La Vie en Rose {Life in Pink} (37 page)

Riley leaned forward. “Is it possible for the cancer to return after that? Could she still need chemo? I mean, if you think she shouldn’t have anymore, what are the chances she won’t have to if she has the tumors removed?”

Dr. Lindsay offered a sympathetic smile. “Unfortunately, until we know more about the cause of breast cancer, there will always be a threat to women with Emma’s diagnosis. Breast cancer isn’t something contracted. It’s a mutation of cells and researchers are still trying to identify the trigger. By removing the tumors and a fair amount of healthy tissue surrounding the masses, we diminish the chances of the damage spreading. The surgery’s often followed by radiation and in some cases, additional surgeries.”

The end—she wanted to get to the end so her life could begin. “What’s the other option?”

“The other option is an MRM, Modified Radical Mastectomy.” The gravity of option B dramatically altered the energy of the room.

“Losing my breast?” The words were possibly the most painful words she’d ever spoken, heavy and clunky, jagged and crude against her tongue.

Dr. Lindsay nodded. “Yes, removing the affected breast.” He folded his hands and adjusted his posture. “I want you to understand the advances that have been made, Emma. This isn’t the same procedure practiced twenty years ago. This sort of surgery no longer removes the pectoral muscles, only the breast and the affected lymph nodes. Cosmetically, there are countless reconstructive options. You might be a good candidate for nipple sparing as well, meaning the incisions are fairly hidden and the nipple is conserved.”

“Is the MRM more effective than the partial mastectomy?” Riley asked, taking the next question from her mind.

She was so grateful he was there. She’d never be able to handle all this on her own.

“The chance of reoccurrence is slightly higher with a lumpectomy, but still considerably low; that’s why radiation’s used, thereby making both procedures equally effective. The decision comes down to the patient and peace of mind.”

She supposed it was like weeding a garden. They could remove the weeds, bit by bit, but if they missed any seeds the weeds would return, and they’d treat the area with more poison. Or, they could remove the garden forever. But there would always be the chance one of those pesky seeds might get left behind and form in the surrounding areas where the beds once were.

“Does keeping the nipple raise the chance of reoccurrence?”

“Unfortunately, yes, but the risk is very low.”

Pressure. Ungodly pressure built in her shoulders and tugged at her belly as if his words physically pushed her down. Riley stood and dispensed a glass of water from the cooler in the corner and handed it to her. “Have some water.”

“Thank you.” She sipped and looked back at the doctor. Exhaling harshly, she shook off the fear and sat a little straighter.  “Sorry. Go on.”

“I want you to understand, one operation does not guarantee survival anymore than the other, Emma.”

Bleak.
Every time she leaned on the slightest reassurance someone shook her, reminding her there were no assurances. “I understand.”

“Neither does either surgery guarantee a future free of chemotherapy or radiation, and because this is an invasive kind of cancer, patients often need additional therapies.”

He steepled his fingers. “I want to be perfectly clear on that matter, because I don’t want you to make your decision and then get blindsided if things don’t turn out the way you expected. Every patient’s different. We can only go by what we know. You’re very young and the strand of breast cancer you’re dealing with is aggressive and requires equally aggressive treatment, but we’ve reached a point where
you
get to decide which angle of approach we take.”

Her hands trembled so she lowered them to her lap, wrapping her numb fingers around the empty cup. “What about my other breast?”

“If you opt for the MRM?” He nodded as though expecting the question. “There are prosthetics available, but each woman’s different. Some women opt for a prophylactic mastectomy—or double mastectomy—in this case for multiple reasons. It might be a desire for reconstructive symmetry or a method to put their mind at ease.”

She glanced at her chest, oddly recalling a time she’d wanted boobs so badly she stuffed an entire box of tissues in her bra. “What would you tell your wife if she was in my shoes?”

He slid her a pamphlet. “I’d tell her this isn’t an easy decision and there are always going to be benefits and risks. It’s natural for a woman to want to maintain her breasts, but we also live in a time when augmentation isn’t unheard of. I’d support her decision either way, because it’s a very
personal
decision. But at the end of the day, it would be hers.”

Doctors were experts of evasion. She was glad she wasn’t married to one. Blowing out a slow breath she sat back. An unexpected sense of empowerment washed over her. She just had to decide and then they’d move to round two. If she made the right decision, it could possibly be the last round of this tiring war.

It was
her
decision. She smiled, her expression a bit shaky. “I appreciate having a choice at all.”

She hadn’t decided anything in quite some time. The last choice she made was to fight and from then on she’d fought without rest. Now things had calmed and she was given a choice again. She blew out a breath. “It’s a lot to consider.”

“I advise my patients to write down the pros and cons, really take your time considering how each approach will put you at risk or be beneficial, and which is going to affect you most on a personal level. Every woman’s different as is each case of breast cancer. You don’t have to decide what’s right for womankind. You only need to choose what the best solution is for you.”

“Thank you.” Yes, she said thank you—as far as messengers went, he was a decent one and didn’t deserve to be shot.

As they left the office she reconsidered this new information, simplifying the facts as much as possible. Somehow that made the news more manageable.

Was her cancer gone? Not at all.

Did her tumors disappear from chemo? Nope.

Would she keep her breasts? Maybe. Maybe one, maybe half of one, maybe none. It was mind boggling that this still felt like good news.

This disease might very well be the fastest overhaul a person could experience in terms of the way they viewed the world. Had she gotten this news two months ago, she would’ve been in an inconsolable puddle on the floor. Having gone through hell and back, things looked different. In her opinion, she was handling everything quite well.

Riley was silent as he started the car. She’d been so lost in her own thoughts she’d barely noticed he hadn’t spoken a word since leaving the office. Once they were driving she turned to him. “Are you going to say anything?”

He kept his eyes on the road. “I don’t want to influence you either way.”

“So you have an opinion.”

“I have lots of opinions, but I don’t know if any of them are right.”

She chuckled. “Human.”

She had opinions too. First, chemotherapy sucked, hardcore—a thousand times worse than anything she’d ever expected. Yet, she’d do it again if she had to. Strange that fact never changed. Her instinct to survive always outweighed the temptation to give up. But if there were ways to reduce her chances of suffering chemo again, she’d do them first.

Being diagnosed with cancer was the tip of the iceberg. Cancer was quiet. It silently crept into an unsuspecting life and secretly destroyed one cell at a time. Fighting cancer on the other hand was war. It was brutal and volatile. Cells—friends and foes—were massacred. It was a struggle that pushed a person as close to death as possible and then fought to bring them back, leaving all the bad behind.

She didn’t want to spend her life fighting that war. There was no quality of life when submerged in such an endless battle. She wanted to live. It was that simple.

Somewhere in the midst of ignoring the pain that stole her breath, the agony radiating in her bones, the absolute conviction that she would die before morning, somewhere in the middle of all that, the superficial worries were stripped away.

She never expected to think of herself as too skinny. And her hair, which she’d fussed over, singed, flattened, and tried to cook the curl right out of...she didn’t care about that anymore either. She was so busy competing to survive, her instinct to compete with others disappeared.

There was no room for distractions like envy or hate, no time for strife or vanity. These months had taught her no one really had control. They only had an unpredictable amount of time, so she better make every second count.

It was a peaceful epiphany and, as she accepted this lesson into her heart, she found it ironic such accord could be borne of despair. Above all, she wanted to be whole again, spiritually
and
emotionally. The physical didn’t so much matter anymore.

For the first time in a long time, she was confident enough to truly—
truly—
hope, and all the anger she’d lugged this far was swiftly put down and left behind. Her courage was borrowed, bullied out of her—by her—for those that longed to see her recover. She certainly wasn’t going to let one boob get in the way of all that, not after everything they’d done to help her this far. If there was a way to end this, she wanted it over.

“Tell me your opinions,” she said, concerned he might oppose her.

“I think this conversation deserves more attention and respect than us chatting it out on a car ride home from the oncologist’s office, Emma.”

“Then pull over and look at me, Riley. I want to know what you think. It matters to me. You’re one of the few people in this world whose opinions mean something to me.”

He bit his lip and maneuvered through traffic. Yanking the wheel, he pulled into an open spot on the shoulder and faced her. He was angry and she didn’t understand why.

“Fine. If you died—” His words were harsh, dousing her with more reality. “—do I get to keep your boob?” He huffed out a breath, his knuckles white as his fingers gripped the wheel. “Do you hear how ridiculous that sounds? It’s a tit, Emma. I don’t care about it. I care about
you.
I care about having a life with
you,
by my side. I think letting something as meaningless as a boob get in the way of that happiness is insane.”

Who knew how a normal girl would react to such a statement from her boyfriend? She stopped trying for normal a long time ago. What she did know was that she loved him. She loved him for getting angry, for caring enough that he could barely speak of her demise without crying. She loved him because he never lied to her and when he said her breasts didn’t matter, she knew without a doubt, he was telling the truth. Honesty. Trust.

Her hand touched his. “I want the mastectomy.”

As he exhaled a harsh breath, his shoulders drooped forward and his head rested on the steering wheel. “Are you sure?”

His face tightened and she silently counted the worry lines around his eyes that weren’t there two months ago. He’d walk away from this scarred as well.

She rubbed her palm over his cheek until he faced her. Then she nodded. “It’s just a tit.”

His seatbelt unlatched and his arms wrapped around her, his face burrowing deep inside her scarf until his warm lips found her neck and he sighed. “I love you.”

“I love you too,” she said, holding him tight.  He really was the most incredible man she’d ever known.

****

S
he was supposed to be shockproof by now, but she wasn’t. Once they’d told Dr. Lindsay her decision to have the mastectomy everything moved at jet speed and before she knew it, it was the eve of her surgery. 

After endless research and exhausting deliberation, she opted for the bilateral mastectomy, removing the unhealthy breast as well as the unaffected one. It really was a personal decision; one she struggled to justify. The more she explained her choice the more frustrated and certain she became. Thankfully, Riley was open minded and shared many of her views.

Yes, there were risks to a double mastectomy and yes, the recovery would be longer and more difficult, but this decision felt right to her. No one knew what caused breast cancer. Was it plastic? Microwaves? Estrogen? The chemicals added to their foods? Stress? She was now mindful of all those things and her breasts were her greatest source of anxiety.

She once loved her boobs, long before they betrayed her. Her entire body battled against them and they no longer felt like a part of her whole. Detached.

The idea of removing her breasts brought an utter sense of comfort she didn’t expect others to understand, but she was eager to be rid of the stress.

She’d be lying if she claimed to be above vanity. She wasn’t. Symmetry had always appealed to her and she worried the asymmetrical shape of a unilateral mastectomy would break the remainder of her self-esteem. Right or wrong, she was human and she didn’t want to break, not after sacrificing so much already.

She might be two-thirds the weight she was when this started and she might be balder than a baby boy, but she was still a woman and once she got her strength back she was putting on a sundress—breasts or no breasts.

Rolling to her back, she cupped her breasts through her nightshirt. “I can’t believe I’m losing my boobs tomorrow.” No matter how many times she said it, whatever she assumed to be a normal reaction, it didn’t come. Shouldn’t there be some sort of angst or doubt? There wasn’t.

More reassurance you’re making the right choice.

It was
real
; there was no denying that. Tomorrow, at nine-thirty, they were taking her breasts. How was she okay with this? Strange.

Certain hurdles couldn’t be jumped. The stakes were just too high. Nor could they be maneuvered around without risk. Sometimes, the best option to get through something difficult was to just get through it. Tomorrow she’d be on the other side. All she had to do was get there.

She didn’t want to dwell on the magnitude of the situation, because her mind was made up. It was happening. She wanted to keep it light. “Poor Starsky,” she sighed.