Monday Inspiration: I'm Not Pleased With You, Larry the Lump (Cancer Diaries)

Oh, my, Larry the Lump! You've done some mean things in your time, but this beats all! I am not at all pleased with you.
Since you were diagnosed at Stage Three last August, I have tried to look on you, not as a malignant creature, but as some of my own cells that are confused and disaffected. Good cells gone bad, you might say.
But there's definitely a mean side to you. Like the fact that you are a species that doesn't always or readily show up on a mammogram, so I went through all those uncomfortable boob-flattening mammograms, year after year, just so that I could feel safe from the likes of you. I actually felt I was taking care of myself, going through the necessary tests that would sound the alarm bells the moment just one tiny cell started to misbehave.
How innocent I was! How mean you are! No doubt you had a good laugh about that, Mr. Meanie.
Even my own doctor dismissed my anxieties about pain in the breast with the comment: "Oh, your mammogram was clear, so there's nothing to worry about."
It took a breast scan and a biopsy to decide just what you were. And MRI tests to keep track of you.
It's cold comfort to hear that if a professional didn't know this, it doesn't seem so dumb that I didn't know. Invasive lobular carcinomas can be difficult to diagnose as they are generally symptom free or have few symptoms, are difficult to feel and don't show any changes in breast shape until they've grown big and strong. Even when they can be felt, they don't necessarily show on a mammogram. They account for about 15 per cent of all breast cancers. Read more here.
Apparently Larry had been around for up to six years before being detected. That was the first nasty trick.
The second was the side effects in response to the drug I began to take to shrink him. Larry did not enjoy being on a diet (he has estrogen receptors and the drug blocked his daily intake so he was starving and even more mean.) This left me feeling more fatigued than before the diagnosis, with symptoms of menopause like hot flashes, memory lapses, occasional depression, etc.
But it seemed it was all going to be worth it. Larry had shrunk by about 70 per cent and it looked like I could do a lumpectomy, a much less radical surgery than a mastectomy or the removal of the whole breast.
That's where another mean trick came in - as he shrank, Larry broke into several smaller pieces, little Larrys, I guess you'd call them.
But they inhabit the same space that the large tumor did, and the odds of them all being removed, along with all possible cancerous tissue, plummeted.
So it's a mastectomy now.
That means an eviction for you, Larry.
No more warm and cozy nest.
I suppose, in a grim way, I have the last laugh.

Larry the Lump - More Famous Than Me? (Cancer Diaries)

It appears that Larry the Lump, that little knot of confused and disaffected cells that has nested in my left breast, is more famous than me. That is something I do hate him for.
Oh, I can accept that his appearance in my left breast is purely random. Sure, he doesn't actually mean any of the harm he has caused me. Nothing I or anyone else has done likely caused his existence.
I can live with the prospect of surgery soon; I can cope with the sometimes very debilitating side effects of the drug I am taking.
I can definitely enjoy the idea that Larry's estrogen receptoring little presence is being quietly starved of estrogen because of the treatment. Shrink and die, you little beast!
But what I hate him for is that he seems to have caught the imaginations of so many people.
Really? You ask.
Yes, indeedy.
My regular blogs, where I meander on about writing and life, usually enjoy the attentions of a few hundred readers.
But blogs where Larry is the star, we're looking into the four figure numbers of readers who log in to read his adventures. Yes, Larry is more famous than I!
Although there has been a kind of secondary benefit to me for blabber mouthing about this cancer, a lobular tumor that doesn't show up on mammograms.
I know that this concept, that there are breast cancers that the mammogram may not pick up, has been food for thought for quite a number of readers and friends. Indeed, some have sought further medical checkups. Sadly, at least one woman has been diagnosed with cancer after she insisted on a breast ultrasound after hearing about the symptoms that finally led to my diagnosis.
Strangely, many people have commented about my willingness to give Larry the Lump centre stage as I talk about this experience. The words courageous and brave have been used, and yet that's not how I feel.
For one thing, as a writer and journalist, I think that knowledge is power. If you know the possibilities, you can perhaps prepare or protect yourself from them. I know I was shocked to learn that all the mammograms I had had faithfully over the years had failed to pick up on what the oncologist says is a tumor that has been around for five or six years without detection.
I belong to a generation in which the word 'cancer' was never spoken. In my family home, if totally pushed, you might refer to the 'Big C', but never THAT word. It was as though mentioning it would bring the curse down on someone's head. Even the close relatives of people who had actually been diagnosed were advised by doctors not to tell that person he or she had cancer. It was such a scourge that people feared a victim - and that was the word used then - would commit suicide rather than face the odds of dying from the disease.
So I talk about cancer. Everyone I know knows, and hundreds more people who have never met me know. And there is a benefit for me, too - all the love and support, prayers and good thoughts I have received must surely be causing some kind of ripple in the ether, because so far my test results are looking good.
I can only repeat: if you have pain or discomfort in your breast don't assume that if the mammogram is clear there is no problem. Ask for further investigation.
And educate your doctor - mine told me there was nothing wrong because the mammogram was
clear. When I finally got a biopsy and MRI, the little beast was more than eight centimetres long and growing lustily on a diet of estrogen.
Even so, I still resent Larry's popularity. That he should be more famous than me!
Sometimes, even on his starvation diet, I think he's laughing....

NOTE: I was shocked to discover that there is actually another Larry the Lump mentioned in a blog by someone with throat cancer! And I thought I was so original! Here's a link to that other Larry: https://selfy0105.wordpress.com/

Monday's Inspiration: Larry the Lump Gets Rude About My Treatment Decision

"Incoming Storm"

Since my post "Good News for Me, Bad News for Larry the Lump", when I was trying to make an important decision on the treatment of my breast cancer, I have had a lot of people asking just what decision I made.

Basically, I had to decide whether to have a mastectomy now and then go on to an anti-hormone treatment to starve out any roving cells, or to take the hormone treatment first, which might shrink Larry the Rather Large Lump, and hope that he would be slim enough for a lumpectomy, thus saving my breast.

After a long weekend of agonizing I decided to go ahead and postpone surgery while I take the drug Letrozole (Femara) for the next four to six months, when we will review the situation and see whether Larry's estrogen free diet has worked. Larry is a lobular carcinoma, the kind that don't show up on mammograms, with receptors for estrogen, which he sucks out of me to form his daily diet.

So far I have met wonderful doctors, including Dr. Angel (yes, that's her real first name) and Dr. V., both of whom I have grown to trust. Dr. V. held my hands, looked into my eyes, and told me that I would be looked after and the treatment carefully monitored for the very best results. If at any time I was worried, or the side effects of the drug proved too much for me, I could call him and get the help I needed.

Can't ask for much more than that, can you? Plus, the support staff are kind, friendly, smart, and committed.

So, then I had to break the news to Larry the Lump. There's a pain therapy that advises naming your pain, getting on first name terms with it and using that connection to discover the source of the pain and what your body needs to heal. It might sound a bit weird, but I've found it very helpful.

We've had lots of chats, Larry and I - I've spent a lot of time visualizing him shrinking, and much more time explaining that we really weren't mean to be soul mates.

So I opened up another of our little chats with the phrase: "Larry, I know you are just a bunch of

confused and disaffected cells from my own breast and I do feel for you, really I do."

This gambit, as always, was met with a snort from Larry.

I went on: "While I have nothing against you personally, old buddy," (the doctors said he'd been around for five or six years, comfortably nesting in my left breast."We're down to the wire and it's really you or me. So, we're cutting off your food supply. From today onwards, no more tasty estrogen for you."

I received an angry screech of "F**k you! I want my dinner!"

So rude, Larry.Tsk, tsk.

And I swallowed the first of my Letrozole pills.

"Sionara, old buddy."

Monday’s Inspiration – Good News For Me; Bad News for Larry the Lump

Have you ever noticed how sometimes the most important decisions you must make in life come at a time when you are least able to make them?  

Today is decision day on my breast cancer treatment. If you’ve been reading this blog, you’ll know that I was pretty depressed last week after my consultation with Dr. Angel (that really is her name!). Not all the tests were in, but it wasn’t looking good.

Larry the Lump was designated a Third Stage cancer, weighing in at the very first ultrasound/physical exam at 10 cm. That’s pretty big. The second visit with the oncology surgeon she thought Larry was more like 8.5 cm, the rest was bruising from a core biopsy. Still a big boy, and a type of cancer - breast lobular carcinoma – that usually affects the other breast as well. Then it appeared a shadow on the MRI suggested that there was a small tumor in my lymph glands. Which meant that Larry was inviting friends to the party, too.

Which all added up to bad news for me. And very likely a double mastectomy.

Had much better news from my 'Angel' doc on Thursday. All the test results were in, including some new ones. No other cancers were visible, not in my other breast, in my lungs, liver, abdomen, bones – all the places were Larry’s friends were most likely to be lurking. A needle biopsy of the shadowy lymph gland came back negative. Good news for me there was no established tumor in the lymph system, those all-important little glands that form a pathway throughout the body for all kinds of vital stuff.

Even better, Larry the Lump was now weighing in at 7.8 cm – not exactly a lightweight, but significantly smaller than first thought. Was it just that all the bruising from the core biopsy had finally subsided, or had all those prayers and good thoughts that had been circling around me from so many people, family, friends, and friends I hadn’t actually met, had actually shrunk the little guy a wee bit? That’s a nice thought.

Good news for me now there is a treatment that might save my breast. The bad news for Larry is that being a bit smaller, he’s now a candidate for this treatment and his days are definitely numbered.

So to my decision. I can go ahead and have a mastectomy, followed possibly by radiation and by anti-hormone treatments. The cancer I have, like many other breast cancers, feeds on estrogen, so one tiny pill a day will starve poor Larry – and any of his pals and offspring that may be lurking around.

The alternative is to postpone the surgery and have the ant-hormonal treatment first. Between four and six months of pill popping and frequent checkups, and Larry might just be small enough for a lumpectomy, which would save my breast. Which is a very attractive prospect.

Sounds wonderful, but there are no guarantees. As the doctor said, can you patiently take pills for four to six months while knowing that cancer is still sitting on your chest? Well, can I? When first diagnosed my reaction was that I wanted surgery like, yesterday, if not sooner. Get this thing off me!

Now I have a chance to keep my breast with the hormone treatment. It doesn’t work for everyone, second it doesn’t shrink the tumor away to nothing – although Dr. Angel says she has seen some ‘miracles’ like that. If I’m lucky, though, it would reduce Larry to a much smaller version of himself and a candidate for the less drastic surgery of lumpectomy.

I feel like a pinball, flying back and forth between the two options. I have to decide by tomorrow, because I’m on a surgical list and if I decide not to go ahead with surgery, someone else can move into my spot and be prepped for surgery while I take the other option.

So by the time you are reading this it will all be done and dusted. Please keep those good thoughts and prayers coming.

PS - the photograph above is one I took a couple of years ago and titled "The Long Road Home'. Which is what I feel like I'm on right now, a long road to better health....

Monday's Inspiration: Larry the Lump Sneaked Past the Mammogram....

 Perhaps 'inspiration' is the wrong title for this blog, but I wanted to get word out about how a clear mammogram doesn't necessarily mean there is no cancer - or early 'in situ' cancer cells. That's not to frighten anyone - but sometimes, a little knowledge can be a lifesaver.

I posted a while ago about Larry the Lump, the nasty little cancer located in my left breast. I was shocked to discover that this had already progressed to Stage Three before I even knew it was there.

"How can this be?" I asked. "I have done mammograms religiously and they've all come back clear, I've done self-exams and it's only been recently that I thought there was a slight thickening. Even my doctor said that if the mammogram didn't show anything, then there was nothing there..."

There's no breast cancer in my family, either. Foolishly I thought there was little chance I would ever develop it. Another myth busted. .

I have a type of cancer called invasive lobular. Seems this is a sneaky beast, a long, thin cancer that doesn't show up on a mammogram.

I had a routine mammogram last September, complained to the tech that I had some 'crinkly' skin on my breast and shooting pains. She said that if the mammogram came back clear and I was still worried, talk to my doctor.

A few weeks later the letter came - the mammogram had shown nothing. All clear.

Gradually I became aware that the wrinkling skin was getting worse, and the pain and aching were still there. So I mentioned this to my doctor when I went for a pap smear (yep, I did all those regular exams!) and she said nothing showed on the mammogram.

Fast forward a few more weeks. The bathroom mirror announced that my nipple was inverted and the wrinkling was worse. Then I felt a slight thickening in my breast. Back this time to see the nurse practitioner, who thought she could maybe feel a slight lump 'and we should get another mammogram'.

Another mammogram, two ultrasounds and a biopsy later, a cancer diagnosis.

Larry the Lump was by this time eight centimeters long. Stage Three.

Pass lumpectomy and go straight to mastectomy.

Invasive lobular breast cancer makes up about 10-15 percent of breast cancers.

It doesn't show up on a mammogram in the earlier stages, if at all.

And it often affects both breasts.

Now, after a whole panoply of tests and biopsies, I'm meeting with the oncology surgeon this week to hear just how drastic the surgery must be.

I'm fortunate to have a lot of support from family and friends, and an oncology doctor who specializes in this kind of cancer,

Plus her first name is 'Angel'. Here's hoping she's my angel :-)

So again, I don't want to frighten anyone, but be pro-active. If you feel something is wrong, do insist on further investigation. My type of cancer needs an MRI to properly diagnose it..

And many, many thanks to all the folks out there who have contacted me with good healing thoughts, prayers for a fast recovery, and comforting and encouraging stories of others who have been through this. Please continue to keep me in your thoughts.

Will keep you posted as to when Larry the Lump is to be evicted the sooner the better!

The Day I Faced Larry the Lump....

I've met a couple of the Larry the Lump nasties before, but somehow always managed to escape unscathed. I’m not a very confrontational person. In fact, I’ll do anything rather than make a scene or get into an argument. I will, when pushed, stand up for my rights, but I’d rather walk away than stand my ground if it means stirring things up….

But today I had to face down Larry the Lump. He’d been bothering me for a while, with sharp little barbs and promoting a general feeling of discomfort.

So I finally bit the bullet and visited my medical team. “Uhmmm, I think I can feel the edge of something here,” the nurse practitioner said, palpating my tender left breast. “I think we’d better do a mammogram.”

”But I had one less than a year ago, “ I argued, happy to miss another round of crushed and flattened boobs..

“Well, even so, I think it won’t do any harm to have another look.”

So I had another mammogram. Followed by an ultra sound.

And because everything seemed fine, we went out for lunch at a new Chinese restaurant to relax.

Then a call back from the hospital early the next morning – could I come in  for another ultrasound? The radiologist wanted to take another look.

Uhm. So another ultrasound, with me lying on the examining table furtively watching that little screen without understanding a single pixel of what I was seeing. And that little prickle of unease starting to niubbble….

"That’s good. If the doctor wants to do a biopsy we'll call you this afternoon."

The afternoon sped by, and at four o'clock I hadn`t heard anything. "I think I ducked that bullet," I said to my Better Half as we drove home.

And right that moment the phone rang.

"Doctor thinks we should do a biopsy. Would you be free to come in?"

Swallow. Deep Breathe. "Sure, sometime in the next couple of days?"

Silence on the other end of the line. Then, "Actually, we`d like you to come in first thing in the morning."

And that`s when I knew I’d have to face the reality of Larry the Lump. And he wasn`t going to be very co-operative. There's a form of pain management that encourages you to name your pain, which as far as I can tell allows you to befriend it because you recognise that pain is your body`s way of letting you know there`s a problem,. By befriending, naming, talking to your pain, you can learn what your body needs to heal.

Except that Larry's thick skin interfered with the anaesthetic and that needle hurt. Round one to Larry.

Fortunately it was all over quickly and the radiologist was kind and gentle.

Now it`s a matter of waiting, something I don’t do well. Five to seven business days to get the results. Within the next few days I`ll know just how much of a disruptive influence Larry is going to be in my life – or whether this is just a fleeting acquaintanceship…..

Note: Three business days after the biopsy, after I had written this blog, as we headed out for lunch with our daughter who was on vacation, the cell phone rang. I knew even before I answered that it was bad news. That nasty little lump was cancerous.
I'm getting by with help from my wonderful family, some good friends, and Facebook friends, many of whom have defeated their own Larry the Lumps.

So now I can't ignore him but Larry, if you're listening, you're going down. There's a nice lady surgeon just waiting to meet you....

I'll post again to let you know progress!