Diagnosis and Plan

March 8, 2023

You sit with your husband for several hours in a stagnant hospital room and meet the team. Two nurses precede three doctors. A nurse and three different doctors ask permission to examine you. You bare your chest to them and each set of hands runs over the landscape of your breasts, getting familiar with the topography of the Beezleboob. One of them says you have the breast tissue of a young woman. You wink at your husband and say, “I hope you heard that.” They follow up, qualifying that young women have “lumpy, bumpy breast tissue.” Not quite the compliment you had taken it for. You bet he heard that.

Just yesterday, you had your breast flattened, squished, manipulated, pressed between paddles of varying sizes, and —under guided ultrasound—numbed and biopsied. They snipped six more samples from your traitorous boob, and you laid there, avidly raking your eyes over your breast under ultrasound. You tried to discern how the medical terms being dictated from behind you actually translated to the alien landscape on the monitor. It looks like the craters and valleys on old footage of the lunar landing.

So, you’re sore. You’re tired. You’re confused. You just want answers.

And, by the end of the day, answers you get. Stage one, estrogen/progesterone positive, her-2 negative. You have two choices:

Door #1: lumpectomy/radiation. Chemo if it’s in the lymph nodes.

Door #2: Single mastectomy. Remove all the breast tissue. No radiation. Reconstruction later if desired.

It’s a lot to think about and weigh. It’s not an easy decision. But, let’s be clear–it’s an extremely personal decision. It’s as personal as deciding on a birth plan, a baby name, or any major life decision. And while you choose to seek out the opinions of some close friends who have shared a similar experience, and you truly appreciate those brave enough to share their own experiences with you, you find yourself bristling at some who want to be negative about the choices you are about to make for yourself. I mean, none of the choices are painless. None of them will leave you unscathed.

You are researching the long term effects of radiation. You are weighing the recovery time, time away from work, short- and long-term physical limitations of both options. You are trying to mentally prepare yourself for the early aging your body/metabolism/skin will undergo as you block all estrogen afterward with hormone blocker (because apparently cancer loves estrogen!). You wonder how these things will impact the quality of your life when you are elderly. You hope you get to be elderly. But you’re selfish. You want to be “Betty White/William Shatner Elderly.” You know, the I’m-loving-life kind of elderly. Not the everything-hurts-all-the-time kind of elderly.

And other people telling you their horrific experiences is not helping you assuage the black panic that pushes up from your heart into your throat when you lie awake at night, or when you pray at church, or when you set the dish you were just drying down. It’s in the quiet moments that you feel the lack of imprint you’ve made on life yet. You feel like a footprint that’s half disappeared in the sand as the tide rolls over it. You feel regret for every day you’ve lived complacently.

You vow to beat this thing. You know so many people who have done this. They are heroes with their own unique stories, trials, plans, regrets, and decisions that altered their lives forever. And they are trying to help you. You thank them, and consider the things they tell you. You try to be respectful, rather than resentful. And if you are resentful, it’s not really at them. It’s at the whole situation, which for the record totally sucks.

But cancer isn’t kind. It doesn’t discriminate. It doesn’t make promises.

There’s truly no way to know which option is best. You have to just decide, own that decision, and deal with the outcomes with as much gumption as you can.

And I have a lot of gumption. I’m ready to do the hard things if it means I get to live longer. I’m ready to take on whatever’s behind whichever door I choose.