My journey through breast cancer
I was 32 when one morning, lying in bed with my new boyfriend, I discovered two small lumps as I was scratching an itch under my left armpit. Instantly I felt a sick feeling in my stomach - my mother had died of breast cancer. I tried to reassure myself that it was probably nothing (surely I was too young for breast cancer), and made an appointment with my GP to get it checked out. She too could feel them quite clearly, and reassured me that it was probably nothing, but given the family history, suggested I have an ultrasound 'just to be sure'. It felt weird going into the radiologist, surrounded by older women, I felt rather silly and almost like I had no right to be there, but was keen to get the procedure over and done with so that I could return, with a clear conscience, to my normal life. Back at the GP a week later for the results, she told me that the radiologist reported that they were probably enlarged lymph nodes and that, apart from keeping an eye on them, it was nothing to worry about. Just the words I wanted to hear! So off I went, safe in the knowledge that I had done the right thing and all was OK.
Twelve months later, I changed GPs. During the initial consultation, while I was providing my medical history, I almost forgot to mention the two small lumps, still palpable in my left breast - the 'enlarged lymph nodes'. My GP looked at me rather puzzled as she felt for them. She didn’t want to alarm me, but asked me to return in three months so that she could check them again. I did this and since there was no change, she told me she was going to refer me to a breast surgeon for an opinion. I was still not worried, glad that we were being thorough, but unconcerned as I was in excellent health, running everyday, feeling fitter and better than ever, and besides I was too young for breast cancer.
It was a couple of months later before I could get an appointment with the surgeon and she scheduled another mammogram and an ultrasound. The results were not clear so she arranged a fine needle biopsy. As I lay on the table I remember how kind all the staff were, explaining the procedure. At first she had trouble piercing the lump as it kept moving, and said this was a good sign, as often the 'bad ones' didn’t move around as much. When she got the second lump on the first attempt, everyone was silent. When I returned to the surgeon for the results, she told me they were inconclusive, but she wanted to remove them.
Day surgery was arranged for a lumpectomy the next week, and I went in for the results, two days after that - about 18 months after I had initially discovered the lumps. It may seem strange, but even at this stage I was still confident that the news would be good. I went alone to the appointment with my surgeon. When she said: 'This is not what you want to hear - it’s cancer.' I was truly shocked. Despite the several weeks of appointments and procedures I still thought it couldn’t happen to me. I could barely hear her explaining that I had early breast cancer which was hormone receptor positive as my mind raced to death and how I was going to tell my family, friends and boyfriend. When the breast nurse came in to speak to me, I started to cry uncontrollably. They were talking about another operation to remove lymph nodes and then possible chemotherapy and or radiation, while all I could think about was all the things I hadn’t done yet – that I wasn’t ready to die. After sitting with me, and me assuring them that I was OK to drive myself home, they gave me a large envelope of information, and allowed me to leave.
I cried in the car on the way home, and I cried again when I got home and told my boyfriend. Both my parents had died of cancer, I remember them being sick and how awful the experience was for everyone. I somehow managed to get the courage to call my brothers and sister to tell them the news - a task made all the more difficult by the fact that it was the week of the ten-year anniversary of our mother’s death. I then began reading the literature I had been given, all this stuff that seemed to be for someone else, with all kinds of percentages for survival, none of which sounded good to me - all I could think of was death. Pictures of older women, and advice on explaining your condition to the grandchildren only horrified me more - I hadn’t even had children yet!! I was scared not only of dying, but of getting really sick.
Over the next few days I prepared myself for further surgery and the possible outcome. I tried to be positive; I’d read so many times that a positive attitude was essential to beating this disease. But I couldn’t help feeling angry and hopeless. Here I was in a minority, one of the small percentage of women who get breast cancer before they’re 45, I felt like there was every reason to believe that I would again fall into the exception category of women who do not survive. All the time I felt guilty for not being positive - I was driving myself mad thinking that I was going to cause my own death with all these negative thoughts!
The surgery went well and thankfully my lymph nodes were negative. Now I had to make some tough decisions regarding treatment. I started to feel like I had say in what was going to happen to me, the feeling of empowerment helped. Keeping my mind on the next step and decision that had to be taken helped me to focus on the concrete, rather than the ‘what ifs?’ I started to seek information wherever I could get it, finding out as much as I could about how this disease was treated, and what the side effects were.
Having children had never been an urgent thing for me, I was now 33, but still wasn’t sure if I wanted any. Suddenly the prospect of being thrown into menopause and denied the opportunity made me angry. Many of my friends were choosing not to have children until their mid-30s why would I not be given that opportunity? Even if I wasn’t going to have children, I certainly wasn’t ready for menopausal symptoms, making me old, I thought, before my time. Difficult issues at a time when I was still establishing a relationship with my boyfriend. It felt like many of the decisions I was forced to make had implications I was not ready to face.
Eventually I decided to go ahead with the four courses of AC chemotherapy and six weeks of radiotherapy recommended to me, and review the Tamoxifen later. My GP referred me to a fertility specialist before I began treatment who outlined my options. We decided to do nothing as, given my age and the course of chemotherapy I was having, there was a good chance that I wouldn’t go into early menopause, and I wasn’t prepared to undergo surgery again to take ovarian tissue. We agreed to reassess my fertility after the treatment.
I decided to continue working through my treatment, wanting my life to continue as normally as possible. I took a long weekend each time I had the treatment, and allowed myself long lunch breaks when I needed them. I was lucky that my employers were very supportive, allowing me as much time as I needed. I really dreaded losing my hair, but in the end it really wasn't that bad. I hated wearing the wig I had bought myself, and wore it only to work - more for everyone else’s benefit than mine. I found it allowed me to go relatively unnoticed, particularly with new clients. The rest of the time I wore scarfs and hats to keep warm.
During my treatment I discovered The Young Ones, a support group for women with breast cancer who are under 45. Finally I had found a group of women who had been through, or were going through, the same things I was. It was great to be able to share my story, concerns and fears with women in similar circumstances. I’ve made some great friends and had some wonderful times, they were able to understand in a way that, despite heir love and concern, my family and friends couldn’t.
My family and friends were fantastic, showing me support and encouragement, without pity. They allowed me the space to deal with it the best way I knew how, to keep my life as normal as possible. I didn’t want to feel different, even though sometimes I had no choice. They were there for me all the way.
In December it will be two years since I was diagnosed. I had to stop taking the Tamoxifen as it was causing ovarian cysts, and my fertility specialists sees no reason why I couldn’t become pregnant, though I’m still not sure I want to. Breast cancer has certainly changed my life; I feel stronger, and I will never again take for granted my health or my future. I now make sure I don’t put off doing things I want to do and try to remember to appreciate those around me. This year I decided to take a long trip around Australia, something I’d always wanted to do, but thought I couldn’t afford either the time or money. I had an amazing time. Like many women in my situation I fear that I am living on borrowed time and that a recurrence may be just around the corner. I have days when I feel sorry for myself, but I’ve learned that worrying does not change the out come. What I can control is the way that I feel, and what I do right now. The way I figure it, I might as well feel happy, live and love life, because if I’m going to get sick again, being miserable and worried about it happening is not going to prevent it from happening, only ruin the time that I have.
Rita Marigliani, diagnosed aged 32 in 2001, writing in October, 2003
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Rita Marigliani 
