Wednesday, November 18th, 2009

 "Never to suffer would never to have been blessed." - Edgar Allan Poe

 You know when there are days that you will remember for the rest of your life? Kind of like your first kiss, the time when your boyfriend says that he loves you, an argument that you have with your parents and you yell out, I hate you, when you really don't..... One of the days I will always remember is Wednesday, November 18th, 2009.

As I was on my way to work, on the train, no doubt, I get a call from my doctor. I noticed something off on one of my breasts. Something like a rash of some sort. (I know, this is mad disgusting) Unfortunately I've had something like this before when I was in high school and it turned out to be a fungal infection (yeah, I know, totally gross right?), but after all the stuff I went through with aunts on both my dad's side and my mom's side suffering from breast cancer I knew I had to get this taken care of. I paid for some anaerobic and aerobic swab testing to be done twice, two weeks apart, and had a friend of the family that is now my  temp doctor receive the results of the tests. Mind you all, I don't have insurance right now since I've been on and off unemployed the past year and a half. COBRA's already gone and I haven't stayed long enough at my previous job to be eligible for health insurance. I've been so careful with my health since I had to put it on the backburner til I can get myself back with a stable job and such. I work at a job now where I can receive insurance even being part time and I am looking into it. This is something that I just couldn't wait on tho.

So, about this call, I got some really disturbing news. The tests came back negative for fungal infections, but positive for cancer cells. I'm like, WTH?!?!?!?! At first he even thought it was a fluke and waited for the second set of swab results to come and again it came back positive for cancer. I told him that from my last mammogram (because I had an aunt that was diagnosed with breast cancer I felt the need to be on top of it to make sure that I don't have it so I got a mammogram) there was nothing there. He told me that given the fact that I now have history of breast cancer, he looked into other forms. I have a rare form of breast cancer called, Paget's Disease.  When he found this out, he felt the need to call. Granted I was kind of pissed off that he calls me and tells me on my cell phone, WHILE I'M ON THE TRAIN TO WORK, but I calmly asked him if I had time to wait til January when I have better insurance. He said yes, but he still wants to do a couple more tests. I honestly can't afford anymore tests, but I'll do the best that I can.

In case any of you might be wondering, this is the definition of what I might have:

Paget's (PAJ-uts) disease of the breast is a rare form of breast cancer, accounting for less than 5 percent of all breast cancers. Paget's disease of the breast starts in the breast ducts and extends to the skin of the nipple and to the dark circle of skin (areola) around the nipple. Paget's disease of the breast isn't related to Paget's disease of the bone, a metabolic bone disease.

In case any of you might be wondering, this is what I will have to go through if I do have it:

Paget's disease of the breast usually requires surgery. Which type of surgery you need depends on the condition of the skin around your nipple and how advanced the underlying cancer is.

Surgical options include:

• Simple mastectomy. This procedure involves removing your entire breast, but not the lymph nodes in your armpit (axillary lymph nodes). Simple mastectomy might be recommended in cases in which an underlying noninvasive breast cancer exists but hasn't spread to the lymph nodes.
• Lumpectomy. Breast-conserving surgery (lumpectomy) involves removing only the diseased portion of your breast. Your surgeon removes your nipple and areola along with a wedge- or cone-shaped section of your breast. The surgeon focuses on removing as little breast tissue as possible, while ensuring that the tissue removed includes an outer margin free of cancer cells so that only healthy cells remain. Lumpectomy to treat Paget's disease of the breast almost always requires follow-up radiation therapy as adjuvant treatment. Lumpectomy wouldn't be recommended if you can't have radiation therapy for some reason. Nipple reconstruction may be an option after your treatment.

Sentinel lymph node biopsy
Anytime invasive breast cancer is present, the lymph nodes under your arm (axillary lymph nodes) need to be checked to see if the cancer has spread to this area. This can be done in a procedure known as a sentinel lymph node biopsy.

During the biopsy, your surgeon locates the sentinel nodes — the first lymph nodes to receive the drainage from breast tumors and therefore the first place cancer cells will travel. If a sentinel node is removed, examined and found to be normal, the chance of finding cancer in any of the remaining nodes is small and no other nodes need to be removed. If the sentinel node tests positive for the presence of cancer cells, you may need to have more lymph nodes removed.

Adjuvant therapy
After your operation, your doctor may recommend additional treatment (adjuvant therapy) with anti-cancer drugs or hormone therapy to prevent a recurrence of your breast cancer. This depends on the extent of your breast cancer and whether the tumor tests positive for certain characteristics, such as having estrogen or progesterone receptors. 

Yeah, this is some scary shit huh? All that has been going through my mind is what am I going to do now? I'm already struggling through life on a very thin rope. I have friends and family around me that are sick, have been deathly sick, or have died. I don't have a real job. I have no savings. I barely have a relationship with family. I might be losing my boyfriend over something in my mind is stupid, but not to him of course. This is the last thing that I need. All I can think of right now is how alone I am. I can't really turn to people with this. I don't know if I have it for real or not. I don't want to bring anyone else down for that matter. Everyone around me has gone through something crappy this past year. I can't burden anyone with what's going on with me. I'm not selfish like that. I couldn't even tell Becca because of her fundraiser that went down that weekend. I didn't want to lose focus on what we're trying to accomplish. Once again I'm in this awful waiting game called life. All I can do right now is sit and wait til next year when I can get more tests done and see if cancer is what's really growing inside of me. Once again I feel utterly alone.