Post Transplant Cancer Scare... (and a cancer diagnosis)

I have the unique perspective of having three different biopsies in three weeks. All to rule out cancer. Two were negative, and one was positive.

It all started with a routine physical. Hey, I am 5 years out with my transplant, and aside from steroid induced cataracts, it has been perfect. Then came a phone call last December. My screening mammogram was abnormal, the clinic would need to see the films from my pre-transplant mammograms. I didn't really take them seriously. I had no history of breast cancer in my family, I did self exams, and there were no lumps, there was no way that I could have cancer. I told them that they could wait until after Christmas.

Then the center sent me a letter - they were serious - there was a 1cm abnormality on my mammogram, and they needed to rule out malignancy ASAP. In January, I scheduled a follow up Mammogram. The day I walked in to radiology, I knew that something was up because I was alone in the waiting room, and everyone was REALLY nice to me. I didn't even have have to wait for my appointment (That terrified me - it's just not normal), and then after many, many, many "views" I was ushered in for an ultrasound. I hadn't planned for an ultrasound. I was not prepared. I know kidneys. Aside form owning a pair of C cups, I know NOTHING about breasts. I was in uncharted waters.

The radiologist explained what she was looking for, and then she said it was time for a biopsy and a marker (a metal clip left after the biopsy to "mark" the abnormal tissue). That was when Invasive Lobular Carcinoma was mentioned. I was terrified. I blamed the transplant drugs. I Googled chemotherapy and transplant. I updated my will. I didn't know how to even face the thought of a mastectomy. I have never been so scared in my life. And I didn't know how to talk to people about it. I e-mailed my Rockstar, my "go to" guy for support, and I decided that I would write about it. He agreed. My family freaked and said "You better not put your Mammogram on Facebook", his reply "Save it for a blog post". So here I am on IHD writing about it.

The day of my stereotactic biopsy, I was resigned to treat cancer like I treated kidney failure. Face it, fix it as well as I can, and live. My OB/GYN was amazing as she summed up what was happening. No matter what, it is early. 1cm is the smallest that can be detected. Stage 0, with a 98% survival rate. And clinics over screen for breast cancer. 80% of all breast biopsies are negative for cancer. If 100% were positive, they would not be doing their job right. I felt a bit better after speaking with my OB/GYN. Then she and I discussed the uterine polyps that she had removed and sent off to pathology the week prior. Those too were benign, but I've had polyps before, and I really wasn't worried. With polycystic disease, I am never surprised when cysts, aneurisms or polyps appear, I just figure that they go with the territory of living so long with a deadly disease. After all, my kidneys failed almost a decade ago, I am living wayyy past my "sell by" date.

This Tuesday, I got the call. It's not cancer. It is atypical lobular hyperplasia. It makes me at risk for breast cancer, and I'll have to have a mammogram every six months, but I don't have breast cancer.

On the same day I found out that I didn't have Breast Cancer, I went to my dermatologist to have my semi annual post transplant skin check. She removed a growth from the bridge of my nose. In November, I was reading on my iPad in bed, and I was wearing my glasses. I dropped the iPad on my face, and my glasses cut into the bridge of my nose. It wasn't healing. My dermatologist excised the scabby tissue. Did you know that Basel Cell carcinoma can grow from a wound?

Five years after my transplant, I had my first skin cancer lesion removed. I was high risk even before the transplant, now it is going to be hypervigilent sunscreen for the rest of my life. But I really wasn't that phased. When I got back to work that day, with the band-aid on my nose, my co workers asked "What happened?" all I could say was "I don't have breast cancer".

I'll update this post with "Adventures in Skin Cancer", if any more lesions develop.

The moral of my story? It's all about perspective. Once you've survived kidney failure, there are other medical issues that can knock the wind out of your sails, but you keep on plugging away, and you choose to live. Yeah, this week, I was diagnosed with Basel Cell Carcinoma on my nose. A common occurrence when you are on immunosuppressives after a transplant. But with early detection, it is easier to deal with it. And for me, I'm just happy that it's not breast cancer.