No Cancer.

I met with my surgeon yesterday. She inspected the pretty scar she’d left me, and we agreed that it was healing very nicely. She told me those suspicious looking cells she’d extracted had turned out negative for carcinoma.
I mistook this for good news. No cancer. No worries. Right?
Wrong. The surgeon asked me if I wanted to know the results of my Tyrer-Cuzick Breast Cancer Risk Evaluation, then ducked out of the examining room before I had the chance to answer. She returned with a four page document that concluded with results she and I read very differently.
She’s the surgeon. She’s got the medical degree. I’m the patient. I’ve got the MFA. I’ve never been good at math.
The results were as follows (capitalization theirs):
“Ten Year Risk:
This woman’s Risk (at age 50): 11.0%
Average women (at age 50): 2.7%
Lifetime Risk:
This woman’s Risk (to age 85) 39.9%
Average woman (to age 85) 11.4%”

Maybe I’m a glass-is-half full person, but even if I wasn’t: the ten year prognosis glass is 89% full. That’s pretty darn full.
The surgeon immediately offered me a medication I could take to fill that glass to 100%—a medication, she swiftly added, that could only be taken for five years.
“No medication,” I said. “I take enough medications.”
“If you want to reduce your risk to zero percent,” she offered, “you can get a double mastectomy.”
I didn’t say, “And lose that pretty scar you left me?”
I didn’t roll my eyes. For while I did think her suggestion was crazy, I understood she was coming from a crazy place, witnessing women being brave because they have to be, as they fight for their lives, and all-too-often lose. I took it as a kindness, really, that she didn’t want me to join their ranks. I don’t think she’s an opportunist, trying to make money from some ounces of my flesh. I went along and booked my appointment for another mammogram in six months.
And then I went about my life. I took my “Freedom from Falls” class in the morning. I ran the writer’s workshop at the Senior Living Center in the afternoon. I told the writers my odds. These writers are in their seventies, eighties and nineties. They’ve seen a lot of life. They’ve seen a lot of death. They all agreed with me: those odds looked pretty darn good. I drove home. I did not update my neurologist. I did not update the NIH. I did not update my blog.
I wanted one day of those numbers looking pretty darn good.
If I go ahead with my plan to switch to Ocrevus for my MS medication, those numbers would go up. There’s a bullet point on the Ocrevus site under “WARNINGS AND PRECAUTIONS”
“• Malignancies: An increased risk of malignancy, including breast cancer, may exist with OCREVUS”
What would my surgeon’s Tyrer-Cuzick Tool have to say about Ocrevus? What will my neurologist have to say?

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2 thoughts on “No Cancer.

  1. I’m so glad. Not surprised. But glad.

    I do think it’s a thing to think about for the future, though, and some numbers to probe more deeply. 11%, given everything else going on, isn’t terrible. But that 40% figure: where is that coming from, how does that curve go? Does your expected risk trundle along, thn shoot up when you’re old, or is it a straight line estimate, or is there an inflection point in your 60s? Wherever that risk is likely to go high, that’s when surgery might be a thing to consider. Depending on what other risks surgery + MS are likely to mean.

    I am struck increasingly by how bad this culture is with aging and dying. Yes, 80-year-old women get breast cancer. Some die of it. A lot don’t. The thing is, they’re 80. Whatever’s going to get them probably isn’t too far off anyhow. Nobody who’s 80 misses this, but medicine is a pathological rescuer here. We have the technology.

    My dad told me once about going to get a dental implant when he was 60, and the young dentist was advertising the procedure at him, told my dad the tooth would last 50 years. My dad started to laugh, which confused the dentist. “I won’t last another fifty years!” he said, and the poor guy didn’t know what to say.

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