On our first date, my late husband Tom talked about cancer the whole time. It almost did him in; I’d come away bored and depressed. He’d taken me to an Italian place, nice enough to have white tablecloths—on a weeknight, no less. I hadn’t dated in years (that’s a story for another time) and here was a handsome guy, not too much older than me, a physician and professor at Michigan, who I’d met cooking dinner for a homeless shelter. And I was ready to toss him back? What more did I want? Royalty?
It wasn’t like he could be faulted for talking about cancer. It was his work. He was a GYN pathologist, diagnosing cancers, teaching medical students, and running a research lab, taking steps toward cures. And I knew by then he wasn’t “one note.” Since I was traveling a lot for work, we’d chatted a few times on the phone before we could get together in person. Each time we forced ourselves to hang up after an hour—because otherwise we might talk all night.
It was the cancer talk I reacted to, not Tom. I’d never known anyone with cancer, but I shuddered from talk of it the way I shuddered at stories of serial killers. Which makes some sense—what greater serial killer is there, than cancer?
Thankfully, Tom didn’t give me a choice about seeing him again. He rode his bike into town the next Saturday morning, knocked on the door of my brownstone, and suggested brunch. This time, cancer kept its distance, and we stayed together for the rest of his life, the next eleven years.
Now I’m missing him all over again. This time it isn’t the shattering grief following his death nearly 16 years ago, but something purely practical. My pathology report is finally posted, and I can’t make sense of it.
The words following “Final Diagnosis,” read like gibberish:
Estrogen Receptor Assay (ER) is Positive
Progesterone Receptor Assay (PR) is Positive
HER2 Assay by Immunohistochemistry is Equivocal (2+)
Tom could have de-ciphered these items, and much more. By the time of his death, he was an internationally known expert on breast and ovarian cancers.
Now I want Tom to talk to me about cancer. Now he can’t.
I don’t have Tom to consult, so until tomorrow’s appointment, it’s the Internet I turn to.
I can already see one good thing: Estrogen, Progesterone, and HER2 are the three components of Triple Negative, one of the most dreaded breast cancers. With at least two positives, I don’t have it.
But HER2 positive is also the subject of much alarm on the Internet. From what I can glean from the breast cancer sites, “Equivocal,” means more testing is necessary. I see that a 3 means positive, so my 2+ score seems to tip dangerously close.
The rest of the items on the report, Nottingham Grade, Ki-67, and Magee Equation 3 all seem more straightforward since they’re measurements. I can look at my numbers and see where they fall on each chart. Checking each, I see that my tumor’s characteristics hover around a middle ground— it wants to get out and explore, but at least it hasn’t stormed the barn door.
I don’t have Tom, but I do have an appointment with Dr. Fisher in the morning to put all of this in perspective.