Ann’s Story

Breast Cancer

When I was eighteen I remember saying to a mate: “Those old people – all they ever do is talk about their illnesses” (though I may not have put it so diplomatically). He and I grumbled a bit, then got back to our undoubtedly well-informed discussion of the world’s problems.

Well, now I’m old (I prefer “mature and still hangin in”), I hang out with old people and – guess what – we do talk a lot about illness. Because as we age we do get hit with illness more often. Duh!

There is a need to talk about cancer; – this is Anne’s (and to a lesser extent my) tale from 2015.

Bob Pascoe

Anne had noticed a dimpling on her left breast; hardly anything at first, but soon not to be ignored. Religious about mammograms, she had missed one a year and a half ago – probably made no difference in the end.

A quick visit to Anne McEniery at Bright Medical and an ultrasound and mammogram was arranged down in Wangaratta. Followed up by the scheduling of a biopsy. I go along of course – partly to support her but partly because I am fascinated with medical technology. Simple procedure, topical anaesthetic, all done and a nervous wait for results. They arrive, back to Anne McE, results negative. Phew! The good doctor however did not look as happy as we felt; “…have another biopsy in a month or so while you are up in Darwin”. Hmmm. We may owe Anne’s present good health to her.

We did ” have another one” of course. And the Darwin medical system is superb and responsive. But we had a new “front-end” doctor relatively unfamiliar with the Australian system who somewhat stuffed up the referral procedure, but in the end – more ultrasounds and another procedure room very like the one in Wangaratta.

In both sequences of visits we had looked at the ultrasounds and – to our totally untrained eyes – could see clear indication of a neoplasm (new growth). Which makes us marvel at our optimism and willingness to accept the first negative result so easily – how often do we choose being happy over being properly informed?. We now had another nervous wait.

More thanks to Anne McEniery, and, regrettably, positive results this time – fairly speedy action is called for. We had been in Darwin working on our boat and visiting with our 6 month old grandson, but made the decision to have Anne’s surgery back in Bright rather than Darwin. Liu Ming Schmidt – what a wonderful mix of oriental and germanic naming – in Albury specialises in breast surgery and to her we were referred. Two weeks later Anne is preparing for surgery.

Modern technique is to receive nuclear imaging before surgery. In this, radioactive tracers are injected into the suspect area of the breast, and drain to nearby lymph nodes. This is then imaged to show the lymph nodes – so-called sentinel nodes – where breakaway cancer cells (if it has spread) will first lodge. Like most soft tissue cancers, management consists of cutting out the primary tumour if possible, then managing any secondary spread (metastases).

So we rack up at the Albury public hospital for the nuclear medicine.

Don Chipp – a politician and good fellow who you may remember – founded the Australian Democrats political party and “tried to keep the Bastards honest”. Don had a handsome but particularly rugged face (yes, you are still reading the same article). A rugged, lined and haggard face. A journalist once rather unsympathetically described him as “…apparently having mainlined radioactive waste”. Ever since that day I have had a fear of being injected with any nuclear material.

Not to worry – the isotope they use for Anne’s imaging has a half life of only a few hours – which essentially means it decays well before you do!

And then off to the day surgery ward of the Albury Private hospital for the (hopefully) lumpectomy. Anne goes in, Bob hangs around, … and around and around. Anne comes out. Later that day Bob takes a look – yup, all there. Thanks Liu Ming.

During the following week various pathology reports are processed, then back to the surgeon for a review. The excised section is a little larger than they would have hoped (lesson – keep up the mammograms), but the margins are clear (meaning the surgeon’s difficult job of removing just diseased cells but not healthy ones, and making sure that all diseased cells are removed) has been successful.

During the surgery the sentinel lymph nodes are also removed. These have been examined by a pathologist and although there was no immediate evidence of any spread, microscopic examination using a staining technique showed one “micro-metastasis”. Better to have none, but not a bad result.

Having now had the primary tumour load removed, further treatment is aimed at preventing a recurrence and catching any metastases which may have escaped detection. This comes from the team of Eek and Ong (I can’t stop thinking of the seventies comedians Cheech and Chong). Richard Eek (the oncologist) will determine that no chemotherapy is required, since the type of cancer is susceptible to hormone therapy which will probably last five to ten years, and Eddie Ong (medical radiologist) will supervise 6 weeks, 5 days a week of radiation therapy to the operating site and surrounding area. Radiation can cause cancer, but it’s even better at getting rid of it.

For those interested, much of the attack on cancer – including basic chemotherapy – aims to take advantage of the fact that cancer cells lose much of the normal controls which cells have, and they divide rapidly. When cells divide and their genetic material is duplicated it is also exposed to damage. And radiation is here used as a fairly blunt instrument to cause damage.

Bob – who started off studying physics at Melbourne University – is fascinated. You wouldn’t wish cancer on anyone, but it’s great to see the medical technology in action, and often – with Anne lying on the treatment platform – Bob is often found hanging round talking to the techos as they adjust the linear accelerators, their controlling computer systems and the like.

So all this is now over, and although Anne has only recently recovered from ongoing tiredness – a result of the radiation treatment – and will have 6 monthly follow ups to monitor her response to the tablets, life is pretty well back to normal. Anne’s risk of dying as a result of her brush with cancer is there, but is not substantially higher than the background risk of living. Such as you get from crossing the road, driving long distances or generally being older.

We are both grateful for the support we received from the professional staff involved and from our fellow Bright residents. During 2015, many of our friends have gone through other medical procedures and two we know have recently likewise addressed breast cancer. We know people who have been through experiences which must challenge their sanity. (Humorous aside which I couldn’t possibly use – “… and in some cases it obviously has”).

What can you say – Thank you for friends, long live life!