Munira Premji

 

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:

Lymph Nodes

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.”

– Munira.

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21 Comments

  • Anonymous , February 18, 2016

    God bless you Munira!
    I heard about you from my friend who is also yours.
    From what she says and, what I’ve read in your blog…
    You are beautiful life force with a warrior strength!
    A.J.

  • Megan Burgess , February 16, 2016

    I am almost in tears reading this, how can a person be so strong and continue to go on? You are such an inspiration and if anyone can continue to emerge stronger and more incredible from the challenges life throws at them, it will be you.

    I don’t remember if you said it to me personally or wrote it in your blog at some point, but I have a faded sticky note on my desk that says, “Every day, in every way, I am getting better & better and stronger & stronger.”

    I believe in you and if there is anything I can ever do, please reach out and let me know.

    Megan

  • Nargis Hajee , February 14, 2016

    We pray for your speedy and painless recovery with good health, strength, courage, peace and happiness as well as for your protection against any adversities in your life. Ameen.

  • Anonymous , February 14, 2016

    Don’t know if you remember me Munira, but we were in college in the 70’s when you were in Nairobi.
    We spent some good months together until you moved to Canada. When I read your story I could not
    believe how strong you are and how strong your faith in God is. Praying for you all the way from Nairobi, Kenya. Keep strong!

  • salome , February 14, 2016

    there is a reason for all of these things happening… be positive…take each day at a time, dont let depression sink in ,it will be even harder…..weare all with you ,i mean our prayers,
    eat healthy as usual ,we cant stop diseases from coming ,but have some control on how to manage it ,shouldnt we ? it is not your fault ,dont regret,dont feel bad , dont look back

  • Elizabeth Lancaster , February 14, 2016

    Munira,
    Wow. This totally sucks.
    Two things I know for sure about you are that you know how to love and you know how to live. Here is to your full recovery – something your body knows how to do in the face of the obstacles it has encountered.
    And at every step of the way, I’m both wishing and reflecting the power of your incredible love and your unparalleled ability to fully live life – magnified and multiplied by all the people around you whom you’ve touched and who encircle you with care.
    Elizabeth

    PS piss off cancer

    PPS apologies for any offence my language may cause anyone on this post. Definitely not the intention!

  • shamim Bhayani , February 13, 2016

    My Dearest Mukhianima,
    I am speechless, my heart goes out to you. I am so sorry to hear this news. I know that it’s easier said than done, but hang in there – we are all praying for you. Yes, cry as much as you need to (I am crying with you), but then get up again and fight as you always do. With Allah’s grace you will conquer this cancer.
    I am there for you and your family in any way you need.
    Wishing you a full recovery,

    Shamim

  • Begum Janmohamed , February 13, 2016

    Mukhianii Maa, Our prayers are always there. We know, you are very strong and will be able to handle this new problem. You are very strong MAMA who has good family and friends to pray for you.

  • Kathy Thom , February 13, 2016

    “Hope is the thing with feathers
    That perches in the soul,
    And sings the tune, without the words,
    And never stops at all.” (Emily Dickenson).
    Like mountains that you’ve climbed and challenges that you’ve conquered in the past, you’ve got this my dear friend. We’re here to help in any way that you need us to.

  • K. Amersi , February 13, 2016

    Dear Munira,

    I keep you and Nagib and family in my daily prayer, that you may be absolutely guided and protected through your journey.

    I am inspired by your faith.

    Sending you strength and courage and heartfelt wishes for healing.

  • May , February 13, 2016

    Munira, I am sadden to hear this news. Please know that I am hear for you if you need a friend to hold your hand. My love and prayers are with you

  • Safia , February 13, 2016

    “These things I warmly wish for you: someone to love, some work to do, a bit o’ sun, a bit o’ cheer, and a guardian angel always near.” – Irish blessing

    That angel – the silver lining – is always with you Munira Aunty. You hear her, and she listens…#smallmiracles filled with big love. May she continue to illuminate the way <3

  • Anonymous , February 13, 2016

    It’s very sad..We are praying for you..Inshallah, everything will be fine..

  • Alysha , February 12, 2016

    Dear Mukhiani Ma,

    In my heart I know you will fight this battle and win. You are always in my prayers and your faith and support of family and friends will bring you the strength and courage to overcome the obstacles ahead. Think about you always..❤️

  • Sabir Kaba , February 12, 2016

    Our Dearest Mukhianimaa,
    Our prayers and good wishes are always with you. We are all full of tears and heavy heart to hear this news. Please call upon us anytime, if you need us even if it’s a shoulder to cry upon or tell you my of my corny jokes to bring a smile on your face.

    Love, Sabir & Yasmina

  • Shain Hajee , February 12, 2016

    Dearest Munira, you are a great inspiration to all of us. We need you . We love you very much. The whole family is praying for you including mom and dad. I’m sure you’ll pull another “Muni”. God be with you and guide you.

  • mylegacytoyou , February 12, 2016

    Dearest Munira,
    I am all yours from March to June… I will be there for you any day, any time, in any capacity; to share a laugh, hold your hand (the one not hooked to the IV drip), give you a foot massage, make your bed, give your room a makeover, cook you a meal, sing with you, swim with you, go for a walk with you, grow flowers in your garden, listen to your beautiful voice, and even in your gloomiest hour to share a tear with you. I will be there by your side whenever you need me. I will be your trusty follower once again. You’ve got a support group in your family, friends, and a fan club that are crazy about you… Most of all, you are YOU! Grieve, cry, and even feel sorry for you if you have to but at the end you’ll see that you got this!
    Love you very, very, very much.
    Deva

  • Lynda and Dave Cavanagh , February 12, 2016

    Oh Munira. I am so sad to hear your news. You deserve better. You worked so hard to stay well. But, there is hope. Those doctors of yours are up for the challenge and they want you to survive this. I know you will. It is just all the s… you have to go through to get there.
    You can do it. I know you can. You will be in my prayers every day.
    Lynda

    Sent from Lynda’s iPad

    >

    • mstracyg , February 12, 2016

      Praying for strength as you walk this process out!

  • Naz , February 12, 2016

    Hey Mukhiani, our prayers are with you! I am shedding tears with you, you are a heck of a brave Mukhiani and you will fight it. Love ya!😘

  • Noor , February 12, 2016

    Oh Munira, you are right …what if you had not found that deep tiny cancer the story would be a different one. There is indeed a silver lining and know that all your sisters of different mothers will hold that lining aloft with prayers for however long it takes. Hugs.

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