When this particular patient visited her general practitioner, she was as healthy as a fish (with the occasional back pain, but that was nothing out of the ordinary for someone who practiced a lot of sports). She just wanted him to examine a small lump in one of her armpits.
That was the only thing.
The GP is not worried about the lump, but he still orders some further tests to be on the safe side. And the tests reveal a new truth: the tiny lump is a message which has to be decoded very carefully. It is a cancerous lymph node, whose cancer cells originate from a primary breast cancer tumor.
This is where the story becomes tedious.
The woman is still young (and she has two young children), and it turns out that she had an aunt on her mother’s side who died at roughly the same age from aggressive breast cancer — she was one of the unhappy few with mutated BRCA genes (only 1/500 women have this kind of bad luck). And this drastically increased the patient’s chances to have these faulted genes as well.
BRCA genes help to repair damaged DNA and prevent uncontrollable cell growth, and harmful BRCA mutation disrupt this repair process. The cancer control unit is basically disabled, so that cancer can have its way.
The lymph nodes in the armpit can act as a hub for the cancer cells to travel through the lymphatic system to other, distant parts of the body, and the oncologist who is handling the patient knows this only too well. (The back pains are an extra worrisome detail which might not be a detail at all.)
So the patient’s body is scanned in search for tumors, and the outcome will determine her destiny. If they find tumors at a distant site, she is doomed.
The day comes when the oncologist will finally diagnose the patient. The scans have been analyzed. The information is available.
When Jenny leaves his office, she is still crying. The cancer has metastasized to the bones, and that’s what caused her back pain. Most probably, the cancer took years to develop in her body before the first symptoms came, and since she never interpreted her strained back as a symptom, it got extra elbow room to ravage even more.
In less than four years, the cancer empties her on the inside up to a point that even her eyes start to look glassy, because there is nothing in this life that she can see anymore.
I was married to Jenny, and I was a witness of her demise from afar and in the end from up-close.
Until she was no longer there.
She just wanted her GP to examine a little lump in one of her armpits —
That was the only thing.
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