Living with High Risk Cancer
Health Guide October 02, 2005
At this point, six months away from the ten-year anniversary of my breast cancer diagnosis, my four month checkups with my oncologist generally are more social than medical. In fact, if I wasn’t so fond of my oncologist, I’d probably be on a six month check-up schedule. Then again, I’m a world-class worrier and I like the constant reassurance. The checkups are so much a part of my normal routine that I barely get anxious about them anymore. Which is not something I can say about my annual mammogram appointments, which are always fraught with fear and trembling.
But during my checkup last week, something unexpected happened. After my blood had been drawn, I was sitting around, as usual, in an exam room, wearing my paper towel shirt, waiting for Dr. S., one of my favorite people in the world, and not just because he’s saved my life a few times. As I waited, I finished my New York Times, then my Washington Post, and then a three month old copy of People lying on the window sill.
A knock on the door was followed by the entrance, not of familiar and genial Dr. S., but of his new post-doc fellow. Dr. Post Doc was a nice enough guy, even after I politely declined his invitation for a guest examination, explaining that I prefer my own doctor. Well, then, could we chat? he asked. Sure, I answered. There’s not much else I can do to pass the time while sitting in a room clad in a paper towel.
“I read your medical records,” said Dr. Post Doc, lest I think we were going to discuss the weather. “Gee, that huge tumor, three lymph nodes, you were really high risk for a recurrence. It's amazing that you've done so well.”
This was not the conversation I had envisioned. Dr. Post Doc wasn’t telling me anything I didn’t already know. But who asked him? Dr. S., knowing my propensity to visit the dark side, has always been far more tactful. “Yes, I’ve been lucky,” I answer. I wish I had stuck with the dog-eared magazine. I certainly didn’t need to be reminded by a total stranger that I had dodged a big bullet.
For the rest of the day, my anxiety level slowly crept up as I replayed the conversation in my mind. Then I got mad. Why should I be spoken to that way? Can’t these young doctors take some sensitivity training before they are allowed to ambush innocent patients? I self-medicated with a large glass of wine before dinner, but I couldn’t shake my bad mood.
I tried to analyze why I was so upset. Dr. Post Doc merely had reminded me of the simple truth. I was high-risk. When I was diagnosed, in February 1996, with Stage II-B, multi-focal breast cancer, no one was more convinced than I of my impending death. What were the odds? I was 41, no family history, there was no reason in the world why I should have breast cancer. And if that huge tumor wasn’t bad enough, the bad news kept coming. The surgical biopsy revealed a second, smaller tumor in the same breast. The cancer, which had not been visible on my mammogram of 18 months ago had already spread to three lymph nodes.
It took a few days for my anxiety level to recede to normal --normal for me, that is, which is akin to a person trapped in a burning building. (I can’t blame that on cancer. I’ve always been a world-class worrier.) I tried to reassure myself. It’s been almost ten years, and the longer you go without a recurrence, the better your chances of staying healthy. I’ve done everything a person can do to ward off a recurrence--aggressive treatment, including surgery and chemotherapy, followed by tamoxifen for five years, followed by nearly five years on the new wonder class of drugs, aromatase inhibitors.
The real reason I was so upset was that Dr. Post Doc, and his clumsy comments, had managed to do something I try hard to avoid. He had wedged open the door to the Closet.