Flirting with cancer

The onset was sudden. I undressed and felt a hot pain in my right breast. No lump, just a throbbing mass of agony.

It was the evening of Monday, January 29. On Tuesday morning I called a doctor friend about where to get a reliable mammogram with quick results.

She was at the airport heading out to check on her cancer recovery. She advised against the mammogram, recommending a consultation with a suitable colleague instead. Unfortunately, he could not see me till Wednesday, late.

By Tuesday morning a fever had started, with chills, body ache and exhaustion. I did not connect the painful breast to those symptoms, but to that dreaded flu everyone had been warned to beware of, or covid.

By Wednesday morning a bright red one-inch spot had appeared on the far right side of the angry breast. It did not like being touched. As the day progressed the red area grew larger and more furious and the rest of me felt increasingly ill.

My head could have been an earthquake about to erupt. No painkiller was adequate to the task of quelling it. At times like that the desire to just close one’s eyes and drift off into a deep, unending sleep of oblivion is irresistible.

I had already diagnosed my condition as an abscess. I knew what the doctor would have to do and was prepared for the inordinate pain I would have to endure, although together with a flu that was really pushing it.

I had suffered this before, twice. About three years after ending breastfeeding, similar symptoms had appeared, but near the nipple. The cause was an infection in the milk duct. Then again 20 years later in the other breast, and now – too far away from lactating and too old for it not to be worrisome. I knew a horrendously long needle would be plunged into the tender, swollen area and the extracted contents of the syringe sent for analysis.

The doctor’s manner was perfect – charming and reassuring, but also plai- speaking.

He did not like what he saw in the ultrasound he did in his office. The large mass was not palpable and there was something hidden inside. The underarm lymph was enlarged. It was probably an abscess, but we had to rule out cancer, specifically inflammatory breast cancer (IBC). I did not have influenza or covid.

He did not dodge. If it were IBC, treatment would have to be aggressive – radiation, mastectomy and chemotherapy. I refused a course of antibiotics at that time.

I spent Wednesday night on the internet. Who sent me? Layman’s knowledge that cancer does not hurt, at least in the early stages, went out of the window. By the morning I had come to terms with the possibility of cancer.

IBC is rare (less than two per cent of all cancers) and aggressive, with poor prognosis. It develops from cells lining the milk duct, typically in women aged under 40. It is easily confused with an infection. Because there is no detectable lump, it is usually stage 3 or 4 and likely to have spread at the time it's found, plus it is more likely to return after treatment than most other breast cancers, making survival rates comparatively lower.

My blood turned to ice. A line was there in the sand between life up to that moment and the possible short future. I had always ruled out chemotherapy if the Big C hit me, but now I planned to have it start immediately, so that, even if I felt like death on legs, I would have time to sort out my 102-year old mother’s care, rid myself of all earthly belongings, rush through ideas in train for the NGO I had founded and make arrangements for my funeral before the morphine, etc, rendered me useless.

There was no fear of the Grim Reaper, only the wonder of experiencing how one’s life could change in a minute.

I had to share it with my closest friends and my niece. They were supportively matter-of-fact – terrible news, but not let’s jump the gun. We would all hope together. Their solidness rendered me even more unemotional, but still in a state of shock. I cancelled this column and everything else. I was numb.

On Thursday morning I attended a facility my doctor chose, near Curepe, for expert ultrasound, mammogram and quick results. Friday, I was back in his office for the horrid ultrasound-guided biopsy the otherwise encouraging diagnostic test recommended.

Only the agony of childbirth compared. Despite anaesthetic, the needle in the acutely inflamed breast was not dulled. I howled uncontrollably from the unspeakable pain as well as the pent-up emotion.

Biopsy results on February 6 showed no malignancy, but close clinical follow-up was advised. Seven days to diagnosis and four more weeks to reduce the infection and recover my equilibrium.

By contrast, my mother’s cook has waited six weeks for the results of a mammogram done at the Port of Spain General Hospital – referred by her health centre for a painful breast.

Fingers crossed that cancer truly does not hurt.