Can You Hear Me Now

“Can you hear me now?” Yes, the entire waiting room can hear you and it’s not “good.”

After checking in with the receptionist for my oncology appointment and taking my seat in the waiting room, in walks a chewing gum-smacking man with his mask dangling just below his chin.

He is dressed in very tight and extremely itty-bitty shorts. His gym socks and tennis shoes completed the look. I think to myself, wow, Richard Simmons has entered the building. He even had the signature curly mop of hair. No disrespect to Richard Simmons. I fondly remember Sweatin’ to the Oldies from my childhood. This doppelgänger, who was obviously not a cancer patient with his “visitor” sticker on, then proceeds to loudly use his cell phone asking the person on the other end while on speakerphone, “Can you hear me now?”

I was ever so grateful to the medical assistant for promptly calling my name and escorting me back to a room for my appointment. With my metastatic breast cancer remaining stable on Olaparib, my appointments have been scheduled every six weeks to monitor lab work and to check in. My labs are being closely monitored because of the increased risk of myelodysplastic syndrome that comes with PARP inhibitors. I have been having yearly scans unless I am having an issue that would warrant a scan sooner.

At my February visit, I had just read an article about the new blood test by Signatera now being covered by my insurance. Signatera is an individualized test looking for circulating tumor DNA and can detect recurrence before it becomes visible on scans. I mentioned this article to my oncologist and it was decided we would give it a try in place of scans this time.

I had my blood drawn through my port by the infusion nurse. As she was getting all the vials lined up on her rolling cart I glanced over to see how many tubes were there. She noticed me looking and asked if everything was okay. I have been doing this for what feels like a lifetime, or at least for the past ten years since my de novo diagnosis when I was 38, and I recognize the usual vials they use for my blood draws. I didn’t notice any extra tubes for the Signatera test and mentioned it to the nurse. After checking the doctor’s notes she confirmed that, yes, he did request this test but I was only the second patient in their office to utilize this circulating tumor DNA blood test and she wasn’t sure if they had a kit. Fortunately for me, they were able to locate one.

The Signatera test results are either positive or negative, which got me thinking about the medical jargon and choice of wording. In the English language generally positive is used when referring to something good and negative refers to something bad. In medical terms, this usage is completely the opposite. This is also true with scan results being unremarkable. Most humans strive to be remarkable and positive, just not when it comes to cancer. Another example is when one has cancer progression, they aren’t making progress, they are getting worse. What a letdown when my results came back as neither positive nor negative but as insufficient DNA, even with three full vials of blood samples.

Six weeks later it was time for a do-over. At my next scheduled lab appointment, another three vials were drawn and sent off for Signatera testing again. The anxiety while waiting for results is always agonizing and to have to do this twice was double the stress. The scary thoughts and what-ifs running through my mind were keeping me awake at night and no results had been returned as of my follow-up visit.

Then came the notification of a missed call the day after my oncology appointment. Calls from the doctor’s office send me into utter panic every time, my fast heartbeat and fluttering stomach as I reach for my phone and tap the playback button on my voicemail. This was the news from my oncologist that I had been waiting for — no circulating tumor DNA — the message was loud and clear.

Can you hear me now, metastatic breast cancer? Good.

Photo courtesy of the author.