A bombshell

On the morning that I received a call from my doctor telling me that the results of the fish testing were back, and that I should come in to see him to discuss the results, I had no conception of the shock that I was in for. From the beginning of my relapse until now, the doc had told me to continue with the hormone therapy that I was on until we got more definitive results from the testing. I honestly thought that all that could possibly happen was that he would tell me that we would have to change my hormone therapy to a stronger one perhaps, as the cancer was obviously becoming immune to the present medication that I was on.

When I walked into his office, he was sitting with my rather substantial file in front of him on his desk. One look at his face confirmed the fact that, as I had just known in my gut from the beginning, that this was going to turn out to be far more serious and complicated than originally anticipated. His exact words were, ‘I’m so sorry Sarah, I have no idea how this happened but it does occasionally occur in some patients…your cancer is now testing triple negative. Negative for estrogen, progesterone and Herceptin.’

My immediate response was total denial. I said, ‘No, this can’t be, it’s not possible…does this happen?’

To my utter dismay, he nodded ‘yes.’ ‘Breast cancer has been known to change receptor status like this as it adapts and becomes immune to treatment.’

I could barely talk…I battled to find the words to articulate myself as my blood ran cold. My next immediate thought was that as scared as I was, this was it. This was the end of the road for me. I sat there fully expecting the doctor to say to me, ‘It’s time to go home, be with your family and get your affairs in order.’

He continued to tell me that he couldn’t be totally sure that some of the cancer sites had remained hormone receptor positive whilst other areas had changed. He said that my case was an exceptionally complicated one, and that he had consulted specialists around the globe about it. With that, the only piece of remotely good news that he had for me was that after putting their heads together, they had come up with a treatment plan for me. This however, would include 6 more grueling months of chemotherapy…something that I wanted to avoid at all costs. I was angry and frustrated at this prospect and started arguing with the doctor. I still contend to this day that the lesion that appeared on my sternum wasn’t new at all. I distinctly remember having a lesion on my sternum from the beginning, but the doc said I was mistaken. He also asked me how I thought it got there in the first place. It could only have travelled through my blood stream, therefore it was systemic hence the need for chemotherapy.

At that point I was so exhausted and mentally defeated that I decided to choose my battles and just go along with the treatment plan, after all, the reason why I was with the doctor I was with, was because I trusted him and this was no exception. Feeling like I literally needed to bend over and pick my heart up off the floor, I started crying. Sitting there all teary eyed, the doc was brutally honest with me, telling me that although triple negative breast cancer does respond very well to treatment with chemotherapy, that there was still no guarantee that is was going to work. I had a very long road ahead of me and he said that I had enough to cope with psychologically and wasn’t going to overwhelm me right away with what treatment protocol we were going to follow after chemotherapy, but that I should rest assured that he and the rest of my health care team would find a way to get me through it. My chemotherapy would be starting in three days and as I left his rooms to walk through the hospital to the parking lot where my car was, I cried openly. All heads in the hallways turned to stare at me, but I didn’t care. When I got into the car, I sat behind the wheel for about half an hour trying to compose myself before driving back home again. At one point I started to hyperventilate slightly. I put my cupped hands over my mouth and nose and waited it out.

me on table mountain

Me on Table Mountain in Cape Town, 6 months before my 2nd relapse. Late December 2012.

Driving home the tears continued. I stopped on the side of the highway several times because I couldn’t see where I was going. Screaming and crying, I beat the steering wheel with both my fists repeatedly. I didn’t care that the next day they would be swollen and black and blue. I didn’t care about anything at that point…not even about my husband and children. All that I could focus on was the fact that if I thought I was in a bad position when I’d first been diagnosed in 2003, it was nothing compared to what I faced now. I was looking down the barrel of a gun, and as much as I wanted to run away and preserve my fragile existence, I couldn’t. I was being forced to play Russian roulette. The trigger had already been pulled twice. Would the third pull produce a bullet? The terrible part was that I had no idea…no idea what was to come next.

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