From the category archives:

Surgical Oncology

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Whatever it was that showed up on my friend Elise’s mammogram, it needed a biopsy. A different doctor might have said “Let’s wait and see. Come back in six months.” But not Dr. Guru, he claimed that a biopsy was “the medically prudent thing to do.” So Elise went ahead and had her biopsy “just in case.”

It was a lucky thing too. Elise’s voice was shaking a bit when she told me they found cancer.  This was the second time in twenty years she had received this dreaded diagnosis. You’d think one gets jaded, but that is not how it works. If anything you are far more scared the second time around. You cannot help but think: “What is wrong with me?”

Dr. Guru assured her “it ” was early and extremely unlikely to have spread. She was relieved thinking she could probably avoid the much feared chemo therapy. Elise had a mastectomy, what the heck, her other breast was already gone. Why not even out the front side and avoid radiation?

That evening in the hospital, Dr. Guru stopped by her bed to check on her, and to tell her that he found a cancer cell in her sentinel node. On top of that, it was a different kind of cancer than the one he found in the breast. Elise could tell how shocked the normally cool Dr. Guru was at this unexpected turn of events.

After a review of the pathology report on both cancers, Elise’s oncologist allowed her to skip chemo therapy and opt for hormone therapy only. She is doing fine – so far. That is the horrible thing with cancer: you look good, feel good, and whoops, a little cancer cell jumps up and rakes havoc with your life.

I am telling you this to let you know: always look into something that is “probably nothing.” Yes, a breast biopsy is not pleasant, but it is no worse than getting a crown at the dentist, and infinitely much less painful than a bee sting. Remember the words from Dr. Susan Love: breast cancer is not about statistics, it is about the individual.

When you hope for the best always plan for the worst. Medically, it is the prudent thing to do.

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My friend Elise, who had breast cancer more than 30 years ago, sends me an email. Back when she had her first breast cancer bout, she was a law student with two young children. She had a mastectomy. No implants. No chemo therapy. No radiation. Now she has discovered something in the breast she has left.

Right away I pick up the phone to call her.

“ I went over to the Magnolia Cancer Center to get a diagnostic mammogram and to see Dr. Guru,” she says.  “He is not overly concerned but wants me to have a biopsy. Told me it would be the medically prudent thing to do.”

She pauses. I am looking for the right words because I can tell she is more worried than she lets on.

“I must admit I am a bit rattled,” says Elise. “Although Guru seems to think it is highly unlikely this is cancer.”

“So did he look you straight in the eye when he told you it is nothing,” I ask Elise. “Or did he avoid eye contact, shuffle the papers or glance at the cell phone as he spoke? Did he say it was “nothing ” or “probably nothing?”

Elise and I speculate over the phone, like two high school girl friends speculating about some boy. Did he really say he likes me? Do you think he will call? Except Elise and I are now two middle-aged women, not two loved-crazed teenagers. And our speculations are not about a boy one of us fancies. It is about the surgeon oncologist we both share. And we are not trying to read tea leaves about love, but about biopsy results before they are in.

We analyze Dr. Guru’s every gesture as he talked to Elise. Every nuance of his demeanor, of his tone of voice, of the words and how he weighed them. Finally, I conclude: Well, Elise, if that is what guru said and if that is the way he said it, then it is from God’s mouth to your ear. Of course you will be OK. He would never say it that way if he wasn’t sure, I tell her.

Elise sounds relieved. I am relived too. I believe what I just told her. But then again – even if I didn’t – I would have told her that  she would be all right. Just as I would have assured her if she had asked: Do you think he will call? Like any   real friend, I would have said: Of course, he will call you. And then if the call never came: “He didn’t call you? How strange. Maybe he lost your number? Maybe he dialed the wrong number, could he have read your 4 as a 9? You write your fours like nines some time. Maybe he is too shy?”

What is even more typical in my friend Elise’s situation, she would speculate with a friend rather than turn to an expert. Her husband is a doctor, he works with guru, and they are practically neighbors. The most logical step, perhaps, would have been to ask her husband to ask Guru if he really thought it was “nothing” or if he was more concerned than he let on. But no, Elise mulls all these scary details over with someone, me, who is probably the least qualified in the world, medically speaking, to give advice. But I will say what she wants to hear.

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Truth Between Dr. Guru And Me.

February 18, 2010

Dr. Guru calls me at work with the pathology report.  “I just got it,” he stresses. (So he did read my  blistering email after my first surgery. Then I complained about him not sharing the pathology results until two weeks after he himself received them.) “Everything completely clear, just as we knew it would be. […]

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Re-Excision Day

February 6, 2010

Second time in OR, I feel like a pro, familiar with the routines of the ambulatory surgery unit.  The prep-nurse and I exchange recipes and talk adult children. While we chat,  Dr. Guru flies by the open drapery, grins,  and gives me a half baked wave. He looks a bit like the cat who ate […]

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Another Duel With My Surgeon Oncologist

January 28, 2010

This is the week Dr. Guru promised to do my re-excision.  But not a word from his office or from his assistant, Joy,  who  supposedly is “arranging the details.” No explanation. No apology. No  follow up. Meanwhile I am obsessed with my research, trying to figure out the dangers of putting off radiation. Everything I […]

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Dr. Guru Agrees to Re-Excision

January 22, 2010

Twenty minutes after Professor Oncology nixes chemo therapy, five minutes after Dr. Alpha, the radiation oncologist, calls to tell me that I need a re-excision to get clear margins (you are supposed to have 2 mm) I am sitting in my friend’s garden sipping tea from her bone china cup. I am “in the moment” […]

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Re-Excision After All

January 17, 2010

Three distinguished physicians, all cancer specialists,  seem lukewarm – or indifferent – to the merits of chemo therapy, in my case. I feel as light as a swallow, and just as fast, as I leave the Magnolia Cancer Center. I tip the valet $10, but before I can drive away, my cell phone buzzes. “Charlie […]

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