this thanks to Keith’s diligent note-taking from meeting one, and it’s immediately obvious. Mr Young is calm and confident, very friendly and very relaxed, which is comforting but I wanted only one sentence to leave his lips.
He asks what Kenny - Dr Elder - has told me. We shorthand through the 90-10, 5/5 tests, poor odds. He nods and agrees with Dr Elder, adding that the biopsies have confirmed that I do have cancer.
Grade 3 - but don’t confuse this with the Stage, we’ll come back to that - it’s an unusual cancer. It’s not one they see often. It’s non specific. It’s HR positive which means it feeds off oestrogen. We’ve caught it early, so it’s only Stage 1. He nods pointedly throughout to gauge my acknowledgement, since I am silent.
He holds my gaze to reiterate that it’s curable - Dr Elder has this characteristic nailed - and tells me that the biggest challenge with cancer and treatment is psychological. He could clearly tell I wasn’t really listening. Every part of me sat crossed, my legs, my arms, my hands. I sat nodding at him. Not talking much but also not crying, I was mentally prepared for this.
I have Stage 1 (caught early) Carcinoma of the breast.
It’s Grade 3 (looks different to normal breast cells and is usually fast-growing and aggressive, likely to spread).
It’s officially called Invasive ductal carcinoma of no special type.
It feeds off of oestrogen*, the hormone you produce on the daily.
Options and next steps
We start to chat about children, whether we have any or want any in the future. That we can do emergency IVF. We begin to cover my treatment options; surgery plan A and B, chemotherapy, radiotherapy, Pertuzumab: a new biological drug, Herceptin. He tells me again that it is curable.
He checks my lump for himself, carefully, knowing that it’s still healing post-biopsy. He confirms my lymph nodes feel normal. He guides me back to sitting by pulling me up with one hand whilst the other is on my back. He tells me again that it is curable. He tells me the drugs are brilliant nowadays. He tells me I’ll only be on them for 5 - 10 years.
I am to meet Larry - Dr Hayward - my Oncologist this week, my appointment is Friday and Larry will help me make a decision as to the best treatment route. He reminds me that the treatment plan we put in place is my decision.
We’re wrapping up and as I stand I tell him I take a lot of decisions at work, I’m okay if someone takes it for me. Because really, I’m okay not taking this decision. Just tell me what to do.
Bring me the A Team
Mr Young is known as Olly to everyone I’ve since met. Following this meeting I trawled the Internet for information on him, I googled every member of Keith’s team when we got started too. If you know how to search efficiently you can uncover all sorts; journal articles, biographies, private healthcare summaries, official board papers, a doctor’s death statistics dating back a while, should you ever wonder.
Of course, it doesn’t matter what your Google uncovers, this person has your life in their hands for the foreseeable. You’ve already formed a trust bond. You’re already bought in.
Dr Olly - the moniker we’ve given him because Olly feels too informal and Mr Young seems to juxtapose his character - is great. He’s calm and direct, swears a bit, with just the heap of arrogant confidence you want in someone charged with a scalpel and your person.
But we won’t see or chat with Dr Olly again for a while, although he technically oversees my care journey. My surgery, and his part of the puzzle, will follow chemotherapy and therefore I am now in the hands of my Oncologist, Dr Hayward.
We found this switch between doctors and specialities hard during Keith’s treatment. Just as you get used to one doctor they switch out and you need to get acquainted with another. Then you begin to rationalise and suddenly take comfort in the expertise you’re building around you. The big cancer safety net, made up of years of medical dedication, is folding itself around you.
I’ll take as many doctors as the NHS will throw at me.
*Oestrogen regulates your periods and menstrual cycle, but also affects the urinary tract, the heart and blood vessels, bones, breasts, skin, hair, mucous membranes, pelvic muscles, and the brain. It’s feeding my Cancer and I need it every waking day.