Girl on Top (Part 9) – Back to Square One

The cold, hard facts stared at me and I stared back at them, unable to look away. The chemotherapy hadn’t worked. My cancer had returned.

Maybe the most difficult part for me was not coming to terms with this myself, but having to break the news to those close to me. Everyone had breathed a steady sigh of relief at the end of my chemo, thinking that the only hurdle left was a course of radiotherapy and then I would be cancer-free. However, the appointment with my surgeon had told a very different story.

So many questions kept coming into my head which I unable to push aside.  I tried to rationalise, tried to understand what was happening and, more importantly, how it could possibly have occurred.  I was determined to be proactive and to search for both answers and some sort of resolution.  Even certain facts eluded my surgeon and he was unable to explain exactly why my cancer was behaving in this manner.  Deep down I knew I had to accept, trust and leave the solution to my medical team again.

In a meeting with my surgeon, he explained what was ahead of me: new weekly appointments, more biopsies, more scans (to make sure it hadn’t spread elsewhere) and then, finally, another operation.  In my case  (due to the fast-growing nature of my cancer) it would be a double mastectomy and reconstruction, all at the same time, which obviously meant a much bigger operation than I had first anticipated.  As I endeavoured to comprehend all the information, my surgeon informed me of something which made my heart jump a little with happiness: I wouldn’t need chemotherapy again after the operation, just radiotherapy on the affected area.  It might sound silly, but the very fact that I wouldn’t have to endure another six months of treatment as I had done previously, made the huge operation which lay before me seem insignificant in comparison.

A few weeks later, more good news followed; my scan results had come back clear; the cancer had stayed contained in my right breast and hadn’t spread to any of my organs or my bones.  My operation was set for a few weeks later and I made the decision to return home to Lithuania to visit my family there.  This would provide me with valuable respite, along with much needed time with my relatives.

The day before I flew, I was requested to go back to the hospital for two last tests – a micro-bubble biopsy and ultrasound.  I had found the staff there so friendly and, whenever I went, I would share a laugh and a joke with them.  Time after time, they would tell me that I didn’t have to be strong, that it was all right if showed some sort of weakness, be it in the form of an ‘off day’ or even a few tears.  I understood that people deal with what I was going through in a range of ways, showing a whole spectrum of different emotions, but for me, my outlook and persona didn’t change; I was a positive person and was determined to remain that way.  As I watched the doctor take the biopsy, I was intrigued by the procedure, just as I had been on all of the other occasions.  I found that entire side of medical science fascinating and, as I observed, I asked questions and learnt as much as I could.

While the biopsy was taking place, the doctor conducting it noticed that I had a few angry, red marks on the skin, just adjacent to my new lump.  I had seen them a few days previously, but hadn’t been that concerned, assuming that they were the marks left on my skin by my bra.  The doctor, however, seemed slightly suspicious and decided to take a separate punch biopsy of the area, which would determine their cause.

The following ultrasound highlighted that the lump had, in fact, grown considerably since the last examination and that my surgeon’s decision to operate as soon as I returned back to the UK had been a valid one.  I resolved again to push this out of my mind for the time being and concentrate on the happy summer days that awaited me over the next few weeks.

Back at my flat, I was  finally all packed and ready to go on my imminent vacation home.  Although I had planned it to be a relaxing trip, spending time with my loved ones, I had one challenge facing me during my stay there.  If telling my friends that another tumour had been found was hard, then explaining this to my ninety year old nan was heart breaking.  She had been so strong for me, over the past eight months, sharing in both my pain and my determination. After the initial celebrations on my return to Lithuania, I decided that I couldn’t put it off any longer, and that I must relay to her what had happened to me over the past month.

Sitting in the warm Eastern European sunshine and explaining that I would have to undergo another major operation, took all my emotional strength.  As glimpses of fear flickered in my nan’s eyes, I realised all too well that she must have sat through a very similar conversation with my mum just under twenty years previously, when her cancer returned.  However, her resolve matched mine and, after our conversation and her understanding of it, she made sure that my stay was one that I would never forget.

Ten days passed happily; full of laughter, memories and fun.  Spending time at my aunt’s house by the lake with members of my family made for a summer to remember.  There can’t be a party in Lithuania which doesn’t involve singing, dancing, eating and drinking, and if there was an Olympic Medal for such activities, I would have won straight Gold!  It was exactly what I needed in order to both mentally and physically prepare myself for the test which lay ahead of me.

During this time, I hadn’t failed to noticed that the red marks on my skin, just above my tumour, had spread considerably within the ten days of my stay in Lithuania, and had become increasingly itchy and sore to touch.  On my arrival back in the UK, and in my surgeon’s office the next day, more unexpected news hit me.  The marks signified that the cancer had broken through the skin and had spread rapidly in a very short while.  Drawing a breath, my surgeon explained what he had to do: there was no time to contemplate the double mastectomy and reconstruction that I had hoped for.  He must, instead, act swiftly in order to halt the spread of the cancer in its tracks.  There was a slot the very next afternoon and my surgeon clarified that he would operate on me immediately.  The cancerous breast must be treated as soon as possible and the removal of the other breast and reconstruction of both would have to wait.

As I sat, trying to absorb the latest development, I felt quite simply as if someone had physically slapped me right across the face, hard.  For the first time, my surgeon witnessed tears in my eyes, as I tried to swallow back my bewilderment and confusion.  This was not what I had expected, planned or wanted.  Shock rocked me, as I tried desperately to get my head around the new situation facing me.  The goal posts had been well and truly shifted and my immediate future was suddenly spiraling out of my control.  Furthermore, I had less than 24 hours to prepare myself for the operation and what would await me on the other side of that.

The practicality of it all made total sense to me, but cosmetically I now found myself faced with a new and unexpected hurdle.  How would it feel having to view myself with just one breast, having to worry about padding one cup of my bra out every day, having to come to terms with the fact that part of my body was gone?  In tandem with those thoughts, I was also filled with a certain amount of injustice and anger; I had hoped so much that this would be the last operation, but it wasn’t to be.  After I had healed, there would be another operation and reconstructive surgery to follow that.  The story which I had so wanted closure, was turning out to be one without an ending in sight.

Two hours later, I was back at work in time for a dinner out, which had been planned by a large number of my colleges and regional manager.  Sitting amongst them chatting and laughing along, I tried to put what had happened that afternoon into perspective.  The operation would be successful and the cancer would be gone.  I could then begin to plan again for the future, even if it was one which would be blighted along the way by treatment and surgery.  It was a case of mind over matter and full steam ahead, towards a cancer-free beginning which I could only hope waited for me somehow, somewhere on the other side.