My friend has breast cancer ... should I shut up or ask this question?

[RoughCollie]

My friend was diagnosed with breast cancer a few weeks ago and it was removed, along with large areas of calcification, last week.

 

She went for her checkup yesterday.  The surgeon told her that he was amazed to discover that she has lots of tiny cancerous tumors in that breast, and there are several different types of breast cancer in those tumors.  He had the lab results run twice because he didn't expect it.

 

As is typical of many people around here, that's the info she retained.  The doc knows what he's doing, so there is no need for her to ask questions or take copious notes (like I would do).

 

The cancer that led to the operation last week was ductal carcinoma in situ (DCIS).  The remaining cancers are not this type.

 

She will undergo a mammoplasty in two weeks.

 

Why was the doc surprised?  Because these tumors didn't show up on her mammogram or on her MRI.

 

My concern is the other breast.  It also had an MRI and a mammogram.  No cancer showed up.   But I think that something more ought to be done to check out her other breast.  After all, the affected breast had cancer no one knew about ..; the other one may too.

 

This lady is 69 years old and sharp as a tack.  1/3 of one of her lungs was removed in February because she had 2 kinds of lung cancer, both caused by the pollution in Pittsburgh -- she lived next to a steel mill when she was growing up.

 

So, should I keep quiet or should I recommend that she have the other breast checked out?  It seems like a no-brainer to me, but she hasn't thought of it... or she would have told me.  I don't want to worry her more, but if she's going under for another surgery, she may as well have both removed if necessary, than discover her remaining breast is also riddled with cancer.

 

That's my motive -- to save her going through another surgery and to make sure if there is cancer in the other breast it is caught early.  She is a good friend and we are straight with one another -- no beating around the bush.  I just hesitate to jump in where fool's fear to tread.  If this is her business, then so be it.

 

Thanks for your advice!

RC

[ErinE]

They really didn't check the other one out too? That seems odd.

 

I think I'd ask if they checked the other one out too. That would sound more like you were curious and it would plant the idea in her head if she didn't already have it in there. KWIM?

What Roy said. She may already be thinking about it, but I would ask just in case.

[datgh]

I would ask it.  The older generation looks at doctors like gods who can do no wrong because they are doctors.  My poor dad went through an unneccesary procedure from which he developed a massive infection that landed him in the hospital for eleven days because the doctors involved in his care weren't on the same page and he and Mom didn't worry about it because the doctors can do no wrong.  I worried about it but felt I had to respect my parents.  If I had to do it over again, I would have pushed a lot harder for answers before dad had the procedure even if my parents and the doctor found me really annoying. I also learned that my parents could be very good about being in denial.  It was their way of coping.

 

[datgh]

I would ask it.  The older generation looks at doctors like gods who can do no wrong because they are doctors.  My poor dad went through an unneccesary procedure from which he developed a massive infection that landed him in the hospital for eleven days because the doctors involved in his care weren't on the same page and he and Mom didn't worry about it because the doctors can do no wrong.  I worried about it but felt I had to respect my parents.  If I had to do it over again, I would have pushed a lot harder for answers before dad had the procedure even if my parents and the doctor found me really annoying. I also learned that my parents could be very good about being in denial.  It was their way of coping.

 

[ThatHomeschoolDad]

It is true that an older generation seems to have more difficulty viewing their doctors less as deities and more like hired guns, so she needs an advocate to ask the questions and take the notes.

 

As for scans not picking up tumors -- yes, that happens.  I've had docs find more spots than showed up on scans. Some lesions are just too small to register; one MRI machine is different from another; and still other lesions show up better on x-ray or CT scans.

 

Hopefully her doc appointed an oncology social worker to guide her through the mazes.  If he didn't that wold be something to suggest as well.

 

So yes, speak up.

[RoughCollie]

Thank you all for your advice.  I took it!  She is getting another MRI and will make sure it is of both breasts.  Other than that, the doc said there is nothing he can do -- even if he biopsies some tissue from the good breast during her surgery, it wouldn't tell him anything because he could have missed a spot that did have cancer.

 

Hopefully everything will be all right.  Two cancers (actually 3, if you count surgeries) in one year are a lot for my friend to deal with.  Luckily, she is the type to bounce back quickly -- after this last surgery, she was back to normal activities the next day and only took 2 of the 30 percocet she was prescribed because she wasn't in any pain.   This time, she is going to wait  9 days before she returns to her dog training classes and a weekend trip we are taking with our dogs to visit a collie breeder friend. She is sure all will be well, even if the doc has to remove a lot of lymph nodes, but she did agree to let me drive her van.  We have to take her vehicle because we are bringing at least 4 dogs with us.

[ThatHomeschoolDad]

Thank you all for your advice.  I took it!  

 

 

One thing for caregivers/friends of patients to know is that there is a place for everyone to provide some sort of service to the patient.   You might be the one who brings over a lasagna, or the one walks the dog.  Being the one who prods someone to get scans is also invaluable.  You may have just prolonged a life.

 

Bravo!

[G5052]

You're a true friend.  You provided needed feedback that she may have missed.

 

We have a friend who had two spinal tumors removed from upper spine. They only did an MRI of one narrow area of the spine.  At the time I asked the husband why they hadn't done a full spinal scan, and he said that he trusted the doctor.  I asked again, and he said that if she had problems, they'd go back.  I didn't push further. but I wish that I had.

 

Well, she almost died four months later and was in rehab for six months because of a tumor further down that was much, much worse than the others, and when they finally did a full scan, they found over a dozen more tumors in her brain and spine.  Waiting caused permanent damage that may have been prevented if they had dealt with it right after the others.  The tumors are genetic with no treatment other than surgery, but she went through more than she could have.

[Spy Car]

I would also speak up. It seems to me that very often strong lucid people don't go into the "questioning/self-advocacy" mode. I'm not sure if it comes from over-deifying doctors, or (more likely) from feelings that are more akin to a state-of-shock, but it is not uncommon.

 

Those who have a clear-headed friend or loved one who can lift the burden of "advocacy" off patients are blessed indeed.

 

Bill