Hard Truths about Cancer

Over the next few days I had an appointment about my breast cancer with my consultant, Mr Osman. He explained to me that the  tumour he had removed was slightly bigger than anticipated. It was about 8mm long. He had expected it to be about 5mm. It still did not sound big to me, but I knew bigger, in this case, did not equate to better.

Mr Osman also explained to me in some detail that the tumour was HER2 positive and that I would benefit from treatment with the drug Herceptin. 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.

He told me that some breast cancer cells have a lot more HER2 receptors than others. In my case, the tumour is described as being HER2-positive and that it is thought that about 1 in 5 women with breast cancer will have HER2-positive tumours.  HER2 is a gene that sends control signals to the cells, telling them to grow, divide, and make repairs. A healthy breast cell has 2 copies of the HER2 gene. Some kinds of breast cancer get started when a breast cell has more than 2 copies of that gene, and those copies start over-producing the HER2 protein. As a result, the affected cells grow and divide much too quickly.

This genetic problem is not inherited from your parents. The most likely cause of this problem is aging, and wear and tear on the body. It is not yet known if environmental factors (pollution, smoke, fumes) are part of the cause of this problem.  If your breast cancer is tested for HER2 status, the results will be graded as positive or negative. As my results were graded as HER2 positive that meant that my HER2 genes were over-producing the HER2 protein, and that those cells are growing rapidly and creating the cancer. Mr Osman thought that he had removed all the cancer from my body with the surgery but in order to be sure of this and to minimise the risk of return, he recommended that the oncologist discuss with me the benefit chemotherapy would offer me.  

The oncologist, Dr Lumsden, recommended that I should have three lots of three weekly cycles of chemotherapy. The first 3 would be Herceptin and then docetaxel in a liquid that I would get through a drip (infusion) into a vein (intravenously). Each infusion of herceptin takes about 90 minutes, the docetaxyl takes about an hour and I would have one treatent every 3 weeks for 9 weeks. He recommended that I would then have chemotherapy as a course of 3 cycles of FEC (fluorouracil, epirubicin and cyclophosphamide) for a further 9 weeks.

Docetaxel can cause an allergic reaction. To try to prevent this, Mr Lumsden explained I would be given steroid tablets to take, usually for 3 days, starting the day before each treatment. He went on to tell me that FEC treatment would be given to me as a day patient. Before I started treatment, I would need to have a blood test a day beforehand. He also told me that I would be seen by a doctor or specialist nurse. If the results of my blood test were normal, the pharmacy would prepare my chemotherapy drugs. All of this might take 2-3 hours.

A nurse would insert a thin, flexible tube (cannula) into a vein in my hand. Dr Lumsden told me also that some people need to have their chemotherapy given through a thin, plastic tube that is inserted under the skin and into a vein near the collarbone (hickman line). He did not know if this would be necessary for me. I was also to be given some anti-sickness drugs as tablets, or more usually by injection through the cannula, which is often connected to a drip.

The chemotherapy drugs are then given separately after this.

It was so much to take in. The disease had been found so early that I had had no symptoms that I was aware of. Looking back, the extreme tiredness and exhaustion caused by any degree of physical effort, so typical of cancer, had already started to show. I just did not know to consider it. Still, it sounded like the cure was going to be worse than the disease. All of a sudden it was emphasised to me that my condition was serious and needed to be fully eradicated.  I was forced to face some hard truths that, until then, I had preferred to try to ignore.

Valerie Penny


Friends and Flowers

I have never believed anybody who claims to have hundreds of friends. Friends are a treasure to be valued high above rubies and true, loyal friends are a very rare commodity. It is when times get tough that you really realise who your friends are. After the operation, word of my breast cancer spread amongst those I know quickly. I was truly overcome by the kindness, love, affection and support shown to me. The cards, flowers and chocolates given to me were lovely. Even more overwhelming were the phone calls, texts and visits.

When all of a sudden frailty struck and I had to accept the possibility of my own mortality, it was rather nice to know that there are those who care.

I received many lovely cards too. The living room of the house was so finely decorated by all these lovely things that the flowers given to me by friends at my book group and the local poetry group were displayed in the bedroom window.

There was only one problem. My disease had been found early in a scan. I had not had any symptoms. I had never felt ill, indeed, I was not aware I was ill. So I felt completely unworthy of all the good wishes I was receiving. I felt like a complete fraud. .

My sister and brother-in-law even came drove across the country to have lunch with my husband and me. Both their cars were out of action so they had to hire a car to spend time with us. What dedication to duty! How generous and kind!  We met for lunch at The Rowan Tree Restaurant, Ardrossan, Scotland. Have a look st a review of that restaurant: https://hotelandrestaurantreviews.wordpress.com/2013/04/13/the-rowan-tree…ossan-scotland/It was a lovely lunch.

The Rowan Tree offers an excellent choice of food at very reasonable prices. My sister and brother-in-law joined my husband and me for Sunday Lunch. We had a choice of the Roast of Pork as well as the regular menu. Service was unobtrusive, the meal was freshly cooked and tasty and the coffee very smooth. I always enjoy a visit to The Rowan Tree Restaurant. This visit was no exception. 

So much kindness: it all seemed too much. I was amazed how even just going to lunch made me so bone achingly tired. Exhaustion makes me miserable, but the love of friends and family is wonderful.

Valerie Penny

Breast Cancer Operation Day!

The nights always seem so long when I do not sleep. Luckily, that does not happen often.  I did not sleep well on the night before my operation. I was scheduled to be at the hospital by 7.30am on April 30. It was a grey morning and I suspect my mood was grey too, but the staff could not have been kinder. I filled in my pre-registration form and my husband waited with me until I left reception. I do not know who was more scared, him or me.

When I went through to the waiting area nurses gave me a bag to put my clothes into and put on a hospital gown and sat with the other women waiting for surgery.  I flicked through papers as the television in the waiting area played Jeremy Kyle. It felt like it was going to be a long day, but somehow it flew past.  Of course, Mr Kyle had his own battle against testicular cancer in 2012.  He credits his wife, Carla for helping him through the treatment.  I have no doubt that the unfailing care and support of my husband, David, were vital to my recovery too.

During the morning I was taken for additional X-rays, ultra sound checks and went into the nuclear medicine department to have a wire inserted into my tumour so that Mr Osman would be able to find it easily during the operation. The various visits to different departments helped to make the time pass more quickly.

Mr Osman took the time to come and speak to me before the operation. He explained to me that the purpose of the operation was to remove the tumour from my right breast and also to remove 2 lymph nodes from under my right arm. The purpose of removing the lymph nodes was to confirm whether or not the cancer had spread.

Lymph is a clear fluid that travels through your body’s arteries, circulates through your tissues to cleanse them and keep them firm, and then drains away through the lymphatic system.

Lymph nodes are the filters along the lymphatic system. Their job is to filter out and trap bacteria, viruses, cancer cells, and other unwanted substances, and to make sure they are safely eliminated from the body.  

Also traveling through the arteries is fresh blood, which brings oxygen and other nutrients to all parts of the body—including your breasts. Used blood leaves the breasts through the veins and is pumped back to the heart and lungs to be refreshed. Lymph must also be refreshed and recycled. Lymph drains away from your breasts through the lymphatic system, which is made up of lymphatic channels and lymph nodes.

When Mr Osman asked if I had any questions for him, he apparently meant questions that related to the surgery and not this week’s lottery numbers. That being the case, I do not know enough about medical procedures to know what to ask. I had no questions for him. I was even given a menu to allow me to choose my evening meal. This was a nice touch.

Most of the rest of the day was a bit of a blur. I remember being shown to a hospital bed and sitting reading and doing puzzles. I remember the anesthetist coming to speak to me and explaining what she would be doing. I remember she seemed very young! Then I have no clear recollections until the porters came to take me to theatre.

I do remember being in the theatre before the anesthetic took effect. Happily, I remember nothing thereafter until I smelt the evening meal, but I was still too tired to open my eyes, never mind eat the meal. When Mr Osman came to see me after the operation and to re-assure me that all had gone well.

The highlight of the evening, of course, was visiting time when my husband came to visit. I remember being given a cup of tea and a couple of biscuits. I was quite insistent that my husband should have a biscuit.  I also remember holding his hand, so that when I fell in and out of consciousness he could not leave without me knowing. To be fair to the man, he showed no signs of planning to leave early! When visiting time did, eventually come to an end and by then I was a little more awake and hungry. I am vegetarian and the nurses were so kind and got me some cheese and crackers to eat. The nurses could not have been more considerate or helpful.

I did not sleep well, probably partly because of the anaesthetic and because of the strange surroundings. I was also disturbed when the nurses came around and shone a torch at the beds to make sure the patients were settled. It was meant to be non-invasive, but struck me as a little strange.

The following morning I had the choice of having breakfast in the ward or in the waiting room. I chose to have it in the ward and then when the doctor gave me the all clear, I got dressed and phoned my husband. I waited for him to come to pick me up and take me home. It was lovely to be back.

Valerie Penny

Freaky Breast Cancer Friday

I was amazed when the hospital arranged an appointment for me to meet with my surgeon, Mr Osman on Friday, just two days after I got my diagnosis of the tumour. All of a sudden every thing seemed to be moving. In a few days I had gone from feeling fine, to having a battery of tests and then being told that I had a potentially fatal disease. It was too much to take in. I could not believe how fast everything was happening. Looking back, I am ashamed to say tat I simply had not recognised the discharge from my nipple nor my extreme tiredness as signs of breast cancer.

I called my friend across the road and told her. She asked me the name of my surgeon.  I had slightly misheard his name and told her it was Mr Osmond. I joked that I hoped it was Donny Osmond!donny osmond My friend disillusioned me by telling me that her surgeon was the same person, it was Mr Osman and certainly not a American entertainer! She also told me Mr.Osman is delightful and very helpful.

My appointment was for 11.30 on the Friday morning. but I was not seen until after 1pm. By this time, as I had arrived stressed, I was almost climbing the walls and had read almost all the magazines in the waiting room. It did not help that there was a man in the waiting room who chatted loudly and personally to many of the others there. Maybe it was his way of dealing with his own stress, but I found him intimidating and was glad to have my husband with me.  My Husband is a big guy, needless to say the man with the verbal diarrhea came nowhere near us. However, by the time I went into the consulting room I was up to high doe.

So to the embarrassment of my long suffering man, I asked the nurse who took me into the consulting room why my appointment had been made for 11.30 if I was not being seen until nearly 2 hours later. She explained that the clinics were very busy, but that did not answer the question as to why appointment were, apparently, made too close together if patients regularly overran their allotted time. She said I would need to take it up with Mr Osman. I agreed to do this. However, this became unnecessary, as my cancer care nurse came in to see me and calm me down. cancer care nurse I think my husband was even more glad about this than anyone, but I did get him to agree that I had not been rude and that the long wait had made a stressful situation worse.

Shortly afterwards, Mr Osman can in. He explained to me that the biopsy had shown the tumour to be malignant and that it needed to be removed. He also informed me that the tumour was found to be related to the fact that I had been taking HRT for many years. He told me I should stop taking that drug immediately.  I asked him about this because I had understood from my GP that the evidence of this was ambivalent. Maybe I had misunderstood him. Mr Osman smiled and said that the studies were not clear for those who had been taking HRT for 5 years or less. However, he said that for those who had been taking the drug for ten years or more. He noted that I fell squarely into this latter group as I had been taking HRT tablets for at least 12 years.  Mr Osman was, therefore very clear in his advice, I must stop the HRT now.

Then he asked me about when I thought my operation would take place. My friend had told me the time-lag was usually 2-3 weeks so I mentioned this to Mr Osman, but also said I appreciated this would largely depend on his schedules and work load. his kindly face broke into a wide smile. 2-3 weeks would be no problem. I returned his smile and smiled at my husband as Mr Osman went on to tell us that he had only that day negotiated an extra theatre day and he wondered if I was free on Monday.

Monday! This Monday, two days time. I gasped and grinned at my husband. I could not think of anything more pressing I had to do on Monday, or any other day. The thought of getting rid of the cancerous tumour so quickly was wonderful. I felt a bit ashamed that I had complained about the wait in the waiting room and was thrilled that the surgery would take place so quickly.

I was told to be at the hospital for 7.00am and that I would go for the various tests and scans before surgery in the afternoon.   Although the surgery s classed as day surgery, I would be required to stay in hospital overnight. I would be having a general anesthetic and the hospital wanted to keep an eye on me overnight.

We left the hospital in shock. Happy shock, but shock never the less.

Valerie Penny

Breast Cancer on Black Wednesday

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.

doctor's room

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.

Basic RGB

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

The Longest Week: Waiting for Breast Cancer Screening Results

When it finally trickled down into my consciousness that, in fact, breast cancer maybe could happen to me, and perhaps the highly qualified radiographers might not have made a mistake, my life, all of a sudden,became quite tense.  Imagine how surprised I was when my husband and I pulled up at home after that morning in the hospital to meet one of our close friends and neighbour. I had not seen her for a few days. When I asked after her health and she told us she had recently been diagnosed with breast cancer, my blood ran cold. It was as if a hand cold from the ice-box had gripped my heart. This was all too real.


My husband and I decided not to tell anybody else about the investigations that were being carried out for me as we did not yet know whether the tumour was benign or cancerous. There seemed to be no reason to worry anybody when there might be nothing to worry about.

So I hugged my friend and tried to say all the right things. True to form she brushed my concerns aside telling me that it had been a bit of a shock but she would just have to get on with it. Her main concern seemed to be that she would not be able to join her cousin and his wife on a cruise in the Mediterranean they had planned. Her husband joined us. He looked sick. When my husband and I crossed the road to go home he said to me that he felt that way too.

I think waiting for the news was one of the longest weeks of my life. I spent the time hoping for the best and preparing for the worst. It was advice my Uncle had given me many years previously at another stressful time. The advice stood me in good stead then and did again now. My husband and I fretted individually, but we rarely spoke about the elephant in the room. My temper grew short. He withdrew into himself.

Eventually we had to talk. We hugged and cried and spoke about the fact that we may be worrying about nothing. Whatever happened we knew the tumour had been found early during a screening. I had no symptoms that I was aware of. I got tired easily and had a little discharge from my right nipple, but I felt fine. If I had even a basic knowledge of the signs of breast cancer, I would have realized these were classic signs of the disease. We would find out soon enough, the following Wednesday, whether or not there was anything to worry about. In the meantime we tried to be calm but that week seemed to last forever.  tumor_sizes[2]_tcm8-79578
Valerie Penny

It has to be a mistake………..Breast Cancer could not happen to me!

It is true that, at the end of the breast screening session at which I had my first mammogram, the radiographers did tell me that some people are recalled to have their mammogram results checked. It is also true that I did not pay a great deal of attention to that. Breast cancer could not happen to me, could it?

This is partly because I knew the staff had reached the end of their day and I did not want to hold them back. It was also because having a mammogram is not a very pleasant procedure, so I just wanted to get back to my husband waiting patiently in the car and go home. Most importantly, it was because I discounted the information: I was sure the breast cancer was not going to affect me. The mammogram was just a precaution.

I have already explained, my mind set, breast cancer did not happen to me.  Imagine my irritation when I got a notification for recall after the screening. It was clear to me that there must be a mistake. Perhaps the radiographer had been in such hurry to get home as my appointment has been the last one of the day, that she had made a mistake.  It must be a mistake……………………..

Breast cancer can affect anyone, man or woman. Breast cancer affects                                                       220px-Ayrshire_Central_Hospital_-_geograph.org.uk_-_56348
1 in 10 women in Scotland at some time in their life. It is
known that if breast cancer is found at an early stage,
treatment has the greatest chance of being successful.
The best way of screening for breast cancer is by having
regular mammograms, as you may not be able to see or feel any early changes to your breasts.

So on 19 April I attended the breast screening centre.  The correspondence I received in relation to the breast screening explained that the series of tests and examinations could take several hours. My long suffering husband did take me to the hospital, however, he did not sit and wait around. That is too hard for anybody.

This area of the hospital has been refurbished and is bright. The staff, without exception, are supportive, cheerful and professional. The patients remove their upper clothing and wear little pink shawls which will never win a design award, but are convenient, bearing in mind the examinations they will undergo.

The tests I was subjected to during this recall were, first of all another mammogram. By now I was paying more attention. A mammogram is a low-dose x-ray exam of the breasts to look for changes that are not normal. The results are recorded on x-ray film or directly into a computer for a doctor called a radiologist to examine.

A mammogram allows the doctor to have a closer look for changes in breast tissue that cannot be felt during a breast exam. It is used for women who have no breast complaints and for women who have breast symptoms, such as a change in the shape or size of a breast, a lump, nipple discharge, or pain. Breast changes occur in almost all women. In fact, most of these changes are not cancer and are called “benign,” but only a doctor can know for sure. Breast changes can also happen monthly, due to your menstrual period.

In addition to this the doctor required me to have an ultra sound. The primary use of breast ultrasound today is to help diagnose breast abnormalities detected by a physician during a physical exam (such as a lump or bloody or spontaneous clear nipple discharge) and to characterize potential abnormalities seen on mammography or breast magnetic resonance imaging (MRI).

Ultrasound imaging can help to determine if an abnormality is solid (which may be a non-cancerous lump of tissue or a cancerous tumor) or fluid-filled (such as a benign cyst) or both cystic and solid. Ultrasound can also help show additional features of the abnormal area. When an ultrasound examination reveals a suspicious breast abnormality, a physician may choose to perform an ultrasound-guided biopsy. Because ultrasound provides real-time images, it is often used to guide biopsy procedures. An ultrasound exam will usually need to be performed before the biopsy in order to plan the procedure and to determine if this method of biopsy can be used.

The doctor could not find the shadow that he saw on the mammogram in the ultra sound scan, so he did decide to try to burst the shadow, but when that did not work he decided to have biopsies taken.  The nurse who took the biopsies was very skilled. She managed to take 12 biopsies from a nip on my breast no bigger than the size of the top of a pin.

The visit took a total of almost 3 hours. At the end of it the doctor explained that he could not tell if the shadow he saw was benign or not. When he asked me if I had any questions, all the questions were dependent on the shadow being a cancerous tumour. Therefore I chose not to ask anything.  At this point even I began to have doubts, maybe breast cancer could happen to me.  Make sure you get checked regularly.

This wicked, shamed disease is no respecter of dignity.  It could happen to you.

Valerie Penny

Man or Woman: Breast Cancer Could Happen To You

invasive_lobular_carcinoma[2]_tcm8-79021  You have to appreciate the mind set. It couldn’t happen to me…………  I could not be one of those statistics. There was no question of me suffering breast cancer. So when I was sent an appointment for a mammogram, I was more concerned about the convenience of the time slot; the embarrassment factor of getting my tits out and the pain and indignity of the process. At no time did I consider what a remarkable machine has been developed and what skilled people interpret the results. It never occurred to me that this could be a significant event.

When you have a mammogram, a skilled technologist positions and compresses your breast between two clear plates. The plates are attached to a highly specialized camera, which takes two x-rays of the breast from two directions. Then the technologist repeats the technique on the opposite breast. For some women, more than two pictures may be needed to include as much tissue as possible.

Mammography can be painful for some women, but for most it is just mildly uncomfortable, and the sensation lasts for just a few seconds. Compressing the breast is necessary to flatten and reduce the thickness of the breast. The x-ray beam should penetrate as few layers of overlapping tissues as possible. From start to finish, the entire procedure takes about 20 minutes. A diagnostic mammogram generally takes more time than a screening mammogram because it takes more pictures from more angles.  mammogram

So, having rearranged the date and time to one that suited me, I was the last appointment in the mobile breast screening unit on 22 March. I was greeted with a smile and made to feel as comfortable as possible before the screening began. While the unit was effectively a modified caravan in a health centre car park, the female radiographers could not have been more courteous or professional.

This is not a dignified process. It is uncomfortable. However, it is worth swallowing your pride, put aside your embarrassment and shame, because, you see, those suffering from breast cancer are not statistics. It could, and did, happen to me: in fact, whether you are a man or a woman, it could even happen to you.

Valerie Penny

Lucky Woman: Surviving Breast Cancer Now!

I am a lucky woman. I have a loving husband.  Here I am with my fabulous man.   I also have two fantastic children, a supportive family and loyal friends. I have even enjoyed reasonably good physical health: until now.  I am presently being treated for breast cancer, but I do not need to walk this road alone. It is a very frightening journey but I hope that, if you join me on my journey, it may help you. We will walk the road together. If you like you can follow me on twitter too @valeriepenny or follow my other blogs https://hotelandrestaurantreviews.wordpress.com/, https://wordpress.com/posts/bookreviewstoday.wordpress.com. Whatever happens, I am surviving breast cancer now!

Valerie Penny

Next Newer Entries

%d bloggers like this: