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2011 - Blog

KEEPING ABREAST

It’s about time that I made a clean breast of it!

'Zwei Seelen whonen, ach! in meiner Brust'

In other words . . . I've only got one now!


April 1st 2011 fell on a Friday . . . should JH have had a sense of foreboding?

During the month of April 2011, JH received a letter from Professor Jack Cuzick who is the Chairman of IBIS-I at the Centre for Cancer Prevention, Queen Mary University of London.

 
IBIS image from 'The Newsletter of the IBIS Women's Group Issue 8 - March 2000' (more at the end of this article)
 
Whilst I was working as a Medical Secretary at Derriford Hospital in Plymouth, I was on the spot to receive information about participating in a Study to ascertain if taking Tamoxifen would reduce my increased risk of developing Breast Cancer:- I was at higher than the baseline risk of developing Breast Cancer as I have a first-degree relative - my sister Ann - who had had a mastectomy at the age of 43 in 1981.  I was a participant in the International Breast Cancer Intervention Study (IBIS-I) commencing in March 1997. 

On 3 March 1997 I travelled to the South West Study Centre, in Frenchay Hospital Bristol, for my first appointment; thereafter I was 'scrutinised' every six months.  I was randomly allocated to take Tamoxifen or a placebo tablet each day for five years . . . and given a pot of white tablets to take away (TTA).  At each visit I had the appropriate blood specimens taken and/or a mammogram performed, and other examinations and/or investigations done as specified in the Study Protocol.  Also, Ruth Illingworth the IBIS Co-ordinator, counted any tablets left in my pot which I brought back . . . just to make sure I was a compliant participant . . . and gave me a fresh supply of tablets TTA for the next six months.  I only actually remember missing one tablet in the whole of the five years!  I attended a follow-up appointment at Frenchay Hospital on 7 March 2003 - a year after completing the Study. 
 
Subsequently, each year - between 2004 until 2009 - I received a letter from the IBIS Office together with a questionnaire about my wellbeing - which I duly filled in and returned to the Office.  In 2009 I was informed that the results of the IBIS-I trial had been positive in so much as taking Tamoxifen did have a long-term benefit.  A second trial, IBIS-II, had been set up:- in this trial the participants took a new drug, Anastrosole (or a placebo).  It was suggested to participants of IBIS-1 that they should not, necessarily, enquire as to whether they had been taking Tamoxifen - especially if they anticipated becoming a participant in IBIS-II.  I did not wish to ascertain if I had been taking Tamoxifen, and did not participate in IBIS-II: in any event, I do not think my 'personal criteria' would have fitted the protocol for the second trial!  I received a questionnaire from the IBIS Office in 2011 - two years since my previous follow-up questionnaire: I completed this questionnaire and dispatched it as directed.

In May 2011 I received a letter from my General Practitioner's Surgery informing me that women between the ages of 50 to 70 would be invited to be screened for Breast Cancer every three years; in June 2011, I  was also offered an appointment to go down to the Breast Screening Unit - housed on the ground floor of Plymouth Guildhall - when I would actually be four months past my 70th birthday!  My previous visit for Breast Screening on 16th October 2008, had been to a Mobile Unit, which was a bit bijou for the purpose - although the Radiographers' modus operandi ran smoothly!  Furthermore, in the Guildhall there were seats on which accompanying husbands/partners could sit - rather than them having to make themselves scarce elsewhere because there was no room for them!

On Wednesday 8th June 2011 I had a mammogram.  Such is the magic of modern digital technology I was shown the image - at my request - by the Radiographer, who pointed out a few anatomical features but passed no further comment:- my mammogram would be scrutinised by a Radiologist at the Imaging Department in Derriford Hospital.  I thought that, in the medial lower quadrant of my left breast, there was a spot of X-ray enhancement. 

I wondered if a bruise could produce this artefact, as I had been doing some gardening and managed to impale myself on a garden cane!  Gardening was no longer my 'leisure' activity in my own garden.  However - in spite of the bending required - I did some in The Deeble's garden in Pensilva.  Pam Deeble and I had done our Midwifery Training together in the 1960s, and we had kept in touch.  In June 2010, Jayne, Pam's eldest daughter, rang JH to say that her mother had had a stroke.  Pam had had a diagnosis of Parkinson's disease for a number of years, and so this added insult to her wellbeing did, of course, bode ill for Pam.  JH planted cucumbers, peppers, and aubergines in growbags in the greenhouse, and then planted broad bean plants in the garden, and in due course planted out runner bean plants which Geoff, Pam's son, had germinated in the greenhouse.  I remember leaning over to tie up the long wigwam of canes and receiving a sharp stab!  I could not subsequently find a bruise, but I felt a bit sore.

In due course . . . I received a summons to attend the Primrose Breast Care Centre at Derriford Hospital - which actually was no surprise to me but thoroughly upset me.  The exhortations on the literature I received . . . such as 'Please do not be too worried about this as we recall for a variety of reasons.' and  'Please do not be too alarmed as 1 in 20 women are called back and most turn out to be normal' {really!  What if I'm abnormal to start with by just being me?} and 'After these tests most women will turn out to not have any problem and be reassured . . .' rather aggravated me!  Furthermore, the Radiographer, Mrs M Jenkin - who introduced herself as an Advanced Practitioner - told me that 'we can tell the difference between a bruise and breast cancer': I should not have asked, but we all 'grasp at straws' at some time or other . . ..



 
 
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