I have Cancer

I woke up super happy about my date with Shane and completely forgot I was worried about my test results.  I felt on top of the world and just had a cheesy grin.  I put in a hard day of work, even though I was slightly hung over.  Then at 4pm I got a call, I just assumed it was for work.

“Hello,” I answer.

“Hi may I speak to Kim”, says the voice on the line.

“This is Kim,” I answer.

“We got the results from you biopsy and unfortunately it is cancer,” says the voice.

“Oh,” I mutter.  I go numb.  I’m in shock, but manage to keep listening like a diligent student.

“So you have an infiltrating carcinoma.  I actually have a lot of information for you, do you have a pen handy?” says the voice.

“Yes” I answer.

“Good, so your tumor is cancerous.  It is infiltrating carcinoma.  Actually it would be better if you could come in.  I close in an hour, would you be able to be here before 5?”asks the voice.

“Yes, I live only 15 minutes away. I will head to you now” I answer.

“Great, just go straight to the 2nd floor ask for me at the front desk” says the voice.

I hang up.  I sit very still.  My dog stares at me and I start to cry.  I gather myself and start to think.  I realize I shouldn’t go to this appointment alone, so I call my friend Amber, who is unemployed and lives a few blocks from me.   There is no answer.  I talk to myself, “Kim you got this.  You can do this on your own.  Just stay calm and get it together!”

I realize I’m still in my PJs.  It was such a busy day at my work.  I grab a quick shower and cry as I wash my body.  I gather my self again and get my clothes on.  It is now 4:15.  I need to hurry to get there before the office closes.  So I rush out the door.

As I walk to the breast clinic each step I take is heavy.  My life is changing with each step, and the news is sinking in and the fact that I’m about to find out how bad.   Thoughts just rush through my head: I might not be here soon, can these people know I’m sick, what a nice sunny day, crap I didn’t send that email, I have cancer, I have to start telling people, what a nice skirt she is wearing, I have cancer, I have breast cancer, I might die. I  start to tear up.   I then remind myself  “You have this Kim, don’t stress.  Nothing you can do, just wait to see what she says.” I take some deep breaths and manage to fight back the tears on the longest 10 block walk.

I walk into the clinic and go straight to the elevator as the nurse instructed me.  The elevators open and then close.  I tear up again.  Thankfully I’m alone, but I really try and steady myself.  I turn off my phone ringer.  Dang these elevator rides are really long like in Grey’s Anatomy, maybe that show is based on some reality.  The elevators open and I am like a light switch I’m fine.  I leave all my fears in the elevator and head straight to the receptionist.  I ask for the nurse and she grabs me immediately.

In her office we sit at a table.  There is a packet of information, tissues, and water.  She starts to tell me about the cancer that I have.  She tells me about what the treatment will look like.  I of course ask questions.  I remember a moment when I ask about loosing my hair and almost cry again.  I’m scared, I wish I had someone with me, but I am learning so I’m able to stay focused on the information and not let myself cry.

The nurse pauses and asks, “Are you okay? You are taking this news very well.  This is really the best I have ever seen anyone be.”

I respond, “I think I’m just in shock.  So just taking in each moment as I can.”  I don’t feel like I am taking it well, but I also realize I already knew this is where I would be when I found the lump.  Maybe this isn’t as much of a shock as it is for others. We chat for about 40 minutes.  I manage not to cry and just breathe trying to retain as much information as I can.  I leave with the packet of information and walk home.

I try and hide the packet, so strangers on my walk back can’t see the words breast cancer that is written all over the folder.  I feel embarrassed by my illness.  I walk back processing all that was told to me and just let the thoughts flow in and out of me.  I don’t try and focus just go through it all.  At some point I check my phone and noticed that my friend called and call her back and let her know.  She comes over and with some red wine we go over the information the nurse gave me.

The diagnosis is that it is a infiltrating carcinoma, mixed ductal and lobular type.  Grade II, positive for hormone receptors estrogen and progesterone.  No sign of HER2/neu and intermediate proliferation rate of 25%.  So these are a lot of words that meant very little to me, but here is how I understand it.

The first is infiltrating, it means that I have an invasive cancer.  The invasive means that the cancer has grown beyond the milk ducts and the lobules of the breast.  The mixed ductal and lobular means, in my case, that the cells are typical of a lobular carcinoma, but the cells were also positive for ductal carcinoma. which is why it is mixed.

Grade 2 is not the cancer stage.  This is how close the cancer looks like normal breast cells.  There are three grades and mine is smack in the middle, which is that the cells don’t look much like normal cells.

Hormone receptors are proteins that makes the cancer cell grow.  I am postive for both ER (estrogen) and PR (progesterone). So basically estrogen is making my cancer grow.

Good news is that I am Her2 negative.  Her2 is a gene that controls the growth and division of cells.  So if the cancer has too many copies of the gene it will grow faster. It is good that I don’t have this.

The proliferation rate is how fast the cancer cells are growing.  In my case it is intermediate rate, so not too fast but not slow either.

The treatment strategy that the nurse laid out for me  is:

  1. Surgical:  The first step will be to have surgery.  Remove the tumor and then do a lymph node biopsy (remove lymph nodes and test it).  They will then test all the removed cells and determine the stage of cancer.
  2. Medical Oncology:  This is where chemotherapy and hormone therapy will happen.  Because of the positive receptors I will likely get a hormone therapy, which is a daily pill taken for 5 years.  It basically will stop the estrogen in my body and put me in early menopause.  However this won’t happen until all other treatment is done.  Chemotherapy will depend on the results of the lymph node biopsy.  If the cancer has spread to my lymph nodes I will have to do chemotherapy, which will range from 3-6 months.
  3. Radiation oncology:  This of course is radiation therapy, which will be given 5 days a week for 3-7 weeks.  I will highly likely need this.  The side effects is radiation dermatitis (feels like a sunburn) and fatigue.

Basically it is going to be a long year.  Thankfully I have cooking to distract me.

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