Absolutes that are not coated in the sticky reside of bleak prognosis have been few and far between. A talented and compassionate, straight talking Russian GP summed up my concern in delay in undertaking bi-lateral mastectomy surgery, with these words, ‘who cares?’. The goal posts had shifted from the original treatment plan in November, post lumpectomy surgery, which proposed 4-6 weeks of chemotherapy, followed by 6 weeks of radiation.
My surgeon had called me, in early December, before his rooms closed for the Christmas/New Year period, to advise me that a bi-lateral mastectomy was recommended. He delivered this information via the phone. The shock of that recommendation was overwhelming, the method of delivery inconceivable for a professional. The art of a surgeon’s blade and neatness of his stitch, is more important than ‘bed side manner’ and surgeons are well known for their lack of emotional connectivity for obvious reasons. It seemed that there was no end to the proposed carcinogenic treatments and the devised mutilation of my body, in the pursuit of saving my life.
The advice regarding the recommended bi-lateral mastectomy was supported by a radiologist a member of multi-disciplinary team from Royal Perth and Sir Charles Gardener Hospitals. I was grateful that my case had been presented to such a team for a second opinion. The new proposed treatment comprised of 4- 6 cycles of chemotherapy, then a bi-lateral mastectomy after a month’s healing, post chemotherapy. The former proposed radiation was considered ineffective in guaranteeing maximum protection for re-occurrence and the risk outweighed the treatment. In the weeks, between my last contact with my surgeon, I had not undertaken chemotherapy treatment. I had accepted only one of the three cards offered.
My cancer had been removed by an well respected and acknowledged surgeon, the margins around the tumours were ample, my blood test for CA125 (cancer marker) was normal, there was no sign of infection throughout my body, no lymph node invasion, my remaining right breast tissue was without concern and my left breast clear of legions, so there was both no need for chemo or concern for short surgical delay. The three GP’s I had seen and who were managing my case, two in the absence of Dr Kelly, as she too, was overseas visiting family for the festive season, had suggested additional testing to guide my decision making. Armed with these positive absolutes, I steadied myself for the next encounter with my surgeon.
His administrative officer, a gentle soul rang to express concern in fitting me into the surgeon’s schedule as I had been planned for surgery in four months. ‘We expected you to have chemotherapy’, she said in a tone that betrayed frustration that a well planned schedule had been effected. She did however find an appointment date as soon as possible in January with the surgeon to discuss the recommended bi-lateral mastectomy and immediate reconstruction surgery. It is in these moments, that having private health insurance really pays off, as the secondary question involved my health insurance status.