Network News - Winter/Spring 2010 - Canadian Breast Cancer ...

My Story
By Lorna Marshall
I
wish there were a mandatory course
that all physicians took to deal with
cancer screening and to learn how to
tell someone they have cancer. From the
time I turned 40, every couple of years
I would ask my GP whether or not I
needed to have a mammogram. Every
year it was the same response: “You
don’t need a mammogram until you
turn 50, especially because you have no
history of breast cancer in your family.”
Then, I found a lump in my breast just
after turning 48 and I knew immediately
that it was cancer because of its size.
Did she help me with booking the
mammogram after I went to her about
the lump? No, I had to use a pay phone
in the middle of a retail mall and make
the phone call myself. Only after bursting
into tears when told that it would be
four weeks before I could get in did the
technician feel pity for me and booked
me within that week. The mammogram
was followed by an ultrasound and then
my doctor’s office called to ask me to
come in for the results.
“I’ve been told to tell you that you
have cancer” are the words my doctor
used. “Told” to tell me. How about,
“I’m very sorry but it looks like cancer
and we will need to do a biopsy to be
sure.” Then when I asked if it meant I
would need to have a mastectomy she
responded with, “Well it depends on
how attached you are to your breast.”
I met with a surgeon within a week,
had a same-day biopsy and when I
went back to the surgeon to receive
the results, he made a phone call and
had me see a plastic surgeon about
reconstruction. He wanted to schedule
surgery in ten days and I needed to
make a decision. At this point, I was
walking around in a complete fog.
After discussing this with my family
and friends I decided that I didn’t need
to rush this decision – after all the
cancer didn’t grow overnight – did it?
I requested to be referred to a specialist
in Kelowna, one whose field was
breast cancer. This delayed everything
by several weeks but I was much more
confident with this new surgeon and
the added bonus was that I would
be having my surgery in Kelowna
Hospital, where the B.C. Southern
Interior Cancer Center is located. After
the lumpectomy, the pathology report
came back with both good and bad
results. My cancer was diagnosed as
triple-negative, invasive and Grade
III but it had not spread to the lymph
nodes.
Lorna and Jay Marshall
In November 2008, I started my chemo
cocktail. At the end of February,
two days before my fifth chemo
treatment, my mother who lived in
Ontario had a stroke. She was 88, the
primary caregiver for my father who
has dementia and I am an only child.
There was no question that I would
have to fly to Ontario. We moved my
chemo up one day and I arranged for
a live-in caregiver for my father and
flew there right after my session. I still
don’t know how “Dr. M.” did it, but
one week after arriving in Ottawa I had
an appointment with an oncologist to
schedule my last chemo session. What
a different experience! In Nelson, we
had a maximum of six people receiving
treatment at one time and there was a
lot of talk and laughter. Yet, here I was
alone in Ottawa, and in a room with
36 strangers.
I flew from Ottawa to Kelowna to
commence my 20 radiation treatments.
This meant that I had to live in
Kelowna (350 kilometres from Nelson),
for the six weeks of my treatments.
Fortunately for me, I had a very
good health benefit plan through the
company I worked with, so the costs
associated with living there were
covered. Without my health benefit
plan, it would have been a large
financial burden on my family.
In August 2008, I was told that my
breast cancer had returned – it was
in my sternum. The message was
delivered differently this time, mainly
because it came from another doctor.
She called me at home to tell me, but
only after she had called my radiation
oncologist in Kelowna to find out
where we would go from here. She
was able to tell me radiation was
unlikely because that spot had been
previously radiated. She also told me
which blood tests she would arrange
and she called Dr. M. to get me in as
soon as possible for chemo.
I had a Portacath inserted on
September 3 rd and my first chemo was
on September 4 th .
I did quite a bit of research and found
that because I had triple negative
breast cancer there was a high
likelihood that I had the BRAC1 or 2
gene mutation. As this could affect
my treatment, at the end of September
2008 I submitted the necessary forms
to the British Columbia Cancer Agency
(BCCA) Hereditary Cancer Program
to request genetic testing. I was told
it could take up to 18 months for the
results. I decided to pay for the genetic
test myself (3100.00 USD) as I wanted
to be aggressive with this cancer. I had
the results within three weeks and
they revealed that I had a mutation
but it was an “unclassified” mutation.
Meaning, the genetics experts do not
know what it really means or how it
could affect me.
I didn’t want to stop the process
through the BCCA so I met with a
genetic counsellor from the Hereditary
Program at the end of March 2009 and
she approved the genetic test but said
it would likely take twelve months for
me to get the results. I’m still waiting.
In January 2009, we discovered that
after six rounds of chemo the cancer
had progressed. As a result of my
research, I knew that “Dr. G.” was
conducting a clinical trial in Vancouver
on patients who had triple negative
cancer in addition to a BRCA1 gene
mutation. I met with her at the end of
8 Network News Winter/Spring 2010