getting to the root of the problem

Modified radical mastectomy.

I couldn't say these words for three days without my voice breaking. It's taken me more than a week to be ready to write about it.

My surgeon is very compassionate, yet blunt. After examining me, he told me that my tumour is too "bulky" to do a lumpectomy. His exact words were, "It would look like hell."

He also asked me how I would feel if he told me he was going to take out "some of the cancer."

Not that I was arguing. I was shocked and silent, my brain trying to catch up with all the information that was being thrown at me.

The surgeon did offer me "neoadjuvant chemotherapy" - chemotherapy given before surgery in an attempt to shrink the tumour so that a lumpectomy (or "breast conserving surgery") can be performed. He said that studies in the US show this process to be succesful 65 per cent of the time. In his personal experience, results have not been so good and women have often still needed to have the mastectomy.

The surgeon said I could take some time to think about it if I wanted but I could tell which way he was leaning (and while he does seem to have a bit of a god-complex, he is also very confident and has an excellent reputation). And I don't think I can face two full rounds of chemotherapy (before and after surgery). So I signed the release form. And then I went home and fell into a deep funk.

I have always had an ambivalent relationship with my breasts. They have been a source of pride and shame (I am both a product of Western culture and my Catholic upbringing). They have fed two children for a total of 40 months. When I weaned my boys, I felt both sadness and relief. Only recently have I come to feel comfortable in my own skin, to like what I see in the mirror, this familiar body.

And now it will change, dramatically and permanently.

Modified. Radical. Mastectomy.

I'm assuming that those who read this will know what a mastectomy is.

The modified part means the surgeon will also do an axillary dissection (the removal of my lymph nodes).

And radical means 'root', as in getting to the root of the problem (hey I learned something in university!). And this is what the surgeon and I are chosing to do.

I have come to terms with my decision. It is the right choice for me. At least I feel that way most of the time.

Before he wrote my name in his calendar beside February 2nd ("Groundhog Day!", I exclaimed. I then had to explain that I wasn't objecting to surgery on Groundhog Day...), my surgeon said, "I will cure you."

I went for a run with my dog in the snow today. It was hard work but breathtakingly beautiful. And the joy of a dog in the fresh snow is contagious.

I am writing this while sitting by my small son's bed. He is pretending to be asleep.

Right now, at this moment, it feels easy to be hopeful.