Sunday, May 24, 2015

The Alien gets a name

The day after my surgeon called, Rebecca and I were sitting in his office as he tells us that The Alien is in fact a "Ductal Infiltrating (DCIS) Estrogen Receptive Tumour."

So The Alien has a name and we are scheduling a double mastectomy for the earliest possible date available on Dr. Bill Williard's calendar.  I distinctly remember that both Rebecca and I were relieved that Dr. Williard would be my surgeon.  The physician who initially excised my tumour had worked with Dr. Williard's group but had left to pursue work elsewhere.  Rebecca and I both felt much more trust and faith in Dr. Williard from the first time we met with him.

Dr. Williard is the primary surgeon of the Northwest Surgical Group, a division of South Sound Surgical Group in Olympia Washington working out of Capital Medical Centre.
3920 Capital Mal Drive SW Suite 201, Olympia, WA 98502

Suddenly the world seemed to have come crashing down onto my life. Rebecca and I spent the mercifully short time between diagnosis and our surgical date in what Patrick McManus described as "Linear Panic."  I was frightened but the central theme of my emotional state at the time was one of utter confusion.  I mean, listen to the media regarding breast cancer.  What do you hear?  Breast Cancer Research.... for your wife, your sister, your mother, your nieces...  Search the internet under breast cancer and what do you routinely find?  Photos of women, women of all ages, young women, middle aged women.  What you very seldom see are photos of men on these sites and information about male breast cancer is even more difficult to find.  The myth seems to be "men don't suffer from breast cancer."

Where did I fit in this puzzle?  Surely there has to be some mistake.  I am not anyone's mother, sister, wife or niece.  This can't be happening to me, there has to be some mistake..... doesn't there?  But no, there was no mistake.  I had breast cancer and, as it happens, a rather aggressive and dangerous cancer at that.  What was interesting and truly wonderful for me is that given the size of the tumour it had been growing in a milk duct for some time. (Yes, men have those too.) Most such tumours of that size would have erupted through the membranous wall of the duct and become a much more invasive cancer, placing me at much greater risk. 

So, there I lay, stretched out on the gurney, my stomach in knots and still in denial; covered only in a surgical gown and warm blanket, Rebecca and I waiting for Dr. Williard to come in and talk to us prior to surgery.  We discussed the options.  One breast?  Both?  Should we do a prophylactic procedure on the left?  On the right, the site in which The Alien had taken up residence, was a foregone conclusion: we would do a full blown radical on the right to include sentinel nodes adjacent to the site.  I struggle even now to remember the specifics of that discussion.  It is odd how such earth shaking news and the aftermath of a cancer diagnosis can distort time and muddy one's memory....or at least it did mine.

When he came to speak to us after surgery, Dr. Williard was pleased to tell us that of the four sentinel nodes he had removed and sent to pathology during the procedure, none had shown any sign of cancer cells. 

I was discharged the next day and went home in a daze. Recovery was no picnic and not for the faint of heart. I would have gone nuts had it not been for Rebecca.


If there was one overriding feeling in the process of being a male diagnosed with breast cancer I would say that feeling was one of complete and utter frustration.  Certainly I experienced a variety of emotions from the first indication that something was amiss.  Perhaps the place to start is at the beginning.

Rebecca and I were making love.  In the process, which was a heck of a lot of fun bye the way, she became very serious and as she backed away, she gently placed her index finger on a tiny lump just under my nipple and said "what the hell is this?"  The offending lump was something I had never noticed and I said as much.  She was not to be distracted from her concern however and we talked about this little invader we came to know as "The Alien."  After some discussion we determined that first thing Monday morning we would call my Attending Physician and make an appointment to be seen.

The following week we went in to see my physician and he examined The Alien and said that I ought not to worry, that it was "just a cyst" and that we needn't be concerned.  He also said that if we were not comfortable with dismissing the issue, or if the size or texture of this lump were to change, we ought to call and have him have yet another look. 

Well that didn't sit well with Rebecca and we discussed it for a couple weeks following our initial appointment with the doc.  In truth neither of us was terribly comfortable with the lack of detailed information we had concerning the lump and we called and set a second appointment with Steve.  He seemed perplexed when we sat there insisting that The Alien be removed at the earliest possible opportunity but offered to refer me to the surgeon across the hall from his office.

Several days later we received a call from the surgeon's office and an appointment had been set for me to come in and have The Alien excised.  So there I sat, propped on the surgeon's exam table as he prepped my chest and injected a local anesthetic.  As he prepped the site, he too said that I needn't worry as The Alien was surely "just a cyst" and would not pose significant issues for me or in this case for him to excise it. 

Well, that was easier said than done.  As he cut deeper and deeper he found that what we thought was a tiny pea sized lump was much larger and much more deeply imbedded than any of us had thought.  After several more injections of local anesthetic and a lot more cutting the surgeon lifted an encapsulated shiny white mass about the size of my thump from the wound and placed it in a specimen container.  I thought I would be relieved to see The Alien removed from my chest but in truth, I wasn't relieved at all.  What I felt was dread. 

In Washington State, the law requires that any mass removed from a body must be sent to pathology and we were told that the surgeon's office would call when the pathology report was in.  Weeks passed,  two weeks and counting.  Both Rebecca and I lived with anxiety through that period and never seemed able to relax into the belief that it was "just a cyst."  Early in the third week after the excision I called the surgeon's office and inquired.  I was told that the lab that had examined The Alien was not comfortable with the findings and that The Alien had been sent on to yet another lab for further study.  It was then, my heart in my throat and my guts threatening descend through my chair I asked.... where was it sent?  I was told that The Alien had been sent over to "Fred Hutchison" for further examination.

A week later my office phone rang and as I answered the caller identified himself as the surgeon and his words still echo in my mind.  He said "I'm so sorry....  Can you come in to see me?"