I found a Lump, now what happens when you're told it's Malignant?

I went to see my GP for my follow up appointment the week after my Mammogram and Sonogram appointments. I hated having to go back into that office. I just didn't want what was happening to go on.

If it couldn't get anymore like a bad novel, my Cat, who was like my only child, of 17 years, had just died over the weekend while waiting out the follow up appointments, and our roof started to leak in the living room from a down pour we had the week before. At this sad time, I just wanted to be in bed. It was like a bad sign.

But, I also wanted answers on the next steps as to what this was and what to do about it so off my Husband and I went. To face it together. 

On the way to the appointment all I could think of was what was going to be next. To be honest, by this point, I had more then enough time with myself about the subject, talking out the 'what if's' in my head, and frankly, I just wanted the lump the hell OUT of my body! Let's all figure out what it is. Yes. Great idea, uh-huh. But let's get it out, get it out now!  It's not gone away on it's own. I wanted an answer. So what if I wasn't panicked a month ago, I was now. Now ladies and gentleman, now you have my attention. I was a dog with a bone. It seemed like I couldn't get any traction on what this could be. No-one wants to 'go there with you' until they have more details. Everything was a wait. At this stage of my journey, I knew very little about Cancer, and let's face the facts, that was what we were all fearing the lump was. I didn't know, and still don't - for that matter, it's capabilities. I just wanted to get it out of my body, and move on. Yet we waited for appointments and follow ups. Was everyone around aware it was STILL in my body? AND by the by, still doing things in there like.. oh, I don't know ...maybe... growing??? hello? anyone? anyone at all?? alarms? anyone? no? It was like screaming in a dream that you can't move your lips to, but you can hear the deafening sound of your own voice.

We arrived for the appointment. Finally, someone else s' voice I could listen to for awhile.

My Doctor asked my husband and I to come into one of the exam rooms and take a seat while reviewing a copy of the Mammogram and Sonogram. They have found a lump that is about 2mm in size, we are being told as we arrange ourselves in the chairs. They can not see anything in the lump, the doctor goes on to say, and no liquid to allow them to see through the lump which means its a solid lump, and not a Cyst. Solid lumps while not all cancerous, are not great signs. The Sonogram notes read that while there is nothing to be said at this time about the lymph nodes, they highly recommend a biopsy of the lump and further testing and a chest xray.

Great. No answers. More waiting and now, more tests.

"Biopsy?" My husbands voice cracks a bit. "Shouldn't we just move forward in removing it?"

"We can not remove it without knowing more about what it is. Which is what the tissue biopsy of the lump will do for us. It will allow us to know a path."

In other words, that is not the path. The path is: Doctor>Referral>Mammogram>Referral>Sonogram>Follow Up Appt for Results>If needed next step is Biopsy>Follow Up Appt>If needed, well, we can't talk about that yet.

More time with myself. More waiting I think. She interrupts my thoughts.

"Well, I have another idea, if you trust me to do it. I think I could get us a faster result on what this could be."

Faster. Yes.

"What is it?" I ask.

"A needle biopsy as opposed to a tissue biopsy."

Why didn't we do this last week I think to myself.

She continues, "Lets attempt to aspirate the cyst and send in the cells for testing. We may get that result back within a week while you call and wait for the tissue biopsy date."

"Yes, let's go for it." I answer without too much deep thought, I want to move this thing forward. 

The Doctor sets up to do the procedure next to me on an exam table in the private exam room that we are in. My husband on one side, the doctor on the other. My husband looks at me and squeezes my hand, he asks if I am okay with this. I look him in the eye and calmly say yes. She inserts the needle into my right breast tissue and goes in for the first draw. Nothing comes out. I think to myself why would it? If there is no liquid and its not a cyst ...it's something else. She thinks she misses it. She asks if she can go again. I agree. This time, a very small blood droplet comes out. She puts it on a slide kit. Folds it into a bag, opens a box with a digital bar code and asks her assistant to mail the box off to the lab.

"We should get these results back in no less than a week. In the meantime, you can pick up a list of places that can do the biopsy and begin to call to get a date for a procedure."

I get home and call my closet girlfriend. She knows Cancer. She has just lost her Mother less than a year ago, to an almost 20 year battle with Breast Cancer. Her sister works for John Muir ER. "What do I do?" I ask her. She tells me to hold on while she makes a call. I hang up and sit down looking at my kitchen wallpaper. I wait. I pick up the phone after the first ring, it's her, I don't even say hello.

"What do you know?" my husband rushes into the room to eavesdrop on the conversation.

"Find a Surgeon to just get it out, and keep calling for a canceled date with the biopsy imaging center to get results, if that's what you need to get a referral and an earlier Surgical consult date. But you need to get it out."

I begin the calls. I have two paths right now, Biopsy and Surgeon. I need a biopsy quickly with results even quicker to get to tell me if it's Cancer or not. Surgeon's move you up the list of appointments if it's Cancerous as opposed to you being in the earlier stages of a possible benign lump. Why? Because that's how many patients they see. That's how many lives have been touched by this. It takes me about a week and a half but I finally get a line on a nurse in a nearby city that may be able to fit me in a week sooner for a tissue biopsy. In the meantime, I am also investigating Surgeons. I have a referral from my GP, I have my friend's Mother's Surgeon as a second referral and a few others in my network.

I begin each day making calls. The same calls. To the same places. Pleading with the same people. For an appointment closer then they have given me. I want it out, and need to put my energies somewhere besides the what if's. This feels more like moving forward in the Cancer journey. And, it feels like I am advocating for myself as opposed to being a victim.

Fight or flight I tell myself.

Through my girlfriend's recommendation, I get a hold of the Surgeon who is highly regarded in her field, in the John Muir network, for Breast Disease. March 24th is the soonest date she will be available to see me for a consult. I call the surgeon my doctor recommends. He can interview me next week in the Silicon Valley. Great. I take both the dates. I call the image place back and ask if there is any movement. None. My husband tells me to relax. There is nothing we can do right now. Nothing but wait.

And the waiting is excruciating.

We share the news with close friends who help us pass the time while we wait for results. They are very supportive as they, themselves have been survivors of many a different situation. Some Cancer, some other life crisis. All of substance.

It's the beginning of February. It is a bright day. I pour myself a cup of coffee and wait for my husband to come in the breakfast nook to join me for awhile so we can discuss what is going on and our next step plans before I begin the calling again.  The phone rings. He answers as he normally does. I hate to answer the phone. More of a in-person talker, I am. I can hear him, I think it's my Mom, "okay let me put her on" he says as he hands me the phone. I look up. And he has tears in his eyes. It isn't my Mother. He grabs my only free hand with both of his hands.

"Hello"

"Hello Lisa."

It's my GP.

"It's malignant."

"It's what type?" I ask. Who is this talking for me while I freak out in my head?

"It's malignant."

"No,.. umm pardon I meant, what type of Breast Cancer is it?" I think she is set back by my reaction.

"It's an Invasive Carcinoma type of Breast Cancer with Basil characters."
 
I ask if she can tell the stage from that pathology report she has. She tells me that they need to remove the lump for that information, the sample couldn't give that information. It needed to be biopsied so they could test it for receptors to not only stage me but to further tell me the type of Cancer treatment I may need. I ask her to repeat the Breast Cancer type to me again, repeat the words on the report one more time so I had them correct. I write it down, word for word. Fight or flight I keep thinking. Fight or Flight. There is no time, keep the wave back, stay focused, I know I will need this information. I am not sure why but, it will help me. This knowledge will help me. It will keep me focused. Fight or Flight. I arrange to get a copy of the report with an assistant in her office and hang up.

I am in utter shock. Not sure where to put my thoughts first. My husband. I grab him. I feel for a moment that I failed him. I made a promise to him that I wont be able to keep. How awful. That he is with me. When he could have had another life. Another chance at another adventure. I am beyond devastated that I have ruined our chances. We had dreams, you know? Plans? I feel them going away. I feel out of control. He holds me. We comfort each other. We say all those things you say .. that it will be okay, that we will get through this, that we will find our path. The wave is coming and harder to hold back.

You always wonder what your end may be, and there is no saying that this is it. It could go another way.  Bus, car, sleep, skiing (I don't ski but.. okay.. it could happen, I guess)..... but this is a higher percentage now. My second hand clock is ticking louder now. There is no more waiting on 'someday' now. It is all, right, now. Rushing by like sand in your fingers and you can't stop it. There is nothing you can do but enjoy all of it, but you realize that, and you have lost so much sand already, as it keeps going by and it is just out, used, lost. Snap shots, memories, moments, paths unchoosen, feelings, experiences, the many different faces of those that have gone by you in your life, all of it. Going. 

I need to tell everyone. I need prayers. I need to know that people know this is out there for me.

Fight or flight I keep reminding myself.

I wrote an email. I cant bare to make all the calls. How will I get through them all. Like a band-aid this will be easier. Or so I think. I takes me almost 4 hours to write the email. I cry, I scream, I erase and rewrite. I add to the list of receivers. I delete. I delete again. I spell check. I re-add. I cant read through the tears. They will get the message. I hit send. I need to move on to the next piece now. Hold the wave back. Fight or flight. Stay focused.

I call the recommended Breast Surgeon from John Muir back. I tell the assistant that I will come to the office, sit quietly and wait for any opening that the Surgeon might have. That I now know my results, and it's time to to move. They tell me to come, they aren't sure how they will fit me in, but to come next Tuesday. February 14th.