Detail from Caspar David Friedrich’s Frau am Fenster

This piece was written by a friend of Two Different Girls who wishes to remain anonymous. 

Last Monday was not a good day. After months of medical tests, I learned that I have breast cancer, which has metastasized to my spine. The tumor in my breast is quite large (5cm, VERY large in relation to the size of my breasts), I have several enlarged lymph nodes in my armpit, and because the cancer has already spread to my bones, treatment for the cancer is beginning at what is commonly referred to as Stage IV, and the long-term prognosis is not as good as it would be had the cancer been found early on. This cancer has been around for a long while; the tests indicate that it is a slow-growing type, and is easily treatable when detected early enough.

I have been doing monthly breast self-examinations since I learned how to do them in high school, particularly as my dense, cystic breast tissue made it so obvious why self-exams are so important (while also making detection of small tumors very difficult). The density of my breast tissue also made it clear that regular cancer screening would be vitally important; I had my first at age 28, and started having mammograms every year or two after I turned 40. I’ve been following the guidelines for early detection of breast cancer, so what went wrong? Why wasn’t this cancer found sooner?

…so what went wrong?
Why wasn’t this cancer found sooner?

I had been noticing changes in the shape of my left breast. Such changes could indicate breast cancer, or be solely the result of the aging process after menopause. My primary care physician didn’t think it was cancer, and my mammograms have always come back negative (but with dense breast tissue noted). In February, I noticed some enlarged lymph nodes in my armpit. These nodes are not usually included in a breast self-exam, but I was getting very concerned about the physical changes I was seeing in the breast and widened my search. I went to my primary care physician to discuss this latest development, and another mammogram was ordered for April 1st. The mammogram result was negative once again—no change was noted from my previous mammograms. Looking back, it almost feels like an April Fool’s joke. Ha.

Then another serious medical issue reared its ugly head, and a search started in earnest for a benign tumor which was causing osteomalacia – bone demineralization as a result of hypophosphatemia. When I first got the diagnosis of tumor-induced osteomalacia from my endocrinologist, I mentioned the enlarged lymph nodes in my armpit, so she ordered an ultrasound of the left breast and axilla. This ultrasound was performed at the same clinic where I have been getting all of my mammograms done since 1995. I met the radiologist who reviewed my mammogram images, as he spoke with me during the ultrasound. According to him, those enlarged lymph nodes were a result of an infection and would probably get better in a month or two. I told him that I had first noticed them in February. This didn’t change his diagnosis.

Looking back, it almost
feels like an April Fool’s joke.

Ha.

A week after the ultrasound, I had a whole body PET/CT scan to find this elusive osteomalacia-causing tumor, for which I had to go to a Nuclear Medicine facility, rather than the local radiology lab. My left breast, armpit lymph nodes, and spine lit up like a holiday display at Disney World. The radiologist who analyzed the PET/CT also took a look at the ultrasound images which had been captured, and recommended a breast MRI. He also noted that the activity in the spine could be metastatic disease. BINGO… based on those results, I got connected with a facility that specializes in breast cancer, where I finally got a full diagnosis of my condition.

The day after I received the results of the PET/CT, a written report came in the mail from the radiologist I spoke with in the mammography department, stating that the ultrasound was normal. Apparently, upon closer examination, that radiologist had decided that I didn’t even have an infection. So if I hadn’t had the osteomalacia problem, and thus hadn’t had the PET/CT, I would still be blissfully unaware of the cancer spreading through my body.

* * * * *

I’ve been a skeptic from a very early age, thanks mainly to my devoutly religious parents. My father considered illness a punishment from God, avoided doctors, and used some bizarre home remedies to treat my siblings and me. Getting hot raisins stuffed in my ears to cure an earache (which only makes it more difficult to hear and does nothing to ease the pain), and hearing that no medicine that doctors prescribe would work when the real problem is that my “heart isn’t right with God,” I learned fairly quickly to question claims of faith and miracles—even if that did get me into trouble while I was growing up.

The thinking seems to be that
victims are morons who
should have known better

When in the 80’s I saw James Randi’s magnificent exposé of Peter Popoff on the Johnny Carson show, and discovered CSICOP and skeptical activism, I thought it was important work, and have been involved with promoting skepticism ever since. But over the years I have noticed the tendency of some skeptics (and atheists) to disparage those who are being victimized by quacks, charlatans, faith healers, and other purveyors of woo. The thinking seems to be that victims are morons who should have known better, and that the religious are delusional and need verbal abuse, either because they deserve it, or to better convince them that they are wrong to believe in a god or gods. I’ve never agreed with that approach, as I think it demonstrates a lack of compassion and empathy. Furthermore, it shows little understanding about how difficult life can be, and why false beliefs can have so much appeal.

I have just gone through a barrage of doctors’ appointments and medical tests to get a diagnosis of breast cancer that should have been found years ago. I know at this point that my long-term prognosis is not as good because the cancer was not discovered at a much earlier stage, so I am more painfully aware than ever that medicine is not an exact science. Mistakes happen, so tests and procedures don’t always produce accurate results. And as with any profession, there are good doctors and not-so-good ones (and as patients we can’t always tell the difference).

I have a much greater appreciation for
why people seek the simple (if wrong) answers

Despite all this, I will not be seeking pseudoscientific medical treatments, miracle cures, or promises of an afterlife. However, I have a much greater appreciation for why people seek the simple (if wrong) answers, the hope (however false), and the comfort that the purveyors of medical quackery and religious woo are so good at.

We should treat the victims of pseudoscience with compassion, not derision.

Detail from Caspar David Friedrich’s Frau am Fenster

Categories: Friends

Tags: Cancer, Skepticism