64 Grandpa Metastatic

In September 2006 my maternal grandfather was diagnosed with breast cancer after a needle biopsy. He got the diagnosis and chose to do nothing. Part of him didn’t believe he had breast cancer.

In 2008 he had a hernia, and finally decided that he had become uncomfortable enough from the hernia to risk surgery. The surgeon refused to repair the hernia unless Grandpa allowed him to remove the large breast cancer tumor on his chest as well.

The surgery went well for both issues, but during surgery the surgeon noticed a shadow on his lungs. A chest x-ray and CT scan were ordered to follow up and they revealed two tumors – one on each lung. They’re big at 4 cm and 5 cm, respectively, and that means Grandpa’s breast cancer has become metastatic.

Grandpa’s form of breast cancer is a rare one. He has mucinous (colloid) carcinoma. It is slow growing and usually has a good prognosis. Then again, most people don’t wait 20 years after they first notice a lump before doing something about it.

Grandpa is a World War II veteran. He told me he mentioned the lump to the doctor at the VA. He was told that men can’t get breast cancer.

I know that's misinformation, of course. It's less common for men to get breast cancer, but men do have a small amount of breast tissue and they are vulnerable to the disease. Here is a link to an informative posting on Dr. Susan Love's web site about breast cancer and men.

He insists that his cancer started when he was a young man, smoked cigarettes, and carried his cigarette lighter in his shirt pocket. That is approximately where the tumor was. Of course, this is the same man that suggested that the lung tumor might actually be dog hair. Dog hair on your lung, Grandpa? Clearly this is a person who does not want to face reality.

He’s 84 years old. He doesn’t want chemo. Doesn’t want radiation. He didn’t exactly want the surgery that removed the tumor but I don’t think he regrets it. He complains that the scar itches.

At first it shocked me that he didn’t want treatment. Then again, at 84 it’s a quality of life issue. At 84 with lung metastasis, and by the rate he’s lost weight I would guess he’s got liver metastasis as well, time is shorter than it used to be and he doesn’t want to spend it feeling sick from chemo. I don’t blame him.

I found myself in the role of patient advocate in October 2008. I took a day off work and traveled with my mother to Brenham, an hour and forty minutes or so away from Austin. We accompanied her father to a checkup visit with his oncologist.

Knowing the common medical terminology as it relates to breast cancer, I was in a better position than some to understand what the doctor said. It worked out well. I had questions. He had answers. I had more questions. He patiently explained options. Grandpa is hard of hearing and I had to remind the oncologist to speak loudly enough for his patient to hear. My mother and grandfather were happy that I understood the discussion because I could explain things again to them later.

Grandpa is also given to understanding things the way he wants to rather than the way it is. He showed his oncologist a newspaper article which said a recent study showed a decline in the benefit of colonoscopies after age 75 versus the risks of that invasive test. Grandpa proudly told the doctor the article said that tumors decrease in size after age 75. He thinks because he’s over 80 that his tumors will get smaller as he gets older. I know that tumor’s don’t shrink because you reach a certain age or because you wish them away hard enough. The doctor wisely nodded and smiled, and then winked at me when Grandpa couldn’t see him. I decided I liked Grandpa’s oncologist.

Twenty years. He had that stupid tumor on his chest for over twenty years and did nothing! He let an ignorant doctor at the VA tell him it was nothing to worry about instead of following his gut and insisting on proper testing. That’s the part I cannot fathom.

I’ve heard of two young women in the area where I live being put off by their family doctors because they were supposedly too young to get breast cancer. They were both Stage III by the time they were diagnosed. That makes me angry.

It also makes my point. We must be our own advocates when we can, and get help when we don’t know what we’re doing. We have to pay attention to our bodies the way we should pay attention to our vehicles, noticing changes and fixing issues before they turn into extensive repairs.

When you’re not sure how to be your own advocate, hire it out. Sometimes friends or family members can help us with that role. Sometimes payment is in hugs and kisses, and that’s just fine.

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