and a fine needle biopsy of the lump at a private hospital. The doctor who looked at my Mammogram ordered an
Ultra-Sound scan as well. As for the fine-needle biopsy, I hardly felt the prick, although it had to be done a second time. The report was that I was clear and I felt pleased.
Since the fine needle biopsy cleared my lump of malignancy, my surgeon, Dr. G., recommended a lumpectomy the very next day. `Lumpectomy’ means a fairly simple surgical procedure whereby the lump is removed under a local anesthetic. I went home in a couple of hours, having been given the “lump” (floating in a bottle of spirits) to be handed in for a biopsy.
We then informed my eldest daughter who happens to be an Oncologist practicing in New Jersey, USA. Ranmali was on the ‘phone to me immediately. I told her the fine needle biopsy had cleared me, but she spoke candidly and was of the opinion that the
lump was very likely to be malignant, as the fine needle procedure doesn’t always give an accurate result. This deflated me somewhat. In the event, she was right and even before we got the biopsy report confirming Ranmali’s suspicion, she arrived here in person and accompanied me on my next visit to Dr. G. He read the biopsy report and discussed what options I had. It was a huge relief to me and to all the family that Ranmali was present to guide us, in discussion with Dr. G. I was to have a full mastectomy of the left breast, with removal of lymph nodes. It all seemed unreal. I wasn’t at all nervous, but felt as if it were happening to someone else.
I had my breast removed by Dr. G., under general anesthesia on February 8th, in the late evening – this is what is called a Mastectomy. Thirteen lymph nodes were also
removed. When I regained consciousness I felt no pain whatsoever. It was nice the next morning, to have the ministrations of a most competent nursing attendant who gave
me a wonderful sponge from head to toe. Nicer still, was the appetizing breakfast of stringhoppers with pol-sambol and a curry. I guessed I was on pain-killers and antibiotics when the nurses brought round pills of various shapes and hues and I am happy to declare that at no point did I have even a twinge of pain. I was able to get out of bed and go to the toilet on that first day. I came home on the evening of Feb.11 and was able to come to the computer after dinner to send off an e-mail to Ranmali (who had gone back by then) and to my other children abroad, assuring them that I was doing fine.
While in hospital, I had a tube draining fluid from the wound into a bottle. This was taken out the day before I left, but on two subsequent visits to Dr. G., he had to drain
fluid again – this procedure, again, is hardly felt. I had stopped taking the pain-killers quite early on, with the surgeon’s permission. On Feb. 21st, with the surgeon’s blessing, I travelled to Kandy by car and on the 25th I was able to sit through SIX
solid hours of the Peradeniya University’s General Convocation 2009 at which my granddaughter was among the graduates.
Back in Colombo, I resumed my normal life. I’ve been to see the Oncologist, Dr. A., with whom Ranmali had spoken when she was here. He was as satisfied with my progress as my surgeon had been. He asked me whether I had started taking the pill, `Femara’, which he knew Ranmali had brought me and he asked me to continue with that for a few years. No chemotherapy and no radiation. No dietary restrictions. I should see him every four months.
Ranmali gave us a very lucid account of my diagnosis and prognosis at a family conclave held round my dining table one day. I’d like to share with you some of what she said from a medical viewpoint, because it might be helpful. Although it is hoped that the removal of the breast lump would ensure a cure, sometimes the cancer “returns” because there are microscopic cells which have already escaped. These are not detectable and remain dormant, but can start growing at any point in time and show up as “metastases” in any part of the body. This could happen up to 30 years later in slow- growing situations, and much sooner in others. Four common factors are considered when assessing what the risk is and what can be done to prevent it. (1) Is there lymph-node involvement? (In my case, 2 out of 13 lymph nodes that were removed, had cancer cells – but the plus point is that these lymph nodes were taken out). (2) The size of the tumour. My lump was 2.5 cms. In general, if any tumour is more than 1 cm. some kind
of treatment is recommended. (3) Was the tumour sensitive to Estrogen? This is measured by what is called the Estrogen Receptor and Progesterone Receptor. Mine were highly positive – 99% and 93% - and this is a GOOD thing for 2 reasons. The first
is that in general, people with ER and PR positive tumours, have a better prognosis. The second is that because these tumours are sensitive to Estrogen (that is, Estrogen can make the tumour grow), by blocking the Estrogen, any microscopic cells that may be around can be “killed”. This is the single most effective way one can prevent breast cancer from recurring. (4) A check is made for a protein called the HER2 protein. This was negative in my case, which was also a good sign as people with HER2 positive have a
higher risk of recurrence.
I understand that since two of the lymph nodes that were removed were cancerous, cancer cells could be lurking undetected in some part of my body. In younger people, this would mean chemotherapy as well, but it has been found that in older people with ER positive tumours, the risk of recurrence is reduced by almost 50% with these Estrogen Blockers – I should take the tablet I am on, “Femara”, for 5 years. In general, older people have slower-growing cancers. Ranmali explained to me that I don’t need radiation since I had the mastectomy, but if my tumour (or lump) had been over 5 cms, or if more than 4 lymph nodes were positive (high risk), then Radiation would have been
indicated. The down-side of the pill, Femara, is that it promotes Osteoporosis and X-rays have shown that I already suffer from this condition. In order to counteract this, I am also on a weekly pill called Osteofos 70, along with two tablets of calcium
(Regucalcium) which I take daily.
Overall, my prognosis is fairly good, but, as Ranmali says, with cancer one never knows. One other point she stressed is that a positive outlook is always a plus point. I thank God that I am naturally a resilient type and I have plenty of interests to take my
mind off disease. With cancer spreading around the world like global warming, I would add that having an Oncologist in the family is a big bonus!
“Courtesy of Sunday Times, Colombo”
Re-printed here with permission
Anne lives in Colombo, Sri Lanka. She has been a journalist her whole adult life. She is 86 years old and still contributes articles to newspapers as a free-lance journalist. Writing is what she most enjoys doing. She has one published book. “Hurrah! For Large Families” which is about life with her brood of seven!
Stitch by Stitch
Barbara Abbott
November 2010 was a life-changing experience when I found out I had inflammatory breast cancer. I began treatments in December after having surgery to install a port for the chemotherapy. It has been heart-warming to receive so many cards and prayers from even strangers who tell my husband and me that they are praying for my recovery every day! From the warm hugs I receive from a lady assistant store manager at the local grocery store to so many asking how I am doing and telling me to let them know if I need anything, I know I am not alone in this fight.
I have received two prayer shawls from a local group and a United Methodist church in Virginia. I know that each stitch was lovingly created with prayer for me. Two weeks ago, I received a beautiful red prayer quilt sent to me from a United
