Writer, mother and grandmother DIANE TREMBATH lives in Exmoor. After being given the all-clear three years ago, she has recently been diagnosed with breast cancer for the second time.
The days immediately following my ultrasound and biopsy appointment were strange and flat; it was if every speck of colour had leached from the world. I had yet to tell my immediate family that it was almost certain that I had breast cancer again, having decided to wait until I had the results of the biopsy.
I was still clinging on to a flicker of hope and had not wanted to worry my daughter and her husband. In any event they had already planned to come down for a long weekend with my young granddaughter. If the news was not good, we would be able to talk about it, once my granddaughter was asleep. If it was good news, well, there would be nothing to tell.
My results appointment had been scheduled for the Friday morning, my CT scan for late afternoon the day before. It’s normally an uplifting drive, most, through a rolling rural landscape that is very dear to me and it was one of those gloriously hot English summer days that stop you longing for the warm south, the sort of day that I love. But that day I felt leaden and it took every ounce of inner strength to get myself to the hospital. As I was only attending for a scan, I hadn’t bothered to ask anyone to come with me, which – I thought – was probably just as well as I wouldn’t have been very good company.
It was only when I tried to check in at the X-ray department’s reception desk that things started to take a surreal turn. The receptionist couldn't find any record of my appointment so checked with his manager.
‘Your scan has been cancelled, apparently,’ he told me.
This was news to me. I asked why and, at this point, a helpful young radiographer joined the conversation. He had taken the call from the radiologist in the breast care unit who had cancelled the appointment, saying that it was no longer necessary. But the radiographer didn’t know why. The only reason I could think of was a positive one. Maybe the biopsy had returned an unexpectedly good result? Maybe I don’t have cancer after all?
‘Could this mean good news?’ I asked him, adding quickly, ‘I know you can’t answer that but…’
‘Let’s hope for good news,’ he replied. What I wanted, above all, was clear information, so he offered to track down the radiologist. A few minutes later he was back.
‘I’ve spoken to Dr S, she hasn’t left yet; she’s still over at the unit and if you go straight there, she’ll explain about the cancellation.’
‘On my way,’ I said – and the young radiographer wished me luck. It’s quite a hike from one department to the other but for the first time in days, I was beginning to hope and the leaden feeling began to lift.
Dr S was waiting for me and smiled as I was shown into a consulting room. She confirmed that the scan had been cancelled as a result of a decision by the multi-disciplinary team (MDT) that afternoon. So I asked, again, if this could possibly mean good news.
‘Mr J is here. He could see you in about 20 minutes and he can talk you through it if you like.’
Despite beginning to feel like a hamster on a wheel, I agreed to wait. I know Mr J and I trust him implicitly; he was my surgeon the first time round and he is very good at what he does. Whatever I needed to know, I wanted to hear it from him. I sat in the sunshine in the unit’s small garden area and sent WhatsApp and text messages to the few close friends whom I had taken into my confidence. ‘It might be good news…’ They all cheered me on.
Meanwhile, an incident almost 200 miles away reminded me that things were happening in the outside world too. I had started to receive messages from my daughter to say that they had been involved in a car accident shortly after leaving home. They were all unhurt but badly shaken and would not be arriving until much later than anticipated and was that OK?
‘Of course, just take care and stay safe,’ I replied, as any parent would.
Telling it like it is
Twenty minutes later, a nurse called my name and showed me into… an examination room, asked me to get changed, and said that Mr J would be with me directly. The scintilla of hope started to dissolve. There could be only one possible reason for having to don an examination gown.
Mr J arrived within seconds, accompanied by a breast care nurse, and it was only at that point that I was asked if I had anyone with me. As I’d come to the hospital simply expecting to have a scan and go home again, no, I didn’t have anyone with me.
Mr J got straight down to business. I did have breast cancer but not the same type of breast cancer as before - Stage 2 invasive ductal carcinoma. I had a new primary breast cancer – Stage 2 invasive lobular carcinoma. The original cancer was out of the picture, having been successfully treated and there had been no secondaries. The MDT took the view that I shouldn’t be exposed to the high levels of rays involved in a full body scan unnecessarily. With my original diagnosis, I had had surgery – a wide angle excision, which had left my breast intact – followed by 15 rounds of radiotherapy. This is seen as the optimum treatment for this type and stage of breast cancer. But a wide angle excision, said Mr J, was not an option this time, as I could not have any more radiotherapy (too risky). This time the optimum treatment would be a mastectomy.
And then there were the lymph nodes. As I had already had a sentinel node biopsy, which involved removing several lymph nodes - all clear, as it happened - from my armpit, I couldn’t have another one. This time, it would be an axillary node removal, which carries a considerably higher risk (20-25 per cent) of developing lymphodoema.
Did I have any questions, asked Mr J…
I’d been making a note of questions since my ultrasound appointment; they were in a notebook at home. I didn’t think I would need them for a CT scan appointment. My mind, by now, was a complete blank; I couldn’t think of a single thing. Surgery wasn’t desperately urgent, he said, and I could choose my preferred date, within reason.
Breast Cancer Care – and my loved ones - to the rescue
Mr J left me with a breast care nurse who ran through the ‘what happens now’ and ‘things you need to do’ lists and handed me a folder and several Breast Cancer Care leaflets. But I had beaten her to it because I had already ordered the same leaflets and many more from Breast Cancer Care immediately after the ultrasound, when I first learned that there was a possibility that I had breast cancer again. The fat package arrived very promptly and I had read very single one. Breast Cancer Care had been a lifeline the first time around; it was to become even more so this time…
And that was it. I walked back to the car park in the late afternoon sun and drove home. But a strange thing happened; the leaden mood had gone, the picture was now clear. I knew exactly what was wrong with me and I knew exactly the nature of the treatment I was facing. The weight of uncertainty had gone and it was, much to my amazement, a great relief.
Much later that evening, my daughter, son-in-law and I sat down after supper and I shared the news that no parent wants to give to their children. There were tears, of course, but there was reassurance too; there was even some black humour. We were in the realms of what we had previously called the Massive Inconvenience and now we had to deal with the Massive Inconvenience Mark 2.
My son-in-law took my granddaughter out the next morning, to visit some of their favourite local Exmoor spots, so that my daughter and I could talk more fully. We did talk and then we did what we have always done when we’re up against it, we put our heads together - and we made a plan.
To be continued
Diane with her beloved canine companion Pumpkin
For detailed information and advice about breast cancer screening, tests and diagnosis and individual support visit: Breast Cancer Care
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