If cancer’s a gift, you can have it right back

Precisely one year ago today, I had my final radiotherapy session, thus ending the hospital-based part of my treatment for breast cancer. I couldn’t let the occasion pass without writing something. Here goes.

Each to their own, but I want to say for the record that it’s beyond me how anyone can view cancer as a gift.

Everything changes when you get a cancer diagnosis. “Whatever your prognosis, whatever your hopes, whatever your personality, the second that you know that you have cancer your life changes irrevocably,” says Peter Harvey, a now retired consultant clinical psychologist whose essay on life after cancer treatment is one of the best things I’ve read on the subject.

Yes, good things happened to me as a result of having had cancer. I met some great people, made new friends. A huge amount of love, affection and support came my way. I learned a lot. I wrote. And as you’ll know if you follow my blog, I’m enjoying the benefits of the positive lifestyle changes I made as a result of my diagnosis.

I accept that I’ve experienced to some extent what’s called post-traumatic growth, ie positive change experienced as a result of the struggle with a major life crisis or a traumatic event. But that’s not the point. I’d really far rather not have experienced the trauma in the first place.

You do come out the other end of your cancer treatment with a certain freedom you didn’t have before. Lots of things that I would have worried about before now just don’t bother me. On other levels, though, despite trying hard not to, I still sweat the small stuff. I still get annoyed at things I know are really not worth getting annoyed over. I’m very aware now that you do only live once but, trust me, I really haven’t had a big spiritual awakening like some people who’ve had cancer (I still can’t bring myself to use the term “survivor”) claim to have had.

A friend asked me a while ago if I thought cancer had changed me. In fact she may have said damaged rather than changed. I pondered the question and said I thought it had made me sadder. I’ve thought about it a lot since and I’d say that’s a fair assessment.

I’m aware the bottom line is that I’m alive. I’m hugely grateful to the doctors who treated me and to all the other people who had a part in my care. I’m hugely grateful to the family and friends who supported me during treatment and beyond. But that doesn’t mean I’m grateful I had a disease whose treatment is, frankly, brutal and leaves you at risk of serious side-effects for the rest of your life. I’m not grateful I now have to take anti-oestrogen tablets every day for ten years or more that increase your risk of developing osteoporosis and womb cancer. And finally, I’m not grateful I had a disease that can hide undetected in your body for years and come back at any point and ultimately destroy you.

One year on from finishing what’s called “active” treatment (“…3, 2, 1 and relax. Congratulations!”), I’m well into what Peter Harvey calls “the long, slow process of putting [your cancer] in the right box in your life – not forgetting about it, not denying its importance or power, not pretending it didn’t happen”, but incorporating it “into your own life pattern and experience in such a way as to not interfere and interrupt any more than it has to”.bad pressie

The impact cancer has on you as an individual is just one part of it, though. A cancer diagnosis doesn’t just affect you. It has a massive impact on those around you. Wouldn’t saying it was a gift be insulting to them?

Everyone has their own way of coping. If some people do that by viewing having had cancer as a gift, fine. As for me, I’m pretty sure I’ll never feel that way. I’m not sure I’ll ever want to feel that way. At most I’ll concede that if cancer is a gift, it’s one where you know the second you open it that you’ll be taking it back pdq to exchange it for something you actually like and are happy to take possession of.

 

 

 

 

 

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Why I’m cycling 100 miles for Breast Cancer Now

I’ve done it. I’ve signed up to cycle 100 miles on July 30th in aid of the UK breast cancer research charity, Breast Cancer Now.

I’d applied for a place on the “Prudential Ride London-Surrey 100” via the public ballot. I have a good few friends who’ve done this ride in the past and I really fancied giving it a go. It’s been described as “cycling’s version of the London Marathon”. I was adamant, though, that I’d only do it if I got a place in the ballot. I found out earlier this month I didn’t get one.

Therelogo were two reasons I didn’t want to do the ride for charity. First, I’m less than a year out of treatment for breast cancer – my one-year anniversary of finishing my hospital-based treatments is on February 26th (“…3, 2, 1 and relax. Congratulations!”) – and I wouldn’t want people to sponsor me because they felt sorry for me or because they somehow felt obliged to. Second, I felt it was too soon emotionally. I’ve been doing pretty well at “moving on”. The fact that this is my first blog post in two months is evidence of that. The fear that my cancer will come back one day and ultimately finish me off still lurks there in the background, but I’m managing things well at the moment and I’m in a good place on that front. There are hundreds of worthy causes out there but I knew that if I did the ride for charity, I’d have to do it for an organisation that focused on breast cancer research. That, I felt, would plunge me right back into a world that I’m working hard to move on from.

But then the other night I was flicking through the magazine the ride organisers send out with the letter telling you that you haven’t secured a place in the ballot. The magazine contains page after page of ads from charities looking for people to ride for them and raise lots of sponsorship money. I came across an ad for Breast Cancer Now and, as I read it, I realised this isn’t just about me. It’s about the nearly 11,500 women and the several dozen men who die from terminal or secondary breast cancer in the UK every year and their families and friends. It’s about the women with secondary breast cancer from around the world that I’ve met on social media who are trying to change things so they get better treatments and care and who are advocating for more research to be done so that sometime in the not too distant future, secondary breast cancer will no longer be the killer disease it is today. And it’s about the scientists who are working to understand how and why breast cancer spreads, how it can be treated and what needs to be done in order to stop it becoming resistant to treatments.

Secondary breast cancer is when the cancer that began in the breast spreads to other areas of the body and forms a tumour or tumours there. It can develop years after you were successfully treated for primary breast cancer and it happens in an estimated 30% of cases. The vast majority of deaths from breast cancer in the UK are as a result of secondary breast cancer. Some people live with it for many years, but they’re a minority. Statistics are hard to come by but it seems that as many people die within two to three years of being diagnosed with secondary breast cancer as live beyond that.

Given the stage my cancer was at when I was diagnosed, I’m at high risk of developing secondary breast cancer (Recurrence 2: So what are my chances?). At the back of my mind as I was reading through the magazine and mulling things over was something somebody said some time or another, that if you really want to do something, do it today, because tomorrow you might wake up and find you can’t. So rather than wait and apply again next year for a ballot place, I went ahead and this very morning signed up to ride for Breast Cancer Now. I’ve paid my non-refundable forty quid registration fee and I’ve undertaken to raise a minimum of £650 in sponsorship money.

Breast Cancer Now is focusing on four areas: prevention, early detection and diagnosis, treatments and secondary breast cancer. It believes that by 2030, more than 50% of those diagnosed with secondary breast cancer will survive beyond five years. Its overall aim is that by 2050 no-one will die of breast cancer. That seems to me to be a worthwhile goal.

Cycling 100 miles in a day over the route in question won’t be easy. I’m nervous already. I love cycling. I love my bike. It really helped me during treatment (Bike 8 – Car 7. Victory is mine.). However, I’ve hardly been out on it since September last year, when I did a two-day bike ride with a friend to make up for my having had to cancel a long-distance bike ride to Brussels the previous September as by then I’d started chemotherapy (Laying to rest the ghosts of mammograms past). That same friend has a guaranteed place on the Prudential Ride this year, so hopefully we’ll do it together.

I’ve done one mass bike ride before and that was about 60 miles and about thirty years ago. I’m fit; I play lots of tennis and I run 5 or 10k two or three times a week but that’s not the same as long-distance cycling. I’m hopeless at hills (running and cycling) and there are, over the course, “leg-testing climbs”. I’d better start training soon.

Wish me luck. And if you’d like to sponsor me – for whatever reason! – feel free to do so at justgiving.com/maureen-kenny.

The best laid schemes… and you really are “a lang time deid”

Spoiler alert: The following post has melancholy overload.

Being Scottish, I’m probably one of the few people alive who knows the ending to the saying by the 18th century Scottish poet Robert Burns that starts “The best laid schemes of mice and men”.

It’s “gang aft agley”, which means basically “often go tits up”. Now perhaps that’s too loose a translation – especially in the context of this blog – but you get the gist.

That’s exactly how I felt when I awoke this morning feeling like death warmed up. In truth, I’d spent half the night awake, sweating, sneezing, coughing and spluttering and when daylight finally came I realised I’d have to cancel all the lovely plans I’d made for the day. It was December 19th, a year to the day after my massive breast cancer operation (right-side mastectomy, lymph node clearance and immediate reconstruction – Saturday’s op – a daunting prospect but a key step on the road to wellness).

Maybe I’m destined to spend every Dec 19th in bed, I thought.

It’s been an interesting few weeks. Among other things, I’d had the first of the annual mammograms and ultrasounds that I’m to have for the next five years (What does follow-up look like?). These were clear. I was determined to make this anniversary a celebration.

So what had I lined up for today?

First of all, I’d booked an early session of physiotherapy so as to get the day off to a great start. There’s still some stiffness in the underarm area and the physio sessions – that I’m still having monthly – really make a massive difference. That was to be followed by a walk on Wimbledon Common with the woman I met during treatment who’s now a great friend. Then I’d arranged a tennis match in the afternoon, after which I had plans to cook a nice family meal for husband Andy and our two boys Jamie and Finlay.

I cancelled the physio, the walk and the tennis before doping myself up with paracetamol and ibuprofen and going back to sleep. I woke up a few hours later, realised I felt considerably better, and thought I’m damned if I’m going to spend today of all days in bed feeling sorry for myself.

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Photo 1: Post-op, December 19th 2015

So I got up, showered and headed off to make the most of the rest of the day. It was a strange day and I have to admit I spent a lot of it just reflecting on the 18 months that had passed since I was diagnosed with breast cancer in July 2015. It being the day it was, I tried to focus on how far I’d come in the year since my operation. Pretty damn far, I can tell you. From Photo 1 and this Post-op progress report No 1: Biting off more than I can chew to Photo 2 and this Post-op progress report No 6: If this is as good as it gets, I’ll take it.

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Photo 2: Now, every possible Saturday morning

Even more specifically, I knew it was really important that I made myself focus on the fact that the pain I’ve had in my hips on and off for a couple of months is down to nothing more serious than early arthritis in my lower back (it’s all relative, folks). I thought I’d convinced myself that it couldn’t possibly be that the cancer had spread to my bones. However, when I get confirmation following a bone scan that indeed it hadn’t – and that it’s “only” early arthritis and totally unrelated to the fact I’ve had cancer or to any ongoing treatment – the first thing I do when I get back home is pay the deposit on the accommodation for the skiing holiday I’m going on with friends at the end of January. It’s really only then that I realise I’d been holding off from doing that. That fear of recurrence clearly has a very strong hold. Then I wonder whether there will ever be a time I book a holiday without wondering whether I’ll still be healthy by the time the holiday comes. Then I realise it’s ok to feel like that and that I needn’t beat myself up about it.

Driving back home from the shops today – feeling pretty ropey again but also rather smug for having completed successfully various pre-Christmas tasks I’d expected to be doing later in the week – I happened to catch the classic song Enjoy yourself, it’s later than you think on the radio.

As I listened, I reflected on how this song was the much more life-affirming version of the fatalistic Glasgow phrase “You’re a lang time deid”*. I realised that while I may not have made a bucket list as such, that’s precisely the reason I’m trying to run faster every time I do my local 5k Parkrun on Tooting Common on Saturday mornings; that’s the reason I’m working three days a week – which I love – instead of the four I did before my diagnosis; that’s the reason we spent twice as much on our summer holiday as we usually do; and that’s the reason I’m planning on taking my 80-year-old mum off to somewhere sunny in January for a few days. At the other end of the scale, that’s the reason I now eat asparagus whenever I bloody well feel like it – even if it’s been flown in or shipped from Peru – instead of limiting myself to the four short weeks this most wonderful vegetable is in season here in Britain! I could go on, and on, and on.

Anyway, it turns out it more or less rained all afternoon today so the tennis match I’d been due to play would have been cancelled anyway. Also, it’s the holidays and it’s nearly Christmas and the last place our 16- and 18-year-old boys are going to be spending their evenings is round the dinner table with their mum and dad, so the family meal was out too.

You know what? The big lesson in all of this is that it really is later than you think and you really are a long time dead. In the end, it was a good day.

*I googled this and it turns out it is in fact the second half of an old Scottish saying: “Be happy while you’re living, for you’re a long time dead”. Not a bad sentiment at all… and much more positive than it first appeared.

Post-op progress report No 6: If this is as good as it gets, I’ll take it

I was at the cinema one evening in late October and towards the end of the film I became aware of something really weird. A couple of hours had gone by and I hadn’t felt the need to make any of the stretches or movements I’d been used to making regularly throughout the day to ease the feelings of discomfort in and around the area where I’d had breast cancer surgery more than ten months earlier.

Basically, nothing had felt wrong for at least two hours. I hadn’t felt the need to lift my right shoulder up and back to stretch out the tightening around the scarring in the area where my reconstructed right breast – which they made out of my tummy fat immediately after my mastectomy – meets my chest. I hadn’t felt the need to lift my right arm back behind my head and straighten it out to ease out the tightening or cording that’s still there in the armpit area where I had lymph nodes removed. I hadn’t felt the need to rub the inner part of my upper right arm to lessen the feeling of numbness and tingling I still have there, also a consequence of the lymph node removal surgery. Finally, I hadn’t felt the need to stretch out the tightness I still feel from time to time around the horizontal hip-to-hip scar where they took skin, fat and blood vessels for the breast reconstruction.

Ever since that evening at the cinema (My Scientology Movie, if you’re wondering), I’ve been noticing ever-longer periods throughout the day when all I can say is that nothing feels wrong and I’m not aware of any discomfort anywhere on my whole body. I’m still not used to it but, almost a year on from surgery (The basics), that’s what I call a result.

I wrote a blog for the Macmillan cancer support charity in mid-September on the importance of exercise during my treatment and ongoing recovery. I read back through it recently (What do you mean I look like a wreck?) and was amazed at how much things have improved physically even in the past two months or so.

So where are we now? Well I do still stretch out my shoulder and arm every so often during the day, though nowhere near as regularly as before. It’s far less uncomfortable than it was. I’m still having monthly physio sessions and those really help; I also still do stretching and strengthening exercises. The feeling is gradually coming back in that upper arm area; I still give it a good pummelling every now and then. The uncomfortable swelling in and around the operated area that was diagnosed as lymphoedema has all but gone; I still do a special massage in the affected area to help prevent the build-up of lymph fluid. Sometimes I’m aware of a general feeling of mild discomfort in the whole area but, more often than not, I’m not aware of anything.

What else? Well it’s only in the past couple of months that I’ve been able to sleep on either side or indeed on my front. Being able to sleep in whatever position I want after so many months of having to sleep on my back with my right arm stretched out behind my head is a really big deal. Having to stretch out the area around my abdominal scar is not a big deal; what 53-year-old woman is going to complain about having a tight tummy?!

There’s more. It’s been a good while since I’ve experienced anything like that fatigue I would feel from time to time that would make it hard to move very far from the sofa. It didn’t happen often, but when it did it wasn’t nice. Finally, I caught myself the other day running down the stairs on the London underground and diving onto a train. I’d stopped doing that as I was scared of falling or bumping into someone (Sod the compression bra, it’s summer!). Clearly not any more!

All in all, then, there’s been quite some improvement in recent months.

There’s stuff going on that’s related to treatment rather than to the surgery I had last December, but none of it’s too bad. The chemotherapy-induced peripheral neuropathy I had in my feet really is all but gone, although I still get some low-level tingling and numbness when I run or play tennis. It’s either that or my trainers are too tight! I’m tolerating letrozole, the daily anti-hormone therapy that I’m on, well. Letrozole can bring on hot flushes; for a couple of months these would appear out of nowhere but they’ve now subsided.

The “trigger thumb” that I’ve developed in my right hand is persisting. This is a known but rare side effect of letrozole, and it’s a bit of a drag. I can’t bend my right thumb and I’ve had to change the grip I use to serve at tennis and the way I hold a pen. My serve is neither better nor worse but my handwriting has gone from bad to appalling. It’s hard to do things where you need to apply pressure with your thumb – such as opening bottles and jars, tying shoe laces or using a grater – but it’s not the end of the world. I guess I could/should get treatment for it; instead I’ve just got used to it.

Finally, I sometimes wake up with stiff fingers on my right hand and my knuckles on that hand are a bit swollen – letrozole again. My rings don’t fit any more, which is a shame as I used to wear my late grandmother’s wedding ring and a signet ring I got for my 16th birthday on that hand. There’s no other joint-stiffening to complain of at the moment (I do have a painful left hip, but I’m hoping it’s nothing more sinister than a sports injury; I’ll get it checked out if it doesn’t go away).

This is my sixth post-op progress report and I reckon it could well be my last. The consultant breast surgeon told me that on the physical front we’d be doing well if I got back to 95% of what I was before. I don’t know quite how you measure that but if the way I am now is as good as it gets, I’ll settle for that and be quite happy. Now if someone could just give me a guarantee the cancer won’t come back, things would be just fine. But they can’t, of course. I don’t believe my “recurrence anxiety” will ever go away but in the meantime there’s no doubting these physical improvements are reasons to be cheerful.

 

What do you mean I look like a wreck?

This post isn’t new. I wrote it in mid-September for the Macmillan cancer support charity on the importance of exercise during my breast cancer treatment and ongoing recovery. I read back through it the other day and realised – to my astonishment, really – that nearly 11 months on I’m still seeing improvements from the surgery I had last December. Details will follow but in the meantime I decided I wanted this on my own blog for the record. I really like it; it’s nice and upbeat and it makes me smile. 

Here it is…

When the consultant breast surgeon greeted me at my most recent appointment with the words, “You look like a wreck”, I was more than a little confused. It seemed completely out of character and was, I thought, downright rude. More importantly, though, I was feeling really well physically and just couldn’t fathom why he’d say such a thing.

I’m fitter and healthier than I’ve been in years. Since finishing pretty gruelling treatment for breast cancer nearly seven months ago, I’ve been eating healthily, I’ve cut down on my alcohol consumption, and I’m exercising loads. As 53-year-old women go – never mind one who’s relatively recently been through cancer treatment – I think I’m doing pretty well.

“A wreck?” I said, trying not to sound put out. “But I feel great.”mo-parkrun-edit-2

“Not a wreck,” the consultant said, amused that I could think he’d say such a thing. “A rake! You’re fading away.”

I laughed at the misunderstanding and reassured the doctor that I was not in fact fading away. Since my diagnosis in July 2015, I have, however, lost the six, seven or eight kilos that I’d put on gradually over the previous decade. The consultant’s comment illustrates just how much I’ve taken on board the recommendations for healthy living that you’re advised to follow when you finish cancer treatment. Doing certain things, you’re told, reduces the risk of your cancer coming back. I’m at high risk of recurrence, so it’s perhaps not surprising that I’m trying to do everything I can to lessen that risk.

Initially I was ambivalent about the lifestyle changes I was making. I felt they were driven by fear of recurrence rather than by a genuine desire for change. But now I’m positively enjoying being fitter and healthier than I was pre-diagnosis.

I’m loving the extra exercise. I’ve always been sporty – tennis and cycling have been part of my life for years – but for the first time in my life I’m enjoying running. I’ve even joined a local running club.

I invariably feel better after exercise. During treatment itself, on more than one occasion, I felt it was my saviour. There were days when I’d be feeling tired and low and I’d force myself to cycle to the hospital or clinic appointment rather than drive. During radiotherapy I challenged myself to cycle to more sessions than I drove to. It wasn’t always easy, but I won – just! No matter how I felt when I left the house, I always felt better by the time I got to my destination.

When I did my first local 5K Parkrun in mid-April six weeks after finishing radiotherapy, I was both relieved and elated. Around 300 people did the same run that morning. I was amongst the slowest. Running the same route at the same time as all these other people, however – and knowing thousands of others were doing exactly the same thing in Parkruns up and down the country – in some way made me feel I was back in the real world after having been in some sort of parallel universe since I was diagnosed in July 2015.

I had Stage 3a breast cancer and went through six-and-a-half months of treatment that comprised eight sessions of chemotherapy, a right-side mastectomy with immediate own-tissue reconstruction, lymph node clearance and 16 sessions of radiotherapy. It takes a long time to recover from that kind of treatment. The chemotherapy-induced peripheral neuropathy that I had in my feet is pretty much gone, but I still get the odd niggle, especially when I run (ironically). My upper arm on the operated side is still numb and there’s a feeling of discomfort in my chest and armpit that never quite seems to go away. There’s a little swelling in and around the operated area that’s been diagnosed as lymphoedema. Some days even now, I can feel really fatigued and have to take things easy. I’m on letrozole anti-hormone therapy and if I stay sitting for too long I feel my joints stiffening up. Hot flushes appear out of nowhere. In my right hand I’ve developed trigger thumb, a painful and annoying condition that can be caused by low oestrogen levels, which is precisely what letrozole is designed to achieve.

There’s no doubt that exercise helped and is helping me deal with both the physical and emotional effects of having had breast cancer. Everyone has their own way of coping, and exercise, it seems, is mine. There’s no downside as far as I can tell. I’m aware that what is a huge challenge for some is a breeze for others and vice versa. It’s about knowing what’s right for you and about setting achievable goals and not being overambitious. Exercising with friends or in a group can help.

For me, exercising is empowering. I’m fitter, I’m healthier, and over the past few months I’ve met some great new people. On the recurrence front, I know there’s no guarantee my cancer won’t come back. Exercising is a massive help in keeping in check my fear that it might.

 

 

 

Defying gravity – well, one of them is

I need to say at the outset that this seems such a crazy thing to be writing about. I never thought in a million years that I’d be considering having a breast lift. On just one side. You are allowed to laugh. Believe me, I have, lots. That in itself, I guess, is something to be thankful for.

OK, background first. After finishing four months of chemotherapy for breast cancer, I had a right-side mastectomy last December followed by an immediate “own-tissue” reconstruction known as a DIEP flap reconstruction. This is a major operation involving complex microsurgery in which skin and fat is taken from your abdominal area and used to build a natural-looking breast after mastectomy.

A key benefit of an own-tissue, or autologous, reconstruction over an implant is that it changes with the rest of your body as you gain or lose weight and as you get older.

At least that’s the idea, but here’s the rub. It seems that the radiotherapy I had after surgery to reduce the risk of my cancer coming back has robbed the reconstruction of at least some of the elasticity it otherwise would have had. Don’t get me wrong, I’m really happy with it and it looks great. Don’t just take my word for it. I had an ultrasound scan on it recently and the doctor performing the procedure remarked admiringly as she rolled the probe over it that it looked “just like a real breast”. I almost said “Thanks” but stopped myself. After all, the credit’s not mine. The doctor asked who’d done it and we agreed they’d done an amazing job.

It does indeed look “real”, but the radiotherapy damage means it may not change very much from here on in. I met with the consultant plastic surgeon earlier this month, three months after our previous appointment, and she said what I’d already pretty much worked out for myself, that the symmetry that we hoped would come with time (Looking forward to a “much more symmetrical overall shape”) was not now going to happen… at least not without surgical intervention.

Things have undoubtedly continued to improve since I last saw the surgeon. The skin tethering of around an inch long down the right-hand side of the reconstruction and the scar tissue where the underarm lymph nodes were removed are less pronounced. And there’s very little – if any – swelling left in the reconstruction. But I’m pretty lopsided. And let’s face it, that’s only going to get worse. I’m 53 and I breast-fed my two children. The reconstruction may be defying gravity but the real boob on the left is most certainly not!

I wrote back in April about the potential side effects of radiotherapy on reconstructed breasts (Side effects you really don’t want to think about) so I can’t say I didn’t know this could happen.

I’m quite conflicted about the whole thing. I know I said before that I could live with less than a perfect match. The practical side of me knows the main thing was getting rid of my breast cancer and that there’s more to life than having symmetrical boobs. There’s no denying, however, that it would be nice to be matching once again. Also, the inquisitive side of me would love to see what is in fact possible. As I said to the plastic surgeon, one part of me says why bother doing anything at all, but another part of me is tempted to give you free rein to do whatever you think would be appropriate. That would be a lift on the left and some fat grafting on the right, with fat taken from my hips, to try and even out the area on the reconstruction with the tethering and the scar tissue nearer my underarm.

The pull to be like you were before is quite strong. I know that sounds strange coming from me, given that I really did very seriously consider choosing the “flat” option. I have nothing but admiration for those women who actively make the choice to go flat and stay flat and who are, as it were, “flat and proud”. I totally get the explanation that American comedian Tig Notaro gave when she decided against reconstruction after her double mastectomy. Why on earth would you go through such intense procedures just to have fake boobs, she said. I know there’s a lot more to it than that – and I mean a lot – but I get what she means.

My own decision on whether to have revision surgery or not would be a bit easier if I didn’t have what’s known in the business as wait for it… “good in-bra symmetry”.

It would also be easier – and this is key – if they hadn’t made such a good job of the reconstruction in the first place. That is so clearly not a complaint but it helps explain my dilemma. For example, there are no visible scars on the reconstruction. The scars are in the “intrammary fold”, where the breast and chest meet, so you can’t normally see them. With a breast lift, or mastopexy to give it its proper name, you inevitably have visible scars. It depends on the type of lift you have, but if you want to know exactly where they can be, click here.

I know I heal well – if you saw how faint the horizontal hip-to-hip scar I have from the original reconstruction operation is now, almost 11 months on, you’d see what I mean. The scars following a breast lift would fade in time too, but they’re unlikely ever to disappear completely. So do I really want to disfigure my good boob in the first place? Especially when there are no scars visible on the reconstruction. Then again, I have scars in lots of other places and I’m quite fond of them. They all tell a story – from the two big circular burn scars on my lower left leg from a childhood run-in with a radiator to the one under my chin from just a few years ago when the dry cleaning I’d just picked up got caught in the front wheel of my bike and I flew off over the handlebars in spectacular fashion.

One of the big things revision surgery can be for is nipple reconstruction. Since I had a nipple-sparing mastectomy, that’s not relevant in my case. Also, sometimes the abdominal scar needs revising; mine doesn’t. Or lumps of dead fat tissue develop in the reconstruction that need removing; I have none of those either.

But there’s more in the against camp. With a breast lift, there’s a small risk of reduced or complete loss of sensation in the nipple/areola, often temporary, sometimes permanent. Given that there’s no sensation at all in any part of the whole reconstruction (On very intimate terms with three new people), I do wonder if that’s a risk too far. In addition there’s the recovery period to consider, and the inherent complications of surgery. You’ve also got to bear in mind that nature will again take its course once you’ve had the lift; that lifted breast ain’t gonna stay lifted forever.

Anyway, I don’t have to decide any time soon. Part of me says wait a while and go for a lift when the good breast really has gone south! Or perhaps I’ll end up not doing anything at all. In the meantime I think I’ll park this particular issue and just get on with living life. And on this particular Sunday morning, that means a league match down at the tennis club. Wish me luck!

 

Here’s to remaining forever “entirely unremarkable”

It turns out that being described by your oncologist as “entirely unremarkable” is a good thing.

To be fair, the oncologist didn’t use the term to describe me personally. She used it in the context of the physical examination she did of me one day last month, at the appointment I had with her just before I had my latest round of zoledronic acid. That’s the bone-toughening drug I get a dose of every six months to counteract the bone-weakening effects of letrozole, the hormone therapy drug I take daily to lower the amount of oestrogen in my body and so reduce the chance of my breast cancer coming back.

The oncologist had a feel in various places for lumps or swellings or anything else that might have given cause for concern. Later, in her report to the consultant breast surgeon, she described the examination as “entirely unremarkable” in that there were “no signs of recurrent disease”. Of course, an absence of lumps is only that. All it means is there’s no palpable sign of trouble at this time. There could be lots of other stuff going on that we’re just not aware of (How would you know it’d come back?). But it’s something, and on that front I’ll take whatever reassurance I can get.

As well as having bone-strengthening properties, zoledronic acid has been shown to reduce breast cancer recurrence in post-menopausal women such as myself. It’s given via intravenous infusion (that’s a drip to you and me) over a period of 15 minutes; you’re in and out of the chemo unit in no time but it felt really strange to be back there after six months away.

My next round of the drug is due in March next year. Here’s hoping I’m still entirely unremarkable then and indeed that I stay that way for evermore.