“Okay, put your arm out to the side. A little more to the left. Now back. And hold it. And breathe.
“Put that arm down. Now the other one up. A bit more to the right, and up. And now hold. And breathe.”
If you didn’t know any better, you would think I’m in a yoga class, or perhaps Pilates. But I’m not wearing yoga pants and a T-shirt, I’m in a hospital gown. And I’m not at the gym. I’m in a radiology exam room.
The woman telling me how to move isn’t a fitness instructor leading a class. She’s a radiology technician and she is giving me a mammogram.
I’ve remembered to take my painkiller before I left home; even so the visit won’t be without pain. An acquaintance once described getting a mammogram as like having a fridge door slammed on your breast. I can’t disagree with that description.
I’ve learned not to tell people when I go get mammograms. If I do, they usually remark on how young I am. They question if this is really necessary, fear that I am worrying too soon about something that likely won’t happen. “Why do this now?” those who don’t know my circumstances often ask. “There are so many things in life to be worried about. Why worry about this now when you don’t need to?”
It isn’t something I speak about much, or even think about all that often. It is just the genetic reality of who I am. I have brown, curly hair, I need to wear glasses and I have a familial risk for breast cancer.
When a big story breaks in the news, as it did this past week regarding new guidelines that call for cuts in breast-cancer screening, it becomes hard to ignore all the talk about who should be tested and if and when. I’m one of those women under 50 that the new guidelines say should still be screened because of high risk.
Then the talk goes away and the laundry still needs to be done and I’m low on milk and when was it that I last vacuumed?
If I don’t tell people I’m going for a mammogram, if I say I’m going to the dentist, that I have “personal business,” that I need to go to a random appointment, then I don’t need to explain to them why I do need to worry about this and why it is necessary to start now.
I don’t need to tell them that my mother and aunt and grandmother all had breast cancer, though they were diagnosed in their 70s, and that my cousin died of ovarian cancer in her early 50s.
I don’t need to walk them through my medical history or show them the list of my risks. I don’t need to tell them about what those of us in high-risk categories go through while we wait to find out the results.
These days the wait isn’t so bad. Not more than a week or so, and if you have experience you can read the results on the face of the technologist. No news really is good news, and if something the least bit suspicious was seen, I would know about it within days and immediately be booked for further investigation.
So when I dial my doctor’s number precisely a week after the exam and ask to be told the results, I already suspect what they are. If I have to wait, then nothing is wrong. Getting results over the phone means the exam is negative. “He’d like you to come in for a chat” is a much more serious matter.
It isn’t all that bad, not when compared to the first time, about six years ago. Then I was told that while they hadn’t seen anything serious, there might be something they would like to monitor so would I come back in three months please? No need to worry. Just a formality.
But how can you not worry? How can you sleep? Or eat? Or smile? You listen to people talk about their daily lives, about how expensive it is to buy real estate in Toronto or plans for their vacations or the sweater they bought on the weekend, and you begin to wonder. Will I do these things – buy a place to live, go on a vacation? Will I wear sweaters and bathing suits? Or is there something growing inside me that will prevent these things from occurring? Will I be a sick person? And, much more quietly, even to myself, will I die?
The breast-cancer risk calculator that I have bookmarked, the one I am up nights looking at during the times when I wait, the one that asks about my maternal family’s medical history and mine, tells me that in the next five years, I have a 98 per cent chance of not having breast cancer. Good.
It also tells me that between now and age 90, I have a slightly less than 20 per cent chance of getting breast cancer, about a 60 per cent greater chance than the average woman, given my combination of risk factors.
So I wait from year to year. I know I probably won’t be diagnosed this year or the next, or even the one after that. I don’t know what will happen in the next 25 or so years when I will be around the age my mother and aunt were when they were told a lump had been found.
Maybe by then there will be a non-surgical treatment. Maybe by then there will be a way to prevent cancers from forming. Between now and then so many, many maybes.
But among the maybes there are for sures. There are risks I can do nothing about, but there are the ones I can control. I can make sure I get screened every year. I can watch how much alcohol I drink. I can eat my leafy greens. And I can keep doing yoga.
Glenda West lives in Toronto.