I see ye visibly, and now believe
That he, the Supreme Good, to whom all things ill
Are but as slavish officers of vengeance,
Would send a glistering guardian, if need were
To keep my life and honour unassailed.
Was I deceived, or did a sable cloud
Turn forth her silver lining on the night?
I did not err; there does a sable cloud
Turn forth her silver lining on the night,
And casts a gleam over this tufted grove.
John Milton, Comus: A Mask Presented at Ludlow Castle, 1634
February 10, 2016 – Devastated. Hopeless. Unsettled.
That is how I am feeling after my post surgery follow-up appointment with my surgeon, Dr. Pinchuk, and my oncologist, Dr. Robson, of North York General Hospital, yesterday afternoon.
I went to the appointments full of optimism, expecting to hear that my breast cancer was mostly done and done, and that I would receive dates for when I can start radiation treatment and then I would be in the clear. But that is not what happened.
Dr. Pinchuk started by saying that my surgery was successful. He had removed the tiny 14 mm tumour in my breast, as well as surrounding tissue and the pathology report showed that there is no remaining cancer in my breast. He checked the site of the surgery and gave me the thumbs up that I am healing as expected. But even as he was giving me this great news, I felt uneasy. I felt in my gut that there was more information coming — and that it would not be good news. And it wasn’t.
As part of the surgery, Dr. Pinchuk removed 16 lymph nodes from my underarm. The pathology report showed that every one of the 16 lymph nodes had cancer:
Metastases – I hate that word – meaning that the cancer has spread from its original tumour in the breast. And, one of the secondary tumours is more than twice the size of the original tumour (35mm vs 14mm)! How did I not feel a lump bigger than 1.5 inches under my arm?
This is devastating news and a disappointment for both doctors. Based on all factors, my diagnosis has been confirmed as Grade 2 DCIS (Ductal Invasive Carcinoma In Situ), Estrogen Positive, Progesterone Negative, HER2 positive, with metastases in the lymph nodes; in other words, Stage III Advanced Breast Cancer.
Dr. Robson indicated that, with this level of cancer activity, it is highly likely that the breast cancer will return – and return with a vengeance – if it is not treated aggressively. So the plan is a combination of chemotherapy, antibody therapy, radiation, anti-hormone pills and, sometime down the road, bone strengthening therapy.
The next step is 6 cycles of chemotherapy (TCH) given by IV every 3 weeks, for a total of 18 weeks. The plan is to start the chemo mid-March after I heal from the surgery. This will take me to mid-June. After the chemo, I will need targeted radiation treatment to zap any cancer cells that may still be lurking. The radiation is expected to take 5 weeks, every day from Monday to Friday.
I am not sure how to process this information and am sitting in this place of loss, of sadness, of trying to make sense of this. Yesterday, I was sobbing so much that poor Dr. Pinchuk kept coming back to me to ask if there is anything he could do. He gave me a bottle of water. Then he gave me a power bar – and one for Nagib. Dr. Robson’s face was ashen as he delivered the news.
I continue to shed many tears today as I think of what lies ahead, and for putting my family through the cancer roller coaster again.
Yet, through all of this, I see the “silver lining” and know that God is watching over me. What if I had not felt that tiny lump in my breast early on? So tiny that my family doctor could not feel it, yet trusted me enough to send me for a mammogram. So tiny that two other doctors who subsequently examined me, had difficulty finding the lump so deep in my breast. If I had not caught it early, chances are that the cancer would have spread through my entire body.
I am also encouraged by the fact that the 5-year survival rate for breast cancer is a whopping 88%. That’s impressive given that 25,000 women are diagnosed with breast cancer each year. I like the odds and will move forward with courage. I have to believe that God has a master plan for me and I have faith that He will give me the strength to overcome this new adversity.
As John Milton says in the above quote, “the Supreme Good … would send a glistering Guardian, if need were to keep my life and honour unassailed.”
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