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Liberty, NY
It was a Thursday. Just as Val had expected, the biopsy came back positive, and now she pondered her options. Hopefully, the cancer had not spread beyond the small, pea-sized tumor itself, and had not affected the so-called “sentinel nodes,” those lymph nodes just beneath the breast, under the armpit. Dr. Eisenhauer had patiently described the surgical options, and based upon his experience had recommended a simple lumpectomy if at all possible.
“We believe in breast conservancy,” he counseled. “I can’t see any good reason for a mastectomy. There’s no indication that the cancer has metastasized, and unless we find otherwise, why go there at all?”
But, the final decision as to a lumpectomy versus a mastectomy would belong to Val—unless it had spread. She had read about women who had opted for an immediate double mastectomy—even when the cancer was confined to a single breast—to eliminate altogether the possibility of a recurrence. In Val’s mind, they were foolish (but in her heart she understood how they felt). For a split second, when she had first learned of the cancer, she had even considered having it done herself—before dismissing it out of hand. She felt guilty for being so judgmental. Her rationale was that there was never a guarantee that the disease would not reappear somewhere else, so why disfigure her body needlessly. A simple lumpectomy would almost certainly contain the cancer—provided, of course that she accompanied the procedure with the proper follow-up of radiation and drugs. No, she had thought. The choice was obvious. She would have the lumpectomy.
* * * *
The “procedure” as Dr. Eisenhauer had referred to it, took place the following week. Everything went as expected, and Val was released from the hospital the next morning. A few days later, she and Matt returned to the surgeon’s office for a follow up examination. What concerned Val most was whether she would need “chemo.” She hated the thought of having to wear a wig. One of the things Matt adored about her was her beautiful hair; and she loved having him run his fingers through it whenever they kissed or made love. Naturally, he told her that it made no difference whatsoever.
“It’s you I love, Val, not your hair,” he’d said.
It was so “Matt.” It was no wonder that she was so crazy about him.
“You’ll need eight weeks of radiation, five times a week,” said Dr. Eisenhauer, “but you won’t start for another five or six weeks. Luckily, there’s a radiological facility right here in the adjoining building, and since you’re not working right now, there’s no reason why Dr. Smathers, our radiology oncologist, can’t just schedule your daily treatments each day at your convenience.”
At my convenience, thought Val. There’s that word again. Oh, God, she thought, there’s nothing convenient about it at all. She wished it were just a dream. Now that would be convenient.
“There are different types of breast cancer,” Dr. Eisenhauer explained. “What you had was ductal carcinoma in situ or DCIS as we refer to it. It’s the most common type of non-invasive breast cancer.” At that point, Val started to cry softly. Just the mention of the word “cancer” terrified her.
“But, that’s the good news,” Dr. Eisenhauer quickly added. He had a wonderful way of explaining things; and his enthusiasm, even when talking about cancer, made Val less apprehensive than she might have been with another doctor. “Ductal means that the cancer started inside the milk ducts,” he continued. “But in situ means ‘in its original place.’ DCIS is called "non-invasive" because it hasn’t spread beyond the milk duct into any normal surrounding breast tissue—and that’s great news. We removed all the sentinel nodes and biopsied them. There were three in all. And each one was benign. There was no spread.”
Matt listened attentively, storing every bit of information, so that later, alone in the privacy of their home, he could explain it to Val in a way that would make sense to both of them.
Thank God for Matt, thought Val. What would I ever do without him?
“DCIS isn’t life threatening,” Dr. Eisenhauer continued, “but having DCIS can increase the risk of developing an invasive breast cancer later on...” The rest of his words were a blur, lost in space as far as Val was concerned. Matt could listen. That was his job. He was good at that. But, she refused to hear another word, and that was that.
The radiation treatments would begin in early July.