Defining a Breast Cancer Diagnosis

It is ten days into my first session of chemotherapy and my mouth is feeling like a rough badgers arse. I have a sore on the corner of my lip developing. I've had my bowel movements play up for seven days until senokot came to my rescue. Thrush oh, yeah bloody thrush jeezzzz! I hate thrush. Plus I can’t ignore a tender itchy head also. To sum it up the side effects of chemo are slowly creeping into my life. Yet I still maintain a smile!!!

On speaking with my BC nurse she says, so Sarah when did your treatment start. My reply exactly three years ago today. She said, Oh no back then that was not a true cancer Sarah. No your treatment now? Now I am thinking Mmm! hang on if it weren’t a true cancer what does recurrence actually mean.

Oxford Dictionary time: happened again or repeatedly..

I am such a sarcastic clever arse when people treat me like an idiot. Maybe I should hand the dictionary to my BC nurse next time.. mmm now would I do that?...
Of course I would.. I like to see faces to upturn with frustration...

This is why being a part of the breast cancer lottery within a world of jargon creates anger. Anger because how can you say the start of my treatment actually has no part in a recurrence of stage 3 cancer. I bite my lip with a smile and go up stairs to add a few pounds to the Macmillan coffee morning. On returning home I look at my friend and say, I am just a damned Guinea Pig with a large price tag mounting. If I had lived in America no insurance company would insure me. She tilted her head and agreed because she is from America. We are so lucky in the sense we have the NHS in the UK, but sometimes when I check past blog postings even I have doubts. I know it isn’t the NHS that is the problem, but the constant pressure for cut backs that lead to failings in treatment. My blog is three years of do they? Should they? Have they? Could they be messing up?

I was told when moving to London by nurses who had moved from London. Sarah whatever you do don’t get pregnant whilst you live in London and if you do be on the ball or get back up north. Now for two separate nurses to say that on two separate occasions away from each other says a lot about the NHS system in London.

My BC nurse does have a habit of putting her foot in her mouth at times.
By her saying, but your first lot of treatment did not involve cancer would make anybodies eyebrows raise. The evidence and test results with the word recurrence tell a different story. Were they trying to make savings? Could more of been done to prevent the recurrence? Well plenty people did say why weren’t you on Herceptin on such a strong HER2 result? Even if it was just pre-cancer surely that warranted you having that drug as a precaution measure. The fact Herceptin is advised on a strong pre-cancer diagnosis and has advantages on preventing a recurrence leaves question marks on my treatment I don’t doubt, but while a patient is seen as a mounting pound sign. We are indeed in a dark place.....

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The Dreaded Confirmation Letter

The morning clunk from the . confirming my up coming treatment...

Dear Miss S,

Re: Mendoza, Sarah. DoB 29/07/1970 Sex F NHS **********

       18 M*** F*** Road, ******** Middlesex *** ***

Diagnosis:

1.         Left mastectomy and LD reconstruction October 2009 for wide spread high grade DCIS with micro invasion.

2.       3mm recurrence in reconstructed left breast with C5 axillary node August 2012 (Grade 3, ER 6/8, PR -, Her2 +++)

Many thanks for asking me to see this 42 year old youth worker whose history is well known to both of us. She underwent left mastectomy and LD reconstruction in October 2009 for fairly extensive high grade DCIS of the left breast with small areas of micro invasion. She remained well for 3 years thereafter but noticed a small nodularity in the left reconstructed breast which was subsequently biopsied confirming a recurrence of her disease. An excision of the area has confirmed a 3mm grade 3 invasive ductal carcinoma with excision complete but the margins being positive but HER2 staining was strongly positive. Despite there being no lymphovascular invasion a separate left axillary node also noted C5.

Mrs Mendoza who came with her husband and daughter is a type II diabetic although only diet controlled since the age of 19. She has two daughters aged 22 and 8 and in addition has a loop diathermy for CIN of the cervix in 1996.

Clinically her wounds have healed well and she will receive adjuvant FEC 75 chemotherapy which will commence on the 18^th September in view of the Grade 3 nature of her recurrence and her HER2 positivity

She will receive a total of 6 cycles of chemotherapy followed by adjuvant radiotherapy to the reconstructed left breast and thereafter a year of adjuvant herceptin coupled with Tamoxifen which she will take for a total of 5 years. Her longer-term outlook is excellent but I do note that she is peri menopausal with her mother having reached the menopause at age of 36. I have warned her that it is very likely that her periods will cease with the chemotherapy.

With many kind regards

Yours sincerely

Mr L

All I’m going to say is roll on tomorrow morning J

 

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What if's in Cancerland

A message had been left on my answer machine from my BC nurse. I had a urgent appointment booked for a core biopsy to be taken from the so called cyst. Cancer cells had been detected after having a aspiration and they needed to do further tests to find out what further treatment would be required. On arriving at the hospital my BC nurse would be explaining further.

After a sleepless night and mulling on the what if’s. I was so bloody glad I had found this lump. The cancer that I had there before was not hormonally receptive only HER2+++.

I arrived at the hospital at 8.30am and went straight to my BC nurse asking her what the in’s and out’s were. It was explained that I could be facing chemotherapy and Herceptin if it turned out not to be DCIS. If it was the high grade DCIS which they had left behind it would mean just a operation and maybe radiotherapy. My BC nurse asked how I would go about explaining to Sophia. Well how do you explain to a seven year old? The fact is it is a one day at a time situation. The BC nurse went on to explain what they see from the mammogram that has been booked today will judge whether I need the MRI. I have been here before and this conversation this time seemed totally different to the one I had for my mastectomy. The questions and details of what I would be going through was totally different. The urgency within her voice to get this lump biopsied was all about prepping me for the worst outcome.  

On arriving at the mammogram room the radiologist team were waiting for my arrival. Each one of these people now know my face well and could not believe the result from what seemed like a harmless cyst. They all sat with me explaining the details as best they could about the what next with my BC nurse.

The reconstructed left breast is more or less numb, but my right breast now rebels. The fact my right breast is full of cysts does not help. A couple of minutes and several images taken I am then taken to the ultrasound room to have a core biopsy done on the lump. It is bloody ironic that all of this is happening in July. My dad had passed away July 16^th 2009 and my birthday is the 29^th fan-bloody-tantastic!

On arriving home from all the upheaval of the day another message was flashing on my answer machine. A MRI appointment had become free for tomorrow morning and I was to arrive at 9.30 am. These guys meant business and yes it had been explained there was a possibility I would be booked in for a MRI also.

Am I pissed off well yes of course I am pissed of who wouldn’t be, but I have already mapped out my week whilst I wait for the MDT to decide what will be the next move on Tuesday. This is the only way to deal with the ticking clock and Mr P taking control. Another issue that infuriated me about this whole scenario was the fact I had seen my GP who has messed up before on Monday. I had mentioned the fact I had stomach pains and they were getting worse. I had explained this to my BC nurse and how he had given me once again Omeprazole to ease the stomach pain. He had said that if the problem has not cleared this time he would send me for a ultrasound. I had a prescription for two months supply. Now what if this is all bloody link then what? I was advised to change my GP because they know the outcome from having my mastectomy was sheer luck. Not only that, but what if I had gone to the breast clinic back in January 2009 rather than August 2009. Maybe just maybe this situation would not be happening. It is all about what if’s in Cancerland.

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Living, Laughing and Breast Cancer

My six month oncology appointment is on the 25th and yes I don't deny I am nervous.Yet as normal I have kept myself busy by learning new tricks as I say. Although my house is still needing a good lick of paint on fresh plaster I have personally decided enough is enough. I have sat on my arse and let my husband clean up the rest of the house. I had rushed to complete two rooms and my husband thought what I did was alright. The perfectionist in me has said you know what the only way this man will learn is to treat him like he treats me. And I have had fun doing exactly that. A friend put out a request for a place to do a short film in, so I said he could use my home. It was three days of laughter and mayhem, but hey that is the life I love. My kitchen was a massacre scene from a horror movie, but it was fun. Do not get me wrong my husband had fun also whilst puffing out his plumage, and I had to clean up the mess after filming. But it was something other than my husbands company and a ticking clock.

Me holding a boom and the cameraman.

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