2001 | Diagnosis and Determination: Facing Breast Cancer, Finding Strength and a Sense of Normality

I spent my remaining sick leave days after the mastectomy in front of the television set, too despondent to continue with my life. It was difficult to bathe and dress with all the drainage tubes that I had to drag along. Not that these things mattered because in the aftermath of that winter, it was still very cold, and I did not see the need to remove my warm pyjamas, as I was not going anywhere.

On my first visit to the surgeon two weeks after the mastectomy, he was very pleased with my progress. The drainage tubes were removed, and I demonstrated that I could already hold my arm above my head and could brush my teeth and hair. I, nevertheless, continued to use the battery-powered toothbrush the children bought for me after the mastectomy, while reading or watching television, to their growing irritation!

The pathology lab results after the surgery confirmed the diagnosis of Invasive Lobular Carcinoma (ILC). I only recently obtained and studied the clinical reports relevant to my diagnosis and treatment that I received in 2001. I had no idea until recently that all this information for all cancer patients was already centralised at the time and remains available at the National Cancer Registry.

What I learned from those reports and subsequent reading of topic-related articles recommended by my oncologist is that ILC is a type of breast cancer that starts in the milk-producing glands (lobules), unlike the more common ductal carcinoma that begins in the milk ducts. ILC cells often grow in single-file lines or scattered patterns, making them difficult to detect on mammograms. Unlike ductal carcinoma, which usually presents as a distinct lump, ILC frequently, but not always, presents only as skin thickening, which can prevent detection by self-examination. This means that ILC may be detected at a later stage.

I was fortunate that the radiologist identified the mammographic anomaly, and that, subsequently, I was under the care of an experienced surgeon who demonstrated concern for his patient and ensured that I received the best possible care. This led to early detection and treatment of breast cancer in my case.

Although the surgical and pathological teams found no signs of metastasis during surgery and subsequent lab tests, this was not a 100% guarantee that there were no rogue cells present in my body. Therefore, the surgeon referred me to an oncologist for further tests and evaluation of my case. He also warned me that chemotherapy as a form of preventative treatment may be on the cards for me.

Shortly after, I had my first appointment with the oncologist. Still, first I had to spend a few more hours at various departments of the clinic for blood tests, x-rays of my lungs, ultrasound video recordings of my heart and intestines. It felt as if I were turned inside out and put on display for inspection. For me, a true control freak, it was a horrendous experience to feel so helpless and exposed. Fortunately, all these facilities were available under one roof, and the staff were professional and friendly.

All the test results indicated that my organs were healthy and functioning correctly. However, he also confirmed that I would have to receive chemotherapy as a preventive measure, as breast cancer is known for early “broadcasting” (spreading of cancerous cells in the body), and the treatment would aim to destroy any cancer cells that might still be present in my body.

Looking back on that time after all these years, I regret that the PET-CT scanner used today to detect cancer cells in the body was not available to the public until a few years later. I imagine that maybe I could have escaped the trauma of receiving preventative chemotherapy at the time if such a scan had been available to me. However, I do not spend too much time pondering this possibility. My oncologist assures me that I received the best possible treatment available to me at the time, and I choose to be grateful for that.

I realised there were still many dark days ahead. I have always been a very private person, and I was not yet ready for other people’s ”interference” in my life. At the office, only those colleagues in the department where I worked knew about the mastectomy, and this was how I preferred it. I was not in the mood to answer questions or to discuss my prognosis, regarding which I myself had no clarity yet.

I still had to get my head around the idea of having cancer. Moreover, I am one of those people who hate to admit to any weaknesses and put them on display. I only wished for my life to return to everyday normal as soon as possible. This became a challenge, the goal I wanted to achieve as quickly as possible.

With the sword of the upcoming chemo sessions hanging over my head, I could not endure the thought of having to hang around, doing nothing worthwhile. I chose the only option that made sense to me in a world suddenly turned upside down. I had to start working again. My employer, and especially my department head, was most accommodating and provided me with a laptop to work from home. I also started going to the office again when I felt up to it.

Being busy at work took my mind off my new cancer world. This restored a certain degree of normality to our family life. Corné drove me to work every morning and picked me up again in the afternoon. Although we lived a mere 20 kilometres from the city centre, the traffic was a nightmare. This was in the days before power steering became the standard in all cars, and I would have struggled with the steering wheel and the gearshift.

Returning to the office was the right decision and helped initiate the emotional healing process. My co-workers, who all shared an excellent sense of humour, did not hesitate to make me the target of their pranks on those days when the anxiety and perpetual fatigue (due to insomnia) got the best of me.

I still remember the chain letter, the bane of our lives those days, that arrived in my e-mail box on a day when frustration was running high. The subject of the message is long forgotten, but I clearly remember the last paragraph: "If you do not pass this message on to seven people within seven days, your other tit will also rot and fall off". I went into peals of hysterical laughter, with everyone peeping out from behind the dividers to share in the hilarity.

Featured image: AI illustration of a woman demonstrating a breast self-exam, using her hand to palpate her breast tissue for potential lumps.