The drive from Ashcroft to Kelowna, via Merritt to pick up David's aunt, was uneventful and fairly stress-free. However, as we left our favourite Thai restaurant after lunch and headed towards the Cancer Agency, my brain was a jumbled mess of emotions. I did my utmost to scurry and duck, trying to avoid the inevitable anxiety of retracing last summer's steps to the scene of so many dates with the radiation machine. Somehow, I just couldn't shake this unsettling apprehension that started deep in my gut and was soon in every cell in my body.
Leaving the car and making my way into the building, my brain couldn't quite process the sensations and nervousness. "This world feels unreal," I thought, like it wasn't me, but rather someone pretending to be me walking down the hallway towards the waiting room. Watching in fascination, my alter ego observed baldness, skin-covered skeletons, and faces etched with deep lines of worry. That was me, not too long ago! Remembrances of my 28 visits haunted me and, suddenly, intrusive speculations of recurrence washed over me. Would my cancer return? Would I have to lay still on the radiation table once again?
Hearing my name called by the nurse gave me a jolt back to reality -- time to go chat with Dr. C.
After a quick catch-up chat, Dr. C. recorded a detailed history of my last year and then gave me a thorough physical exam. I pointed out all the new "lumps" my body seems to be producing, and he decided a biopsy would be a good idea, just to be safe. Every doctor's precautionary thinking gives me such reassurance that if anything does go amiss (aka ... recurrence), it would be caught very early. Dr. C. reassured me that my lumps (on my forearms, back, and a nice arch of them under my rib cage), do not feel like cancer. Cancer is rock hard - these are soft and mushy; cancer is immovable - these are movable; cancer is painful when pressed - I feel no pain with these lumps. But ... let's err on the side of caution. Ultrasound-guided biopsy ordered.
I was extremely disappointed when the Kamloops Cancer Clinic called to say Dr. P. was not able to see me and that another oncologist would be doing my check-up. Dr. P. and I know each other -- he knows my case inside out, I know his quiet but thorough manner. However, Dr. T. was the epitome of thoroughness, having read every page of my 2" thick file and double-checking that no liver scans or the likes had to be followed up on. Surprisingly, there was already a note in my Kamloops file about my visit to Dr. C. the day before, so Dr. T. examined my lumps to offer her opinion. Although she agreed that they did not have cancer-like characteristics, she felt it best to have an entire lump removed from my forearm and sent for pathology -- another cautious oncologist -- yay! The order for the biopsy was cancelled, and a referral to my original surgeon was initiated. During her physical examination, Dr. T. felt a tiny lump close to my armpit, right at the end of my mastectomy scar. Although likely scar tissue, or a lymph node trying to repair itself, carefulness reigned once more and an ultrasound of the area was ordered. Oh great -- more medical appointments to attend!
While doing some research a few months back, I had learned (and later asked Maureen) about a blood test for tumour markers. A tumour marker is a naturally occurring substance in the body that, if present in increased amounts, can indicate the presence of a cancer. Some tumour markers are specific to one type of cancer, while others are related to several different types of cancer. Wanting to do every little thing I can to know if cancer is regrowing in my body, I decided to ask Dr. T. about the blood test. David even thought if I had to go the "private clinic" route to obtain the test, it was worth whatever cost was associated with the test. Dr. T. explained to me that the reason the blood test is not routinely done is that the results can be very inaccurate. You see, tumour markers may increase even with non-cancerous conditions. If the results come back indicating increased tumour markers in the blood, a person would be put through a gamut of scans and tests only to discover the test results were inaccurate and no cancer exists. Likewise, results can come back as "false-normal". I decided to trust the professionals, stick to doing my routine check-ups and mammograms, and forget about an inaccurate blood test.
If you are interested in doing more reading about the tumour marker blood test, here is a link to the Canadian Cancer Society's website, Tumour Marker Tests.
Even though my two check-ups resulted in two more procedures being ordered, it is a relief to have them out of the way. I'm definitely not concerned about either the lump pathology or the ultrasound. These oncologists do not beat around the bush to make patients feel better -- they call it like it is. Since neither doctor seemed alarmed, I won't be either.
On with my summer plans :)
