Tag: cancer

Breasts and cancer

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It’s been a while since I’ve posted here, I’ve recovered from radiotherapy (harder mentally than surgery because you’re completely exhausted), I’ve travelled to India (will blog more about that later), and it’s almost Christmas.

I’ve been collecting some articles about breast cancer, the cost of treatment, what we die from young (women = breast cancer), how trans people need to be careful of breast cancer, and really what you can do to ensure that you catch cancer early and get it treated quickly.

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Welcome to the 89th Down Under Feminists’ Carnival

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Come one, come all to the 89th Down Under Feminists’ Carnival.  I know an apostrophe goes in there somewhere, and that is where it goes today.  There are many wonderful things about the number 89, it’s 24th prime number, following 83 and preceding 97. 89 is a Chen prime and a Pythagorean prime. It is the smallest Sophie Germain prime to start a Cunningham chain of the first kind of six terms, {89, 179, 359, 719, 1439, 2879}. 89 is an Eisenstein prime with no imaginary part and real part of the form 3n - 1. M89 is the 10th Mersenne prime. (all from Wikipedia)  I don’t know what most of that actually means, but I share it for your edumacation.

Anyway, September was yet another fantastic month to be a blogger in Australia and New Zealand, particularly a feminist blogger.  There was the “knifing” of Tony Abbott, a new Minister for Women in Australia, a new Australian Prime Minister (more primes), Chris Brown effectively banned from Australia, lots of commentary on the scourge of domestic violence, spring started and Melbourne eventually started to warm up.  I haven’t been paying attention to the weather in other parts of Australia and New Zealand, so I hope your weather was also more spring like, and less winter/summer like.

If you reside in Australia or New Zealand and you’d like to host a future Down Under Feminist Carnival please let Chally know here.  It’s not very difficult, and I promise I will help by sharing relevant posts with you.  And now on with the carnival.

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Cancer Update: Radiotherapy Day 6

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So I’ve had a few days of radiotherapy now, and thought I’d provide a general update as to how it is.

So I rock up at the hospital, sign in and be advised if my appointment for the following day/week has changed, go to the waiting area, and hang about and wait.  The waiting usually isn’t for very long, and then I get changed into my hospital gown, go wait in the second waiting room for a few minutes, and then get into the radiation room.

So far I’ve only attended one of these appointments alone.  I’m very lucky I have the support of friends and family to keep me company in the waiting room, even if it is for a short period.

So in the radiation room I tell them who I am, what they’re treating, and lie down on a table under a big machine.

 

Not the actual machine at the hospital, just one like it from a site on the internet

As I’m getting treated for breast cancer, my arms are above my head and I’m holding onto some bars.  The technicians mark on my skin where I got some tiny tattoos, and then line me up under laser beams (I am high tech) to make sure I’m in the right spot for the radiation to be delivered.  Once they’re happy they leave the room and I get shot with high energy photons, twice, diagonally through my breast in order to avoid my heart.  It takes maybe 5 minutes.

I don’t have a problem appearing nude in front of people, so constantly being topless in front of the technicians isn’t a problem for me, I can imagine it would be for some people, particularly as some of the technicians are men.  All of the technicians are lovely, and highly professional.

My breast is beginning to redden from the radiotherapy, which is the expected side-effect.  I am after all getting constantly burnt with radiation.  It’s also a bit tender, which isn’t surprising as all the cells are constantly being damaged and then have to repair each day.

I have been warned that I might get extreme burns (blistering and/or skin cracking) as I progress through the treatment.  I don’t know if the burns will hurt as much as they will be annoying.  The hospital will keep an eye on any burns and side-effects to ensure that I am coping ok and provide assistance where possible.  I have already been provided with sorbolene cream to put on the irradiated area twice a day in order to keep the skin moisturised and soothed.

I’ve also had a cold/bacterial infection while doing this, so it’s been more shit than it normally would be.  I only have 14 more sessions left.

 

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Cancer Update #8 Radiotherapy Mapping/Planning

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So this radiotherapy thing is becoming realer, and I’m getting more anxious about it.  It’s very easy to be flippant about these things when they’re off in an undefined time period in the future, but the moment it becomes real, the flippancy disappears and the anxiety settles in.

I’m more anxious about this than I think I was about the surgery.  I’ve had surgery before, I know what to expect (more or less).  I haven’t had radiotherapy.  Now that I know my radiotherapy date starting I will contact the people I know who have had breast cancer and talk to them about what to expect.  I don’t know how alarmist the radiotherapy doctor is being about being a fat woman having radiotherapy versus a thin woman (apparently I have a greater risk of skin cracking due to the burns I will get), or whether that is because I have larger breasts and I’d have that risk regardless of my weight.

Both the doctors who saw me today, the radiology doctor in training and the consultant weren’t particularly personable.  Their hands were FREEZING and I got quite cold as they poked and prodded my breasts before drawing on them in texta. I didn’t appreciate their talking about me as if I wasn’t really there, but I didn’t mind being part of a doctor’s specialisation education.

The nurses/radiotherapists on the other hand were absolutely delightful.  Their hands were warm, they were reassuring, they talked to me about what they were doing and how long things were going to take.  They apologised when they were about to touch me with something that was cold (mostly the ruler they were using) and ensured that I could get up and go to the toilet when I couldn’t wait any longer during the appointment.

So radiotherapy starts on the 22nd of September. A bit under 2 weeks away.  I will be going to the hospital 5 days a week (business days) for 4 weeks (barring sickness).  I may get very fatigued, I may burns that resemble severe sunburn, I may have none of those things and just have the inconvenience of my days interrupted with a hospital appointment.

I am a bit over the unknowns.  My life generally has a lot more certainty in it, and I prefer it that way.  But soon things will be back to normal (more or less).  I’ll start on the tamoxifen, work through the side-effects, and just be myself.

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Cancer Update #7 Radiotherapy Consult

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So today I went and saw the radiotherapy doctors at the Peter Macallum Hospital, Victoria’s premier cancer hospital.  Before I talk about me, I want to talk about that hospital because it was one of the most amazing patient orientated places I have ever been.

The Peter Mac (as it tends to be known to everyone) is a bit of a maze.  That is a big downside when you’re stressed and confused and don’t know where to go.  However, once you get where you need to be – in my case the Breast Cancer clinic, the waiting space is absolutely amazing.  The various clinics are located alongside each other, with one big waiting room.  And what a waiting room it is.

I wasn’t there for very long, but this is what I saw.  There are jigsaw puzzles, with tables set up to do jigsaw puzzles on.  There is a big box of wool, with knitting needles and I’m guessing crochet hooks, so people can knit/crochet while waiting.  The supporting columns were all decorated with yarn bombing.  There were colouring pencils and adult style colouring pages.  There were board games and a chess board.  There was a library of fiction and non-fiction books.  There were magazines in many different languages.  There were comfortable chairs.  There were treadmills if you want to walk off anxiety or do your daily exercise.  There is also free wifi so you can browse the internet/read RSS feeds/play games on devices.

I know the Peter Mac is moving next year to a new location on Grattan Street, across from the Royal Melbourne and Royal Women’s Hospitals, and I hope they keep this very patient friendly and supportive atmosphere in their new building.  It was great to see so much creativity.  A little more on what goes on is here.

Ok, so me… I saw a younger doctor who initially told me I’d need 6 weeks of radiotherapy, and then went through my cancer diagnosis history and overall health.  I reported something* which I think might be related to the surgery I had, he wasn’t sure it was related, but I’ll speak to the breast care nurse at the Royal Women’s tomorrow anyway.  He took me through the not very likely, but serious risks of having radiotherapy, and then went off to find his supervisor – who is the doctor I’d actually been referred to see.

The supervisor doctor said that I’d only need 4 weeks (which is what the RWH had said), and that overall that’d be better for me as it means that it’s over quicker and the immediate side effects don’t last as long.  I will be called for a mapping appointment which will be in the next two weeks, and then radiotherapy will start two weeks later than that… probably.  Apparently the planning of how to deliver the treatment without impacting on my heart and lungs can take up to a week, so the radiotherapy won’t start as soon as I expected.  This is ok, I am not an urgent case. Given my cancer is at an early stage and appears to be completely removed from my body.

* I have some pain under my breast that seems to be as if some fluid (oedema) has formed as a result of surgery. It might resolve on it’s own, it might need to be drained.  I’ll get a second opinion, because it’s sore and that means that I’m not doing all the things I’d like to do otherwise.

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Cancer update #6 To chemo or not to chemo, that was the question

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And the answer is no, which is good.

This morning we saw the oncologist and she was LOVELY, really really LOVELY, and laughed at our jokes and thought we were funny (which is always nice).  I am still super impressed with how the hospital, the nurses and the specialists are dealing with my two partners.  They pause briefly after I answer their question as to why I’m being accompanied into the room by two men, and then move on like it’s no big deal (which it isn’t).

Anyway, the oncologist said that with my tumour profile that the Oncotype DX test would essentially be unhelpful, and that with radiotherapy, and tamoxifen for 10 years that I will be right.  That’s essentially what she said, she talked a lot about the types of tests already done, the fact that the growth factor test is less reliable than the others (greater likelihood of false positives), and as it is stating a different finding than the other tests (grade 2 tumour, slow growth generally, no spreading into the lymphatic system, tiny tumour, etc) that she doesn’t think the Oncotype DX test is required.

She’ll refer me to the Peter Mac do to the radiotherapy as the Royal Women’s Hospital doesn’t have radiotherapy services, and I’ll need a month (4 weeks) of radiotheraphy at least.  I should have my initial appointment with them in the next two weeks, then an appointment to line up the machine and tattoo me, and then radiotherapy, 5 days a week until it is done.  I should be able to work while being treated, but will feel quite tired and a bit sore.

All in all, it was nice to get some good news.

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Cancer Update #5 – Results of surgery

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So today I saw the breast surgeon and got the results from surgery.  In fact one of the results was delayed and we spent time sitting around the hospital waiting until it was ready – bumping into an old friend who had breast cancer some time ago, and who was there for a checkup.

The good news is that they have removed all the tumour and that there was no cancer in the removed lymph node.  They confirmed the grade of my cancer at 2, and once removed it was 13mm – so 5mm bigger than the ultrasound put it – which apparently is common.  There was some cancer in the surrounding tissue, but not at the edges of the margin they removed so they believe they got it all.

There was no HER2 associated with the tumour so chemo is not mandatory.  However, as I am young (as far as breast cancer goes) and because the growth factor of the tumour is 25% (which is higher than the 5 – 10% they prefer), the surgeon suggested that I might want to considering sending a sliver of my tumour off to the US for further testing to see if chemo would be beneficial.  However this comes at a hefty price tag of $4000 (not covered by Medicare or private health cover).  The surgeon wanted to state that it is something I should consider, but he said that he believed that the radiotherapy and Tamoxifen would more than likely be sufficient given the make-up of the tumour.  I have an appointment with an oncologist on Monday to get more information as to what they think regarding the test and chemotherapy.

The surgeon was extra impressed with my healing prowess.  He said that it looked like I had surgery a month ago, not a week and a half, when he removed the dressings.  I heal well, I probably should have been involved in more risky, extreme sports as a young adult and tested my healing to the limit.  Except I’m not a fan of being adrenaline and pain.

I’m really relieved that I don’t need more surgery, and that I probably don’t need chemo.  I was more stressed about more surgery as that was an immediate, unpleasant experience – one I didn’t want to repeat any time soon.  I’m not sure about chemo yet, I’m going to gather more information, including from people who’ve survived breast cancer, and determine whether or not paying for the testing is a worthwhile investment, or whether I should stick with the most likely to be successful existing treatment of radiotherapy and Tamoxifen (plus other drugs as needed).

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Cancer update #4 (one week since op)

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I’m still here, recovering as well as can be expected really.  It hurts a fair bit, and when it’s not hurting it itches. I know that itching is a sign of healing, but it’s really irritating nonetheless.

The incision under my arm is about 8 times larger than usual, and it’s cut through muscle, so that’s the one that is causing me the most grief.  The lymph node was clearly busy hiding and not wanting to be removed.  I have most of the movement back in that arm now, I even was able to lie on my left side last night, so it’s healing slowly but surely.

I have almost one more week off work to complete the majority of healing, and an appointment with the hospital on Monday to go through the next treatment steps.  It’s unlikely that I’ll need more surgery (15% chance) or chemo (20% chance) so it’s more likely they’ll check how I’m healing up and propose a date to see someone about starting radiotherapy based on how fast I’m healing.

I’m somewhat anxious about Monday because I don’t know what is going to happen.  This is understandable and unsurprising.  I will be taking my partners along with me, who the hospital has been very good with, so I have all the support I need, and so they understand what happens next.

Mostly I’ve been spending time on the computer reading twitter, blogs, playing games, and spending time catching up on TV.  Lovely people have visited me and brought me gifts of tasty food, hugs and their company.  I have received flowers from friends, and calls from people checking in on me that I’m ok. I am very grateful for all the support and love, and it has really helped.

I’m looking forward to joining the Boob Club so I have a support network of people who’ve been where I am now (or who may be where I am now).  There is always the risk when you join a group of people with a specific interest that that may be the only thing that you have in common.  I’m sure I will find other women who are into social justice, queer rights, and cooking (not necessarily all at the same time).  That’s not too much to ask.

I’ve been thinking about Chally’s recent post “What not to say to someone in hospital, part one“, after a call I received from one of my work vendors (as in she’s the account manager for a company and I manage the contract between her company and my client).  She was asking me questions about how I was going, as she’d just found out about my diagnosis and surgery, and I was thinking that some of those questions were incredibly impolite.  I like her, she’s lovely, but asking me if the surgery involved the removal of my breast isn’t really something I’d ask someone I had a professional relationship with.  People are strange.  It’s that blurred line between working with someone for years (in this case about 5) and knowing each other well, and what the actual relationship is.  It didn’t upset me, I just thought it was inappropriate and something I need to consider for the future.

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Cancer Update #3 (post op)

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So I’m sitting at home now, mostly able to type, much clearer headed, and healing.  There is a wide range of movement I can’t do, and I’m still figuring out bits of that.

I’ve been sleeping in our recliner couch for the past 2 nights as I have been worried that sleeping in my own bed would be too uncomfortable, mostly due to an inability to roll from side to side, and getting up being a real pain the side.  I might graduate to sleeping in my bed tonight, I don’t know yet.  My neck would certainly appreciate me sleeping in my own bed, but we’ll see.

I have two rather large incisions on me.  One under my arm where the sentinel lymph node was taken, and one where the tumour was removed. If I cared about such things, I’m fortunate that both of the scars (when they eventually heal) will be in non-visible locations.  I’m actually a little disappointed about that, I think that scars are cool.

The incision under my arm is the one that hurts the most.  This isn’t surprising as that is the location that sees a lot more movement (twisting, lifting, rubbing, etc).

Yesterday was a day of minimal food as I was still feeling nauseous thanks to the operation, pain and the drugs I was taking.  Today I feel way more human and I aim to try the delicious looking cake my sister has made for me. I also want to go for a walk around the block to get my body a bit more mobile and drop the neck pain I have.

I could go through the ins and outs of Wednesday (surgery), but I won’t (unless you want me to) other than to say it was a really long day, the staff at the Royal Women’s Hospital are fantastic, and that it was slightly worse than I expected it to be.

I won’t get the results of the biopsies of the tumour and sentinel lymph node until Monday week, so in the interim I heal, continue to be spoilt by my loved ones, and gradually each day become more and more independent.

Today I could undress myself, tomorrow I might even be able to shower on my own.  The wonders of a body which can heal itself from invasive surgery.

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Cancer Update #2

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So today I went and got my other test results (blood test, biopsy of another anomaly) and spoke to the surgeon and breast cancer nurse about surgery on Wednesday.  I probably won’t be blogging immediately after the surgery, not the least because they’ll be operating under my left arm (in the arm pit) and that means that typing and the like isn’t on the agenda for a few days.

I’ll state this up front – this whole thing seems so unreal.  I am not obviously sick, I do not feel sick.  Apart from some pain where the tumour apparently is against the chest wall, I don’t feel like I have cancer – whatever that feels like.  Wednesday is going to make the whole thing a lot more real, and that’s both scary and reassuring.  Scary because cancer is scary.  Reassuring because I do feel a little like an imposter right now, because I feel mostly fine (just stressed).

Anyway – today’s visit to the hospital had my blood test results completely normal (with slight vitamin D deficiency which is unsurprising as it is winter), and the biopsy coming back completely clear.  We went through all the process for the pre-op stuff, told how much it’s going to hurt (a fair amount), and how much I’m going to have to wait (a lot), and reassured about some of the side effects, like the blue dye that is used to trace the lymph node paths will stain my skin – that’s normal.

Also we went through some worst case scenarios, just so I was across them.  The nurse was impressed that I was so calm and in control – that is my default state, I will probably fall apart later – and that’s ok too.

So a week off work (this week) and possibly some time of work next week to ensure I’m healing well.  A further biopsy of the tumour after it has been removed builds the next step scenarios.  Best case, I have 4 – 6 weeks of radiotherapy a month after surgery, and then on a drug for 5 – 10 years.  Worst case, I have additional surgery and/or chemo before radiotherapy and medication for years.

Yes I’ll probably keep blogging about cancer, because writing stuff down helps me sort through it.  I do want to blog about other things to, and once I’ve gotten the big bits out of the way, I’ll probably go back to doing just that.

I do want to say how grateful I am to have been born in Australia and eligible, thanks to my citizenship, to access free healthcare.  All of this treatment will cost me very little.  The medication will be the most costly part.  The operation, radiotherapy, and consultation visits will be covered by my taxes and the paid taxes of other people.  This is a fantastic thing, and means that I don’t have to ask myself if treating possible cancer is something I need to do or is it something I can live with.  I do wish people in other countries without “socialised medical systems” could access the level of care that I will be accessing for the cost that I will be paying.

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