A – Z of Breast Cancer: AXILLA

Axilla is what medical folk call your armpit. The Collins Concise Dictionary says it’s the technical term for the armpit, comes from Latin and was first used in English in the seventeenth century. Whod’ve guessed? And there I was thinking the correct term was oxter. In all my 45 semi literate years I never once came across the term axilla; not once in all those ER watching hours did I ever hear George Clooney say “Mighty fine axilla you have there mam.” Who ever heard of anyone going off to shave their axillas or should that be axillum? No, its axillae - I just checked. I was so taken aback by my lack of knowledge that I couldn’t even bear to ask anyone what it meant. I needn’t have worried as I received reams of literature telling me all about the axilla and breast cancer.

It has a tail.

The lump I found was in the axilla tail. I tried very hard to concentrate as the doctor was telling me this but I was so distracted by the idea of having a tail in this part of my anatomy that I couldn’t concentrate; I started imagining my armpit as a small predatory animal eating me alive. A kind of savage furry dormouse. I began to resent my armpit almost as much as I resented the offending breast. Then I perked up, if the lump was in my armpit it couldn’t be breast cancer could it? Armpit cancer doesn’t have the same ring to it. I liked it; who ever heard of anyone dying of armpit cancer. When I refocused on what the doctor was saying I realised she was talking about the tail end of the breast tissue that extends down into the armpit and that if anything was eating me alive it was definitely my breast. As it turned out I needn’t have exerted myself with this line of thought because on examination they found a second lump lurking just behind the nipple. Oxter, axilla, armpit, schmarmpit, it didn’t matter anymore.

Told you

I just checked oxter in the dictionary and it is Irish and Scots dialect for the armpit, originating in the sixteenth century and derived from the Old English oxta. So there, oxter has been with us a whole century longer than axilla. I knew I was right.

I had this procedure at the same time as my mastectomy, seems everyone does. It involves removing the nodes of the lymphatic system from your armpit. The lymphatic system is part of the immune system and basically its function seems to be to drain fluid, filter waste and fight infection. The nodes are little bulges situated along this system on which cancer cells can hitch a ride to the rest of the body.

Who'da thought a few nodes would matter?

You’d be forgiven for thinking (as I did before I added the term axilla to my vocabulary) that the doctors are saying ancillary node clearance. This would make perfect sense, as it seemed to me if we can do without the damned things then they were only there in an ancillary or supporting role in the first place. How wrong I was. It is only after you’ve had your nodes removed that you realise just how crucial they are: you are at lifelong risk of L for lymphoedema, your armpit hurts like hell and the lymphatic system can go into a huff causing thick cord like structures to develop along the attached arm, ouch. See C for Cording.

Don't start getting all competitive.

I knew enough from the News and from ER to be aware that cancer can travel to the rest of my body via these lymph nodes so I knew that this procedure would be key to my treatment and prognosis. After the operation the nodes would be examined in a laboratory to see how many, if any, were affected. I had seventeen nodes removed from my arm. Apparently we all have a different amount so don’t be alarmed if the person in the bed next to you boasts of their 28 nodes compared to your paltry 17. I don’t know if this has anything to do with the girth of your arm but I suppose it might. I asked a few times but nobody seemed to find the topic as interesting or vital as I did so I still don’t know.

My life flashing before my eyes.

I knew node involvement was a big deal yet even while they were explaining all this to me I found my mind wandering. Node, funny word that. I’d not said or written the word node since first form science when the biology master had waxed lyrical about the Node of Ranvier. I have no idea what the Node of Ranvier is but I never forgot the name. Something to do with sensory neurons I think. You might have spotted that I have something of an untidy mind but even for me these lapses were new. Everything the nurses and doctors told me seemed to send me off on a tangent to another place, often to the past. And all these little flashes from my past comforted and scared me in turn. It was like that cliché that your life flashes before your eyes just before you drown. Only I was drowning in slow motion.

Beware the cancer bore.

Not having used the word node since I was eleven, I now found I was using it all the time, talking about my nodes as though they were as familiar to me as my eyebrows. These nodes and the system they belonged to had never before occupied my thoughts. Now I thought about it all the time and talked about it quite a bit too, to anyone who cared to listen. Be careful. Don’t fall in to the trap of becoming a cancer bore. I came dangerously close, so let me take this opportunity to apologise to all my friends. I admit it: I saw your eyes glaze over but I kept on anyway. Sorry.

While I’m on the subject, A is also for AXILLARY NODE CLEARANCE ANC.* How I came to love those words. Not axillary node biopsy or investigation but clearance. Like slum clearance in the inner cities, paving the way for a bright new future. Clearance meaning riddance. Good riddance.

Be warned, waiting for the results of your ANC is nerve wracking and even the most lion hearted would be forgiven for reaching for the T for tranquilisers. Luckily, you should be too tired from surgery and woozy from the anaesthetic to fully appreciate the strength of your anxiety. Try not to get too pessimistic. They will tell you that a positive mindset is crucial to recovery and I'm sure they're right. But I couldn't help thinking the unthinkable. My maternal aunt had died of breast cancer; her daughter began chemotherapy to reduce a large breast tumour one month before my diagnosis, and my own sister had died from a tumour on the brain when she was three years younger than I am now, so I could never afford myself the luxury of thinking it couldn’t happen to me. If you do take a glimpse at the unthinkable, make it brief, use the fear to fix up your will and sort out your affairs (see below) then shut your eyes to it and get on with the business of being positive.

*Not to be confused with the African National Congress (made famous by Nelson Mandela) which I confess was the first thing I thought of each time someone referred to my ANC. This made me want to smile and raise a fist in solidarity with Nelson and his chums, but of course I couldn’t because my arm hurt so much.

Read more at http://breastcancercares.blogspot.com/