What a cock-up.

Today was rather an anti-climax.

Actually, today was a complete and utter bloody cock-up if the truth be told.

Today was the day I was supposed to have a joint meeting with the oncologist (House or Chemical Ali) and surgeon (Scouse). This appointment was made for me by Omar, the woolley oncologist, on the day of my last chemo. It was to discuss all my options (chemo, surgery and radiotherapy) taking into consideration the results of my scan and the fact they are 'concerned' about my psoriasis.

Or so Omar the Woolley oncologist told me. Indeed, I distinctly remember, as Best Friend can confirm, asking him which oncologist would be in the meeting ('it won't be me' he said, 'perhaps House or Chemical Ali')

Crap.

First off, the clinic was running over an hour and half late. Or was it 2 hours? I lost the will to live by then...first hour was ok, but then it all became rather tedious and boring. You expect to wait, or so I have learnt over the last 3 months. But this was a very l o n g wait today,

Scouse came out, called my name. Best Friend and I duly followed him into a windowless room. And he went to find my notes.

He came back.

Alone.

No House. No Chemical Ali.

'We thought this was a joint meeting with yourself and the oncologist' we said.

Scouse looked blankly at me and then the Nursey Bernard.

'No, we are here to discuss your surgery' he said.

It was our turn to look rather blank. At each other. This was not what we had been expecting. I mean, we knew he would be there to discuss surgery options, but I didn't know what was happening with chemotherapy (Omar told me to make blood test and chemo appointment for next week as usual) and I need to discuss radiotherapy with the oncologist because of my skin. Scouse is a surgeon, not an oncologist.

'They have told you that they are halting chemotherapy, haven't they?' he asked.

Um, no. I haven't seen or heard from an oncologist since my last chemo. That was when an oncologist told me I was having this joint meeting. To discuss it. To discuss chemo. To discuss radio and everything else.

And this is what I told Scouse.

At this point, he looked at the Nursey Bernard and made a face. The kind of face that says 'what the fuck?. The kind of face that says 'this is a cock-up'. But with no words...

'Well I understand they are stopping your chemo because of your skin' he added.

Right. Thanks for that. Would have been nice to have heard this from the horse's mouth so to speak. To have had a discussion with an oncologist. To ask the perfectly reasonable question 'so have my chances of survival been reduced' or 'am I non-responsive or are my cancer cells resistant?'. To not have this information off a surgeon, who made it quite clear he can't answer any questions on anything but surgery.

When were they going to tell me then? By text message? I would have just gone next week for my normal chemotherapy if Scouse hadn't said 'You do know....'.

He said he would make an appointment to discuss all of this with an oncologist. Next week. Great. More time off work.

He ploughed on, clinically examining Colin (that's groping my tit to you) and telling me that actually, my tumour is nearer 5cm than the 1.4cm that the imaging showed. He was very good at explaining the difference; imaging is just one tool to try and get a handle on size and location. Groping is another, as is mammography. But until you get in that there breast, it is impoosible to know for certain what you are up against. Obviously, I haven't seen him since March 10th when he told me I had breast cancer. No one has discussed Colin with me other than to tell me the chemo hasn't significantly reduced him, so I learnt quite a lot from Scouse today.

I didn't have the opportunity to discuss the ductal carcinomas, the ones I read about in my notes. Oh well. It just seems to be one thing after another. I have partially lost the will to live, let alone take on the surgeon with regards to not telling me everything.

Anyway, depending on what my derm and the oncologist say with regards to my skin and radio, I have two choices. Wide local excision (partial mastectomy) or full mastectomy. I will also have to have all of my lymph nodes removed. That is absolute because one definately has cancer, they may be more and they never leave nodes behind if one is cancerous. That will be a 'Malcom has left the building' moment then...

Regardless of which surgery I have, standard protocol is to have radiotherapy. This is because it is the most effective way of killing any remaining cancer cells. This also means that if I end up with full mastectomy, I cannot have any rebuild for at least 6 months to a year afterwards. This is because radiotherapy can distort the new breast out of shape. And that means I would wake up with no right breast and have to live with it for a long, long time.

If I opt for WLE, there is a risk that I would need to have more surgery if pathology on the margin areas shows Scouse hasn't taken enough tissue away. There is also a risk that the second surgery would end up as full mastectomy if a lot of tissue needs to be taken and the remaining area isn't viable. If this happens, I end up with no breast for 6-12 months again. This is the risk you take in trying to preserve the breast with initial WLE.

I haven't thought about this in any great depth. I will. I will rationalise my feelings on this over the next few days.

Right now, I am still fuming at the total incompetence of the RB's Oncology department...

Dogwankingfucksticksbunchofimcompetentfools.