Symptoms of Breast Cancer.

Breast_Cancer_1Breast cancer affects both men and women. However, breast cancer has been the most common cancer in the UK since 1997, but is rare in men. It is by far the most common cancer among women in the UK (2011), accounting for 30% of all new cases of cancer in females. In 2011, there were 50,285 new cases of breast cancer in the UK: 49,936 (99%) in women and 349 (less than 1%) in men. Female breast cancer incidence is strongly related to age, with the highest incidence rates found in older women. This supports a link with hormonal status. In the UK between 2009 and 2011, an average of 80% of breast cancer cases were diagnosed in women over 50. Indeed, around a quarter (24%) were diagnosed in women aged 75 and over. I therefore find it very frightening that many older women ignore the risks of contracting breast cancer and are ignorant of the symptoms of the disease, with the exception of finding a lump. Finding a lump may be the most common sympton of breast cancer, however, in many cases finding a lump will be one of the last symptoms to become obvious, especially if the tumour is seated deep in the breast tissue. This is important because the earlier the disease is treated,the more successful that treatment is likely to be.

Some of the signs and symptoms of breast cancer include:

1) a lump in the breast
A lump in the breast is the most common symptom of breast cancer. Most breast lumps are not cancerous. They are usually fluid-filled lumps,cysts or a fibroadenoma, which is made up of fibrous and glandular tissue. But it is important to get a lump checked by a doctor straight away. If a lump or other symptoms is caused by breast cancer, the earlier treatment is received the more successful it is likely to be.

2) a change in the size or shape of the breast
The warning signs of breast cancer are not the same for all women. One of the common signs are a change in the look or feel or size of the breast. Breast enlargement alone is not necessarily a sign of inflammatory breast cancer. I see a lot of women who are worried about a change in breast size, and inflammatory cancer is rarebreast size

3) dimpling of the skin or thickening in the breast tissue
You may become aware of dimpling or tethering of the skin of the breast during a self-exam. It is an important part of the self exam to look in the mirror and look for a dimple. The breast should be outwardly round—it should curve outward and not pull in. If you have had breast surgery before and you have some scars, you might find that the breast will pull in around a scar. Of course, this is a different situation. A dimple is a pulling in of the skin, and it may occur when you raise your arm or lean forward. When you lean forward and raise your arm, the breast should stay outwardly round; it should not pull back in. That may be a sign of cancer, and it should be checked.

4) inverted nipple, a nipple that’s turned in
Every body is different. Some people are born with inverted nipples. That is not a worry or unusual for them. However, if you notice a change in your breasts that result in development of an inverted nipple, so you were not born with one,and the nipple cannot be drawn out, this should be checked by a doctor. it may suggest a lump behind the nipple that is pulling it in.

5) a rash on the breast or the nipple
Although tumors are the most common symptom of breast cancer, they are certainly not the only symptom. Women with a rare form of the disease called inflammatory breast cancer can develop a red, pink, or purple rash across part of their breast. The skin of the breast might also appear puckered, like the skin of an orange. If you notice symptoms like these, have them checked out by a doctor right away. Inflammatory breast cancer can spread quickly.breast cancer rash
6) discharge or bleeding from the nipple
Nipple discharge is a normal part of breast function during pregnancy or breast-feeding. It also may be associated with menstrual hormone changes. It appears spontaneously and involves a single duct. Although the bloody discharge may resolve on its own, this situation requires evaluation with an ultrasound of the area behind the nipple and areola. If the ultrasound shows a lesion, you may need a biopsy to confirm whether it is a papilloma or something more sinister. Although most often, nipple discharge stems from a benign condition. However, breast cancer is a possibility, especially if it is combined with one or more of the following: you have a lump in your breast, only one breast is affected, the discharge contains blood, yhe discharge is spontaneous or the discharge affects only a single duct.
7) swelling or a lump in the armpit
An armpit lump refers to the enlargement of at least one of the lymph nodes under your arm. Lymph nodes are small, oval-shaped glands that are located throughout the body and play an important role in the immune system. Most lumps are harmless and are usually the result of abnormal tissue growth. However, armpit lumps can be related to a more serious underlying health problem. Any unusual lumps should be evaluated by a doctor. Armpit lumps can occur in men and women of all ages. However, finding an armpit lump is most alarming for women because it may indicate breast cancer. Women should perform monthly breast exams and report any lumps to a doctor right away.Note that breasts undergo hormonal changes during the menstrual cycle, and may tend to feel more tender or lumpy during this time. This is completely normal. For the most accurate results, perform breast self-exams about one week after your period starts.

The advice you must consider is this: whether man or woman, old or young, if you become aware of a change in the area of your breasts seek medical attention sooner rather than later. Time is valuable: time is life.

Valerie Penny

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Risk of Recurrence of Breast Cancer

herceptin_drugMy body has endured surgery, chemotherapy and radiotherapy. As a result of this I have lost my hair and my energy. Still, that tumour the size of a baked bean is perceived as a threat. Its return must be further discouraged. My oncologist therefore insists on mammograms every six months and prescribes Letrozole. I must take one 2.5mg tablet each day for 5 years.

Breast cancer is often discussed as a general condition, but there are several different types that require different treatments. One way to distinguish breast cancer cells is through your genes. When you are diagnosed with breast cancer, your doctor will test the cancerous cells to determine their genetic makeup. My tumour had more of the HER2 protein in it than it should have had. HER2 is a protein that stimulates the growth of breast cancer cells. It can be found in your blood and urine. Sometimes it is referred to as a tumour marker. Tumor markers like HER2 cannot be used for cancer diagnosis, but they can provide other important information and the presence of HER2 helps the doctor predict how likely the breast cancer is to respond to treatment.

It is estimated that about 20 percent of breast cancers are HER2-positive. Younger women are more likely to be her_2_geneHER2-positive than older women. HER2-positive breast cancer tends to be more aggressive and to spread more quickly than other cancers. That is why it is important to find out if the cancer cells in your body contain this protein. If your breast cancer is HER2-positive, you have a much better chance of successful treatment with methods that target the HER2 protein specifically. Results show that those who tested positive for HER2 at an early stage of the condition (with tumours 1 centimeter or smaller) had a higher risk of recurrence. Researchers have also found that HER2-positive patients had a 77.1 percent five-year survival rate, with no recurrence. However, they also are
around five times more likely to suffer recurrence than those who were HER-2 negative and have close to three times the risk of recurrence of those who tested negative for HER2. So I am absolutely sure I want to discourage recurrence.

Tumours that are HER2-positive are more often associated with factors that increase recurrence rates. For example, HER2 tumours are more likely to occur in younger women and have higher nuclear grade. Generally, the higher the nuclear grade, the more aggressive the tumour. HER2 tumours are also more likely to show positive margins during breast surgery. Positive margins occur when cancer cells extend beyond the edge of tissue that is removed. HER2 tumours also have a higher likelihood of residual disease being found when additional tissue is removed. Up to 70 percent of patients with HER2-positive breast cancer respond to treatment. However, total remission for the condition occurs only in around 7 to 8 percent of patients. Targeted treatments (medicines that target the HER2 protein, like the Herceptin I was treated with) have improved the prognosis for HER2-positive patients. Remissions can also be lengthy, offering another bright spot in prognosis and reports show that remission can last more than 15 years for some patients.

tabletI was diagnosed HER2-positive and this brings special challenges in my recovery from breast cancer. The HER2 protein can make the breast cancer more aggressive. It can also make it harder to treat with hormone treatments used for other types of breast cancer. However, drugs like trastuzumab (Herceptin) target HER2 directly and effectively. This drug, when used in combination with other drugs, shows some very promising results for improving prognosis and survival rates for patients with HER2 cancer. However, there is a small but real risk of heart damage and possible lung damage. Scientists are still studying how long women should take Herceptin for the greatest benefit. I am not ashamed to tell you that I hope their studies are successfully concluded soonest. I have a vested interest in this, as my tumour was HER-2 positive.

All in all, having made the decision to stay alive long enough to thoroughly embarrass my children, when the oncologist tells me that I must take one 2.5mg tablet of Letrozole each day for the next five years, I will do just that. Letrozole has side effects but I have decided that whatever they are, they have to be better than allowing the tumour to return.

Valerie Penny

After Radiotherapy

It is hard to imagine a treatment that only lasts a few seconds, minutes if you count the set up time, causing after effects.  Believe me when I tell you that it does.  There are side effects of any medical treatments, of course.  With radiotherapy these can be quite frightening.  There is some concern that after treating the brain (particularly if combined with chemotherapy) the patient may develop memory problems.

Radiation therapy works by damaging the DNA (genes) of tumour cells.  DNA damage stops tumour cells from dividing, growing and spreading.  Radiotherapy is a useful tool for treating cancer because cancer cells grow and divide more rapidly than most normal cells around them.  Although some normal cells are affected by radiation, most normal cells appear to recover more fully from the effects of radiation than do cancer cells. Radiation oncologists carefully limit the intensity of treatments and the area being treated so that the cancer will be affected more than the normal tissues.  This is why the set up for the treatment often lasts longer than the treatment itself.

Modern radiotherapy has advanced dramatically over the recent years.  It is now possible to focus radiotherapy with extreme precision. This allows the radiation dose to be targeted to the areas of tumour while sparing most adjacent normal tissues even in seemingly complicated and difficult parts of the body.

brain_lateral_adam

Radiotherapy affects different people to greater or lesser extents.  My friend Ismay, who is a real inspiration to me, is facing terminal cancer with and bravery that is awe-inspiring.  She found the radiotherapy to her head (to shrink a brain tumour) really difficult.  She was left with burns to her scalp.  Her hair that had grown back after chemotherapy, was lost again and the burns to her head made it impossible to wear her wig for weeks.  The pain and distress were hard to bear: but bear it she did. along with some forgetfulness, with her relentless courage and humour.

My treatment was to my right breast.  It was targeted to the area from which my tumour had been removed.  I had been told the radiotherapy would make me feel tired.  I had also been told the effect was cumulative. Unsurprisingly, me being me, when I felt no particular effects after the first dose or so, I felt I had beaten the system.  I had been told the cumulative effects would also include burning to my skin.  Again, initially, I deduced my skin was different to everybody else’s.  It is    not.  However, the effects do not kick in immediately, but do last a long time after the treatment has finished.  Radiation_breast

I have found the after effects of the radiotherapy quite depressing.  The burning under my breast was soothed by aqueous cream but the skin burnt and peeled the way it might with sunburn.  I am now six moths out after radiotherapy has finished.  The burns are healed but my breast still looks tanned compared to the other and I still find I get tired far faster than I expected this far on.  I still cannot walk as far as I used to.  One of my favourite hobbies is dancing, but I cannot dance for as long or as energetically as I did before my treatment.

I continue to find it difficult to concentrate for prolonged periods and the exhaustion is debilitating.  I was becoming increasingly upset about this and was speaking to my friend Margaret.  Margaret survived breast cancer and got her all clear about eighteen months ago.  She has been immensely supportive during my cancer journey.  The wonderful Margaret told me that, even yet, she gets bone tired sometimes.  It is not like the tiredness you feel after a busy day or a late night.  It is a wave of weariness that is all encompassing.  The big problem is it can arrive, unannounced, at any time.  So I have no confidence that, if I start a long or complicated task, I will have the energy to finish it.  This is what I find most exasperating.

However, the side effect that I had feared most was depression.  When the radiotherapy comes to an end, you come off the treatment merry-go-round.  All the attention stops and this can cause the depression the doctors and nurses warned me about.  I suppose when you have been using all your energies to defeat this disease, when it comes to an end so suddenly, it can result in an emotional vacuum.  I have mental health problems anyway and I really feared this problem.  I was lucky, it did not happen to me.  Other friends were not so lucky.  They did feel the sudden stop of treatment and attention left a void that led to depression.

Now I am at the stage where I get check up appointments with the consultant approximately every three months. Before I see the consultant I go to the hospital for an echo scan.  It is also called an echo-cardiogram is an ultrasound scan of the heart. It is sometimes just called an ‘ECHO’. Ultrasound is a very high-frequency sound that you cannot hear, but it can be emitted and detected by special machines. The scan can give accurate pictures of the heart muscle, the heart chambers, and structures within the heart such as the valves.  An ECHO can be carried out for many different reasons.   I have it done to check how well your heart is working after the radiotherapy and to look at how well the valves are moving inside the heart.   An ECHO can also help to see any fluid that may have collected around the heart.  So far my heart is holding up well.

I need to undress to the waist and lie on the couch. A probe is placed on my chest (it is a bit like a very thick blunt pen).   Also, lubricating jelly is put on the probe so it makes good contact with the skin.   The probe is connected by a wire to the ultrasound machine and monitor.   Pulses of ultrasound are sent from the probe through the skin towards your heart. The ultrasound waves then echo (‘bounce back’) from the heart and various structures in the heart.  They make a sort of swooshing noise.

featured-breast-cancer

The consultant also arranges for my blood to be checked to make sure my calcium and haemoglobin levels are high enough.  So far, so good.  This is especially important because for the next five years I require to take a medication known as letrozole.   Amongst the more common side effects of letrozole are hot flushes, hair loss, joint and bonepain, muscle pain, tiredness, unusual sweating, nausea, diarrhea, dizziness, and trouble sleeping.  I have certainly suffered the tiredness as well as the joint, bone and muscle pain.   I was told by other patients it should lessen after 8-10 months.  The doctors have not confirmed this!

So I have complained about my difficulties and honestly reported my progress.  I am aware that I am very lucky. The disease was diagnosed early after a mammogram.  The necessary surgery was carried out quickly.  I am to get another mammogram later this month to confirm that I continue to survive breast cancer now.

Valerie Penny

 

 

 

Time to Recover from Breast Cancer Surgery

It was over 20 years since I had spent time recovering from surgery. Then a caesarian section had delivered a beautiful baby, this time less glamorously a cancerous tumour about the size of a baked bean had been removed from my body. I had difficulty, even yet, accepting my limitations and giving in to the time I would need to rest to give my body the time it would need to heal.

Luckily, my husband set more realistic limitations than I was willing to admit were sensible. The care and attention he lavished on me with unquestioning love made me feel so cherished.

During this period, before I went back to have my wound examined by Mr Osman, I needed to rest but also to avoid isolation and boredom. These can quickly result in a deepening depression that can be hard to shake during cancer treatment. Facing cancer alone must be not only frightening but lonely.  The play, “The Strange Undoing of Prudencia Hart”, came to the village. At wkwriters.wordpress.com we put together reviews. This is mine. 

The Strange Undoing of Prudencia Hart

The National Theatre of Scotland brought their performance of “The Strange Undoing of Prudencia Hart” to the Village Hall. It was exciting to have performers of this standard come to the village. Unsurprisingly, the show quickly sold out.

The play was written by David Greig a Scottish playwright whose other works include Outlying Islands (2002) and The Architect which was made into a film in 2006. So it was no surprise that this works was thought provoking and entertaining.

It began with an excellent renditions of “The Twa Corbies” and music played an important part in the performance which tells the story of the straight laced academic, Prudencia Hart. She is a serious child of bookish parents and enters the world of academe. The main story revolves around a conference in Kelso at which the staid Prudencia speaks to her thesis “The Topography of Hell” while her arch academic rival Colin Sinclair offers a much more modern approach to the Border Ballads. The first part of the play is performed in rhyme.

After the conference Prudencia and Colin find themselves stuck in the border town due to a severe snowfall. Colin tries to get Prudencia to unwind, but fails. He joins in the karaoke at the pub with the locals while Prudencia sets off alone to find the B & B Colin has booked for them. She gets lost in a housing scheme and finds herself in a version of Hell that allows her time for self-discovery. The dialogue with a mysterious singer and the devil converts to prose and the second half of the play is much less tightly scripted than the first.

The Hell into which Prudencia descends surrounds her with books which she, alone with the devil, inhabits. Millenia pass. In her bid to escape from Hell Prudencia persuades the devil that he needs to experience life as a human. Ironically it is her nemisis, Colin, dressed only in his boxers who facilitates her escape. A riotous musical finale ensues.

Ballads and Karaoke numbers enhance the play. Music helps to change scene and attitude. Minimal stage settings allowed the small multi-talented cast to bring this provocative new play to our Village Hall.

gerryI also felt fit enough to attend the meeting of the poetry group the meets on the library.  I was thrilled t be able to do that. It allowed me to thank the poetry group for the lovely bouquet of flowers they sent me.

It was a special pleasure to join the group that day as renowned local poet, Gerry McGrath was reading some of his verse.  His website is gerrymcgrath.co.uk.  Gerry’s book A to B is reviewed at: https://bookreviewstoday.wordpress.com/2013/04/05/from-a-to-b-by-gerry-mcgrath/. ‎An example of his work is:

Elegy

No gunshot, just a book

falling shut under the great grey wall-

a ribbon of silk burning dimly,

bivouacked silence

and the blue-headed conscripts

pushing thumbs into the meat of their palms,

a pencil-trace of cloud and treasonous leaves,

indigo, matriarchs and knives,

the leprous planes, park benches,

benedicted, amok children, the scent of camomile

and sweet tedium, somewhere a keening band,

gaping church mouths, this mushroom-flecked

dregs of an unseasonable Sunday morning.

At the library, I also picked up the next book promoted by the book group. It is run by successful, local author Evelyn Hood. It was Gardens of Water by Alan Drew.  The story is set in a small town outside Istanbul, Sinan Basioglu, a devout Muslim, and his wife, Nilüfer, are preparing for their nine-year-old son’s coming-of-age ceremony. Their headstrong fifteen-year-old daughter, İrem, resents the attention her brother, Ismail, receives from their parents. For her, there was no such festive observance–only the wrapping of her head in a dark scarf and strict rules that keep her hidden away from boys and her friends. But even before the night of the celebration, İrem has started to change, to the dismay of her Kurdish father. What Sinan does not know is that much of her transformation is due to her secret relationship with their neighbor, Dylan, the seventeen-year-old American son of expatriate teachers.gardens-of-water-2

İrem sees Dylan as the gateway to a new life, one that will free her from the confines of conservative Islam. Yet the young man’s presence and Sinan’s growing awareness of their relationship affirms Sinan’s wish to move his family to the safety of his old village, a place where his children would be sheltered from the cosmopolitan temptations of Istanbul, and where, as the civil war in the south wanes, he hopes to raise his children in the Kurdish tradition.  However,  when a massive earthquake hits in the middle of the night, the Basioglu family is faced with greater challenges. Losing everything, they are forced to forage for themselves, living as refugees in their own country.

Their survival becomes dependent on their American neighbours, to whom they are unnervingly indebted. As love develops between İrem and Dylan, Sinan makes a series of increasingly dangerous decisions that push him toward a betrayal that will change everyone’s lives forever.  The deep bonds among father, son, and daughter; the tension between honoring tradition and embracing personal freedom; the conflict between cultures and faiths; the regrets of age and the passions of youth–these are the timeless themes Alan Drew weaves into a brilliant fiction debut.

Sharing interests and focusing on things other than my illness were critical to recovery, both mental and physical.

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

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