Journal entry 21/08/2012
I met Dr Aaron Ndhluni today. He will be looking after me as my surgeon. He is nice, reassuring, warm, kind, and has a sense of humour. I am blessed that Derek has made provision for a hospital fund and insurance for the gap cover for the 5 dread diseases.
We shook hands and he said, ‘The prognosis is good. It is multi-focal infiltrating lobular carcinoma: 18mm.’ My mind did wheel spins; I imagined it to look like cotton wool inside – hard to take it in. He carried on, ‘to have a lumpectomy would be suicide, I suggest a mastectomy. It almost went undetected because of your dense tissue. You should thank Dr van Wyk for her diligence, persistence and vigilance in finding the cancer. If they had left it another year, without the biopsy, it would have been 18mm + 12 mm next year – which would have been much worse.’
‘I was afraid I was riddled with cancer’, I told him.
‘NO, you are not riddled with cancer’, his gentle smile assured me as he answered and carried on to say ‘you are going to get through this’. I felt his support.
I am greatly relieved as my diagnosis is T1 N0 M0; but we must wait and see. In the old days we would have called it stage 1. T = the size; N = nodes/nodules. (As seen on the mammogram or felt on examination there are none detected but when they do the mastectomy they will take one out to check in surgery. If they find any cancerous nodes I will have chemotherapy.) And M = metastasis. I might need chemo anyway as I am considered a ‘young’ cancer patient. In young cancer patients cancer is more virulent and they say it is best to fight it aggressively.
By the end of the consultation I understood there are at least 100 different types of breast cancer and it was not the type of cancer one could just have a lumpectomy to keep the breast. Also I would have to go for 6 monthly checks forever more because it is so difficult to detect. One of the options was to have a double mastectomy. (This was shortly before Angelina Jolie went public with her double mastectomy.) I felt alone in making my decision; Derek was not keen. I felt contaminated by cancer and just wanted to get rid of the offending matter and make sure it never came back. Underneath ‘being brave and having faith’ is a little piece that is scared and sad; but I feel accepting of the mastectomy.
When I spoke to my gynecologist her vote was for a double mastectomy; she said, ‘this is about saving your life, firstly and peace of mind, secondly. Are the lay people who are telling you to go for a lumpectomy willing to come pick up the pieces and look after your family when you die?’
Later in the week Dr Ndhluni phoned with the blood test results: ‘they are fine, there are no tumors,’ and he continued, ‘if you need an anti-depressant don’t hesitate to ask.’
I told him, ‘I am struggling emotionally because Derek is still coming to terms with me considering a double mastectomy but I think I will be fine for now, thank you.’
I am booked to see the Plastic surgeon, Dr Shane Barker, to discuss reconstruction. This will be my next step.
If you want to read the sequence of events from the beginning you can find them
Second Cancer continued: meeting my surgeon
Sixth Why me, cancer, why me?
Seventh Breast reconstruction.