Primum non nocere

It’s been 3 years and 4 months since my mastectomy, but who’s counting? In September this year I will be within one year of the magical five-year window when doctors declare a cancer patient is less likely to have a recurrence. For me, the window will never be closed. My mastectomy scar is a constant reminder that I could develop cancer in the other breast. I am much more proactive about my lumps and bumps now. I ask, probe, and demand that my body be given the attention it deserves. When I first felt THE lump back in 1999, I consulted my gynecologist in Atlanta. I was also having severe hot flashes and she prescribed HRT (hormone replacement therapy) in pill form for the hot flashes and other menopausal symptoms. I had a mammogram and was assured that the lump was fibrocystic disease and not to worry. The lump became painful after I started the HRT but my hot flashes and my risk of heart disease were under control, which, I was told, was the conventional medical wisdom then. After moving to Los Angeles in 2000, I had a follow-up mammogram and ultra-sound. My doctor again assured me it was only a fibrocystic lump. My mother and my sisters have fibrocystic lumps so I was not worried and there was no history of breast cancer in my family. I was more worried about our family history of heart disease. The HRT was now being delivered into my system in the new, more convenient, patch. So I had my annual mammograms and every year I went for a follow-up ultra-sound and every year the lump got bigger and every year I was told it was just fibrocystic disease. I moved to the Antelope Valley in 2003 and made my annual appointment with an OB-GYN. I continued having annual mammograms and follow-up ultra-sounds. My 2004 and 2005 mammograms and follow-up ultra-sounds showed a fibrocystic lump once again. Then I moved to Mississippi and missed my annual mammogram and follow-up ultra-sound in 2006. I made an appointment in September of 2007 for an annual check-up and mammogram with my new OB-GYN. After my exam she sent me immediately for a biopsy. It was cancer. Stage-3. How did I go from a fibrocystic lump in 2005 after 6 years of mammograms and ultra-sounds to stage-3 cancer in 2007? What happened to the fibrocystic lump? How could it turn into stage-3 cancer in less than 2 years? Had they misdiagnosed me in California? Warnings about HRT patches causing an increased risk for breast cancer were ignored by my doctors in California because of the protection the medication claimed to offer against the greater risk of heart disease and because of the relief it gave me from menopausal symptoms. There is no empirical proof that the HRT patch was a main contributor to my breast cancer, but I am convinced that it was the patch that elevated my risk unnecessarily. My sisters have never used the patch and they don’t have breast cancer. I don’t have any psychological issues about losing my breast. I feel a little lopsided occasionally and I’m not really comfortable with my prosthesis. My main issue is loss of my peace of mind. I will forever be wary of claims touted by pharmaceutical companies or by my doctors about the benefits of some new medicine or delivery system. HRT and HRT patches are no longer regularly given to menopausal women for their symptoms and have since been proven not to offer protection against heart disease. In fact HRT may contribute to a woman’s risk for heart disease. Big Pharma is worried more about its bottom line than about my quality of life. That’s just big business. My bottom line IS my quality of life. I no longer trust the medical community implicitly. I question every prescription and treatment. Our healthcare system is so overly dependent on maximizing profits that they have forgotten the warning “Primum non nocere” which is Latin for First, do no harm, a fundamental principle for the practice of medicine.