Breast cancer: discovery and diagnosis - Jan 2021

 Kia ora! Before I publish the first full episode, I think it will be helpful to provide some detail about how I discovered and was diagnosed with breast cancer. Hopefully someone reading this will be inspired to check their own boobs (or nuts!).

In mid-2020 I was told that the reason for my tubby belly was not just "middle-aged spread" but was in fact a uterine fibroid. Fibroids are non-cancerous growths in the uterus, in my case, in the top wall of the uterus. It was thought mine could be due to excess estogen, and I was put on the list for an abdominal hysterectomy to remove my uterus, cervix, and fallopian tubes - keeping my ovaries intact.

The fibroid reeeally began making its presence felt in the last few months of its existence, affecting the exercise I could do (goodbye, running), sapping my energy, and causing a fair bit of pain in the lead up to my period. I looked quite pregnant by the end and hadn't been near a waistband in a while :)

I don't have health insurance but am lucky enough to live in a country with an excellent public health service - it's not perfect, but I've been nothing but impressed with my treatment so far. Unfortunately my surgery had to be moved from November to December, which I found very hard at the time but potentially saved my life.

The week before the original hysterectomy date I was undressing in front of the mirror but rather than look at my poor stretched belly I noticed a faint depression on my left breast. "That's odd" I thought, as a small chill of fear ran down my spine. I didn't say anything to my partner as he had already been through the wringer of 2020 with challenges of his own, and I didn't want to worry him.

The next day I toyed with the idea of leaving it until after the hysterectomy but I had a feeling that this wasn't something to ignore. Had it been the week before the surgery I might have opted to forget about it for a while, and that would have been dangerous.

I remembered years ago (before mobile phones were a thing) sitting bored in a waiting room, staring at the posters. One of them was a breast-check poster, and THANK YOU to whoever made that poster, and to whoever put it up on that waiting room wall. Because of them I knew this wasn't something to ignore.

I emailed my doctor and was told to pop in the next day for a quick check. She said it might be a cyst and sent me off for a mammogram. Two weeks later I was in the mammogram machine and not happy about it - it HURTS! After saying it would be just 4 quick photos the lovely woman on the machine said in a too-bright voice "we'll just need to take a couple more shots" and I promptly burst into tears.

Whilst I am a fairly leaky-faced person, I don't usually bawl in front of total strangers. They were absolutely wonderful about it and we had a break and a glass of water and then got back to the serious business of taking the World's Most Painful Photographs. I didn't ask directly about cancer as I knew they'd not be able to give me a definite answer and I dislike making people uncomfortable.

I had an ultrasound (not at all painful) and then they took a biopsy - a sample of the "area of interest". I had a local anaesthetic so didn't feel anything, plus I closed my eyes and just let them get on with it. Normally I love gory stuff but when it was my own boob I thought it best to be blissfully ignorant. The doctor and nurse were both calming and kind, and even laughed at my silly jokes, bless them. When it was over they told me that I'd have the results soon, and that I should take a support person along. Uh-oh.

I hadn't brought anyone along with me to the mammogram as I had thought it was just going to be a cyst, so I drove myself home feeling shell shocked. Apart from awkward humour, my other key coping mechanism is stuffing large quantities of sugar into my gob so I stopped at a dairy and bought TWO ice-creams. BOTH FOR ME. "I bet he thinks I have a friend in the car" I thought as I paid my money. I hoped he didn't come out and see me drive off alone.

The next two weeks passed - they dragged at the time, but now they seem quite dream-like. I had lots of physical things I wanted to do - mowing lawns and taking garden rubbish to the tip - as I knew I'd be out of action for 4-6 weeks after my hysterectomy. I was sent an appointment at the breast clinic for the day before my op, and I remember trying to steel myself that I might end up losing my uterus AND my breast in very quick succession.

We had a very nice, very calm doctor give us the news. "Fuck" I said. "Sorry" I said. "That's ok" said he. I went to say something else but "fuck" came out again. Then once more. I appeared to have lost the power of non-sweary speech. I remembered to stop and take a few deep breaths. Deep belly breathing has a calming affect and I needed some of that. It helped, but the world sort of flips over and it's very hard to concentrate after a cancer diagnosis.

The doctor talked about the type of cancer it was and I made notes. I was very glad to have my partner there as I knew I wasn't taking it all in properly. This is where I wished I'd done some reading beforehand, so I'd have been aware of the different types of cancer and the treatment, and not feeling like I had to make frantic notes and understand everything quickly. The nurse came in and then the doctor made an examination but couldn't feel the lump - I can't either. The puckering isn't very visible and I'm so incredibly grateful that I spotted that slight indentation.

I had a very surreal moment sitting on the bed with a tableau of three faces staring at me with concern and sadness. I felt like I was watching them on a screen and nothing felt quite real. Apparently this is a common response. But it was odd. After the doctor left the nurse stayed with us for ages and re-explained the next few steps. We were given a bag of written material to read and we wandered out, into our brand-new lives.

I was booked in for a lumpectomy in four weeks time, with major abdominal surgery in-between. Neat. Not ideal but the consensus is that I am fit(ish) enough to handle it, and also there wasn't a lot of choice. I'll explain more about the type of cancer and my treatment after I've had my lumpectomy, as we'll know more then. That'll be in the February 2021 episode.

The lumpectomy is a much smaller surgery than the abdominal hysterectomy so I will have a far shorter recovery time. It is, however, a much bigger thing to get my head around. I'm still working on that.

Coming back to the estrogen that I mentioned earlier - having high estrogen (being "estrogen-dominant") is a contributing factor of both the fibroid and the breast tumour. If you have fibroids I would recommend requesting a mammogram asap, just to be on the safe side. Fibroids aren't usually life-threatening, but breast cancer is.

Please don't put off having smears, exams, mammograms, whatever - get to know your body and follow up anything even slightly unusual with your doctor. If your doctor fobs you off, get a second opinion!