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.

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....