My First Day as a Cancer Patient

 Hospital Gown Selfie!! (Taken immediately before being felt up by a whole series of strangers over the course of 5+ hours.)

So. 

It's official. 

I had my first post-diagnosis appointment, and it was in a cancer center, where I wore a patient ID bracelet with my name on it. I'm officially a cancer patient. So weird. 

The day at Mass General started around 11am Thursday, when I walked into the Yawkey Center. I got on the elevator and asked the other guy in there to press Floor 9. There's a department name by every floor button, and the one by Floor 9 said cancer or oncology or something. I wondered if among regulars, the floor you pick is a well-known identifier, like if you're going to the orthopedics floor versus the cancer floor. Did I just ask a stranger to push the button for the cancer floor and somehow out myself as having breast cancer? 

Overthinking is pretty much my strongest game right now. 

I walked off the elevator and down the hall, guided by signs for the Breast Center. I walked past a little gift shop full of women's accessories like blouses, bras, scarves, swimsuits, wigs...oh shit. It's a cancer boutique. 

Funny, coming from a well-costumed city in the middle of Mardi Gras, it wasn't a red flag to see the wigs on the wall; what got my attention was that they all looked so normal. Where's all the glitter, the color, the height, the accessories? Where's the fun? These wigs aren't fun at all. 

Side note: if I end up having to go through chemo and the cold-cap thing doesn't work to save my hair, I'm telling you right now I'm getting at least one fabulous custom wig from Fifi Mahoney's, and I'll wear the damn thing in the middle of summer; I don't care. If I'm going to be wiggin' out, I'm doing it the fun way, with wigs I can wear for many Mardi Gras to come. 

Back to the cancer ward.  

You know, I say cancer ward, but it's actually a lovely place, with lovely people—a spacious room off of a clean, modern, brightly lit hallway that has floor-to-ceiling windows on one side, with a stunning view overlooking Boston. I even thought for a second about taking a picture, but I wisely realized I wasn't in a proper headspace to do so. 

The waiting room for the breast cancer center is soft everywhere. Soft colors, soft chairs--even the angles of the room seem soft. There are plants that divide up the space and lend it some privacy, and some taller-backed chairs along the rear wall for people who are really sick, so they have somewhere to lean their heads. There were a lot of people there, but it wasn't crowded.  Things are spaced carefully to allow ample room for patients in wheelchairs while not looking like a kind of expectant sick-bay loading dock, like in some colder institutions where wheelchairs are only meant to fit into their blue-labeled rectangles. I appreciated that.  

I'm spending so much time focusing on the waiting room because this was where I first had my moment of "I'm a cancer patient."  They ask everyone to confirm their ID and then they print out a hospital bracelet that you wear the whole time you're there. I was still wearing my all-black street clothes and feeling healthier (and more stylish) than most of the really sick people in the waiting room, but then, all of a sudden, I was wearing the same bracelet as them. I was one of them. On a similar journey. There was no more them; it quite abruptly became us.

I looked around at us: the woman in her 60s being wheeled in the door by her husband, who obviously knew the drill by rote. The family surrounding a woman in her 50s wearing a medical mask, and the kids that had her eyes. The man with a mask who was chemo-bald which struck me, but oh, right—men can get breast cancer, too. There were several women wearing pink hats reminiscent of the women’s marches across the country, only they were protesting cancer, not politics. So many people with no hair, thinning hair, masks on, thick sweaters, blankets, tired caretakers... I felt alien and not one of them, but I was indeed one of them. I thought maybe it's because I was so much younger than most of them, but then a girl close to me was asked her birthday. She was 9 years younger than me. 

Before I could really process, they called me back. I saw a string of 8-10 people of the next few hours. One took my vitals; one brought me a legit hospital gown; one brought snacks; one measured the volume of my right arm so that after they removed some lymph nodes in surgery and started radiation, they'd have a baseline in case I started getting lymph edema...wait, what?

One person came in and talked about genetics, taking down three generations of my family medical history so she could see which cancers might be genetically linked and be able to test for that mutation. We're testing for mutations, now. Of course that's what you call it.

(wheeeeeee!!!) 

One woman early on, maybe the second one to come in the room, asked me some things and went over my history and medications, and then said, "Being as young as you are, a lot of times women opt for a bilateral mastectomy, because cancer in younger women tends to be more aggressive, even if we don't find a BRCA gene mutation. Is this something you're considering?" 

Well, um, shit.

No.  Yes.  No. 

Um, now I am. 

God, both of them? Both my boobs? Gone? Was I totally naive in thinking that I probably could get away with cutting out the cancerous little buggers, shooting me in the boob with some radiation lasers and calling it a day? 

I guess if I got new boobs I could get them a little smaller & perkier—that might not suck. But if I had a kid, I wouldn't be able to nurse it and they say that's the best for immunity and...

Wait. Kids. What does this mean for kids? 

I know I'm not exactly a fresh spring chicken, but when I saw my PCOS specialist a year and a half ago, she checked everything out and said I didn't have to worry for a good five years. I've been fighting with PCOS for so long that I haven't even had the chance to even think of a family, and now that I finally have the PCOS under control, is this freaking stupid asshole cancer going to slam the kids door shut for good after all my hard work?   Is it too late to freeze eggs before they get any older? Would I even want to put my body through having a biological kid after cancer treatment if it meant I'd be in my 40s? Isn't that what they call a geriatric pregnancy? Do I really have to confront all of this, too, right now?

She went out of the room and the radiation oncologist came into the room. A few times throughout the day, the non-doctors who came in saw the name of my doctors on my chart and commented "Whoa, you got the A-Team," and this made me feel a lot better. I loved that show. And, you know, good doctors. 

My radiation oncologist gave me his business card: Dr. Alphonse Taghian, the Chief of Breast Radiation Oncology at MGH. He asked me what I knew about my cancer and was totally shocked when I told that him nobody has told me anything about what is really going on with me up to this point.  In seconds, he was drawing charts and diagrams of breasts and ducts and cancer cells, and explaining everything to me, telling me that the tumor was HER2-, ER+ PR+, which is good because it means it's not automatically chemo and that it's the kind that will respond to hormone treatment. So the plan was whatever surgical option they decide on, as well as 4-6 weeks of intensive daily radiation, and then 5+ years on a medication called tamoxifen.  Five or more years? This is going to go on for five or more years?  And how intense is intense radiation?  I’m a lobster after 10 minutes in the sun. 

If all goes well, then all I have to do is go in for annual MRIs and keep an eye on things.  Annual MRIs? Jesus. 

I asked him about the double mastectomy and thankfully, he all but extinguished that idea. He explained that when you are non-BRCA, there is no reason to remove a breast with no cancer or to opt for a whole mastectomy when you can just remove a part of it. There is no lower rate of cancer coming back when you do that. He said, "If cancer wants to be in the body, cancer will find a way to be there. At least with a lumpectomy, we will know where to keep looking for it." 

This is a new concept to me. I like it. I'd like to keep as much of the Pointer Sisters as I can. No need to replace the original lineup quite yet.  

After Dr. Taghian there were a few more people that came through, but my head was swimming at that point. There was a long wait before the final doctor came in.  Her name was Dr. Barbara Smith, and she's the head of the breast program at Mass General. The big wig. 

She's impeccably dressed and all business, but with a kindness to her. She talked me through everything, from start to finish. My whole A-Team had just sat down in a room and gone over all my labs and records and imaging, and they all agree that they think I can get by with a lumpectomy, radiation and hormone therapy, pending they don't find anything weird when they get in there for the surgery, that the cancer hasn't spread, and that the remaining pathology results aren't scary.  

For now, chemo isn't a thing. 

Thank. God.

I pay way too much for my hair color to lose it all. 

One thing she told me was that from what they could tell, the second mass they biopsied was benign, but was an "early satellite" of the original cancer. So basically, this puppy wanted to spread and was putting out feelers, but I caught it. The basic idea is that if I'd waited another 6 months, I'd be in a far more dire situation. If the cancer was closer to the chest wall, or deeper in the breast tissue so it was harder to find, I'd be up shit creek. There are so many situations in which this could have gone so much worse. This still gives me chills. 

I'm ushered to the pre-operative scheduling department, and then to get blood drawn for the genetic testing. I'm given basic surgery prep and told "We'll see you Wednesday!" 

So I'm having surgery Wednesday. 

That just sounds wrong to say. 

It's going to be a lumpectomy with sentinel node removal.  They're injecting the tumor with dye to see which would be the first lymph node to get cancer cells in it, if it were to spread. Then they'll take that one out and look for the cells, and decide what happens from there. 

After surgery I'll have an official stage, and then in a few weeks once the tests come back, I'll fly up for one more A-Team meeting at MGH and come out of it with a solid plan. I can fly home a week-ish after the lumpectomy and get my life together, then drive back up with the pup and my car before the radiation treatments and plan to stay up north for a while. There might be a low-cost place for cancer people where I can stay during the week in Boston during daily radiation, and then I can come back to the Vineyard on the weekends with my sweet pup. Mom & Dad can spoil him while I'm gone and deal with the inevitable skunkings. 

 (I can't help myself with the A-Team references. You know I'm going to be babbling about B.A. Baracus when I'm coming out of surgery...)

So yes, it's a good plan. I mean, right now,  it feels like it's someone else's plan—not my life, my boob, my tumor, my surgery, my cancer plan. I've been increasingly more able to say the word "cancer" out loud without crumbling into tears.  I've started telling some cancer jokes at my expense and talked about how it wouldn't be too too terrible to get a perky new rack. You may call it crass, but it's just the way I deal. 

 It seems like a few of you guys have been following this and have been checking back for updates, and I totally appreciate that. I’m utterly flattered that anyone would want to read it in the first place. But now that I’ve been asked, I wanted to put out an update before surgery on Wednesday.

It's Valentine's Day, by the way. The surgery is on Valentine's Day. 

It's also Ash Wednesday, the first day of Lent after the Mardi Gras season that I pretty much missed because I found the lump before  Xmas. 

So...I guess I'm giving up cancer for Lent.

Yeah, that works.