I am sure it will surprise many people to learn I have breast cancer. Many will not have been aware that I actually have breasts. I know some ladies who have nicknames for their breasts, “The Girls” and so on. I have always thought of my particular pair as “The Walnettos.” As these things go, mine have been a couple of duds.
Pathologists often informally describe a tumor’s personality using terms ranging from “indolent” to “aggressive.” I would describe my breasts as “chronic underachievers.” They certainly have never been outgoing. For years they sat around like bumps on a log and then some rogue cell comes along and they just roll out the Welcome Wagon.
I kept thinking about my left breast. Maybe in its limited remaining time, it would start doing amazing feats, like hanging drywall or perhaps tuck pointing.
Two escaped prisoners were on the lam near my vacation rental. I imagined my left breast bringing the miscreants to justice: “All right fellas,” I would say as I marched the cons into the police station with my concealed weapon. “Nice and easy and nobody gets hurt. Don’t make me get old Lefty out.”
After I got back from vacation, I resigned myself to losing my breast. I bought a recliner. I made sure I had a good supply of button-down blouses. I read a lot about lymphodema. And then I went for a bone scan.
The bone scan technician, who had been sharing her wedding plans with a coworker, fell silent. She called the other woman’s attention to something on the screen. “Katherine, does your back hurt?” she asked.
“No,” I said.
Eventually I got the metastatic diagnosis and my surgeon referred me to an oncologist. She told me the lumbar vertebrae was involved but not extensively. “Hopefully the disease will remain under control for a long, long time although an ultimate cure is probably not attainable.”
I was wearing a pink paper gown. As I was lying on the table, the oncologist concluded her exam by sweeping the gown away from me as though she were a bullfighter executing a two-handed veronica. I found myself sitting upright on the table clutching the table’s paper runner over myself, not so much to hide my shame, but my surprise. I decided to find a different oncologist.
Because the cancer had already spread, my surgery was canceled. If you have extensive metastatic disease, surgery generally isn’t an option. If you don’t have a lot of cancer, a mastectomy will be considered eventually, provided your cancer isn’t doing much.
I had already told our benefits coordinator I was having a mastectomy. Other employees have had non-invasive breast cancer and therefore some combination of chemo and surgery.
When I told the benefits coordinator I wouldn’t be having either, at least for a bit, she was baffled. “Have you sought a second opinion?” she asked. “They don’t seem to be doing much for you.”
Metastatic breast cancer patients start with the least toxic option first, in my case hormonal therapy—a daily pill. I know the medical rationale for this protocol. I understand that the emphasis is on controlling rather than curing the disease. Yet there was still part of me that agreed with benefits coordinator: They didn’t seem to be doing much for me.
After five months of treatment, my cancer looked the same. Nothing got bigger or smaller. I was stable and therefore once again a candidate for surgery. Now it’s just me and “Righty.”
People with MBC never finish treatment. That’s a hard concept for many people to grasp, including me.
Something Larry Norton, a doctor at Sloan Kettering said, has stayed with me. “Don’t forget the moment,” Norton said. “Be in the moment and enjoy it. Sometimes patients get so focused on what happened in the past or what might happen in the future, they miss the moments they have.”