Three down

I saw the third member of my cancer-care triumvirate (surgeon, medical oncologist, radiation oncologist), and while she seemed to agree that surgery should come first, the order in which the three treatments – surgery, radiation and chemotherapy – should occur still seems like a bit of a crap shoot. I’m scheduled to see the MO on Tuesday and perhaps then will find out more. In the meantime, I felt somewhat encouraged by the RO, who says my armpit was not radiated five years ago and that she can treat it this time, along with the bone tumours. Like last time, I’ll have five weeks of daily radiation, but unlike last time she doesn’t propose doing it concurrently with chemo. So which will come first, I don’t know. In any case, she called the MO while I was there, wrote follow-up letters to both her and the surgeon, and I hope that by Tuesday they’ll all be on the same page vis-à-vis me.

It’s hard for me to imagine that this level of pain would not mean I’m toast. But the RO said that because there’s no cancer in my vital organs, I’m likely to still be around in a year. How can she know that when this has been going on for months and it will be weeks before the radiation and chemo will even begin?

Still, I latched onto her hopeful words, and after 10 days of walking around with my stomach in knots, something in me relaxed. Earlier, the friend who came with me had offered me some cookies, and I turned them down, despairing at my lack of appetite. As soon as the RO said I wasn’t in danger of dying imminently and that my weight loss was undoubtedly due to anxiety, my hand snaked into the cookie bag. I reminded myself of Woody Allen’s character in Annie Hall, whose mysterious illness and inability to eat just before he’s due to present an award in Los Angeles, a place he loathes, magically disappear as soon as he’s let off the hook for the award ceremony, after which he begins to scarf down the chicken he’d disdained moments earlier. I went home, ordered a takeout chicken biryani from Lahore Tikka House, ate more than half of it, then lay down on the couch and fell deeply asleep. I was exhausted. When the phone rang a couple of hours later, I didn't know who or where I was. I guess you can only sustain terror for so long.

If anyone is reading this who has been through a recurrence of breast cancer or is knowledgeable about the topic, they must think I’m a complete idiot. Worse, anyone looking for information about it who stumbles on this blog would be mightily misled by my ignorance (a fact that illustrates the dangerous side of blogs). I’m embarrassed that I know so little about advanced breast cancer. After my bout of breast cancer five years ago, I was so convinced that it wouldn’t come back, and so terrified by the prospect if I did let myself think about it, that I purposely have never done a minute’s research on what a recurrence looks or feels like or what it means. I have avoided the words metastasis and recurrence, and my writing has skirted around the concept or concentrated on early-stage cancer. As a result, I was not aware of what symptoms to look for, and perhaps did not make clear enough to my doctors that I was experiencing what I now think were significant symptoms. All I knew was that if it came back, it was considered incurable, and that death was often the outcome.

Last time, I also assumed I would die when I got the first diagnosis, but quickly learned that wasn’t necessarily true. Then I spent hours doing research on the various treatments available and approached my doctors with considerable knowledge. Ultimately, I learned that there was an 80-percent chance it would never come back.

But now that it has, I feel frozen. I don’t want to read the chapters in Dr. Susan Love’s Breast Book about “what happens if it comes back.” I don’t want to let my gaze slip over to the endgame. So I now feel unsure about what to do next, how to assess the choices ahead of me.

Meanwhile, some of my friends have been reading up on this stuff. They’re probably afraid to tell me what they’ve read! The breast clinic nurse says that the MO can show me the survival rate charts. But I don’t think I want to know this time. I have to believe that I’ll live a few years, but, as Erika Heller said to me, “What am I going to do, circle a date on a calendar?”

Pollyanna moments:

• My mother’s hugs and smile
• My dad playing the harmonica in the seniors’ home, where he was in short-term respite care this weekend
• An unexpected email from an appreciative reader of a magazine article I wrote
• Chicken biryani