From the category archives:

Anxiety & Fear

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My husband and I are both stuck in the glue of our gloom, unable to reach out to each other.

I am restless, crabby, scarred, impatient, and distracted both at home and at work. I cannot concentrate on anything. All I do is obsess about a second surgery. It is not the surgery that scares me, but delaying the treatments has me excessively worried. And the type of treatment.

My husband is down for many reasons: his job, my situation, life in general. This time I do not have the emotional resources or stamina to try to help him break out of his zone. I am too preoccupied and self-obsessed. Also, I am, irritated with him.

He has not even glanced at any of the many brochures, articles, and books on breast cancer lying around the house. It would be good to have his perspective on matters. My husband has a scientific mind. He is the type who will read the instructions for a new Panini grill cover to cover. But the pamphlet “What to Expect from Chemotherapy” sits untouched on his bed stand while he gorges himself on a big fat business book. I am pretty sure he has not spent two minutes Googling breast cancer to learn more. It is as if he thinks: That is her problem. But if he had prostate cancer, I would be all over it. So to speak. I would want to try to figure out what he would be facing. What we would be facing.

Late one afternoon, I finally receive an email from Dr. Guru in response to my question about my lack of clear margin.

“I appreciate your concern. The primary excision was not oriented so I don’t know where they came up with lateral. The additional margins, inferior and medial, were removed after the primary excision was performed. They were the closest margins deemed from intra-operative inspection and no residual tumor was in those specimens. You do not need additional surgery. Sorry for the confusion.” Guru

I  read the mail several times without a clear understanding. Did he take out the tumor then went back in and scraped out some more? Is that what he means by “intra-operative perspective?” But what does “the primary incision not oriented” mean? He’d have to cut the first line somewhere.

I believe Dr. Guru when he says I do not need a second surgery (although I am still annoyed with him.) Had he only sat down with me to explain my pathology report, all this hysteria and worry and anxiety would not have come to pass. He would not have had to endure my blistering emails.

Yet, I am  relieved. Now I can move on to the next treatment. Will it be radiation or do I need chemo first? The mere thought of chemo therapy petrifies me.  Millions have endured it. So why am I such a complete whimp? And when will I find out if I need it? Where is my oncodx test result?

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Three weeks after after my lumpectomy, and after some prodding and probing,  my pathology report arrives in the mail. I polish my bifocals. — the better to see you my dear –  and sink down in my favorite reading chair.

On page one, I immediately zero in on these worrisome phrases:

“All other surgical resection edges free of carcinoma”, “cribriform pattern with associated comedo type necrosis”, and “perineural invasion is identified” (slide 3H.)

Cells with cribriform pattern are considered less aggressive. Comedo type cells, on the other hand, are nasty little fellows. They are associated with the most aggressive form of cancers. Comedo-type necrosis, along with  tumor size, nuclear grade, and margin width are all important predictors of the probability of  recurrence.

Necrosis is Greek for death. Comedo type necrosis happens when the cells proliferate so fast they kind of choke on themselves and die. But other type of cells like cribriform, papillary and solid may  also suffer necrosis to a varying degree.

I realize I need to ask Dr. Guru what “my necrosis” means. Guessing is both a scary and an inaccurate activity.  I am a bit annoyed that he did not ask me to make an appointment and offer to explain everything.

Perineural invasion means that cancer cells and nerves are entangled. Do nerves provide the path of least resistance when cancer cells escape the breast, like veins and lymph nodes? I need to defer to Dr. Guru on this one as well.

Before I can compose an e-mail with questions for him, my mind is set on fire by the following:

-tumor less than 1 .0 mm from lateral resection edge

-all other surgical resection edges are free of carcinoma.

Now I am not an English major. English is, in fact, my second language. But “all other edges free of carcinoma” sounds to me as if ONE edge is NOT free of cancer.  Or do I need to take my TOEFL test again?

What happened to my “wide” margins?

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Full Circle In One Month

August 12, 2009

In the morning, as soon as Dr. Guru’s office opens,  I call to nail down my surgery date.
“We can not plan anything until we have your MRI results,” his assistant sounds tired. “We don’t know what we’re dealing with yet. Yes, you can have a lumpectomy next Tuesday.  Anything more involved, requiring more time, will [...]

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Dr. Guru, I Am Mad. Where Are You?

August 7, 2009

Thursday, I only have one thing on my mind, one thought circling my brain like a  hungry wolf.  I want to go under Dr. Guru’s scalpel, I need for him to get rid of my nasty, ugly tumor. Now.
Not a word from Dr. Guru’s office.  Not a word about the MRI results.  Not a word [...]

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Hypochondria Galore

August 6, 2009

No MRI results. No pathology report on the calcification in my left breast. No surgery date  – yet – to remove the cancerous hazelnut in my right breast. Five weeks have passed since I received my diagnosis. Five weeks since I was told I may have lived with breast cancer for a whole decade. And [...]

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“Ask an Expert” – It May Save Your Life

August 1, 2009

You don’t understand your doctor’s mumbo-jumbo, or have doubts?  You are confused about the correctness of your diagnosis or your pathology report? You are too scared to wait six months to find out what may lurk inside your boob?  You have a family member, or a friend, with breast cancer and you want to figure [...]

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Bills, Bills Everywhere

July 24, 2009

The post man sprinkles me with bills. How many have I managed to accumulate, considering I have not yet had my MRI or surgery? Did their computerized billing system over heat? Reluctantly, I open the first white envelope.
“This is not a bill” it reads. Then what is it?
It is a letter from the insurance company [...]

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Another Scary Mammogram

July 14, 2009

As I enter the semi-dark room for my third mammogram in a month,  I notice two large X-rays mounted on a back lit panel. One shows a breast with two lumps and a calcified area, all clearly circled in red. I assume this is the view of  my right breast and freak out at the [...]

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Retrieving My X-Rays from the Breast “Care” Center

June 29, 2009

Friday afternoon. I drive back to the Breast Care Center for the fourth time in less than a month to retrieve my mammograms. I need to give them to my surgeon when I see him.
Again, I ruminate  over the hopeless, pointless, and completely unanswerable question: Why did they not find my lump last year, [...]

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Announcing to Extended Family: Onset of Anxiety

June 29, 2009

Sunday dinner with extended family: Sister- and brother-in-law celebrating the return of a lost son. He is now home after two years in Japan, teaching and one year in Vietnam, doing what? We are about to find out. Luke is sensitive, intelligent, and well-informed, I can’t wait to hear about his Asian adventures. Yet on [...]

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