The good cancer

Often described as 'cancer light', Aucklander Lara Nettle reflects on being diagnosed with ductal carcinoma in situ (DCIS) during the second Covid lockdown.

(Image by Lara Nettle)

“It’s not cancer”. That was the phone call that started it all. A missed mammogram, then a callback for “another look”, then a biopsy, then the phone call.

During the second lockdown I chose to get my results over the phone rather than going in for a face to face appointment alone. The breast surgeon emailed me some illustrations of the changes in ductal tissue that show the different stages of cancer. Normal cells that are extra excitable (ductal hyperplasia), excitable cells that could be thinking about going rogue (Atypical Ductal Hyperplasia - ADH), rogue cells that are still comfortably contained (Ductal Carcinoma in Situ - DCIS), and rogue cells going rampant (invasive ductal carcinoma).

Mine were ADH - not cancerous, but close enough to cancer that they wanted to do surgery to definitively rule it out. Surgery was scheduled, don’t panic, keep chill, it’s all fine. (Image: Lara before their first surgery).

The surgery was routine, a chunk of boob removed and sent for pathology. Recovery was straightforward. The pathology was not. My diagnosis was upgraded to DCIS - “The Good Cancer”.

Cancer is normally staged into one of 4 categories. Stage 1 is a cancer that is well contained, and not spreading to lymph nodes or other parts of the body. Stages 2 and 3 describe cancer that has spread, and stage 4 is “advanced” cancer with a more significant spread to other areas in the body.

Mine was considered “Stage 0”. Because DCIS is typically a slow growing cancer, many women with DCIS will never progress to stage 1 cancer. But predicting which ones will develop isn’t possible, all women with a DCIS diagnosis are recommended to have the diseased tissue surgically removed to reduce the risk of recurrence.

As well as upgrading the diagnosis, pathology indicated that the disease extended beyond the tissue that was removed in surgery, so further surgery was indicated, to ensure “clean margins. Another surgery (this one with an overnight stay in a private hospital with great food!), and that was to be the end of it - until my next annual mammogram.

The recovery from the second surgery was a little rougher, it took me more than a week to feel back to my normal self but I healed well. I was looking forward to being discharged from care and having my cancer card revoked! But again the pathology had some surprises in store. They found clear margins, but much more disease than expected, more than what was in the original sample that was identified on the mammogram. This increase in disease volume pushed me into another path on the diagnostic rubric and now I was recommended a course of radiation. (Image: Lara before their final dose of radiation)

When I am done my risk of recurrence will be quite low for my left side, but I will continue to eye my right boob with suspicion for years to come. Since my diagnosis I’ve been removed from the standard screening program for 5 years, and for those five years I will have my yearly mammogram with a private team who will provide extra scrutiny.

And I’m cured. Cancer free. I have no reason to worry, be afraid, or check myself. I sit beside my cancer buddies and watch them submit to brutal medical treatments, lose their hair and deal with obnoxious bosses and selfish spouses and I know exactly how lucky I am. And I look at my brutalised, irradiated, lumpy and dimpled left boob and I feel like I have no right to feel sorry for myself. I am one of the lucky ones. My story had a happy ending. I’m a survivor.

The good cancer is still cancer. The pain and anxiety is real. But even with the ups and downs of this journey I am reminded of how lucky I am to have support, I am lucky to have great health care, I am lucky to have been diagnosed early, I am lucky to have been diagnosed in this year while treatment and diagnosis is continuing to evolve, and most of all I am super lucky to have the good cancer. More and more cancers are becoming chronic conditions, diseases that we live with, instead of dying from. For my sisters walking a different path, I see you, and I am here for you. And for those of you who haven’t been touched yet, I hope my message gives a glimmer of perspective to your understanding of what a cancer diagnosis might mean.