A New Stage

The PET scan results showed lesions on my hip, spine, and rib in addition to my sternum. In other words, there was not much doubt that the cancer had metastasized into my bones. It’s now considered metastatic breast cancer.

But let’s back up. I had the PET scan on Tuesday morning, November 28th. After dropping Felix off with a friend, I showed up at the Cancer Center and checked in. Looking around the waiting room, I realized that I was easily 20 years younger than everyone else there. I tried to read but was still too shell-shocked from the news barely 12 hours prior. Once they called my name, I began walking back with the nurse. As she shuffled her papers, I saw a card fall from her hands. Bending down to pick it up, I realized it had my name on it, like an appointment card, and handed it back to her. “That’s for you,” she responded, “for Homeland Security.” HOMELAND SECURITY? The nurse continued nonchalantly, you’re going to be injected with a small amount of radioactive dye, so if Homeland Security stops you, they can verify the source of your radiation from your procedure here.

Now at this point, I was sure I had stepped into an alternate dimension, and the universe as I knew it no longer existed. This felt like an entirely new level of surreal: homeland security cards for my radioactive cancer scan? I felt like Alice in a strange Wonderland, surrounded by exotic characters and circumstances, waiting to wake up and realize that it was all just a bizarre dream. Yet, sure as my blood was red during my finger-stick, there I was, and all of this had become part of my new life.

One truth I have realized during all of these diagnostic tests: the more advanced the test, the more comfortable and more civilized it feels. The mammogram, in which my breasts were tightly compressed against cold, hard plastic? Torture. The MRI, where I was offered Valium and given headphones with soothing music? Far less discomfort. However, this scan went to an entirely different level. After my injection with the radioactive dye, I was to sit and relax in a reclining chair for an hour with warm blankets. Then, I was taken to the actual machine for the procedure and didn’t even have to remove my shoes! I laid down with a wedge under my legs, wrapped in more warm blankets, and was able to relax on the table for the 30 minute duration of the exam. It was downright pleasant, until the last five minutes when I desperately had to pee from the contrast liquid I had been given, and was starving due to the glucose fast.

After the test was over, I made a beeline to the hospital cafeteria for some lunch. Dr. G had said that she would call by the end of the day with preliminary results, so my fog continued as I waited on pins and needles to hear from her. She finally called at 8:45 that evening, as Christian and I were sitting on the couch watching some mindless TV show to distract us. We could tell immediately the news was not good. Dr. G cut to the chase, and told us that my lymph nodes showed cancer involvement, and that the presence of multiple lesions on my sternum, hip, and spine were a strong indicator of metastasis. “Benign cells generally don’t move in this pattern,” she said. We were crushed. Christian and I choked down sobs and held each other, as our whole bodies shook with the news. When would the bad news stop? When would things stop getting worse? We talked logistics: the full PET scan results by the end of the week, scheduling a biopsy, our follow-up appointment in several weeks, and the likely course of treatment. She explained to us that due to my hormone markers, there were a number of therapies available with very positive clinical trial results, as well as other clinical trials. She explained to us that chemo and surgery were no longer considered valid front-line options. “This is a marathon, a very long marathon” she elaborated, “we don’t want to hit you with the big, blunt stick out the gate. The hormone therapy treatment we will likely put you on is much gentler and more nuanced, and have very good results.” A poor relief. She apologized again for such terrible news, and we agreed to speak again soon.

What agony, having this information, but knowing so little else. The most frightening aspect of stage 4 breast cancer is the unknown. The path I am facing has so many unknowns. There are so many questions we will not be able to answer for months and years. The uncertainty has rocked our family to it’s core. So now, we continue to wait. We  try to remember that there is life outside of this diagnosis. I still wake up listening to my son’s sweet voice calling out “mama, where are you?” and push back thoughts of a future where he is calling out for a mother that isn’t there. We read and laugh and eat and play throughout the day, letting the normalcy of routine embrace us as we find our path in this new stage: stage 4 metastatic breast cancer.

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