So, late, late late yesterday afternoon St. Joe’s called with the verdict on the biopsy: it’s cancer.
However, as cancers go, it’s far from the worst of all possible worlds. Their pathologist declared it a papillary carcinoma, which is a rare cancer that, in older women, is usually slow-growing. And in my case, both tumors are “encapsulated,” which means they’re closed off from spreading around with gay abandon.
If she’s correct, then as this kind of news goes, it’s actually fairly positive: According to the American Journal of Clinical Pathology “EPCs [encapsulated papillary carcinomas) are in situ carcinomas with an excellent prognosis and can be managed with local therapy with or without sentinel lymph node biopsy.”
That’s from a 2009 paper, so of course it’s a bit old. However, from what the radiologist said, the thinking must still be along these lines. She said they no longer yank out your lymph nodes — which, other than the disfiguration of your boob (which is hardly fatal), is the big issue with breast cancer, because it leaves you vulnerable to infection of even the tiniest little nick or paper cut.
Rummaging through the Hypochondriac’s Treasure Chest, we find a literature review in an open-access journal. Open access is less questionable in the hard sciences than it is in the humanities. As of 2014, this review of published research indicates “this form of cancer is usually low grade and rarely recurs. . . . Understanding the low-grade nature of this form of breast cancer allows treatment options to be less radical and safely omitted.” However, this same group of authors calls papillary breast cancer “diagnostically challenging” and remarks that if the tumor appears in conjunction with invasive cancer, that might not be great, especially if it occurs in a younger woman. However, I fortunately am old as the hills, and I’m told these things were quite small.
And finally, the Brits say, in a website dumbed down for the public, “Doctors usually treat papillary breast cancer with surgery. These cancers usually grow slowly, and don’t usually spread to the lymph glands or other parts of the body.”
So if I’m understanding what the woman said to me, it looks like the outlook is about as positive as it can get for a cancer diagnosis. I feel a great deal less frantic than I did while waiting for news…right now what I most want is just to get the surgery under way, get the damn things out of my boob, and move on.
My son is going to take the dogs for as long as I’m incapacitated. Suspecting this was coming up the pike, I’ve already hired a cleaning lady and lined up a pool guy. Cleaning lady has begun deconstructing my house — in addition to breaking the vacuum cleaner ($140!), she also quietly knocked the shower door off its track. Neighbor is coming over this evening to try to fix it. I just hate hiring cleaning help…honest to god, they do more damage than good! And then when they break things, they don’t tell you — they leave it for you to find out. Had a helluva time getting out of the shower stall this morning.
Let’s hope that’s not true of pool guys.
Tomorrow I’m meeting with a surgeon at the Mayo. I have no intention of letting St. Joseph’s cut me up, having damn near died there a few years ago. Besides, St. Joe’s Healthgrades ratings for patient safety are much lower that the Mayo’s and even lower than John C. Lincoln’s. JCL is located in the heart of a desperate slum, for hevvinsake, a few blocks from the headquarters of a dangerous meth gang. So…one wonders. At any rate, if I have to get radiation treatment and the Mayo doesn’t do that at its (relatively nearby) hospital on the 101, then I’ll have to get that done at JCL or St. Joe’s, since I can’t afford the gas to drive halfway to Payson five days a week for five to eight weeks.
So things appear to be as under control as they’re going to get. Unless, of course, the Mayo’s surgeon upsets the apple cart tomorrow…