(Original title – The Sorting Hat)

So, I’ve been sitting on this for a couple of months now, waiting for the right moment to a) tell everyone; and b) start sorting through my actual feelings about the whole ordeal.

This post is about news in two parts:

Part One – I have metastatic breast cancer. It’s lurking in my liver and in five vertebrae in my spine (T11 – L3 for those of you playing along at home).

Part Two – I kind of have a prognosis at long last. That’s right kids, I’ve gone all this time without hearing what my potential outcome is.

Let’s focus on Part One first.

I thought you caught the symptoms early? So did I. It’s not always “feel a lump, get it cut out, and go on with your life and attend a bunch of breakfasts in October and wear pink to celebrate dodging death”.

What does it mean? Previously, my treatment was being delivered with the intent to “cure” this fucker. Because I have an aggressive cancer, they were hitting it super aggressively with an aggressive dose of an aggressive chemo. Then it was going to be aggressive mastectomy, then aggressive radiation, then endocrine therapy (essentially chemical menopause for 10 years). Now that it’s metastatic, the intent is to control what’s there and prevent it from spreading further. My chemo dose was reduced slightly for dose 3 at the start of December, to give me a better recovery and less nausea. I’m not sure if it was the 8% reduced intensity or the fact that I finally got to have the proper steroids afterwards like you’re supposed to, but it worked. My recovery was much better, I was able to eat properly the whole time, and the same applied for dose 4 just before Christmas. I have two doses of chemo left, and I am counting them down, believe me. I’m ready to be done with it for the moment.

Was it a surprise? I’ve known since very early on that there was weirdness in my liver, and my surgeon, my breast nurse and I had been hoping that it was just a hemangioma (a growth of blood vessels, kind of like a birthmark but on my liver). It couldn’t be diagnosed properly scan after scan, and it wasn’t until I had an MRI with contrast specifically on my liver at dose 2 that it was confirmed to be cancer because it had shrunk when compared to the previous CT scan with contrast (the one that caused me anaphylaxis). That’s a silver lining in the shitstorm that is my life. It was a shock when it was confirmed to be cancer, that’s true, but what really threw me was being told that it was in five bones in my spine as well. In my PET & CT scans I had done just last week, which was the main reason I’ve been holding off telling people the whole story because we didn’t have the full picture yet, I was told that the liver spot is currently inactive, and the same for my spine spots, and my breast is responding really, really well and is showing not a lot of metabolic action.

What happens now? That is a very good question, my friends. After dose 6 of chemo on February 6^th, I’m going to have my ovaries removed to make my menopause permanent and start endocrine therapy (hormone tablets) so my fat cells, of which I have many, will stop producing estrogen (because did you know fat cells do that? I didn’t). Mastectomy is being reassessed by my lovely surgeon at our next appointment in February, and if it’s one it’s both being removed. Radiation won’t be going forward unless I have the mastectomy because they’re not going to put me through the pain, swelling and extreme fatigue. It’s all up in the air and dependant entirely on continuing scans, blood tests, and generally how I am. I will be having treatment in some form or another until the day I die, or I decide to stop treatment.

Part Two is as follows.

My prognosis is not great.

There is no cement prognosis that has been given at this stage. It depends on if I can get through the next two doses of chemo without the cancer starting to grow and spread again, and entirely on the outcome of future scans, just like my treatment plans are. Speaking to my oncologist on Friday, she said the rate of survival has increased from 2 to 4 years. Since I was told it was metastatic, I’ve had the timeframe of 12 – 24 months in my head, with the expectation that I will get at least another year out of it because I’m just stubborn enough to spite everyone. 3 years is a good run.

I won’t dodge death from this. As my surgeon has written on my insurance forms I’ve had to complete for various things, it is inevitable. To put it bluntly, and I need you to all just accept this – I am going to die. The more treatments I have, the shorter my overall prognosis is, and even if those treatments stop the growth and cause it to be inactive again, the time between cancer outbreaks will be shorter and shorter. I will eventually stop responding to treatment. Your body can only take so much before it stages a coup and shuts down. Get on board my train, people. Don’t stay in denial. I am going to die sooner than I’d expected to. If you think it sucks for you to read that, think about what it’s like in my shoes (it ain’t exactly a picnic).

However, I am at peace with this for a few reasons. The main one is that every time I’ve tried to imagine what my future would be like at 50, 60, 70 years old, I just couldn’t see it. Secondly, I’ve always said that I would die of a stroke or cancer – my money was just on a stroke. Thirdly, with shit luck like mine, I should win the lotto at some point soon (sadly I did not win in the $55 million Powerball last week).

If you need to talk to someone about it, if your work has an EAP program – call them. Call Lifeline. Talk to each other. But I don’t want to know how sad you’ll be when I’m not around to deliver reality checks and knit tea cosies, I have enough of my own sadness to deal with. Be the best friend possible and be there if I want to talk, don’t push if I don’t, and find your own ways to cope. Everyone in this group knows me, and not all of you know each other. Get talking. Meet new people. There’s plenty of time for you to work through your feelings before the end of it all, so do me a favour and start now.

I’m keeping a pragmatic outlook, just because things are good now doesn’t mean the trend will continue for a long time. Sometimes when I talk about it, it sounds morbid or pessimistic, but I don’t care. The blunter I can speak about it, the easier it is to not get caught up in my own head about what’s going to happen in the not-too-distant future. I need to be on top of my symptoms and report them as soon as they appear again, and log any new ones that pop up. I do have plans to do a fucktonne of travel as soon as I am able to cash in my life insurance policy. I need to wait for things to get a little worse though before I can do that, but I’m expecting to be able to do that within the next six months.

I just need to decide where I go first on my list.