To Scan or Not To Scan

Last week I went for my 6-month check up with my breast surgeon. I’m so grateful that I got connected to her. She’s both brilliant and compassionate with a great bedside manner. She gives me all the time I need to ask as many questions as I want and discuss whatever is on my mind. So I run a lot of things past her and ask her opinion on every medical question I have.

During my check up she did a breast exam and found no lumps or areas of concern. I do get a rash on my left breast, which is my breast cancer side, so that always worries me. Rashes are on the list of ‘red flags’ to talk to your doctor about. My breast surgeon said that the rash looks ok and because of the fact that it comes and goes means its nothing to worry about. Tumors don’t come and go. So she said everything looked and felt good.

HOORAY!!! Let’s take a moment to appreciate that.

Hooray

I still do my monthly breast exams, as my doctors recommend, feeling around my implants for any tumors that might pop up if any breast tissue was left during my mastectomy. But now I have to get to know my new boobs, and understand what feels normal and what I should be concerned about. So at every doctor’s appointment, I ask my breast surgeon about everything that feels unusual. Luckily, everything I’ve asked about she says is normal.

I also asked my breast surgeon about doing scans to see if my cancer has returned. There’s a lot of conflicting opinions about scans in the medical and cancer world. Some people and doctors think that scans can give people cancer from the radiation (ironic, huh!). And some people and doctors think that doing scans are good to be able to detect cancer early, which raises the survival rate. Early detection saves lives, right?

I’m really conflicted about this. Scans bring on scanxiety. What are they going to find when they do a scan? Then what do I have to do when that something is found – more surgery, more chemo? Ugh! But for me, not doing scans means the constant worry of something growing inside me that I don’t know about, which will keep growing until I feel it myself or get a symptom on the ‘red flag’ list for cancer recurrence.

What a shitty choice? Is ignorance bliss? Or is ignorance stupidity? Do the risks of radiation from scans outweigh the risk of not finding cancer early? Or is it the other way around?

I’m leaning toward doing scans. I’d like to know that I’m cancer-free every year. Mentally that helps me continue to live my life and make plans for my future. Not knowing how long I’ll be here is unsettling – to say the least. And I know that I can get a scan one day and then 3 months later cancer could return. Nothing is guaranteed. At least a clean scan lets me exhale and breath for a moment.

My breast surgeon originally said that we should do MRIs every year to watch for a recurrence. But when I talked to her about it last week, she said she usually recommends MRIs every 2-3 years. (I can’t do mammograms with breast implants, so MRIs are the way to watch for lumps. One of the few positives out of having breast cancer – no mammograms.)

We decided we’d revisit the scans discussion at my next 6 month appointment. My breast surgeon said that most health insurance companies don’t cover MRIs every year. How messed up is that! I have pretty good insurance, so I have to check on that. I’m going to pissed if she’s right.

I spent every other month in 2013 doing ultrasounds to watch for ovarian cancer. That much screening was quite overwhelming and difficult for me. So doing a scan for breast cancer every 2-3 years sounds really good right now.

So for now I’m left to decide – to scan or not to scan?

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Could It Really Be…An Uneventful Doctor’s Appointment

Last Friday, I had an uneventful doctor’s appointment. Let me say it again – I had an uneventful doctor’s appointment. It feels weird to write it. Kind of a foreign concept to me at this point.

Last Friday I went for my first doctor’s appointment of 2014. The appointment was with my gynecologist for my annual exam.

We spent the first part of the appointment with her asking me how I was feeling since having my ovaries removed. How were my hot flashes? (Not great but bearable.) Was I having any pain? (Thankfully, no.) Was I having any vaginal dryness? (Again, thankfully no.)

Then I asked her a series of questions. I will never menstruate again, right? (Right. I knew the answer to this, but just wanted to confirm it before throwing away all my tampons.) What about osteoporosis? (Since I’m at a higher risk for osteoporosis from having my ovaries out, I should eat more foods with calcium or take a supplement.) Since I don’t have ovaries, I don’t have to worry about an unplanned pregnancy, but I should still protect against STDs, right? (Yes, condoms are suggested.)┬áDo I need to continue to do ultrasounds since I still have a 1% chance of ovarian cancer, even though I removed my ovaries? (Thankfully the answer to that was no! Even though you can get ovarian cancer that starts in the uterus, the symptoms will show up in the early stage. Doesn’t seem fair that I remove my ovaries and can still get ovarian cancer, but ok. I also can get breast cancer again even though I removed both of my breasts. But that’s another blog post for another time.)

My gynecologist then told me she wasn’t going to do a breast exam, which I said was fine since I have a regular check up with my breast surgeon at the end of the month. I told her that I have a rash on my left breast, which is my breast cancer breast, but it’s only been there for a few days. Rashes are a warning sign for breast cancer, but I’ve had these on and off over the last year. My doctor’s attribute it to perhaps a reaction to the chlorine in the swimming pool. I told my gynecologist that I’d talk to my breast surgeon about the rash.

Then it was time to get into the stirrups for the vaginal exam. I laid down and my gyno put the speculum in place. She started examining me, then looked up and said, “You’re going to hate hearing this, but there’s a mole on your labia.” I told her that this mole has been there for over 10 years and we biopsied it 10 years ago and it was benign. She said, “Phew. OK, good.”

She finished the exam and said she’d call me with the results of the pap within two weeks. If the test came back normal, she didn’t want to see me again for another year. Fingers crossed.

I got dressed and got out of there as quickly as possible before she could tell me anything else. I know I should continue to be vigilant about my body and anything unusual. But I just want some time where there are no more tests. Where there are no more doctor’s appointments for a while. Where no one is touching me and prodding me. Where no one says, “I see something I don’t like. We need to look at this closer.”

I know you’re never really “done” with cancer. Every week I hear about someone who has a recurrence of some type of cancer. So I do carefully listen to my body and will call my doctor the moment something isn’t right.

But please, could I just have some peace and quiet for a while.

1 Step Forward, 2 Steps Back

Last week I had my regular check up with my gynecologist to watch for ovarian cancer. Since I have the breast cancer gene (BRCA), I am also at a high risk for ovarian cancer. So every 2-3 months I go in for an ultrasound and blood work.

I’ve been doing these ultrasounds since March of this year, so I really thought I was prepared. As I shared in a past blog post, these tests are really emotionally draining. But I was feeling like I was in a good place and ready to tackle this one. I wore my usual good luck pajamas to bed the night before my tests and wore my usual good luck outfit to meet with my gynecologist.

Previous ultrasounds showed cysts on my ovaries, but those would wash away by the time of the next ultrasound. Then new ones would appear and we’d watch those.

I expected this ultrasound to be the same thing. The technician did my ultrasound this past Tuesday and said: so, it looks like we’re just chasing cysts here. We’ll see what the doctor thinks.

So as I waited to see my gynecologist, I started thinking about writing this blog post. I had already decided the title was going to be: Chasing Cysts. I was feeling relieved at the idea that we were just chasing cysts. I can handle chasing cysts.

Then my gynecologist walked into the room. She sat down and had a worried look on her face. She said the cyst is quite large and dark, and has some fluid around it creating a cobweb-like design. None of those things are good news.

My gynecologist said we should wait and see what the blood work comes back with, but she also said she wanted me to meet with a gynecology oncologist to get a second opinion of my ultrasound. So she sent me right over to meet with that doctor.

FUCK! This is when I started freaking out.

This is exactly what happened when I felt my lump last year. I felt my lump, I went to see this same gynecologist, she had me go do a mammogram on the exact same day, and one week later I was diagnosed with breast cancer.

This past Tuesday, I met with my gynecologist, and she sent me to see another doctor the same day, to look into what concerns her. On my way to meet with this gyno oncologist, I even passed by the breast center where I had my mammogram last year. This didn’t make me feel very good or calm me down. Quite the opposite.

When I met with the gyno oncologist, he also had a worried look on his face after looking at my ultrasound. He said a dark cyst with fluid around it is a sign of ovarian cancer. Not what I was hoping to hear, to say the least.

Both my gyno and gyno oncologist are recommending that I do surgery to find out if what they see on the ultrasound is ovarian cancer. I also have to decide if I want to just test the cyst for ovarian cancer or if I want to have my ovaries removed at the time of surgery to significantly lower my risk ovarian, if I don’t have ovarian cancer now.

Difficult decisions and no good options.

On Friday I did get some tentative good news from my gynecologist about my blood work. She said that my blood work came back with a score of 4 for ovarian cancer. Most women with ovarian cancer have a score in the hundred or thousands. So that was reassuring.

However, I am still concerned and won’t know for sure if I have ovarian cancer until surgery is done.

While my family and friends are staying positive, I can’t stop myself from thinking about having to go through chemo again. Once you’ve had cancer, its hard to stay hopeful and positive when the doctor has a worried look on their face. It’s hard to believe that this time you won’t have cancer.

Two weeks ago I was feeling good. I was getting my energy back. I was going out with friends. I was going on vacation.

And now this. It sucks.

1 step forward, 2 steps back.