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Saturday, October 1, 2011

The Diagnosis: Part 2

I discover a new type of anxiety. It's nothing like I felt the first time I went abseiling (off a building at UQ in the dead of night, with a group of half-wit students), or diving or skydiving.

It's nothing like that fortnight I spent, unable to see, with stitches to both my eyes thanks to a car accident.

It's not even like the time I was swept off the airbed I was riding down the swollen gorges of the Obi Obi in Maleny and had only the forefinger and thumb of a fellow traveller to cling to until I was rescued. (I spent that night freezing and beating off the leeches. Apparently a rescue helicopter was despatched but we weren't found).

It's like the anxiety you feel when your child goes missing, that abyss between knowing and not-knowing.

It's Friday, September 30 and Al and I are once again sitting in front of Dr Lambley. After the usual greetings he procures 3 pieces of A4 paper which have just been faxed through.

Literally hot off the presses are the results of my pathology.

He interprets what he reads as his eyes scan the pages.

He seems surprised.

He had thought it was a ductile carcinoma he says, but it's lobular and unusual. Only 1 in 10 breast cancer cases, it seems.

The good news is that it's hormone receptive which means I shall have access to an extra layer of treatment.

The other good news is that it is what's called "node negative" - that is, it has not spread to the lymph nodes.

The bad news is that I will need to return to hospital next Wednesday to have more removed.

The bad news is that he says I will need chemotherapy.

For the first time I hear the term "Medical oncologist".

At this point I notice a subversion of the principles of time. It seems my life is heading rapidly in a new direction. But I must wait until Wednesday to know what my treatment options are. Time is fast but it is slow. I feel as if I am suspended in a different reality.

Appointments are made and we leave.

Al asks me if I want to go to the local bar, Elysium, where it is our habit to catch up with friends every Friday evening. I don't want to go home so we meet 'Burglar' and Natalie, Greg and the Dowlings.

Yet again, I find myself talking about the subject but now there's a new 'C' word eating away at my thoughts.

Afterwards, we pick Ben up from home and go to my sister Nicky's for dinner. My mum and dad are there.

We talk about my situation. Here is what I've learned.

I have what is described by the pathologist as a (classic) invasive lobular carcinoma.

It is larger than it looked either by palpation or ultrasound: in fact, it's roughly double the size. It has 3 tubules, 2 nuclei and 1 mitoses.

It is node negative and is 80% Estrogen receptive.

Invasive lobular cancers represent 1:10 breast cancer cases. They form in your milk glands and therefore, usually do not present as lumps. They present as a thickening of the breast.

When these cancers break out of the lobule, they do so in single file then invade the surrounding tissue in a web-like manner.

At this point it hits me that cancer is an animate, living thing. It is like a life form within a life form. For a moment I am fascinated. In a way, there is a certain fecundity to this phenomena - a pressing forward.

This is the beginning of my understanding of why this disease is usually paired with imagery of battle. These cells are not indiscriminate. They have shape and pattern. They advance in formation, gathering strength with each advance.

I have an enemy within: it is living and breathing.

My friend Mary was diagnosed with breast cancer in 2008. She has already given me this to work with: to imagine these cells as 'Aliens'. She became a fan of Sigourney Weaver. She visualised beating these bastards. Already, I hate these fuckers.

And it's important I understand them. I begin my research and start with understanding the risk factors.

Of these, I suspect only one and only because my grandmother died of stomach cancer.

Inherited genetic cancer syndrome: this is a rare, inherited condition called hereditary diffuse gastric cancer syndrome which increases the risk of both gastric (stomach) cancers and invasive lobular carcinomas.

I have no medical background but that's my intuition. So far, it's been spot on.

In a way, this makes me feel better. It makes me realise that I cannot blame my diet or my lifestyle. I cannot blame my desire for nice-smelling armpits or my love of a rump steak.

I cannot blame underwire bras or those soccer balls I took on my (plentiful) chest.

I cannot blame Mortein or mobile phones, Mr Cadbury, Bundaberg Sugar or Johnny Walker.

I can't even blame Julia Gillard (although, of course, I'd love to).

There is no interplay of myth and mystery here, no hocus pocus nor sleight of hand. It is simply science.

It has happened and there is no way left but forward...

CLOSE ON DOOR: as it REVEALS an inhuman silhouette standing there.

It is Ripley, WEARING TWO TONS OF HARDENED STEEL. THE POWER LOADER.
She lifts the arms horizontally beside her and stomps out...the massive feet CRASH-
CLANGING on the deck. She stops midway to the Queen.

RIPLEY
Get away from her, you bitch!

TIGHT ON QUEEN: as it hisses with pure lethality. Newt looks out of the flooring at Ripley

Ripley moves the arms up for combat, both in swinging positions and takes two steps.
The Queen screeches and charges. WALLOP! A roundhouse from one great hydraulic
arm catches the creature on its hideous skull, slamming it onto the deck. The Queen gets
up and Ripley hits it again with the other arm, sending it sliding into some heavy cargo boxes.

The alien rights itself, standing in a lethal stance. It hisses violently, clearly really pissed off.

Ripley swings around, positioning herself toward the Queen.

RIPLEY
(screaming)
Come on!

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