Beyond Polarity

I AM NOT checking out anytime soon.

The calcification in my right breast—ductal carcinoma in situ or DCIS—mercifully is not the dreaded C-word. My surgeon Dr. Quan refers to this diagnosis as pre-cancerous. 

Yesterday, there was a brilliant essay in the New York Times Not Everything We Call Cancer Should be Called Cancer. If you or someone you know has been diagnosed with early stage breast or prostate cancer, read this article! Please! It will save you a lot of anxiety. 

While DCIS won’t kill me, I need another surgery before it morphs into something very, very bad. And that operation happens next week: a re-incision into the last incision to remove a thin layer of cells so my .5 mm clear margins hopefully become 2 mm clear margins. It’s  scheduled to be a 15-30 minute procedure, under the knife at Foothills hospital, without the need for full-torque knock-em-out anesthesia. 

Recovery time is expected to be similar to the last breast lumpectomy surgery, the one I had early in August. A little post-incision pain-killing will likely be needed. It also means—no lifting my granddaughters and no slinging my DSLR camera around my neck and no biking—for a couple of weeks. Sweet joys, that I’ll miss, but totally doable. And radiation is likely to follow, in a month or two. 

Of course, as I’m learning, this treatment roadmap could be disrupted at any time. The diagnosis is DCIS and what that actually means remains to be seen. But, to repeat, while there’s a chance I could require more invasive surgery ahead, the odds of me dying of DCIS are slim to none. Amen to that.

AN EMOTIONAL RESCUE

I’ve been described as: grounded, pragmatic, steely, matter-of-fact, straight-shooting, tell-it-like-it-is, tenacious, somewhat irritating, and a farmer’s daughter. But these past few months, I’ve seen a side of me that’s rare as the blue super-moon, of late. 

Here’s the thing. On more than one occasion, I’ve been reduced to tears. I’m not a cryer. Nothing at all wrong with crying—I wish I could do it more. But what I’m noticing this summer? The tears flow more easily. 

For example: On Monday, I got the results back of a genetic test I’d completed for a wide range of cancers- including breast. When a Calgary specialist in medical genetics,  Dr. Carey Johnson (a delightful man, by the way), called me to share the results—and it was wonderful news, no genetic markers— I burst into tears. In fact, for a few hours, I couldn’t stop weeping. Hardly in character. But testimony to the extent of pent-up emotions I’ve only barely managed to suppress. It was like I’d been holding my breath, for weeks. 

When I talk to people, I realize I’m not alone in feeling anxious. And not just about cancer. This summer—with all the heat, the wildfires, the uncertainty—it’s felt surreal at times. 

And yes, I admit to paying for healthcare services outside the Alberta Health Services system. Everyone gets antsy about buying healthcare—and Lord knows, what’s going on with the UK’s NHS system is chilling. But, I’m ‘fessing up. After I learned that…in addition to all the other cancers in my family, my paternal grandmother not only had breast cancer but ovarian cancer too…I decided to bite the bullet and fork over $299 US, spit into the vial and get genetic testing done, quickly.

It’s a relief for me, my kids, my siblings, my grandkids, my niece and nephew. Of course, cancer doesn’t just flow along DNA lines but it helps to know if you have the genetic markers or not. 

Having this information in hand helps me to decide on next steps in treatment. Within the AHS system, I could have access to some  genetic testing (because of the family history) but I would apparently have to wait 6 to 8 months for results. Holding my breath that long would have been quite painful. 

Even awaiting these shorter term results, I did a deep dive into thinking about my options if the results had been positive for genetic markers: 

How important is it to keep my breast? It’s just a boob, so what…or is it integral to my sexuality, my identity as a woman?

Am I just prolonging the inevitable with another lumpectomy? Maybe I should just proceed, post haste, to a mastectomy?

If I do a mastectomy—breast reconstruction, or not ? With a prothesis, or not? Plastic surgery or not? 

I reach out with an open heart to the sisterhood, to other women who had made these difficult choices. I listen to their stories. I hear their laughter, their talk of imperfectly shaped breasts. I hold their fears and especially, their anxiety about the risks of cancer coming back. 

“We burn out not because we don’t care but because we don’t grieve. We burn out because we’ve allowed our hearts to become so filled with loss that we have no room left to care.” — Dr. Rachel Remen, Kitchen Table Wisdom

And in my heart of hearts, I keep repeating to myself, calmly and deliberately, this is difficult but I can prevail. I listen to that inner voice, trust my intuition…

And sometimes, I cry.