Cancer a second time

Stacy was woman in her early fifties who in for a routine mammogram.  She was diagnosed with DCIS 2 years prior and treated with lumpectomy and radiation and was currently on Tamoxifen.  Because she was only 2 years out from her diagnosis, I read her mammogram while she was there.

I opened up her study.  Oh no, those calcifications don’t look good.  I immediately knew that her DCIS had come back, but this time in two spots.  I went in to talk to her and her husband.  I could immediately tell that she was a nervous wreck.

“There are two new areas of calcifications in your right breast that look worrisome.  We need to do a biopsy to find out what is causing the calcifications.”

She breaks down hysterically and starts crying.  She screams, “I can’t go through this again!”  As her husband tried to help calm her down, I stood there awkwardly, not knowing what else I could say.  I couldn’t say anything that was going to make things better at that moment.  So, I quickly passed her on to my patient navigator to schedule an appointment.

I saw Stacy again a few days later for her biopsy.  She is much more composed and her husband is with her again.  We finish the biopsy and at the end, I thought, I’d better prepare her for what is to come.

“If the biopsy comes back benign, I am not going to be satisfied with those results.”

What do you mean?

“I am really worried that those calcifications are due to DCIS.  If the results come back benign, I would want to be extra sure that they were benign by having a surgeon take out a larger sample and make sure that I didn’t miss something.”  It started to sink in.

If it’s cancer again, I am going to need a mastectomy.

She starts crying again.  After a moment, I asked her what was going through her head.

I don’t want my husband to find me unattractive.  Men leave women for those things.

Ok, I didn’t see that one coming.  With her husband being with her every step of the way, I didn’t think that would be a concern to her.  I reassured her that breast reconstruction had come a long way and that her husband obviously cared enough about her to come to all her appointments.

She asked me to tell her husband what I had told her.  When I did, she started crying again, asking her husband how they were going tell the kids. I said, “I am sorry.  Is there anything else I can do for you right now?”

“No.  Just find a cure!” her husband barked at me.

I will never forget the look on his face when he said that to me.  I felt so small and powerless.  As a doctor, I was supposed to help people and yet it didn’t seem like I could help either one of them at all.  Again, I quickly left the room.

Stacy did ended up having DCIS, the kind that probably would’ve eventually become invasive cancer had it been left alone.  She had a breast MRI and it turned out she had DCIS in the other breast too.  She decided to have bilateral mastectomies.

Though I often see the fear and anger that patients go through, I got to experience firsthand the anger that family members have when their loved one gets cancer.  It reminded me that it wasn’t just the patients who go through emotional roller coasters with cancer, and the roller coaster can be even bigger the second time around.

Just find a cure… I wish I could…

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2 thoughts on “Cancer a second time

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