Friday, 15 May 2015

The lump

I'll start with the ending which is:


Now back to the beginning....


For about a month, something has been worrying me a bit. I kept thinking I could feel a lump in my "good" breast (ie the one that didn't have cancer). This is the circle I've been going round and round in: Feel lump, worry, convince myself it's nothing, put it to the back of my mind, feel lump again, worry but decide I can't face cancer again so put it to the back of my mind, feel lump again, worry, convince myself it's nothing but I'll just ask my surgeon to check when I see him in June, put it to the back of my mind, feel lump again, worry but decide I can't face cancer again so put it to the back of my mind, and so on and so on.

Yesterday morning I was at a "worry" point, partly because yet another of my most wonderful friends has just found out her cancer has returned, and spread to her liver. The first sign of this was a swollen lymph node by her collarbone which led to her having a biopsy and CT scan, and they confirmed secondary breast cancer. This has really shocked me and upset me. (Obviously.) And it brought my own worries back to the front of my mind. I decided to book a GP appointment to get my Tamoxifen prescription and to also ask the GP to examine me and show me again how to best examine myself - including lymph nodes. As a reminder - my original cancer couldn't be felt, neither could my lymph nodes, so I've actually no previous lump-feeling experience to draw on.


I went in to see the GP and she said of course she would examine me and explain everything. So I lay there on the bed, while she talked through how best to do a self breast examination. And then she stopped talking and her whole face changed. In one moment, the atmosphere in the room had switched from relaxed to very, very tense. I've had enough medical appointments in the last year to know that while some doctors and nurses are quite good at hiding things, you always get at least a moment of truth visible in their face as they first see/feel/read/hear something. I think this GP actually forgot altogether to put on her poker face. She stopped talking to me and stopped looking me in the eye, and focused very seriously on the same area that I'd been worrying about. And in that moment I knew.

She told me that there was a lump there, but that I shouldn't panic or lose sleep. Most lumps are nothing sinister. It was much more likely to be a cyst. I should not lose sleep over it. But because of my family and personal history of breast cancer, and my broken PALB2 gene, she wanted to do the 2 week referral. The "2 week referral" is the less intimidating name the NHS has chosen for what is actually the "We aren't going to hang around because you might have cancer" referral. When you're told you've got a lump and you're being given the 2 week referral and you've only just had breast cancer there's no amount of "It's more likely to be a cyst" that's going to help.


I couldn't face waiting two weeks and I couldn't face getting the "Suspected breast cancer" appointment letter in the post. I'm not sure what I was thinking, I don't think I really was thinking. I just walked out of the doctors, got in a taxi and went to the hospital. At the reception desk of the Breast Care Unit I completely lost my shit and burst into tears. I somehow managed to tell the receptionist that I didn't have an appointment but I'd just finished treatment for breast cancer and now my GP had found a lump, and I needed to see my Breast Care Nurse (BCN) - I didn't care if I had to sit there all day waiting on the chance someone else didn't turn up for their appointment. The receptionist was so kind and understanding, called the Breast Care Nurses' office and left a message. I didn't have to wait long at all until a very nice woman came to collect me and take me to one of the Quiet Rooms. I explained everything to her so that she could then go and relay the information to my BCN once she was out of clinic.

My amazing BCN came in, and I just started bawling my eyes out. I told her what happened at the doctors, and I cried, and cried and said that I just can not go through this again. I can't do it again. I can't. She told me she'd sort it so that we knew what was going on that day and to just think that I am having surgery on that side anyway, so nothing changes except the surgery might need to be sooner than planned. But what if it's in the lymph nodes? "Don't worry about that until you've had the scans and we really know what this is." She said that she would get me in with my surgeon and for an ultrasound that day, and if necessary biopsies, but I would just have to wait a bit until clinic was finished.

So I waited in the Quiet Room on my own, and as I cried, I made a series of decisions. I decided that this time I wanted surgery before chemo. I decided I would try the cold cap again. My hair's just grown back, I want to try and keep it. But I would buy a new wig as my one is old and tired now. I decided I would ask for a PICC line or similar from the outset as my veins aren't going to cope with more cannulation. I decided this time I would eat healthily and drink all the green tea. I decided to write a letter to everyone I care about, ready for if I die, so that they know how much they mean to me. I decided to buy one of those portable phone charger things because I use my phone so much while I am sat having chemo and the battery doesn't last long enough. I decided to buy an ipad. I decided to write a Will.

And then a nurse came to take me through to see my surgeon. He and my BCN came in to the room and again I started bawling my eyes out. I explained things to him, and then he examined me.


He has a MUCH better poker face than the GP. Almost perfect. But not quite. It was just for one split second, but I saw something flicker across his face as he felt it. And a moment later, just for the tiniest moment his right eyebrow raised the tiniest bit. But once he'd finished he told me he didn't think it was anything sinister. He said there are lots of reasons for lumps, ranging from breast cancer down to pretty much nothing. I can't even properly remember what he told me, it's a blur, but it was something along the lines of he thought what he could feel was more like thickening of tissue - and that can be caused by chemo. But he wanted me to go for an ultrasound scan just to make sure. He drew on me to show where I needed to be scanned.

I wanted to be happy but all I could think of was my very first ultrasound scan which was for my peace of mind, after two nurses examined me and thought everything was fine. The scan showed I had cancer. So I just held my breath, crossed my fingers, and waited to be called through for the ultrasound scan (which was being done in people's lunch break because that is how kind and lovely these people in the Breast Care Unit are!)


I lay on the bed and concentrated hard on the radiographers' faces while they concentrated hard on the images on the screen. They both had a go at scanning me, and they used two different kinds of probe. I could also see some dark images on the screen - I still have the ultrasound image of my original tumour imprinted on my brain. But they weren't taking screen shots or measuring anything. Good sign! And then they told me that there was nothing sinister there. I cried and cried and cried! Their report was NAD, U=1 (translation: Nothing abnormal detected, benign). They brought me tissues. I cried some more. They were saying something about scar tissue, thickening, and glands. I don't know. Whatever it was though, it's not cancer. I'm ok.


Those were a few hours of pure hell, but it could have been a full two weeks of hell and I don't think I'd have got through that. I owe a lot to those hospital staff that went out of their way personally to help me yesterday. I'll be writing to them to thank them, and the card will be accompanied by the biggest and best box of chocolates I can find. Amazing nurses, amazing surgeon, amazing hospital staff, all of them. And I am now under orders to not do any self examinations at all, and instead to forget entirely about cancer until my next surgery, and enjoy life.


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