Posts

Firstly, my apologies for the length of this post, there’s a lot to tell. I’m posting rather than Avril because I have had absolutely nothing to do today!

Last week, Avril forgot to say that she was booked to have a heart scan on Monday 11th February. Very appropriate at the start of Valentine’s week.

On the advice of the Nuclear Medicine Department, she drove herself to BMI Mount Alvernia Hospital for the scan because she had been warned that she would remain radioactive for a while and should not be near other people for at least six hours afterwards. The injection of the radioactive dye, via a cannula, was started and true to form her vein collapsed and she immediately felt faint, almost passing out. 

Thankfully, she rallied and the scan was successfully completed. Thankfully also, she didn’t get a parking ticket for overstaying 45 minutes in her parking place.

Despite not buying a Valentine’s Day card for me on 14th February, Avril’s scan has proved that unlike the Tin Man in the Wizard of Oz she does have a heart after all and fortunately the result of the test was completely normal. It will serve as a baseline during the next phase of treatment which can apparently affect the left ventricle of the heart, usually temporarily but occasionally permanently, hence the need for monitoring. She will have further scans every three to four months so her Consultant Oncologist can check how she’s being affected, if at all.

Generally Avril has not suffered any major side effects from the first cycle of the new regimen of Taxol chemotherapy; however last Sunday she felt very weary and listless and then made herself a bit depressed by reading in bed a few chapters of her book “The Complete Guide to Breast Cancer” which told her what awful things might be in store over the next few months. 

She slept well that night and on Monday felt pretty much back to normal… except that she then found it difficult to sleep that night, so the pattern went all the way from needing to rest, to not being able to rest.

Tuesday in Guildford started with a frost but later turned into a lovely winter’s day; quite mild with a clear blue sky and sunshine. So between us we first cleaned the entire house and then blitzed the garden, trimming back all our shrubs and making it look a little like Hiroshima, 1945.

At 23:00, in the dark, we even managed to locate Avril’s lost FitBit at the bottom of one of the bags of garden refuse! We hope we didn’t disturb you Paul and Sarah…

On Wednesday, Avril went to a gentle exercise class at Spectrum Sports Centre and yesterday was a pretty busy day too, with “his and hers” dentist’s appointments and finally a delicious Valentine’s Day dinner thanks to the local Waitrose.

So Avril hasn’t exactly been relaxing, though she continues to pace herself carefully, following my sister Sue’s wise advice.

We knew that today would be long and tiring and as retirees it was very hard to wake up at 07:00 to the sound of the alarm clock. We arrived at BMI Mount Alvernia Hospital before 08:30 so this time there was plenty of parking space and no need to keep “feeding the meter”.

Our hectic day went like this, it’s simpler just to list what happened and it shows that there is never a dull moment in this journey:

08:30	Arrival
08:45	Insertion of a tube into Avril’s Port-a-Cath by Nurse Lily
08:45:30	Ouch! That really hurt!
08:46	Bullseye! Second time lucky
08:50	Why is saline going in but no blood will come out?
08:55	Staff Nurse Ashley comes to check and says not to worry, that often happens, it’ll sort itself out
09:00	There’s 250ml of saline going in and blood is being taken by syringe from a vein in the back of Avril’s hand
09:15	A delicious breakfast for us both
09:20	A visit from our friend Elaine who’s working upstairs
09:35	Two Paracetamol tablets are taken (Tylenol to my U.S. readers) because the next infusion may cause a headache
09:55	Saline infusion complete
10:40	Reflexology by a volunteer from The Fountain Centre http://www.fountaincentre.org
11:20	Visit by the Consultant Oncologist to confirm that the heart scan was normal and that the “super-bug” MRSA blood test last week was negative
11:45	Herceptin infusion commences. This first use is a “loading dose” of almost twice the normal strength
12:30	A delicious lunch
13:15	An hour's “rest” commences to check for any adverse reactions
14:15	Perjeta infusion commences which takes 90 minutes. This is another “loading dose”, double the normal strength
15:45	More saline and slightly more than an hour of observation
16:25	Avril’s suddenly feeling cold and her teeth start to chatter, despite the room heat being set to 27 Celsius (80 Fahrenheit)
16:40	Her temperature is taken and it’s 38 Celsius (100.4 Fahrenheit), so slightly elevated
16:50	The duty doctor arrives and after seeing Avril’s notes advises that this could be an effect of the Herceptin. More paracetamol is prescribed to lower her temperature and the Consultant Oncologist will make a decision shortly about whether the chemotherapy (Taxol) can go ahead
17:00	The Consultant’s decision is that, provided Avril feels she can cope, the chemotherapy can proceed. Avril says "Let's go for it"
17:10	The pre-meds are administered - Piriton and hydrocortisone
17:40	Avril’s temperature is taken again and it has risen to 39 Celsius (102.2 Fahrenheit). The chemotherapy needs to be abandoned as it would be unsafe to continue and of course more observation time is needed for her temperature to stabilise before we can go home
19:25	We set off home, 11 hours after our arrival but without completing the whole treatment. We will return for another try on Monday at 11:00

Avril is now feeling fine although her temperature is still a little elevated – but it’s going in the right direction. 

One of us will post an update early next week, in the meantime have a good weekend!

Today I had the first of twelve, weekly chemotherapy sessions using Taxol, a different “cocktail” to the first four, three-weekly sessions.

I was given a room with a bed this time instead of a reclining chair (the treatment rooms are allocated randomly) and that made things a bit congested – equipment and furniture everywhere!  Margaret, my lovely Kenyan nurse who was with me for my very first session was back from an extended visit to her family in the Masai Mara and she will be with me every week from here onwards.

My Consultant Clinical Oncologist came to see me with the Breast Cancer Support Nurse and they talked me through:

• the administration and potential side-effects of Taxol (paclitaxel);
• the added monoclonal antibodies treatment, starting next week, alongside the Taxol;
• the expected pathway for roughly the next 6 months of treatment.

The Taxol treatment is milder than EC as it is administered more frequently but in smaller quantities. It requires different premeds and is an infusion lasting one hour, with the cold cap for only one hour following, instead of 1 1/2 hours. 

I was advised to protect my toenails and fingernails with nail varnish as this chemo cocktail can lift the nail bed and it has been shown that dark nail varnish helps to block this. That shouldn’t be a problem!

The most common side effect of Taxol is a tingling feeling in the fingers and toes – peripheral neuropathy – I can cope with that.

The monoclonal antibodies rarely cause any side-effects, but they want to keep me under observation for six hours next week just to be sure. We will be going to the hospital to start at 08:30 next week. It’s going to be a long day!

Besides helping to minimise hair loss, I was told that the cold cap also protects new hair growth which is probably already coming through (it’s not very apparent yet, unfortunately!). So it’s still worth having it.

Instead of getting a take-away bag of medication, there is just one anti-nausea drug to take tonight and tomorrow. My white blood cell count has actually increased since last time, so Colin is disappointed because he was becoming an expert at giving me the Saturday injection! 

Everything looks like it’s going to be a bit more protracted than we thought it would be at first, so our travel plans are still on hold.

My surgery will be scheduled about 4-6 weeks after the end of my chemotherapy so maybe it’ll happen around the last week of May.  Hopefully that’ll still be a lumpectomy rather than a full mastectomy; they won’t know until they analyse the excised breast tissue to achieve a clear margin. Radiotherapy may be 4-6 weeks after that, probably every day for 4 weeks.

I’m staying positive with the good progress so far. With only a week to go to the next chemo session I’m hoping that I won’t suffer any side-effects and that it’ll be plain sailing for a while. I may not post on the blog every week unless there’s anything significant to report, so please assume all is well unless you hear otherwise.

As always your emails, calls and messages are very welcome and encouraging!

The side-effects of my chemotherapy have definitely become more pronounced over recent weeks with the first three treatments acting cumulatively. I have felt much more tired; experienced more muscle aches; and my breathlessness has continued. 

On the bright side, for the moment anyway, my hair loss seems to have stopped; however I suppose the less you have left, the less there is to fall out!

Today was my fourth chemo session and I was particularly interested to hear what my red-cell level was as it is slight anaemia that has caused my breathlessness. In fact the level was about the same as last time so I did not need the blood transfusion which had been a possibility.  

This was the last chemo comprising EC (Epirubicin and Cyclophosphamide). It all went pretty routinely although I felt a little nauseous early on… ironically just after the administration of the anti-nausea pre-meds. 

Also the cold cap was much more uncomfortable than before, undoubtedly because I have less hair to insulate my scalp.

So nothing much to report at the moment. 

In three weeks’ time, on 8th February, I start the first of twelve weekly sessions of Taxol (its generic name is paclitaxel) and soon after that the monoclonal antibody treatment commences alongside the Taxol. The different chemo drugs all carry side-effects so we’ll have to see how things go once that treatment starts.

Every week I get a carry-home pack of meds to take during the first few days after chemo, including an injection to help with my white blood cell level.

We were astounded to discover that the injection, containing just 6ml of Longquex costs an amazing £700 and the main anti-nausea tablets cost £40 each! Once again we are so thankful that our private medical insurance is footing the bill!

Happy New Year everyone, we hope 2019 will be healthy, happy and prosperous for you all.

The side effects from my last chemotherapy session on 28th December have been a little more pronounced than before, probably because the chemical cocktail has a cumulative effect. Over the last week I have felt more tired and I have also experienced muscle aches much of the time. I have been able to cope with all this pretty well and I’m lucky that I have suffered far less than many other people undergoing the same treatment. 

This morning I had my second review appointment with my Consultant Surgical Oncologist. After a physical examination, he looked at the mammogram images of my right boob. He showed us the changes from when the initial mammogram was taken on 7th November against last Friday’s mammogram (4th January). 

It was amazing to see how the tumour has reduced in size and its density has reduced too. It has actually shrunk by 39% from 41mm to 25mm after only three chemo sessions; quite dramatic in fact. 

He is very pleased with my progress.

We discussed my ongoing treatment and I asked why the cocktail of drugs will change after the next session from ET (Epirubicin and Cyclophosphamide) to Taxol. Apparently it is “to spread the bets”! 

Put simply, the drugs work in different ways to each other and by using them both in the same treatment plan there is more chance that every trace of cancerous growth will be eradicated. That’s also why I will be having radiotherapy after the lumpectomy surgery in early May – he said it was to “sanitise” the whole area and limit the chances of the cancer returning.

I mentioned to him that I have felt a little breathless of late and also that my resting heart rate seems to be much higher now than in the past (thank-you FitBit!). He said I am probably a little anaemic and he then looked more closely at my blood test results. If my red blood cell count falls much more, he will consider giving me a blood transfusion to top them up. 

His wise advice was that to avoid tiredness and breathlessness I need to reduce my rushing around from 500 million miles an hour to only 400 million miles an hour!  

The next appointment for a mammogram and ultrasound scan is in the first week of March after which he will see me again to review what we all hope will be further good progress.

So all in all I am feeling positive about how well the treatment is going. The next chemo session is set for 18th January and I will post again after that unless there’s anything else to report in the meantime.

From time to time I felt a little tired over the Christmas period but I can’t necessarily blame that on the chemotherapy. After all, we were catering for eleven people, although with a lot of much-appreciated help and support from our guests.

Once again, the only real side-effect I have suffered since the last chemo session has been some occasional indigestion. Or maybe I ate too much Christmas pudding!

I think I have been incredibly lucky so far; even my hair loss seems to have slowed down a bit. I only wear my wig or perhaps one of my trendy hats on important outings. Around the house I still have enough (thin) hair to get by.

Today I had my third chemo session which was uneventful apart from the discovery of a stray suture following the insertion of the Port-a-Cath (it should have been dissolvable, but it wasn’t).

While chatting to my nurse, Lily, I asked how long her shift was and was shocked to find out that they all have to work 12 hour shifts with just 30 minutes’ break. They all work so hard and are so dedicated.

I decided to have the “cold cap” treatment again to try and save my remaining hair.

Just before the treatment started I was visited by my Consultant Clinical Oncologist who examined me and said I am doing very well, which was encouraging.

Everything took rather longer to finish this time because many of the medical staff were still away enjoying their Christmas break; however, we were home by 17:00, a total of 7 1/2 hours.

If my hair should go much beyond its current sad state, not bothering with the “cold cap” for future sessions would save several hours each time.

Next Friday, 4th January I am due to have a further ultrasound-guided mammogram and then on Monday 7th a follow-up review with the Consultant Surgical Oncologist. I will post again after that.

Thank you, as always, for all your moral and practical support. Have a great New Year’s celebration!

Why did I worry so much about the Port-a-Cath? Well, perhaps it could have been the idea of having a big chunk of metal under my skin which was to be pierced by a needle; but actually it was for nothing that I had a troubled night before last Friday’s second chemo session.

My lovely nurse Ashley carefully removed the dressing and popped the needle through my skin and into the Port-a-Cath device and it didn’t hurt a bit. I suppose they had to tell me the worst scenario as some people might experience pain or discomfort.

I had to wait for my blood test results before they could start. They all came back good and the procedure started as before – pre-meds and the cold cap for 30 minutes then the chemo, which took just 45 minutes to administer, then finally another 90 minutes of cold cap. We were finished at 15:35, an hour earlier than last time.

I felt fine afterwards, a few odd twinges around the Port-a-Cath, which has a dressing on for 48 hours, but that’s hardly surprising I suppose.

Ashley, my chemo nurse, suggested I should get a bottle which makes sure you drink enough water throughout the day. It’s very handy as I have to drink two to three litres which is a LOT for somebody of my diminutive size.  Very useful for everybody maybe? Here is the Amazon link to the water bottle.

The next day, Saturday, we went to visit Simon, Kate and our granddaughter Georgie in Hither Green, near Lewisham and Lizzie (Grannie) was there too. We had a lovely lunch and afternoon, but I felt really tired on the way home as I’d had interrupted sleep the night before.

Colin has perfected giving me the injection on the first post-chemo day to help my immunity by boosting white blood cells; this time it was totally painless and there was no blood or bruising.  Skillz!

Unfortunately after we got back home on Saturday I had the same horrible indigestion that I had the last time, but now I have more magic pills and have been fine since.

On Sunday I woke up full of energy. The steroids had kicked in and so we had a busy day with our friends Suz and James and their boys here for a Sunday roast dinner which was lovely.  Well that’s how it was for me, but Colin was exhausted by my boundless energy and was constantly saying “chill”.

The house was tidy and clean by midday, all my cupboards were organised and the dessert was beaten to within an inch of its life.

The washing-up was a somewhat damp affair I now hear – I had no idea Colin was taking photos as evidence.

Today, Monday 10th December, I decided that my hair has definitely decided to give up the ghost.  Lots of fallout, so I went back to our local wig specialists and left there with a wig which I think gives me an appearance very similar to “normal”.

As I said before, the upside of my hair loss is not having to endure the cold cap during chemo.  Sadly, that’s the only upside I can see at the moment.  Well, apart from not having to worry about my hair when I’m going out – I’ll just “whack on the wig”.

Now, the appointment with my Consultant today.  I’ll summarise quickly:

Nothing can be certain, but he is pretty sure that the treatment trajectory, as he calls it, will be very effective. I am “triple positive” meaning that my cancer is oestrogen-positive; androgen-receptor-positive; progesterone-receptor-negative; and HER2-receptor-positive.  The worst diagnosis would have been “triple negative” – had the cancer been of this type it could have meant that there was a genetic element rather than it being a random cell mutation. Very reassuring for me, not to say also Carrie and Amy.

The plan going forward is much as before.  Chemo sessions to continue.  Two more at three-weekly intervals, a check by mammogram and ultrasound in early January, then assuming the tumour is shrinking as expected (a change of “cocktail” if it isn’t) chemotherapy weekly for twelve more weeks including monoclonal antibody therapy (“MAB”) using Herceptin, which will probably go on for a full twelve months.

All-in-all I’m still feeling positive; continuing to feel pretty good with surprisingly few side-effects so far.

We are driving to Scotland tomorrow, until Sunday.

Feeling good about Christmas and the New Year too.

Thanks again for all your positive calls, emails and messages.  I’ll post again if anything changes but for now all is well. Next chemo session is on 28th December.

Happy Christmas and a healthy and happy 2019 to all xx

I am feeling rather sad as I found quite a lot of hair in my hairbrush yesterday afternoon; I was hoping the cold cap had worked and maybe it has delayed or will reduce my hair loss, so I plan to continue with that during the next chemotherapy session tomorrow and will hope for the best.

Apart from that I have been feeling fine since my last post; however, Amy and I did spend five hours in the local Accident & Emergency Department last Friday night as I was concerned about my left eye. A few weeks ago I had a big black “floater” appear which was checked out by an optician who said my eye was healthy and my brain would adjust to the floater, so I would hardly notice it – which has happened. 

This may sound familiar to some of you who I know have had similar experiences, but then I started getting flashes of light and then it felt as if I had something physically in my eye so we went to get it checked out.  To cut a long story short, I was given antibiotic ointment and an appointment at the eye clinic at Royal Surrey County Hospital, which was yesterday.  The doctor said it was “posterior vitreous detachment”, not a detached retina and nothing to worry about, but to blink as much as possible to lubricate my eyes as chemotherapy dries them out. I often have dry eyes anyway and have drops and ointment which I will continue to use regularly. 

Carrie arrived from Chicago last Saturday and we have had a lovely time meeting up with friends and family. Carrie was with me for the Port-a-Cath insertion on Monday, which went fine (Colin was briefly in Cyprus closing down our villa for the winter). I was lightly sedated because the radiologist said he would be using a local anaesthetic so I wouldn’t feel anything. I was awake while he chatted to the nurse during the procedure which took about an hour including recovery time. The most painful bit was inserting the cannula into the back of my hand to put in the sedative. I could feel pressing and him rummaging about in my chest, but no pain. 

The doctor had explained the insertion procedure but did not say anything about how I would feel afterwards and once the anaesthetic had worn off in the evening I was in a lot of discomfort.  My throat, neck and chest hurt but once I went to bed and lay on my back it all felt much better. Getting out of bed was painful but over the last few days it has got better and I am looking forward to the dressing being removed so I can see what it looks like. 

I received a very informative letter from my consultant yesterday explaining all my results and saying he would discuss my future treatment with me on Monday 10th December at our meeting.  So I will post next after that meeting. 

Colin says there are now fifty of you following my blog which is just amazing. Thank you all for your continued support. 

I am very happy to report that I have been absolutely fine since I last posted, which was just after the first chemo session. I felt very thirsty and had a dry throat and a bit of a cough; however there is something going around so I don’t think this is due to the chemo – although you tend to question every little thing.

One downside of the chemo was a 2kg (5lbs) weight gain in one day! I am always watching my weight and I check it every day – so as Amy said, “they must have given me the ‘full fat’ chemo”! I’m planning to ask for the skinny version next time. Colin said it was undoubtedly the 2.5 litres of saline which they pumped into me.

The horrible indigestion over the first weekend has not re-occurred so I am assuming that smoked fish doesn’t agree with me currently and will not be eating smoked mackerel or smoked salmon, both of which I love.

I have not had nausea or even felt really tired. Colin was very happy that I was on steroids for the first few days as I had a burst of energy on the Sunday and cleaned the house! Unfortunately on Monday no steroids, so I felt a bit pathetic although we still managed to visit IKEA – for once I didn’t come out with a trolley full of things I didn’t know I needed. So “every cloud…” as they say.

I was up in the night a lot to start with but was able to get back to sleep easily. I’ve only had one night where I sat up at 04:00 and read for a few hours. Insomnia is a common side-effect apparently. I am having to get up less and less in the night now and am sleeping better than I have for a while. So all is good. I have even lost the 5lbs plus two more, so I’m very happy about that.

I had another marker coil inserted in my lymph nodes last Thursday and next Monday is the Port-a-Cath insertion under sedation, so I’m not looking forward to that very much; however once that is done it is simply a 3-week cycle of chemo until February 2019 when it changes to weekly half-doses of a different concoction of drugs. I’m not sure what the side effects of those may be.

I will post another update just before my next chemo session on 7 December, hopefully as positive as this one. Thank you everyone for your lovely emails, text messages and phone calls, I feel so fortunate to have such an amazing band of supporters.

We had a lovely weekend after the first chemo session, including dinner out on Saturday. Yesterday I had a bit of indigestion which has come back again today but apart from that I am still feeling pretty normal.

At the moment.

I came home from hospital with three sets of anti-nausea drugs which I have been taking exactly as instructed so I don’t know whether I would have had a problem if I’d not been taking them.

Colin seemed to enjoy sticking a needle into my tummy 24 hours after the chemo finished (it contained something to boost my white blood cells).  Actually he said it all seemed like a bit of a joke until he actually had to do it!

It would be very unusual not to get side effects and so I’m bracing myself to face the worst later on.

We are so thankful that we carried on paying for private medical insurance after Colin stopped work in February 2011; it has meant that I could start my treatment just 16 days after my GP referral.  We love the NHS and our system of universal healthcare is preferable by far to what people experience in many other countries, but sadly these are the latest statistics from our local hospital:

It was quite daunting for Avril to go into her first chemotherapy session feeling perfectly healthy, knowing that in all probability she was going to feel very much under-the-weather afterwards.

We arrived early so that she could register in good time and feel settled and relaxed.  The chemotherapy suite was very comfortable and well-equipped for the patient – a reclining chair, TV, bathroom and a couple of chairs for visitors too.  A proper fresh-ground coffee machine just along the corridor.

The first problem was choosing what we were going to want for lunch – all served exactly when we wanted, to fit in with the treatment timetable.

Next, Nurse Margaret introduced herself and set about inserting a cannula into Avril’s arm (later she will have a more permanent Port-a-Cath to make things easier).  It was hot in the room, Avril was a bit stressed and became quiet.  Then she calmly announced that she was going to faint.  Oh dear.  The emergency alarm was pressed and ten medical staff ran in pushing two resuscitation carts.  I was quickly ushered outside the room, but after they elevated her feet and reclined her chair her blood pressure started to rise to a near-normal level. A very tense moment!

The cold cap was fitted next and the chiller started humming. Luckily her mind was taken off the increasing cold by a reflexology volunteer working on her feet!  The cooling took 30 minutes and then the pre-meds were administered and finally the chemo cocktails – bright red, one of them – were fed down the tube with saline.  The chemo itself only took about an hour but with the cool-down time before it and another 90 minutes’ cooling after the chemo finished we were there for about 6 1/2 hours in total.

Next appointment, three weeks away, always on a Friday. Now to see what side-effects she gets.

As forecast, it has indeed been a busy week.

Monday’s PET scan was pretty easy.  Firstly a radioactive marker dye was injected, then I had to wait an hour for it to spread throughout my body before going into the scanner which took about 40 minutes.  The purpose was to highlight anywhere else the cancer might have spread.

The most difficult thing was to heed their advice not to be any closer than 2 metres to anybody for at least six hours, since I remained radioactive for that time!

Tuesday’s Pre-Assessment involved a vast number of questions to answer.  Then we were introduced to my dedicated Cancer Support Nurse and were shown around the St Martha’s Oncology Unit.  I asked if I could see what a “cold cap” looked like (it will perhaps save some of my hair).  Not nearly as scary as I had thought, it was actually similar to a jockey’s helmet, only colder!

On Wednesday afternoon I had an appointment at a local hairdressers to choose and be measured for a wig.  They were surprisingly real-looking and after an at-times amusing session I finally chose one that looks very much like my own hair and style.  They will keep all the information and if/when I need it they can order it quickly.

This afternoon the marker coil was inserted under local anaesthetic with ultrasound guidance and then we waited a short time to see the Consultant Clinical Oncologist.

I was reassured to learn that the PET scan indicated no spread of the cancer, although there was some “low-level activity” in my lymph nodes which indicates that it has spread that far (the lymphatic system is there to filter out harmful things, so in fact the nodes have done their job).  The consultant said that as a matter of routine they would invariably remove one or more nodes at surgery time and that the proposed chemotherapy regimen would deal with it anyway.

The full biopsy results show that I have a HER2-positive cancer.  Treatments that specifically target HER2 (such as Herceptin) are very effective; in fact they are so effective that the prognosis for HER2-positive breast cancer is actually quite good.  Let’s hope so!

So, I am to have the following treatment before surgery:

• Four sessions at three-weekly intervals of ET:  Epirubicin and Cyclophosphamide
• After another three weeks, twelve sessions at weekly intervals of Taxol
• One week into the twelve sessions I will also be given Trastuzumab (Herceptin) which is an antibody treatment using Monoclonal Antibodies (MABs).  This three-weekly treatment will continue for a long time after the surgery, for a whole year in total.

It is very disappointing for me that the MAB treatment won’t finish until the middle of February 2020 but that is how it has to be, unfortunately, our lives really are on hold.

I went to see the specialist again today, 9th November 2018, and he told me that the thin-needle biopsy and the provisional results of the ultrasound-guided core biopsy confirmed his initial diagnosis:  I have a fast-growing cancer in my right breast with an approximate size of 41mm.  Although I check regularly he said that the soft texture of the tumour and the speed of its growth would undoubtedly explain why I hadn’t noticed it earlier.  A slow-growing cancer typically doubles its cell count in about 6 months while a fast growing one would see the same growth in 30 days.

He gave me a simplified explanation of the complex biological systems that underlie the development of the various types of breast cancer and the treatments which might be appropriate for each.  He felt that the most likely pathway would be for me to have a course of chemotherapy at two- or maybe three-weekly intervals over a period of 5 months.  That would be expected to shrink the tumour to a size where lumpectomy surgery would be sufficient rather than a far more invasive mastectomy and reconstruction.

Unfortunately the chemotherapy is likely to give me same the side effects that most people suffer:  The full list of possibilities covers six sides of A4 paper, but the most disturbing for me is the probable temporary loss of my hair.

Next week is going to be busy:

Monday	PET scan (to check whether the cancer has spread to the lymph nodes, or maybe further)
Tuesday	Pre-assessment and tour of the St Martha's Oncology Department
Wednesday	Wig consultation
Thursday	Appointment with a Consultant Clinical Oncologist, when I should find out the full biopsy results and get confirmation of the exact course of treatment. Also, the insertion of a marker coil (the location of the shrunken tumour will otherwise be hard to see when I am ready for surgery)
Friday	First chemotherapy session

We were watching TV in the evening of Monday 29th October 2018 when Avril exclaimed “I’ve found a lump!”.  Immediately we both got an eerie, cold feeling and we thought that she must see a doctor urgently.

The next day she managed to get a General Practitioner appointment at 08:50 so there was not long to wait.  The GP said that she needed to be expertly checked and so referred her to a specialist Consultant Surgeon Oncologist at BMI Mount Alvernia Hospital in Guildford.

The first specialist appointment was on Tuesday 6th November 2018, so a week of waiting and worrying.  She was asked many questions about her medical history then she went along to the Imaging Department for a mammogram.  This showed what appeared to be cancerous tissue in her right breast.

A thin-needle biopsy was then performed to check what it was and a couple more appointments were fixed for an ultrasound-guided core-biopsy under local anaesthetic and a follow-up to discuss the results and the way forward.