After we left our first appointment with my surgical oncologist, Dr. T, we at least had a plan of action. They would set up appointments for me for a consultation with a plastic surgeon and for an MRI, bone scan, and CT scan. These additional tests would tell us more about the tumor and whether or not cancer had spread. They said the lymph nodes looked good but they couldn’t be sure about that until surgery, which was tentatively scheduled for the Monday after Thanksgiving.
Due to a mediation I couldn’t reschedule, I wasn’t able to do all of the tests on one day. First, I went in and had the breast MRI done, followed by the bone scan. I remember thinking that it looked like a lot of lights were going off as the bone scan was being conducted, but I wasn’t sure if that was normal or not. Still, I felt a little weird after the bone scan. I went from there to lunch and then to meet my plastic surgeon, Dr. K, for the first time. I initially thought I’d get a second opinion, but I liked him so much that I decided to just go with it. He had obviously thought a lot about my previous surgery (breast reduction/lift) and how to deal with those scars during a double mastectomy without causing any skin death. (Although he did make me cry for the first time that day when he said, “I can only imagine how hard this must be. It must be especially hard for someone like you who’s used to being the expert in the room in control of everything.”)
The next week I went for my last test, the CT scan. It ended up lucky that this test was done on a separate day because I had an allergic reaction to the iodine contrast and had to be doped up on Benadryl and driven home by my husband. While I was there, Dr. T called to go over “some” of the results from my test. She was surprised that I was in the hospital at the time recovering from an allergic reaction, and I think that’s why she only told me that the MRI confirmed what they thought about the size and location of the tumor. When I pressed her, though, as to whether she was keeping bad news from me, she said that they really needed to read the bone scan and the CT scan together.
(This is not me. But see all the dark spots? Those are “hot spots” of bone activity.)
Two days later Dr. T called me at work. As it turns out, there was bad news on the bone scan, which had quite a few hot spots, though nothing showed in my organs from the CT scan. Some of the bone hot spots were obviously arthritis (mainly my knees and shoulders), and she was surprised when I said my lower back didn’t hurt because I had arthritis there, but she kept saying there was a spot on my sacrum that was “concerning.” There wasn’t any reason for there to be a hot spot there. After a few minutes of this conversation I said to her, “I feel like you’re telling me this is probably cancer.” She paused for a moment. “It’s probably cancer,” she confirmed.
This was, without a doubt, the lowest I’ve felt so far on this journey. Surgery was un-scheduled so that I could meet a medical oncologist and have a bone biopsy. The medical oncologist, Dr. J, wouldn’t say that it was “probably” cancer, but said that the tumor review committee was “baffled” by the sacral hot spot. It could be a number of things, she said, but she wanted a biopsy to be sure. And while my chiropractor and internist, who know my running history, both said that it was probably a stress fracture, I was glad that the medical oncologist wanted to rule out any other possibilities. I got a PET scan too, while we waited, which also came up clean.
There was a lot of insomnia and a lot of tears while we waited for the biopsy results. If there had been cancer in my bones at diagnosis, I would automatically be stage 4. I would then not have surgery, but immediately start chemotherapy. I would be technically incurable. (Also, I was forbidden to run or do much of any exercise until they figured it out, because if I had tumors that were breaking my bones this would obviously be a bad thing). I didn’t even tell my husband this at the time, but I knew from my little internet rambling that stage 4 breast cancer at diagnosis has about a 25% 5 year survival rate (as opposed to 78% for stage 3, which is what I have – and I’m on the “better” end of stage 3 so my prognosis is pretty good).
The day before Thanksgiving I got the call we had been waiting for (the waiting is the absolute worst part). The spot on my bone wasn’t cancer, it was in fact a stress fracture from running. Surgery was back on the table and it was time to put the treatment plan into action.