A – Z of Breast Cancer: MASTECTOMIES and MEN

I’d never had an ectomy before. They were always something that happened to other people and on TV. I thought of my school days when tonsillectomies were all the rage and remembered how envious I was of my friends eating ice cream in a hospital bed, away from teachers and homework. It never occurred to me to consider why they were having the operation in the first place or worry that these tonsils might actually have a use. Now I am grown up I don’t see hospital as an ice-cream filled holiday, I know this ectomy means cancer and I’m fairly sure I can use both my breasts, thanks. Yet when the surgeon said she was planning to do a total mastectomy I didn’t complain. I was relieved. In theory it would have been comforting to hear that I only needed a partial mastectomy or lumpectomy because then I could tell myself things weren’t so bad, and I’d still have two boobs. But you’ve probably noted by now that I am a little inclined to worry and I just know that had she performed a partial mastectomy I’d be going around worrying: Did she miss a bit?

We don't want your lungs falling out!

You’ll be glad to hear that they take your lump and some more, that’s what they mean when they talk about clear margins. Sometimes this might not be possible. In my case not all the margins were satisfactory because one lump was so close to my chest wall. As one nurse put it, if they’d taken any more my lungs would’ve fallen out. Some might think that comment a bit glib but I liked its graphic simplicity. I understood. And I’m quite sure she had me sussed and knew a joke wouldn’t go amiss. Horses for courses.

Appearance isn't everything

Once you’ve been told you are going to have a mastectomy, things move quickly so you don’t have much time to think. I was so preoccupied with the notion of getting this cancer cut out that it never occurred to me to fully consider what I would actually look like after the operation. The nurse had shown me photographs of women who’d had reconstructive surgery but I never really identified myself with them. Somehow I would look better than them, with maybe a flat, nipple free area and a neat line of stitches. I didn’t expect a big scar because the only operation I’d had before was a caesarean and the scar is minute. I thought if they can get an eight and a half pound baby out and leave barely a trace then surely a boob wouldn’t cause too much mess. I was wrong.

You might be anxious about looking at yourself after the operation, I know others were but I was curious to see my surgeon’s handiwork. The day after the operation I took myself off to the shower room and peeled back the dressing to see a large and what I can only describe as bumpy scar: there appeared to be left over bits of nipple knotted into what seemed to me a very long and twisted line of stitches. Hadn’t they told me there was a lump just behind the nipple? Had she forgotten? Oh my God! She had missed a bit.

Not just life saving

I stayed in the shower room hyperventilating for a while then went back to my bed for a lie down and a cry. I’d only been there a few minutes when, (thank you God) one of the registrars came along doing his rounds. He bent over me and peered at the scar, ‘Looks like a skin saving technique,’ he said and he was right. The surgeon hadn’t missed anything; I’d had a skin saving mastectomy which meant that most of my skin was retained (complete with tan lines from the summer). She had also removed the nipple but left the areola. How clever is that? I imagine the surgeon sliced open the skin, scooped out the offending tissue like the filling of a jacket potato gone rotten and stitched me up again. I wonder if she is any good in the kitchen.

Bloomin' heck

A few days after the operation my skin bloomed with purple and yellow bruises that I had not expected. I felt shocked and upset and really stupid. How had I not expected bruising? The bruises took a few weeks to disappear but the scar took longer. It went through a strange process, an unfurling. What I had thought of as chewed up bits of nipple revealed itself to be a healthy looking areola, a bit squished but quite nice actually. Meanwhile the line of stitches disappeared almost completely leaving the shortest crease, barely visible. Honest to God, the craftsmanship is so impressive that I feel like showing it off. Almost.

Get this thing off me

I almost went for mastectomy without reconstruction because it is so much simpler. It means less time under anaesthetic, less recovery time and less potential complications. It means no implants (which incidentally, like the double glazing, are only expected to last about 15 years). I know some women who opted for mastectomy only and I can understand that. They are happy with their decision and with the prosthesis (fake boob) they have been given. I was attracted to the mastectomy only route because at that moment in time I wasn’t thinking oh poor me and my boob, I was thinking, get this thing off me. In the end I opted for a tissue expander. This is the one area of treatment where you really have some say and the breast care nurses are brilliant with their advice and information. But the decision is yours. Go with your instinct, it will tell you what to do.

M IS ALSO FOR MEN

Men get breast cancer too. Now that really is cruel. Not only does the man have to come to terms with cancer but also the fact that he now has breasts he never knew he had. It must be so hard to say the words I have breast cancer if you are a man. You can just hear the locker room jibes and the bad taste jokes. I am being serious, around 300 men are diagnosed with breast cancer in the UK every year. Doctors should spare these men their blushes and invent a new term for male breast cancer. Best not to leave it to the people who named the Cancer Centre though, they would probably come up with something unimaginative like chest cancer.

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