I know what scares me about metastatic cancer. Except when I don't...
Martha lives in Illinois and was diagnosed with metastatic breast cancer in January 2015. She has a husband and three children, ranging in age from 12 to 18, a dog and a lizard.
When you have metastatic breast cancer, you have a lot to fear: the cancer itself, the treatment, the side effects, the specter of loss and change. But, as you live with this disease, you start to learn what is likely to cause fear and ways to manage it.
But there are times when I am blindsided by fear. I recognize what's going on because it is pretty easy to feel the fight-or-flight response kicking in – muscles tense as adrenaline and glucose flood my system and I find it difficult (impossible, really) to focus on anything other than the piece of information, no matter how small, no matter how vague, that has put me directly in the path of fear.
I got such a piece of information just a few days ago in the form of a standard letter sent from the breast imaging department at the hospital where I receive treatment.
"The results of your most recent breast imaging show an area at is probably benign, however..."
Now what, exactly, is a patient like me to make of such a statement? I have been carrying that letter around in my jacket pocket, wondering what to do with it. I can't focus on anything else, yet I know from months of experience reading the reports of various radiologists that this person is very likely just hedging his or her bets.
It is, unfortunately, likely that breast cancer will cause further havoc in my body and life. So, if there's a questionable "spot" in a mammogram that might be almost inconsequential in another patient, it is brought to the fore for me. In the very recent past, I also received a letter from a radiologist reading mammograms pointing out that the density of my breasts could cause difficulty in assessment. I had never been told that in the past.
I get it. I really do.
If I were a radiologist or oncologist or a general practitioner who knew that the patient I was seeing had metastatic cancer, I'd hedge my bets, too.
But I'd be on the phone, too. I'd be talking to that patient about what the words actually mean, and why I included those words in a letter sent to her home with no warning, no accompanying information.
It is altogether too easy for doctors – of any type – to minimize what cancer patients are living with. It could also be so easy for those same doctors to reduce the fear that can overwhelm everything else.
As I read and re-read the letter from the radiologist, my more-civilized, less-instinctive mind tries to beat the fight-or-flight stress that I feel even now as I write this: For two years I have been receiving mammograms every six months. The date recommended for the follow-up is exactly six months from this last one and that is the thing that matters.