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Friday, January 16, 2015

Biopsies: Worry, wonder, and wait

Five biopsies in three months. That's how my 2014 ended and 2015 began.

At first I wasn't sure I'd share any of this on my blog. One's health is a very personal thing. But then that part of me that likes to help others nudged and pushed me to tell you what's been going on because survival rates for the cancers I was screened for are in the 90% range if caught at stage one and 20% or less if caught much later.

To make a long story short I went in for an OBGYN annual. For anyone who's ever had one you know how it goes but for the fellas I'lll explain. There's always a cervical exam and a breast exam (at some point, usually around 40 years of age, the mammograms begin) then you wait for a week and try not to think about the fact that your pathology or radiology results may reveal you have some type of cancer. It's stressful. You do your best not to worry and imagine worst case scenarios. A week later you hear back everything is fine and see you next year.

Until that isn't what happens.

Needing an operation was all very surreal. Kind of like Grey's Anatomy but with no famous actors working on me.

Last fall during the exam my doctor noticed something wasn't right. My mammogram results came back normal. But my cervical exam led to both internal (quite painful) and external ultrasounds, a colposcopy (it's like a pap test on steroids that led to two biopsies), and my first ever general anesthesia you're-going-to-the-operating-room procedure which led to two more biopsies.

While this was all taking place it was suggested I should have a Myriad MyRisk genetic test done to see if I carry any markers for certain cancers (breast, endometrial, and ovarian) that would necessitate a different course of treatment if it came back positive. The holiday caused a delay in obtaining my test results but over the next few weeks I found out I did not have cancer. There was also no signs of pre-cancerous cell changes. Needless to say that was a huge relief.

I also learned out of the 25 known genetic markers that increase your risk of developing 8 particular cancers, I had none. Thank goodness. The test results don't mean I can't or won't develop any of the cancers I was tested for, it just means I don't have a higher than average risk of developing them. Though I do have one health issue that remains, the fact that I don't have the markers means I can watch and wait instead of needing a surgery now. Why take a genetic test? Because your doctor can then create a more personalized screening schedule and treatment options based on your level of risk. For instance instead of mammograms you may qualify to have MRI's to screen for breast cancer. Some tests you may have more frequently than the average person would need to. It's all about helping to prevent you from getting cancer in the first place and/or diagnosing any cancer at the earliest possible stage.

But wait, there's more. . .

Last photo of my mole taken in the parking lot before its demise.

As if that wasn't enough of a scare during one of my two, required, pre-surgical clearance exams for my OBGYN issue my new General Practitioner took one look at the mole on my nose and asked "What's going on here?" I explained the mole had appeared while I was in elementary school. First it was flat and brown. Later in my 30's it became raised. Then the brown started to fade from it leaving it mostly colorless. In the past few years it started getting larger both in height and diameter. Several years ago my doctor in California suggested having it removed for cosmetic reasons but it really didn't bother me enough to have it done. In the meantime it had slowly increased in size. My new doctor's concern was the mole had become a basal cell carcinoma. They're not malignant, but it would keep getting larger. So no sooner had I learned my girl parts were going to be OK (for now) then I had to be concerned about cancer on my face. Ugh.

Not sure if I was allowed to take pictures but leave a blogger alone in a room with a camera and it's going to happen.

My 15 minute consultation with an ENT Doctor last week suddenly became a procedure day when he asked if I was in a hurry. It turned out he had time an hour later to do the removal right there and then. On the good side it meant I would only have to worry about the upcoming procedure for an hour, instead of the two weeks I had anticipated waiting for my next appointment to have it removed. I did stress a bit about what would I look like without it? It's been part of my face for decades and even though others said I'd look better, it felt weird to let it go. I likened it to what if you went to the doctor and came home without your right eyebrow. Or how Jennifer Grey didn't look like herself anymore after she changed her nose. Would people still recognize me? That's what it felt like.

The three lidocaine injections (local anesthetic) were excruciating. The procedure itself was easy and uneventful. He did a "shave excision" where he took a small scalpel and shaved the mole off flush to the surface of my skin then sent it in to pathology for my fifth biopsy. If it wasn't cancer it would heal over on its own and any resulting scar would be far less noticeable than the original mole was. If it was either type of skin cancer (Basal Cell Carcinoma or Malignant Melanoma) he would need to go back in and cut deeper and wider to create margins. I'd probably need some reconstructive plastic surgery but again, he said the scar would be less noticeable than the original mole. So I did my best not to worry. The recovery period was rough the first few days (my nose hurt a lot) but has gotten better and better since then.

I finally heard back this week that the pathology report showed no cancer. Another huge relief.

So why share my story now? Because I want you to go in for an annual exam. Get your pap test and mammogram done. Have suspicious moles checked. Do whatever you need to do to catch any disease in its earliest stage possible when treatments have the potential to be the most successful. As frightening as it is to have to worry, wonder, and wait for biopsy results early diagnosis is crucial to improve your chances of complete recovery.

In case you didn't know:

Breast Cancer there are 4 stages: (via Cancer.org)
Stage 1 survival rate is 100%
Stage 4 survival rate is 22%

Endometrial/Uterine Cancer there are 9 stages (via Cancer.org)
Stage 1A survival rate is 88%
Stage 1VB survival rate is 15%

Ovarian Cancer (Invasive epithelial) there are 12 stages and three other types (via Cancer.org)
Stages 1/1A/1B range survival rates range from 90%-94%
Stage 1V survival rate is 17%

Melanoma Skin Cancer there are 9 stages (via Cancer.org)
Stage IA: The 5-year survival rate is around 97%. The 10-year survival is around 95%.
Stage IV: The 5-year survival rate is about 15% to 20%. The 10-year survival is about 10% to 15%.

Did you know that cancer survival rates are based on 5 years after diagnosis? Meaning the average person diagnosed with a certain stage of cancer will usually live at least 5 years (often longer, sometimes less as there is no guarantee) following their diagnosis if treatment is pursued. Above are simplified examples, the full ranges are at the links on the American Cancer Society's website following each type of cancer.

This information is for your consideration. If it's been a long time since you've been checked and you're scared to find out if something is lurking please swallow your fear and schedule a check up. The best way to beat the odds is annual screenings/health checks and early treatment. If you don't have insurance or even with insurance the cost of screening is out of your reach you can always visit a Planned Parenthood if there is one in your community. They offer many types of health screening for women and the costs can be significantly lower than if you have to pay out of pocket. In the past when I was uninsured I went to PP for my screenings including OBGYN annuals and once a mammogram at no/low cost.

I just want you and your loved ones to be as healthy and happy as you can be for as long as possible. Even though I rarely ask that you share a post, I'm asking you to please share this one. It's one that really matters.

ETA 1/17/15
My friend Tom posted the following message on Facebook after I shared this post. His advice is so crucial for all women of every age I asked his permission to share it here:

". . . I don't have a lot of experience with other types of cancer, but you know that my darling wife passed away almost three years ago, as a result of breast cancer. Now, she was only 34 when we found out she had cancer - much younger than it is recommended for women to begin tests like mammograms, etc. Sadly, by the time she found the lump in her breast, her cancer had already metastasized. One thing that almost certainly would have caught it earlier, and very likely could have saved her life, was a frequent, thorough self-exam. It's something any woman of any age can and should do, as a minimum. So, if I can offer any small bit of advice, even to very young women, that would be it. There is not a day that goes by without my thinking of her and missing her intensely. It breaks my heart knowing that such a simple thing could have given us a very different story to be telling, here."


This post is not intended to be a substitute for professional medical advice. Please seek advice from your physician or other qualified health professionals with any questions you may have regarding your OBGYN annual or any medical condition(s). This is simply my personal experience that I wanted to share with you to encourage others to be pro-active about their health.

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