Today...5 years, 7 months, and 28 days after my final radiation treatment, I have graduated from the Cancer Centre. I will no longer be seeing my oncologist. I will be back under the care of my family doctor. Where’s my cap and gown!?! And not the kind that ties up in the back!
Before I break out the champagne to celebrate though, they are sending me for one more test...an ultrasound. The resident doctor who examined me today found a spot in my left breast. Not a lump but a spot. He asked me if it hurt, and I immediately responded ‘no’. But when he left the room, I felt it and thought...hmmm, it is a little tender. My oncologist came in and examined me. He was not concerned about the spot but is sending me for an ultrasound just to be sure. I recently had my annual mammogram in March and it was all clear. But, I had previously found the lump in my right breast five years before being diagnosed with breast cancer. Every year I went for a mammogram and every year they told me it was just a cyst, nothing to worry about. Until it WAS something to worry about. So I am happy they are doing an ultrasound. But, I will hold off on the celebration until the results are in.
So what does this all mean? Well, I am still doing hormone therapy and will continue to do so for at least another two years. Research studies show that doing five years of Tamoxifen and then another five years of an Aromatase Inhibitor like Arimidex reduces the risk of recurrence in hormone related breast cancer.
I did two years of Tamoxifen and then switched over to Arimidex for the last three years. I will do at least another two years of Arimidex for a total of five years. At that point, I can choose to stop. Or, I can then go back to the Cancer Clinic to discuss staying on the medication for another three years to bring the total time on hormone therapy to ten years. Or, I can simply choose on my own to continue with Arimidex for another three years. In all likelihood, I will go back to see my oncologist if only to get an update on the new research studies that will have come out by then, which will probably say to stay on hormone therapy for another 10 years! I will cross that bridge when I come to it.
In looking back, when I first finished my treatments and was told I wouldn't be seeing the oncologist for three months, I felt lost. After going to the Cancer Centre every day, three months seemed like an eternity. I remember asking my oncologist, “How do I deal with the fear of recurrence? How can I tell if an ache or pain is cancer or not?” He explained it to me this way, 'We can't do every test available to see if you have cancer? And even if we did, it could still go undetected". If you have a symptom that you can't explain the cause of and it persists, then you come to see me. So this is how I moved on. And as they say, time heals. As I got further and further away from treatment, it became much easier. When I graduated from quarterly visits to annual visits, I viewed it as a positive transition. Another milestone.
But, here's the thing. Once you’ve had cancer, it’s always in the back of your mind. It's nicely tucked away but it's always there. I don't obsess about it. In fact, I truly believe I will not have a recurrence. At the same time, I’m also aware I am now considered high risk. I had positive lymph nodes. They removed eight lymph nodes and two had cancer cells. I also did not have clear margins when they performed my lumpectomy, meaning the cancer cells went right to the edge of the tissue they removed from my breast. Radiation is supposed to take care of any leftover cancer cells, kind of like mopping up after surgery. However, one never really knows if they are truly cancer free.
Am I hyper vigilant? No. Am I vigilant? Yes, and I think that’s a good thing. If I experience a new and persistent ache or pain that I can’t explain, or discover a new rash or mole, I pay attention. I get it checked out sooner rather than later. I had a sharp pain in the back of my knee earlier this year. It did not occur very often and only when I was inactive like sitting down, and it only lasted a few seconds. I went to see my family doctor. He ordered an x-ray to rule out cancer. What could be causing the pain then? A pinched nerve, maybe. But funny thing is, since I had it checked out, I have not experienced the pain at all. Go figure, maybe I’m just a hypochondriac! But that’s a whole other blog post…lol.
Most of the oncologists, radiologists, nurses, practitioners, social workers, and volunteers I have met during my time at the Cancer Centre have been wonderful, helpful, and supportive people. And, I hope I don’t ever have to see them again, unless we happen to run into each other at the grocery store.
I’m looking forward to bidding the Cancer Centre adieu…once I get that last test result that is. In the meantime, the champagne is on ice.
This article was written by Colleen Kanna on her July 6, 2017 Graduation Day.
Colleen Kanna is a breast cancer champion and creator of coKANna designs, a line of bamboo knit, Canadian-made adaptive clothing for women touched by breast cancer.