It’s Scary Cancer Fact Friday!

So friends, I’ve got an Oncology meeting coming up so I’ve been mugging up all things cancer. Yay! I thought I’d share a few key scary cancer facts that I’ve learned since moving on over to this side of the cancer fence. Not to terrify myself, mind, or you for that matter (we can all do without unnecessary frights) but just for a healthy dose of realism in amongst all the gratitude as I go into  Phase Two of treatment  (the shitty phase involving hard drugs, but not the fun kind).

Also because, WOW, I’ve realised how little I knew about cancer before this. And, frankly, how little so many non-cancer people know too.

This is happening a lot, for example;

Friend: I guess you’ve given up sugar to starve your cancer?

Me: Fuck off and pass the damn cake.

And this;

Me: OmiGOD, did you know that if the primary breast cancer spreads to another part of your body it becomes secondary and THAT’S INCURABLE (actual horror face)?

Friend: That can’t be true.

Me: Fucking well is.

OK, so that’s the first horrific cancer fact out of the way but I’ll elaborate a bit more because, this, as well as the other has really helped me be kind of ok with the idea of doing chemo, a thought too horrific for me to even contemplate in the early days (ANYTHING BUT THE CHEMO!!).

1. Primary Cancer is curable, secondary cancer currently isn’t. Secondary cancer is when the cancer from the original site spreads to another part of the body., or metastasised.  All it takes is one tiny little cell to break away from the primary tumour, find its way into your blood stream or lymphatic system and then latch onto another organ and start growing. For breast cancer, the next go-tos are often the lung, liver, bone and brain.. Some secondary cancers are curable, but metastatic breast cancer isn’t.

2. It can take years for a cancerous tumour to grow to a detectable size.Some cancers are really aggressive and fast growing. Some are slow growing and it can take quite a while  for one cancerous cell to become a mass** that can be felt or detected on a scan or even to present symptoms you might think worth going to the GP about.. So that means, yes, for slower growing cancers (like mine) you could be blissfully unaware of cancer until such time that it decides it’s time to present itself to you. By which time, if you catch it early, it’s primary, if not, it’s a metastasised secondary. See the first point.

3. There is currently no test or scan to reliably detect Micrometastases in the blood stream or lymphatic system.*** Micrometastasis refers to the tiny cancer cells that have broken from the main tumour but not yet formed their own growth in another part of the body. In my case, cancer cells were detected in one of my sentinal lymph nodes following a sentinel node biopsy at the time of my mastectomy surgery. That means, the node was physically removed, cut open and examined in order to find the cells. These cells were not detected by all the presurgery ultrasound or MRI scans. And they were MACRO not even micro – but still just invisible cancer sittin’ there playin’ the long game.

4. Your immune system alone is not enough to kill cancer cells. Cancer wants to win at all costs. Markers vary greatly from cancer to cancer, and researchers are learning more and more about this, but the long and the short of it is that cancer has worked out ways to fool our own immune systems often by tricking our  immune T-cells into not recognising it as an enemy and therefore fighting it. Antioxidants aren’t going to touch that bastard. It also knows how to spread and how to hide.

5. Chemotherapy kills cancer cells, but not your other cells. Chemotherapy drugs, the treatment demon I’ve been a bit terrified of, stops those insidious cancer cells from growing and dividing and eventually they die. The drugs also affect the healthy cells in our body, but these eventually recover. The chemo is all about halting a recurrence.****

Call me a masochist, but this is me squaring up to cancer’s worst so I can stomach the treatment options. Also kind of handy for you guys to know before you wave your little cancer-curing tincture at me and suggest I try meditation to un-think my cancer into oblivion.  And this is coming from a kimchi-eating, green-juice guzzling, yoga-loving, occasionally-meditating turmeric-junkie who has consciously been re-populating her microbiome for the past year.

I am actually heartened by the kind of clinical trials being funded by charities such as Cancer Research into things like turmeric and asparagine, and it’s entirely possible that the future of medicine lies in a more holistic, integrated approach with traditional and functional medicine working together, but when the chips are down, I am going for treatment with clinical evidence on long-term prevention of metastatic breast cancer.  And if there isn’t a randomised double-blind clinical trial with evidence to support the new miracle cure, it ‘aint on the table.

In short, I’ll take the damn chemo thanks very much. Cake on the side.


REFERENCES:

** Professor Trish Greenalgh & Dr Liz O’Riordan, The Complete Guide to Breast Cancer: How to Feel Empowered and Take Control, page 9.

**** Professor Trish Greenalgh & Dr Liz O’Riordan, The Complete Guide to Breast Cancer: How to Feel Empowered and Take Control, page 132.

*** According to my team, there are clinical trials currently taking place involving methods of detecting cells for triple negative cancers but these aren’t widely available.

I have referenced Cancer Research or Macmillan for definitions that might be directly helpful to link to for this piece. I have also strongly drawn upon Greenhalgh and O’Riordan’s book The Complete Guide To BreastCancer: How to Feel Empowered and Take Control . It has been a key resource for pulling disparate information together which has been key in building the bigger picture and preparing for key stages of my treatment. Cancer treatment teams tend to drip-feed information which is aligned with the treatment process. This can help people cope and process difficult information in small chunks. If however, you are the type to know more and read ahead, then this is a great bedside bible.


Me. But Better: Surgical Thank Yous.

As I type, it’s nearing on five weeks since surgery and people have been asking how I’m doing ‘down there’. The following notes are thank you letters to my surgical team which will explain the situation best.


Dear Nicky,

I quite literally feel like I won the surgical lottery. Hit the jackpot. I know it wasn’t quite like that. You were chosen for me. But I feel so damn lucky to have been your patient.

Even past the bruising and the swelling, I see a breast that looks just like mine. It IS mine. I have my own skin. I have my freckles. I have the same shape, and I also know that what is inside is mine, and is me.

So, I don’t feel at all like I’ve had a mastectomy in a funny old way. It just takes a little re-framing of the situation – I’ve had something really really horrible taken out of my breast, and a bit of me from somewhere else popped back in – a re-org, as it were, a tissue re-shuffle.

My boob is fabulous and SO ARE  YOU.

Thank you. You are, actually, the best.

Siobhann


An edited version of the thank you letter penned from my hospital bed to my Consultant Breast Reconstruction Surgeon.


Dear Dan,

It can’t be easy being registrar when the consultant  surgeon gets all the damn credit for the boobs. I wanted to write and say thank you for the bits you probably don’t get thanked for very often. Like the belly button bit.

I’ve always had what could be conservatively described as a prominent outy. An ‘out there’ outy. An extroverted, flamboyant outy verging on body-political ambitions for abdominal take-over.

Then with two pregnancies, dear GOD, my belly button grew to such grotesque proportions it cast its own shadow across my abdomen at high noon.

And so I resigned myself to one piece swimsuits.

Then came breast cancer-reconstruction surgery. Once I’d gone home and the swelling had settled in my abdomen, I did not, in a million years, expect to wake up one day, lift the sheets and look down to ‘New and Improved Shiv’. Not only a svelte new abdomen but what appears to be a new and improved belly button. HELLO YOU!

And perfect neat scars, healing nicely thank-you-very-much due to some mighty fine stitch work at the tail end of a long and exhausting surgery sesh on nothing more than bean stew.

For the new and improved me, I salute you Sir. Your belly buttons ROCK Dan. Thank you.

Siobhann


My draft letter to Dan, the registrar who played a key part in my surgery.

So people, really, don’t feel sorry for me. I am going to wang on and on about the unexpectedly fabulous new me thanks to awesome surgery by awesome people who work for the NHS, all in the name of ridding me of the cancer and putting me back together again. I will go so far as to say I may become intolerable. I may even resurrect that belly button ring from my late teens. Hold the phone, I might even wear a crop top this summer.

Watch out world, this is Shiv version 3.0.