The surgeon delivered the verdict without looking me in the eye. I was holding my right arm aloft, hardly breathing as he bent forward to study the strange swelling in my armpit. He straightened. “This is malignant.” His tone brisk and impatient, as if I should have known.
That trouble was afoot, I knew; a “suspicious mass” and clouds of insidious white dots were scattered across my mammogram from the previous week, in March last year.
But after the biopsy, I expected to have a few more days of blissful ignorance. Instead, my diagnosis was immediately obvious to a cancer surgeon — an aggressive strain of breast cancer that had visibly invaded lymph nodes in my right armpit. My fate was to die young and leave my four beautiful children motherless, like a tragic character in a movie. Not real life. Not my life.
Until I was diagnosed by one, I had never understood that an oncologist was a cancer doctor. No one in my family or circle of friends had ever struggled with the disease. For 39 years, I was in exceptional health and took for granted I always would be.
With the diagnosis, my world view was turned upside down. Nothing I knew to be true — not relative youth or physical fitness or organic food or never smoking or nursing four babies — had spared me from the disease all women dread. I was in its grip, helpless to stop it.
Or so I thought. This story is about how wrong I was.
The next morning, I told my news to a neighbour who had breast cancer a few years before I knew her. Her response startled me: I should run, not walk, from the downtown hospital where I was and schedule a second opinion at one of Toronto's cancer hospitals.
I had been booked for surgery in four weeks, the earliest slot on the surgeon's busy calendar. But when I consulted a second oncologist, he sharply disagreed, insisting that an aggressively spreading disease like mine should first be poisoned with chemotherapy to defeat any cancer cells marauding in distant and incurable parts of my body.
I turned to a third doctor, and it was he who would become my oncologist.
“This is locally advanced,” medical oncologist Mark Clemons said within seconds of walking into the examination room at the Toronto Sunnybrook Regional Cancer Centre. He seemed to recognize my type of cancer like an old foe, and I later learned that his clinic was busy with younger women like me whose breast cancer tends to be more aggressive and deadly.
The cancer had leached into lymph nodes beneath my clavicle, a sign it was spreading fast. Not only did I need chemotherapy first, I needed it now — he urged me to join a clinical trial the next week — followed by a mastectomy and many doses of radiation.
“When it's here,” Dr. Clemons told me gently, tapping his own clavicle, “the prognosis is not good.”
Second opinion was not second nature to me. At first, there was guilt in asking another doctor to second-guess the first. But I remain grateful every day for whatever good grace allowed me to take charge of my own treatment.
If I am to survive, it will be the work of an intuitive oncologist pushing state-of-the-art drugs, a deft surgeon, the high-tech wonders of radiation therapy and one of the latest triumphs of medical science, the breakthrough breast-cancer drug Herceptin.
But not entirely. What began as a strictly medical search would evolve into a pursuit of health outside the confines of the hospital. A week after my first chemotherapy infusion, a friend handed me a flyer advertising a conference being held a few days later by a group of registered nurses advocating a place for alternative therapies in cancer treatment.
I did not want to chase after miracle cures. But none was on offer. At this conference, I would learn about meditation and therapeutic touch. A naturopath would speak so persuasively about food as medicine that my diet changed immediately. And I would meet Alastair Cunningham, an elegant, silver-haired scientist at Toronto's Princess Margaret Hospital who runs an intriguing program working with the psychological side of cancer.