Wendy Milne (57) shares how her choice of having the Oncotype DX test proved to be a wise one and prevented her from having chemotherapy – something that she feared and didn’t want to endure, and consequently didn’t actually need.
To many people, including myself, cancer is a terrible disease that so many people die from, and is generally seen in older people. The truth is…that is not the case – anyone can be diagnosed with the disease, and at any age, as I recently found out.
I usually go for my annual check-ups, but to be honest, time ran away last year, and I didn’t go for my mammogram. Earlier this year, my nipples were too painful to touch. I thought it could be from chafing of a new bra, a new chemical in my washing powder or some other allergy, until one day, while taking a shower, I felt – what I had always dreaded – a small lump at the top of my breast.
I was diagnosed with breast cancer on 1st July, and subsequently underwent a lumpectomy, as well as a breast reduction on 5th August. A couple of weeks after the operation, I met my oncologist for the first time. He explained all the options regarding chemotherapy and radiation, and of course, I asked a million questions regarding the side effects.
He also told me that all my readings were on the “low” side of the scale, in that my cancer had been caught in its early stages. One of these readings, however, showed up as “moderate”, and at this point he suggested that I contemplate having an Oncotype DX test done on the tumour. By having this test done, it would assist him in determining the risk of the cancer returning, how aggressive it was, and whether chemotherapy would be of benefit to me or not.
The way it was described to me, is that a sliver of the tumour is sent to the USA for testing. The results of the test assist doctors in identifying which hormone-driven cancers have a low-risk of recurrence and may not need chemotherapy treatment. Patients could therefore be spared the toxic effects of chemotherapy, while those with higher risks would get a more effective treatment. The biopsy is couriered to the States and it takes approximately two weeks for the results to be sent back to the oncologist.
Now for the cost of this test. I had to get authorisation from my medical aid, which was initially rejected, so my husband and I decided that we would find the money and fund it ourselves, and work on claiming the money back from our medical aid later.
Discovery medical aid is currently doing a pilot project on the results of this test; our medical aid, which is administered by Discovery, has not been part of it in spite of them being able to do so, hence the reason why they declined to pay for the test. Should a patient not require chemo, there would be a substantial saving to the fund.
Due to the fact that we had decided to pay for the test ourselves, we made an application to the ex gratia committee of the fund to compensate us. We completed all the paperwork, which we submitted and had to wait for the committee to have their next meeting. We were advised upfront that there was no guarantee that the committee would authorise the payment for the test.
It was a long three-week wait as the amount involved was close to R35 000. However, in October, after my first week of radiation was completed, we received the most amazing news – the ex gratia committee had met and were happy to pay for the test. Well, I just cried. It was a huge relief for us!
Right from the start, I was really reluctant to go for chemotherapy as I am petrified of needles, hospitals and doctors. I had also seen what one of my colleagues had gone through and no ways did I want to experience those side effects.
Those two weeks of waiting for the test results felt like forever. When I heard my oncologist’s voice on the telephone, my heart immediately started racing. He sounded so chirpy, and then gave me the good news – it was not necessary for me to undergo chemotherapy as my count was 14, and any amount of chemotherapy would have no benefit to me whatsoever. I was prescribed radiation for six weeks, and later hormonal therapy, which will be for a number of years thereafter.
I chose to do my radiation at The Oncology Centre at Life Vincent Pallotti Hospital. I have met the most incredible radiotherapists – warm, always smiling, professional at every level, caring and willing to please. The centre has the most incredible atmosphere which you feel when entering. I am happy my radiation is over, but very sad to not be able to see my new-found friends.
Written by Wendy Milne.