Meeting My Oncologist

I was both excited and nervous to meet the oncologist. I was excited because I felt like I was now starting my path to surviving cancer. I was nervous because this was to be the first part of my treatment. The oncologist was going to tell me what will happen to me, what treatments I will have, how often treatments will be, which poisons will be put into my body and what side effects I might get.

Lee and I were shown into a small side room just off the Oncology waiting room as soon as we arrived, there was no time to sit and wait, it was as though they were already waiting for us, we were told to take a seat and that the oncologist would be with us very shortly. Lee and I sat there, looking at each other, both feeling a little nervous but still smiling. A Chinese man with a big white coat walked in followed by a nurse. "Karen! Now then, we've been having a really good talk about you behind your back" he said smiling as soon as he walked into the room "I've heard you have some experience regarding this lump a year ago, do you want to tell me in your words what happened?" he said, motioning me onto the coach. I smiled and nodded, took a deep breath and started to explain about 'Dr X'. When I got to the part where she was calling me paranoid I burst into tears. The nurse quickly left the room. Afterwards Lee told me that as she left, she had tears in her eyes. My Oncologist examined me and then very calmly started to tell me about my treatment plan.

Oncologist Mr, examined me and took out a measuring device, to measure for himself the size of my tumour. I liked him, as the way he talked made me feel comfortable. He went through my pathology report in detail, so I understood exactly what was going to happen to me.  I listened to him intently.

I was considered to have Grade II Advanced breast cancer and this was purely down to the size of the tumour. It was measuring approximately 80mm in diameter. Had it been smaller, had I pushed a year ago with 'Dr X' then this story may have been a totally different one, as the size back then felt to be no larger than a small pea.

I am also Oestrogen receptive positive. This means that as the hormones float by the cancer cells they attach themselves and once they are bound together, they send a signal that tells them to grow and divide. Hormone therapy can interrupt the flow of oestrogen to starve and kill the tumour .

Chemotherapy was going to be the first; this would hopefully reduce the size of the cancer before having surgery to remove my boob. I was given the choice between having the standard treatment or to go on a research study called the Neo-tAnGo. The standard treatment would involve six rounds of chemo every 3 weeks apart, with what is known as FEC (fluorouracil, epirubicin and cyclophosphamide.). The research study would involve having 4 cycles of the EC from the FEC followed by 4 cycles of Pacletaxol and hopefully a drug called Gemcitabine. A computer would choose at random the study that I would be in and whether I would receive the Gemcitabine or not. It all sounded very confusing to start off with, as I expected to be just told what chemo I would have, rather than having to make choices. What if I chose wrong, let’s face it, he's the expert, not me. In the end I opted for the Research. I chose this path for a couple of reasons. In my mind I thought that zapping these squatters with 2 extra rounds of chemo would get rid of more, also my oncologist told me that so far the response to the research was very promising and in some cases the tumour had shrunk that much that they had virtually disappeared, another reason in my mind was that I would get better treatment, watched more closely than being on a standard treatment. And I must say that the treatment and care that I have received to date has been tremendous.

My oncologist then started to tell me about the chemotherapy side effects, and as he did so he watched me continuously, taking in my expression and responses to each one.

"You will definitely lose your hair and pretty quickly." he said. I very calmly replied, "It’ll grow back won't it?" He explained to me about the cold cap and told me I could try it if I wished. The cold cap is a type of hat that has come straight from the freezer. To try this would mean sitting with it on for fifteen minutes before the chemotherapy to start restricting blood flow, and then kept on during and up to 1-2 hours after.  The cap would be changed every fifteen minutes throughout so that the temperature of my head would be kept at the correct freezing temperature. The downside to this is that my time at the hospital would be made much longer. He also explained that some people find it very uncomfortable and it can give quite bad headaches. "Does it work?" I asked. "Sometimes" he smiled. "Do you think it will work for me" I asked. Mr Oncologist looked at me, looked at my hair and in a very sincere and apologetic voice said "No".  I have very fine hair and even if I lost an eight of it I would look bald, and so I opted to lose it all. After all it WILL grow back.

The next on the agenda was the sickness. You hear the stories of how sick people get with chemotherapy, the nausea, the loss of appetite and the tremendous weight loss. My oncologist told me that I would feel fine on the day of the treatment but to expect to start feeling achy and tired after the first couple of days. I would be given anti sickness tablets, which I was told were very good, but on the chance that these did not work; I should speak up about it as there are other anti sickness tablets that I can try. I smiled at him and told him very calmly and very positively that I was not going to get sick. I truly believed that, plus I hate being sick. I don't do sick.

He then went on to talk about another side effect of the chemo. "The chemotherapy will put you into the menopause, and because of your age there is a chance that your menstrual cycle may never return." "That's ok" I said, "That is definitely one thing that I won't miss. I also came to terms with the fact that I can't have children years ago". I babbled on. "Also depending what they find when they investigate your right ovary, we may decide to remove your ovaries". He added. "Take them", I answered still smiling and at the same time shocking him with my attitude to the whole thing. "Like I said, I can't have children so I don't really have any use for them. And to me if I'm hormone receptive and you take them won't that mean that there are fewer hormones in my body". (I continued to babble) I didn't care; to me they could take my womb if they wanted to, do anything to get rid of these blooming squatters.

Everything was explained; every small detail and nothing he said could burst my bubble. I was confident and even though it was my first meeting with him. I had confidence in him too.  This I was surprised about, having gone through the ‘Dr X’ ordeal. I wouldn’t have been surprised if I never trusted another medical expert in my life.  Maybe it was because this Oncologist took time out to talk to me about what had happened and sympathized with me, that I took a liking to him  Or maybe it was just to do with him being him and downright  honest.  He explained to me that the chemo would take approximately 5 months so I would be looking at November for my surgery, (the day that I am so waiting for) which would then be followed by radiotherapy and 5 yrs of hormone treatment.

It was arranged that I would come back the following week to have my first biopsy done, and they would hopefully have a start date for my first chemo.

I was asked if I had any questions. My question and only question was "Can you get rid of it". His reply was a very good answer; "If you are asking me if we can get rid of it, then the answer is Yes, if you’re asking me if we can eliminate this cancer and it ever come back, 6 months, a year or even 10 years down the line, then my answer would be that there are no guarantees.  But we will do everything we can to try and prevent reoccurrence from happening". I thought that this answer was a very good one. He wasn't making any false promises; he was telling it how it was, which made me like this man even more.

As Lee and I left the hospital we were both on a high. Things were starting to get moving. Next week I would have some biopsies taken and I would get to know when I would start my chemotherapy. This for me couldn’t be soon enough. As far as I am concerned the sooner they start getting these drugs into my body the sooner it can start killing the cancer.

After our meeting with my oncologist I decided to take charge of things. I had, had the time to come to terms with the fact that I have cancer and believe it or not I was actually fine with it. It didn't bother me that I was going to have chemotherapy, all I knew is that I wanted rid of these blooming squatters and if that meant losing my hair, so what. So it was at this point that I had decided that I didn't want any negative people around me. I was being positive, and if I could be positive then surely the people around me could be positive too. Lee's positive attitude was definitely rubbing off on me.

On our way back from the hospital I rang my mum to tell her the good news of it being contained in the breast. I told her about the Chemo, the Mastectomy and about me asking them to do a bilateral mastectomy. My mum took that bit very hard. I explained my reasons and then said to her "Mum from now on I don't want anyone being negative. I need you to be strong. If I'm positive about it all, then surely you can be. But I am putting my foot down now and from this point on there are to be no more tears". My mum had gone quiet. "Pass the message on" I went on to say, "I don't want anyone being negative. I want people to be positive, think positive and from now on I don't have Breast Cancer, what I have is Squatters and that very shortly I WILL have them evicted". My mum started to laugh. I think with changing Cancer to Squatters, lightened the whole ordeal, took a bit of the worry load off my mum, cos hearing me say this, and the way I said it, proved to her that I am ok with all this cancer wooops squatter crap and what is going to happen to me treatment wise.

So there we have it, I now know the extent of things to come and I'm feeling very positive. I know I can beat this. It doesn't scare me anymore. I just can't wait to start the treatment and to be rid of these things inside me. I feel that if I have positive people around me, then I can feed off this and be even more positive myself. In my mind I think that this can kill some of the squatters off. This madness was my first part of getting rid of it and I truly believed and still believe that a lot has to be said for 'Mind over Matter'.