Surviving Breast Cancer Now!

Some days are better than others. Wednesday 25 April was a busy day. I spent the first half of it shuffling from one doctor to another. My first appointment was at my GP just for a regular check-up. It was then I was able to tell my GP that I had been recalled after my mammogram. He was quite cross that the hospital had not informed him. The GP also wanted to speak to me about the length of time I had been taking hormone replacement therapy (HRT). It was a long time, over 12 years. However, in light of the other appointment I had to attend later in the morning he decided not to make any changes at this point.

When I came back out of the surgery, I phoned my husband and he drove me on to my next medical appointment of the day. This, again was a regular appointment. It was my fortnightly visit to my psychologist. It is, perhaps, also ironic that I did not believe in depression until I was diagnosed with it over 10 years ago. Like many people, I thought it was not truly an illness, but a state of mind that could be surmounted simply by “pulling yourself together”. I cannot help but think a higher being was having a laugh when they got their own back and I have battled depression, without surmounting it, for so many years now.

However, when the psychologist asked how I felt about the possibility of a diagnosis of cancer, I still could not truly admit that it might, even now happen to me. So I put on my mask, as I so often do when faced with a problem too difficult to face, and told her that I did not know how to feel, until I knew what I had to face. It sounds sensible, but really, I simply could not release my emotions or inhibitions: not then, not yet.

When my husband and I walked from the psychology department of the hospital to the breast cancer care department we went quite slowly. Almost as if by not knowing the results of the biopsy and screening it would prevent the news from being bad.

We were not kept waiting long before I was called through to meet with the doctor and my husband came with me. None of the staff that I had seen the previous week were at the clinic that day. It was a little daunting to know I was to get the results from someone I had never met before.  However, the doctor introduced herself and the cancer nurse assigned to me was there and introduced herself too. She is Angela Watson.

It was explained to us that the biopsy had shown the tumour to be cancerous. It was explained to me that the disease had been found early and the tumour was about half the size of a baked bean. (I have always seen myself more as a “petit pois” kind of girl!) The doctor told me I would need to have surgery, a lumpectomy, (such an ugly word) to remove the tumour.  I was given an appointment to meet with the surgeon on Friday and that I would probably go for surgery in 2-3 weeks. What a lot of information.

I was told the tumour was found to be HER-2 positive and that I should stop my HRT with immediate effect. HER2 is a protein found on the surface of certain cancer cells. Some breast cancers have a lot more HER2 receptors than others. In this case, the tumour is described as being HER2-positive. Tumours that are HER2-positive tend to grow more quickly than other types of breast cancer. Knowing if a cancer is HER2-positive can sometimes affect the choice of treatment. Women with HER2-positive breast cancer can benefit from a drug called trastuzumab (Herceptin). Herceptin only works in people who have high levels of the HER2 protein.

To understand HER2, it first helps to know a little about receptors and growth factors:

• Receptors are particular proteins that are present within cells or on their surface. Other proteins or chemicals in the body can attach to these receptors to bring about change within a cell (for example, to make it reproduce or repair itself).
• Growth factors are chemicals that attach to these receptors and stimulate cells to grow.

HER2 is a receptor found on the surface of certain cancer cells. It is made by a specific gene called the HER2/neu gene. HER2 is a receptor for a particular growth factor called human epidermal growth factor, which occurs naturally in the body. When human epidermal growth factor attaches itself to HER2 receptors on breast cancer cells, it can stimulate the cells to divide and grow.

Some breast cancer cells have a lot more HER2 receptors than others. In this case, the tumour is described as being HER2-positive. It is thought that about 1 in 5 women with breast cancer will have HER2 positive tumours. So roll on Friday and then I get to hear what the surgeon has to advise, but I am not ashamed to say, I have had better days.

Valerie Penny