Thursday, April 28, 2016

Spring Screenings

April 20th has come and gone, quietly marking four years since I received the phone call from my doctor which rocked our world. I'm sure you know what I'm talking about, the "I'm sorry, but you have cancer," phone call. I'm sorry that I know I just ruined your day, probably your year, but maybe, just maybe, I might have saved your life phone call. Because even though I received the worst kind of message on that phone call, imagine if I hadn't received it. Imagine if my radiologist missed the spot on my mammogram, missed the cancerous tumor when he biopsied, or the pathologist misread the slides. Imagine if I hadn't gone in for the mammogram when I did. Imagine what my cancer would be doing now, four years later. So, while that might  have been the hardest phone call to receive four years ago, I'm thankful that it came when it did, while I had a chance to fight for a cure before it became incurable.

The word "cure" is a tricky one. Will I ever know if I am cured? My radiogy oncologist used it, optimistic that I was cured, that I should come back to say hi, inferring that hopefully I wouldn't need to come back for any other reason. He carefully phrased his sentences to be encouraging but not give false hope. He was confident in the science, the percentages, that I would be one of the 90% who could say goodbye to cancer. Many people consider five years a milestone, others ten. Truly, the further I am from diagnosis, the less chance I have of cancer recurring.

Yet, cancer doesn't care about numbers. I don't think mine will ever be zero, unless there is a new breakthrough. Those who have had cancer recur 12 or 15 years, even 20 years--not a new cancer, but the original cancer --are warnings of that fact.  No one knows why. How do cancer cells lie asleep for so long, and why do they suddenly wake?

I was speaking with one of my favorites on Sunday, a petite grandmother with a sparkle in her eye, who still works at a local drugstore yet spends her free time rescuing prostitutes and teaching them about God's love, who travels to faraway lands to share about Jesus, who always stops when she sees me to ask how I am doing. I told her about my screenings coming up, how grateful I am for being four years out, but how I'm still nervous about every time I restart my screenings. She mentioned that all the people she has ever heard who had cancer return after years were undergoing high periods of stress at the time. Loss of a loved one. Loss of job. Loss of marriage. It was probably their body's immune system not working because of the stress despite keeping the cancer cells at bay for so many years.

She is right. Stress is one of the enemies we need to fight against every day in our fight against cancer. Stress also cannot be measured by percentages or any other number.

Yet, it all points back to trusting God, doesn't it?

Last Tuesday, after six months of absence, I reentered  the cancer center. My blood was drawn from my right arm, filling four small tubes, each with a different colored top, indicating which test would be run. Those blood cells have probably been analyzed as I type. I won't find out results until next week. They might be posted online by Monday, if I'm courageous enough to look.

On Tuesday, I'll return to the clinic, sit in the same waiting room, and be called back to the examining room of my new oncologist. I will wait for a new tapping on the door, an introduction and then a discussion of the findings.

I'll miss my former doctor and all she guided me through. I am hopeful for a solid patient-doctor relationship with my new oncologist, but maybe not as strong as my last one.  You see, our relationship was forged over trying to find a solution for my chemo-induced nausea, my weightloss, my food aversions. It was tested through stomach problems and a decrease of my heart ejection fraction because of Herceptin. I grew in confidence of her abilities every time a nurse  would comment on how thorough she was, the best of the group. Who knows if they say that about every doctor?

My hope is I find my new onc easy to talk with, that I grow in confidence as we continue to have follow ups in the future, but I won't have a need to test her abilities as I tested my other doctor. I'm hoping for simple, normal follow ups until I'm cut loose, probably when I'm no longer taking aromatase inhibitors (the estrogen-suppressing prescription). That could be as early as January of 2018, but it could change, depending on new research that might indicate longer is better.

In the world of cancer, it's best to stay flexible and loose with deadlines.

When I have an upcoming screening date on the calendar, I find I am hesitant to make appointments in the future. Walt and I are talking about taking a belated 20th anniversary trip, using coupons he received for rescheduling a flight from Florida at Christmas. While we talk about ideas, until I've met with my oncologist and passed whichever additional screening she recommends (I think it's an MRI this year), I will not commit.

In the world of cancer, it's also helpful to not plan too far out into the future. Live today, live in the present, trust God.


At least my thyroid is still acting normally. During my appointment last week, my endocrinologist decided I should have an ultrasound to check for changes in my nodules. A few days later, I went into the outpatient clinic for the first time. (My previous ones were in the hospital.)
As I waited for the technician, I enjoyed a moment of warmth in their well-designed waiting room. I almost looked around for a barista to grab a latte. As soon as I took this picture, I was called back to the ultrasound room. Lying on the table, I started praying that she wouldn't find anything wrong. Then I caught myself  and prayed that if there was something to be caught, that she would find it. I've learned that if something needs to be caught, it's best to catch it as early as possible.

Since then, I've received a letter indicating that my thyroid hormones in my blood were still normal, although the doctor seemed surprised  they were inching closer to hyperthyroidism. He explained that currently my thyroid is inefficient, that it takes more energy to produce what a normal thyroid would produce. I'm guessing that an inefficient thyroid normally doesn't move to hyper but hypothyroidism, which means it isn't able to produce the normal amount of hormone. We'll just have to wait and see. I also received the ultrasound report, indicating slight growth of a couple of the  nodules, but nothing to worry about at this point. With the mysteries of my thyroid still unanswered, I won't need to think about it for another six months, all the way until October.

Hopefully I'll be able to say the same thing about my breast cancer. Early Tuesday morning, I'll know more. I keep reminding myself, it's better to know early. And, God's got my back.   And...