Margaret Innes

New Worlds: Reading, Writing and the Imagination

Tag Archives: Breast cancer; chemotherapy


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6 Chemotherapy or The Hunger Games

The question I asked myself most before my first chemotherapy session was what would I read for the three hours I would be sitting in the chair? I stashed a small collection of books into my bag and with my partner, headed down to Building 19 at the Canberra Hospital, their cancer centre, and then to the fourth floor where they do what they call the infusions. There was, as always, an education session to start, meticulous and detailed and another collection of papers to add to my portable filing cabinet. I asked, will my hair fall out? The nurse said yes regretfully. I accepted this as inevitable and then it was into the large room where everyone else is also being infused. Later there would be a young Asian woman ushered into a chair not far from me. She had the most beautiful long shining black hair whereas mine is only fine and grey. We are both doomed to lose it.

Since I have always mostly associated the word infuse with aromatic ingredients in cooking, it made me a little sad to think of it in this context. But it’s accurate. After putting the cannula into my arm, the nurses arrived in full protective gear, including gloves and eyeglasses, double checked the drugs and began the process, the slow infusion of docetaxel and cyclophosphamide into my bloodstream to counter whatever possible cancer cell might be there. Which is why I have likened this whole process to Suzanne Collins’ novel The Hunger Games. The drugs are poison: they take your hair, your energy, your cancer cells, your white blood cells without discrimination. In other words they make your body fight against itself for the survival of either the cancer or you.

To prevent nausea, one of the hospital’s pharmacist had given me steroids to take the day before, during and after chemo, with the unexpected warning they might give me nightmares. They did no such thing, they gave me a three-day high instead where I thought there was nothing I couldn’t do. Probably a good attitude to take into a chemotherapy session and one that went well with the book I chose to read, a book from a vibrant local publisher, Recent Works Press, a wildly imaginative, innovative collection of prose poems about loss called Errant Night by Jerzy Beaumont. Very simply put, to deal with grief he travels the stars and the universe, returns to where I was in Canberra Hospital to come face to face with the loss of someone loved before going out into the universe again. I speak of this book because, even given where I was, there was something close to exhilarating about reading of imaginary journeys to the far reaches of the universe and all its way stations to deal with grief while sitting in a chair having docetaxel flowing into my veins in the very location that is at the heart of the book. It was in its way a comfort, that wherever I am, my mind can go anywhere. I, all of us, always have that freedom to imagine, to find ways to feel and grieve, to read and to think.

There were other true heroes beside the nurses and the patients in the chemotherapy suite that day. There are the volunteer women who wheel trolleys around with tea, coffee, juices, biscuits (Arnott’s assortment for the nostalgic), cake, sandwiches and who stop to chat and laugh. The hospital also serves lunch, hospital food but it’s there for you. And when it’s all over and the cannula is thankfully taken out of your vein to be replaced by a round white dressing and you get a little shakily to your feet to go home, the nurse comes to wish you the best. I have to come back the next day for a pegfilgrastim injection to boost my white blood cell count. This is the process, a serious gladiator fight within the confines of your skin, within your system. It will keep happening until the doctors think they have done enough to save you from yourself. What I have to do now as a patient is navigate the battleground they have created inside my body to achieve that end. 


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5 Oncologists can be persuasive.

When I saw my surgeon for my follow up appointment after surgery, he was obviously pleased with how the operation had gone. The incisions were healing well, the margins around the tumour were all very clear. He smiled at me. ‘You won’t need chemo,’ he said. The moral of this story is, don’t take your oncological advice from your surgeon. However skilled they are, this is not their area of expertise. The oncologists I saw had a very different opinion.

I took that false confidence into my first meeting with the radiation oncologist. Radiation I knew to expect; three weeks of it instead of four because the margins were clear. We began, as usual, with education and detail. The registrar took all my facts again, I received another thick sheaf of paper to add to what I had begun to call my portable filing cabinet, a thankfully discreet bag from Bosom Buddies. Then the oncologist herself appeared, a young woman with long fair hair.

Everyone brings a demeanour with them when they walk into a room; they’re at ease, they’re ill at ease, they’re nervous, they’re self-possessed. Her first glance at me was serious. She took a seat and began to explain to me they had received the pathology results for the tumour. It had not reached my lymph nodes but had been active, its growth pattern one that would have seen it move out into the rest of my body. They had removed it but what else might be left behind that they couldn’t see or test for?  ‘It’s fifty-fifty whether you need chemotherapy or not. You’ll need to speak to the medical oncologist,’ she said. Her words were measured but her demeanour suggested she saw this as troubling.

I went home thinking again of the front cover of Marisa Acocella Marchetto’s Cancer Vixen and its drawing of a woman spectacularly taking a fall.

The medical oncologist was the same one I had consulted last time. I remembered her as a no-nonsense woman who was a stylish dresser. This being the time of Covid, we had a zoom session. Between her and her registrar, they laid out the situation. The tumour was unusual, an unexpected combination of pathologies. They could not tell if there were still microscopic cancer cells present. There might be, there might not be, there was no test to tell. If there were, they could reappear some years down the track as what is called metastasised distant breast cancer. ‘If they do, we don’t have a cure for that,’ said the oncologist. It would four sessions on the second tier of chemotherapy drugs. Horrible but by no means the worst possibility.

They spoke of it as being my decision, laid out the facts and the possibilities objectively but I could read the room; they saw the possibilities as troubling. I was reminded of both the sonologist and the radiologist I spoke of in my first blog. Without tests, they knew accurately what they were looking at pretty much as soon as they saw it. That kind of knowledge can only be gained by experience. To my certain knowledge, my medical oncologist is a very experienced doctor.

It is an odd thing, a precautionary gamble. Distant breast cancer might still happen even with chemo, it might not happen even if I do not have chemo. The percentages of those chances are low but they are possible. I write thinking of a line of William Blake’s poetry, ‘What is the price of experience?’ He goes on to write, ‘It is bought with the price/ Of all that a man hath.’  I couldn’t help but think that all the years of experience the medical professionals I consulted had collected between them meant they knew almost intuitively what they were looking at. I brought my own judgement to the decision. I said I would go ahead with chemotherapy, as another step along the way.


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3 Everything is Pink.

When my close friend had her biopsy which on analysis would show she had a fortunately slow growing cancerous tumour, the breast screen clinic gave her a massive amount of information in a large bright pink bag, emblazoned in large, even pinker letters with Breast Screen Canberra plus a logo. My friend was travelling by tram and rather than announce her situation to a tram carriage full of strangers, asked if they didn’t just have an ordinary shopping bag. She went home with a plastic bag laden with booklets, pamphlets and papers. One of the first things you find out when you are diagnosed is how much information people have to give you and how overwhelming it can feel. And that everything, everything is pink.

Lest anyone think otherwise, I know it is absolutely vital to come to grips with those parts of this information which apply to you. But it’s always pink. Breast Cancer Network Australia mailed me My Journey, a guide to early breast cancer. It covers everything from diagnosis through all aspects of treatment to a financial guide on the costs. It is well written and easy to follow, each section tabulated and clearly labelled. It has advice for everyone wherever they sit on the gender spectrum. And wherever you sit on that spectrum, the colour is pink.

In the accompanying leaflet, the women are wearing pink and the little female figurine symbolising the network is pink. The Jane McGrath Foundation, which funds breast care nurses including the one helping prepare me for chemotherapy, uses pink as its signature colour as does the Sydney cricket test each year in support of breast cancer funding. As a logo, pink means all these dedicated support people really do care and want you to survive.

But what is it with pink? Why choose that colour for this disease? Is pink a particularly female colour, as in blue for boys, pink for girls? Men can have breast cancer as well, rarely but they can. Yellow, of course, is taken by the Cancer Council for daffodil/wattle day in August but that still leaves effervescent green or the deep gorgeous red roses can have. What about the blue of Wahlenbergia stricta or native bluebells as they are called by us as well as those names they would have in First Nations’ languages?

Alas, no. Pink is the accepted colour and learning how to navigate your way through large amounts of medical information about breast cancer is a lifesaving necessity. Given how any cancer treatment taxes people’s strength and how brutal chemo is, pink is anyway no longer a soft, cute and cuddly colour. Associated with breast cancer, it means out and out, unconditional and unreserved strength.