My mother is the most loving mother in the whole world. We all say so to our mothers. I vividly remember when I was a kid, how she took care of us her 4 precious ones. Me, being the eldest and the only rose among the thorn, has no rival in terms of girly stuff except Mama. If she has stuff that I like, I would ask her to give it to me even though at times I know she wanted to keep it for herself but she lovingly gave way to me.
Last quarter of 2007 she complained of a mass on her
left breast. We took her to the outpatient department of a hospital and right then and there, the
doctor advised for a needle biopsy or the
fine needle aspiration. I can see the pain in mama’s eyes when tears fell silently as the needle was inserted into her breast for the biopsy. The test showed negative results but the doctor said that further test be done as the needle biopsy is not that much accurate in detecting
cancer cells.
Let’s be in the know:
What is breast cancer?
The term “breast cancer” refers to a malignant tumor that has developed from cells in the breast. Usually breast cancer either begins in the cells of the lobules, which are the milk-producing glands, or the ducts, the passages that drain milk from the lobules to the nipple. Less commonly, breast cancer can begin in the stromal tissues, which include the fatty and fibrous connective tissues of the breast.
A tumor can be benign (not dangerous to health) or malignant (has the potential to be dangerous). Benign tumors are not considered cancerous: their cells are close to normal in appearance, they grow slowly, and they do not invade nearby tissues or spread to other parts of the body. Malignant tumors are cancerous. Left unchecked, malignant cells eventually can spread beyond the original tumor to other parts of the body.Breast profile:
A Ducts
B Lobules
C Dilated section of duct to hold milk
D Nipple
E Fat
F Pectoralis major muscle
G Chest wall/rib cage
Enlargement
A Normal duct cells
B Basement membrane
C Lumen (center of duct)
Breast cancer is always caused by a genetic abnormality (a “mistake” in the genetic material). However, only 5-10% of cancers are due to an abnormality inherited from your mother or father. About 90% of breast cancers are due to genetic abnormalities that happen as a result of the aging process and the “wear and tear” of life in general. (breastcancer.org)
What is a fine needle aspiration?
Fine needle aspiration is a non-surgical form of breast biopsy in which a small needle is used to withdraw a sample of cells from the breast lump. If the lump is a cyst (fluid-filled sac), removal of the fluid will cause the cyst to collapse. If the lump is solid, cells can be smeared onto slides for examination. (webMD).
My mother is the nervous type of person who is afraid of blood, needles, hospital, etc in short she did not agree with another test. Few months passed, my aunt, a doctor based in Germany had her vacation on January of 2008. I asked Aunt Ida to convince mama to have another set of laboratory tests and biopsy which after months of much debate, she finally agreed. As the lump on her left breast grew bigger, a frozen biopsy was scheduled. The doctor advised that if the result is positive of cancer, then they will proceed with the operation. Without the knowledge of my mother of what the doctor and the siblings have agreed, my mom went to the operating table with a positive attitude that it's only a benign tumor and not malignant or cancerous. Hours of waiting came the result, she has malignant cancer cells and has spread to the axillary lymph nodes under the arm and near the breastbone, stage IIIA cancer. The doctor proceeded with the breast operation and took the entire left breast with a tumor the size of an egg together with few lymph nodes. The procedure is called mastectomy.
STAGES OF BREAST CANCER
Stage 0
Stage 0 is used to describe non-invasive breast cancers, such as DCIS (ductal carcinoma in situ). In stage 0, there is no evidence of cancer cells or non-cancerous abnormal cells breaking out of the part of the breast in which they started, or getting through to or invading neighboring normal tissue.
Stage I
Stage I describes invasive breast cancer (cancer cells are breaking through to or invading normal surrounding breast tissue) in which:
- the tumor measures up to 2 cm AND
- no lymph nodes are involved
Microscopic invasion is possible in stage I breast cancer. In microscopic invasion, the cancer cells have just started to invade the tissue outside the lining of the duct or lobule, but the invading cancer cells can't measure more than 1 mm.
Stage II
Stage II is divided into subcategories known as IIA and IIB.
Stage IIA describes invasive breast cancer in which:
- no tumor can be found in the breast, but cancer cells are found in the lymph nodes under the arm (axillary) OR
- the tumor measures 2 cm or smaller and has spread to the axillary lymph nodes OR
- the tumor is larger than 2 cm but not larger than 5 cm and has not spread to the axillary lymph nodes
Stage IIB describes invasive breast cancer in which:
- the tumor is larger than 2 cm but no larger than 5 cm and has spread to the axillary lymph nodes OR
- the tumor is larger than 5 cm but has not spread to the axillary lymph nodes
Stage III
Stage III is divided into subcategories known as IIIA, IIIB, and IIIC.
Stage IIIA describes invasive breast cancer in which either:
- no tumor is found, but cancer is found in axillary lymph nodes, which are clumped together or sticking to other structures, or cancer may have spread to lymph nodes near the breastbone OR
- the cancer is any size and has spread to axillary lymph nodes, which are clumped together or sticking to other structures
Stage IIIB describes invasive breast cancer in which:
- the cancer may be any size and has spread to the chest wall and/or skin of the breast AND
- may have spread to axillary lymph nodes, which are clumped together or sticking to other structures, or cancer may have spread to lymph nodes near the breastbone
Inflammatory breast cancer is considered at least stage IIIB. Typical features of inflammatory breast cancer include:
- reddening of a large portion of the breast skin
- the breast feels warm and may be swollen
- cancer cells have spread to the lymph nodes and may be found in the skin
Stage IIIC describes invasive breast cancer in which:
- there may be no sign of cancer in the breast or, if there is a tumor, it may be any size and may have spread to the chest wall and/or the skin of the breast AND
- the cancer has spread to lymph nodes above or below the collarbone AND
- the cancer may have spread to axillary lymph nodes or to lymph nodes near the breastbone
Stage IV
Stage IV describes invasive breast cancer that has spread beyond the breast and nearby lymph nodes to other organs of the body, such as the lungs, distant lymph nodes, skin, bones, liver, or brain.
You may hear the words “advanced” and “metastatic” used to describe stage IV breast cancer. Cancer may be stage IV at first diagnosis or it can be a recurrence of a previous breast cancer that has spread to other parts of the body.
We lack the financial capacity to continue with the procedure but we hold on to our faith in God. After hours at the operating table and recovery room, she was transferred to her room where she finally woke up, groggy and in pain. She asked where she was and still no idea of the operation done to her except for the frozen biopsy. Two days after, she overheard my brother and the doctor discussing her condition and the operation, it was then that she knew she no longer have her left breast. She cried.
Of the supposed 6 cycles of chemotherapy, Mama was only able to have 4 sessions for the reasons 1) as she said she cannot take it anymore 2) we lack the finances to continue.
Few months after, she mentioned that her left breast bone was swollen and protruding, thus, had it massaged by a traditional manghihilot (a local person who gives massage). I was worried because the swelling did not subside and she complained of pain already. As I am already working abroad, I was not there to personal check on her but I managed to call them almost everyday or thru skype. I told her to go to the doctor and have the test. Hard headed as ever, mama refused because she said we don't have money to pay this and that blah blah blah. I sent money for all the tests and it was then that we found out that her breast cancer has metastasized to her bone, bone cancer now. I then went home to attend to her radiation treatment. She completed the 25 days radiation treatment with flying colors but another test showed her left lung was affected - lung cancer. She continued her Tamoxifen.
Months have passed, I asked mama to visit again her doctor because of her complains. The radiation on her breast bone was successful in inhibiting the growth of the cancer cells but unfortunately, it has spread to both lungs now. This time mama's cancer is Stage 4, the final stage. Doctor said she will have 6 months to a year to live. My world fell apart.
I remember when I was still a kid, how she showed her love to us by preparing our meals before she goes to work and prepare our dinner when she arrives from work. When the time we don't have a house helper, she does all the household chores (she is very tidy and hates clutter in the house), wash our clothes and attend to us when we were sick. Maybe we are not able to appreciate all the hardships and sacrifices of our mother until we come of age and looking back, realizes that she gave her all for the love of her children.
It was just recently that I started saying "I love you Mama"as often as I can because before I am shy to tell her that but now, I have to and I want her to know how much I love her and that I appreciated her love and sacrifices even though, many times I have hurt her feelings. Time is running out, she may not be with us more than how we should have wanted her to be with us longer. Only God knows. Since I knew of her limited time with us, I am slowly building memories with Mama. A memory I will treasure when she will be at the other side of the world with God, pain-free and in peace.
When I go home for vacation this year, I will bring her to Hong Kong, a promise I made to myself to let her experience out of the country tour. God willing. I hope she will be in good health as this will be her first trip out of the country and hopefully not the last. Every time I call her, I always remind her to take her medicines so she can have all the health in the world during our trip. One time she told me, you know, I might not be able to go with you because of my health condition, I told her, you should not say that and be positive.
All throughout our fight with her cancer, God has never abandoned us and unconditionally poured His love and support through His angels on earth. There were times that we were down to nothing but somebody will just show up to help us in so many ways. We brought Mama to healing prayers to help her spiritual and emotional struggles. Mama is a better person now with less stress and can see a glowing face with positive outlook in life. Her faith in God is what made her strong. She is fighting a good fight with this thing called - breast cancer.
I love you Mama
