The "Good" Cancer

Before I had cancer, I really had no interest in reading about anyone else's, so if that's you, feel free to skip this.

Let me preface this by saying how grateful I am that of all the cancers I could have had, I had the “good” one. I am incredibly grateful for how smoothly this has all gone, and for the privilege that has allowed me to navigate it with relative ease.

Being diagnosed with cancer isn’t even the worst thing that has happened this year, and I am still grateful in a way that it just got bundled up into the whole thing, and was yet another piece of bad news that we had to roll with, rather than coming out of a clear blue sky. We were already in resilience-mode, and in any case, there has been a kind of inevitability about all of this.

I was diagnosed after a routine mammogram on a Wednesday in early March. I had no pain or discomfort, or apparent lump. Something showed up on my mammogram, and a scan the next day meant my doctor referred me for a biopsy, which happened on the Monday. The biopsy confirmed a malignancy, and I was sent for an MRI. I switched hospitals after this, simply because another doctor, whose mother had had the same thing, gave us the name of a surgeon at Gemelli hospital; I had been very happy at the small and intimate Breast Unit of the first hospital I went to, even though it was awkward to get to, but in the end, if you get the chance to be seen by one of the best surgeons at the best hospitals, why wouldn’t you take that opportunity?

Gemelli is a juggernaut, with all the good and bad that that entails. The bad, it turned out, was the time between being put on the list, and actually being operated on. To be honest, we had been warned that it might take a month to six weeks, but at this point everything had happened so fast - to the system’s credit, everything was done extremely quickly to identify my type of cancer, and I know that had I not been one of the lucky ones, it would have kept moving at that speed - that when it slowed down, I started to lose my mind.

I am not an anxious person. I was not anxious about the cancer: two doctors in two hospitals had told me unequivocally that my cancer could be removed and I would be fine, and I doubt doctors go around making these sweeping statements unless they feel quite confident. I was not anxious about the operation, or the treatment afterwards. I was not anxious about my health in general; I was on no medication, had had no issues with menopause and whole batteries of tests confirmed that - apart from the pesky cancer - I was in good nick. But my whole family had been drowning in uncertainties since the beginning of the year when my father had a stroke and subsequently died just when we were planning on bringing him home, and were caught in a loop of trying to arrange nursing which was dependent on his needs which wouldn’t be fully apparent until he was home; three days after his death my mother was hospitalized and eventually released in a worse physical state than she had been admitted, and it was while I was at home taking care of her, while we were trying to figure out what long-term care she would need, that I was diagnosed. My father died, my mother got better and we found a solution that worked for everyone. I had cancer but it could be cured. But I couldn’t deal with yet another limbo, yet another situation that was out of my control. It didn’t matter how many people - medical or lay - told me what I already knew, that my depression and anxiety were temporary and entirely understandable, they were still paralysing.

And again, I’m so aware of how fortunate I am. I was/am surrounded by support and compassion. I didn’t have to soldier on, I didn’t have to repress my feelings and keep going even though I felt as though I’d had a layer of emotional skin flayed off me. At first I felt guilty about this. I felt as though I should be more stoic. I felt as though every time I couldn’t get it together to do something, I was letting everyone else down, just adding to their burden: not only saying, “I can’t do this so you have to”, but then adding, “Oh yes, and you have to take care of me too, now, because I’m incapable of coherent thought or action.” Was this it, then? I’d always thought of myself as so tough, such a survivor, and then when the not unpalatable chips were down (elderly parents suffer the consequences of longevity, middle-aged woman in otherwise robust health has curable common ailment), despite being encased in a bubble of love and support, with no question that I was carrying any burden alone, I fell apart because I didn’t have a date for an operation that I knew would happen within a certain timeline, and whose delay was not in any case life-threatening? What the hell did I have to feel pathetic about?

Pressing the doctors for more information just yielded up the reassurance that everything was happening within a realistic timeline, and that my cancer was so small, so slow.growing, and so treatable - the “good” cancer - that I had nothing to worry about from what I perceived as delays. And really I knew all that, and I knew that if my cancer had been such that it needed to be operated on immediately, I would be very happy that I was being prioritised over someone who could easily wait. Did I wish they bumped me up the list and pushed someone else back? Of course not. Did I start to think that maybe if my cancer was so low-priority then maybe I didn’t need the top surgeon and the best hospital, and maybe I should have stuck with the other (also excellent) hospital, where I might have been operated on more quickly (but I didn’t really know if this would be the case)? Of course I did, especially when I was finally given a provisional date, and was then told that my operation would not be on the provisional date. That was my lowest point, and it was completely irrational, because I knew by then that my operation was imminent, delayed or not, so what difference did a week make? But I needed to have a date, and when finally I was given one, my anxiety started to lift. My date for surgery was on a Monday, and I would be admitted on the Sunday. Then they called and asked, could I come in on the Friday instead, for Saturday surgery. Somehow, that was the thing that flipped the switch - that I would be operated on at the end of one week rather than the beginning of the next - and I could feel the last remnants of anxiety lift from my shoulders and float away. And that was it for the feeling of dread in the pit of my stomach, and I almost felt excited at the thought of the operation, because it felt like progress.

Gemelli hospital is vast. It’s a teaching hospital, a research centre, a labyrinth of separate departments connected by corridors and elevators: the main entrance is on the fourth floor, and to get to the various wings youn sometimes have to go up a few floors and then round some corners and then down some floors to end up one storey and half a kilometre from where you started. Once you’re admitted and you are being shepherded about for scans and tests, then there are a whole load of back corridors that you wouldn’t even know existed. My granddaughter was born here, and I have been on numerous occasions, accompanying my mother to appointments for her glaucoma, so I have learnt my way around some bits of it. But once you are a part of it, you feel the force of its vastness, and you feel that you are held safe in its efficiency. Go to this floor, present yourself, and they will have all your information, and tell you nicely where to go next, where everyone is expecting you and once you are done there, they dispatch you off to the next place.

The thing about having breast cancer in your 60s is that you stop caring about stripping off at the drop of a hat. In the past few months I’ve had four mammograms, a biopsy, an X-ray, an MRI and too many scans to count. My boobs have been groped and man- and woman-handled by complete strangers and I’ve been grateful for it. I was told immediately, by two doctors in two different hospitals that my cancer would be easy to remove, and that my treatment would be radiotherapy and a hormone inhibitor. I took all this at face value, and obeyed all instructions to not google anything. As a result, I have had not had to think about whether I would consider reconstruction after a mastectomy, or contemplate the prospect of chemotherapy. I had two tiny nodules that have left me with a scar across the top of my right breast - lymph node(s?) removed from the same cut. It makes me feel like a bit of a lightweight.

My hospital roommate and I bonded immediately: she is a decade younger, and while her cancer, unlike mine, was Stage 2, it was spread out across the bottom of one breast, so rather than reconstruction she opted for a reducuction on both sides. We were both admitted on the Friday morning, and she was operated on Friday afternoon. She had her best friend keeping her company, so I called the best friend and snuck her onto the ward when they brought Maria Pia back into the room, and she did the same for me with my daughter on the Saturday (although there were quite limited visiting hours, they were pretty lenient about overlooking the accompanying relative post-surgery).I had a bit of a rough night following my surgery (mainly just extreme discomfort and an overwhelming longing to sleep on my right side, which I couldn’t do), but she had an altogether harder time of it, what with drains in both breasts and a lot more pain. And both of us were having a much easier time than a lot of other people on the ward.

I was home on the Sunday morning, trussed up in a ghastly breast-flattening bandage corset (my granddaughter looked at me in horror and asked, “Where did they go?”). It wasn’t comfortable, but it wasn’t painful either. Getting comfortable enough to sleep was challenging, but once I managed it I slept soundly. My niece was staying with me, so I was well taken care of.

Over a month later, I’m fine. In fact, I’m more than fine, I’m cancer-free. I’ll start radiotherapy soon, and I have to take a pill every day for the next five years. I have residual discomfort and lack of feeling in parts of my right arm, but it improves every day, and in any case I’m left-handed (but ambidextrous out of necessity, like most lefties, so it has still been annoying to have less strength in my right arm). It could be so much worse and I have been so lucky.

I have nothing to complain about, to feel sorry for myself about, and everything to feel grateful for. And I am, oh, I am. So grateful, so thankful.

And yet, I feel slightly whiplashed. March to July, I was coming to terms with the fact that I had cancer, that I am temporarily registered disabled: I had to get my head around the fact that I had a cancer in my body, that I was a person with cancer, that my recovery would be ongoing. I can honestly say that I never entertained the idea that the news wouldn’t be good, but it was still a relief to hear it. But I can’t quite get my head around the fact that I had cancer, they took it out, and now I’m back to how I was before, albeit with a gammy arm, emotional exhaustion and a daily reminder for the next five years. Did I really have it if I don’t have it now? WILL IT COME BACK?

That’s the worst bit. It’s as though having opened the door to the possibility, dread has its foot jambed in there. Even though, as I said, I didn’t google possible bad outcomes, believed my doctors, and indeed had the best of all possible outcomes. I didn’t ever think I would die. But I will one day, won’t I?

As soon as I was diagnosed with breast cancer, I was glad that if I had to have one, that was the one I had. The one with funding and information and research and resources, whole departments with tasteful pink or purple doors devoted to it; the one where everyone knows someone who has had it.

If it hadn’t been for the work of Dr Umberto Veronesi, this slightly surreal situation that I am living now wouldn’t have been possible. He pioneered the quadrantectomy and biopsies of the sentinel lymph nodes, which meant that with the type of cancer I had, and the stage at which it was detected, I got away with a scar and some temporary discomfort, rather than losing my whole breast. I guess we all grow up believing that “a cure for cancer” is some impossible hope that never seems to actually happen, without considering the tireless research that allows the experience of cancer to be mitigated as much as possible with targeted treatment. Of course I know that for many, the research and treatment is still falling short - I heard this week that a family friend had died of cancer - and if my diagnosis had been different, I wouldn’t be in this fortunate position now.

I can’t overstate how grateful I am that I have had everything I needed throughout the past few months. My friends and family have poured love and care over me, and made me laugh whatever else was going on. I live in a country where my taxes pay for my health, and when I’ve needed to shell out for an extra (another mammogram, acupuncture, a meal in our favourite restaurant, a taxi home) I’ve been able to do that. My workplace, and those of my loved ones, have responded with compassion. Almost without exception, everyone I have had to interact with in a medical setting has been kind and patient, from my lovely surgeon to the barista in the hospital.

I am genuinely thankful for everything, and also can’t quite believe my luck. I think I just feel as though I should feel more emotionally robust. Maybe it’s just going to be a few more months before I can feel as though this is behind me.