Chapter One – Discovery.
Grace was just washing up after exercise class; planning to meet her friends for the party later that night.
As she soaped herself, her mind was busy on other things.
She rubbed under her right breast and under her armpit.
As she circled the breast again, she felt something.
She paused, letting the water rinse off the soap.
And pressed her breast — yes, there it was again.
Her heart was thumping.
As she pressed herself, trying to squeeze at the lump, a shaft of pain pierced her breast making her gasp.
She’d heard about breast cancer before.
She didn’t know how people got it ….but she knew breast lumps were a serious matter.
What would she do? Who could she tell?
As she dressed she could feel a little ache in the beast.
After dressing, she looked the same as usual — her breasts looked fine.
She was quiet all evening — her friends said. She said it was work, a headache.
After they dropped her off at home, she sat without turning on the lights.
The darkness suited her mood.
What’s happening to me?
For days, Grace kept checking her breast hoping and praying ‘it’ would go away.
Her older sister noticed she was distracted a few weeks later.
Eventually, she confessed.
They took it to the Lord. But the lump didn’t go away.
It was now 9 weeks after she first felt the Lump.
Chapter Two – Next Steps
They went to the clinic.
(Her sister was advised by a friend to get her to see a Doctor.)
She wept as the Doctor confirmed there was a breast lump.
‘Why me? I’m only 38 years old.’
‘What have I done?
I don’t smoke or drink. How did I get it?’
The Doctor asked about their family.
About drugs; contraception.
She could hardly answer.
all she knew — all she could think was: her life was over.
She felt alone.
Grace sat on the soft chairs at the reception, waiting for her name to be called.
The clinic was busy, but the young lady at the reception smiled when she spoke to people.
That calmed her a little. Outside, the weather was very hot and the windows in the clinic were wide open.
It was Port Harcourt in the middle of July.
She’d resumed work only last week, having been off for the previous 2 weeks — telling her boss she had to travel to the village was the only way to get some time away.
She could hardly face her friends or work colleagues and she’d hidden at her sister’s home trying to get to grips with the problem.
She’d begged Stella to keep this quiet, but initially Stella had argued for seeing another Doctor; though the consultation costs had been high.
She had then endured another examination — and was told the same thing.
When the Doctor started talking about some more tests, they tuned off.
Perhaps they were just trying to make some more money.
Later, her sister suggested they inform her Pastor.
So many miracles are happening, she’d said; ‘with the faith of a man of God, surely they too would prevail’.
Grace had grown up in a Christian family, always attended church but she’d not always been regular recently — blaming pressure of work.
Her sister, though, was more involved with church matters than she was.
Grace had been scared and too weak to protest — and after the last praying and fasting session, there was a prophecy.
Someone in their village had laid a curse on her causing cancer.
By praying that night, they had proceeded to break the curse in the spiritual realm.
They had planned another session, but she told her sister she was too ill to attend.
And the lump had not gone.
Her breast ached most of the time, now.
She could feel it, like a ‘thing’ growing in her body, which she could not control.
Instead that morning, she got on her computer and searched for breast cancer treatments.
But the wash of information she found was overwhelming. Where did she start? They talked of X-rays and scans — where should she go?
And her mind flashed to the first clinic she’d been to with Stella.
The Doctor had been patient, even in her distress, she could recall the calm way she spoke with them.
And so she’d called and booked this appointment.
Attending without Stella, she felt anxious but somehow, it seemed the right decision.
Chapter Three – Hope?
Finally it was her turn; and the Doctor had the same smile.
Even though the reception had been busy, she didn’t appear preoccupied or distracted.
‘How’ve you been?
Its been a few months since we saw you’
‘Yes’,Grace smiled in embarrassment, I wasn’t sure ….. she broke off.
I still have the lump….’
The Doctor smiled gently — ‘That happens a lot’
‘Look, it’s scary,’ the Doctor said; ‘but the best way to approach this is to use all the resources we have to solve the problem’
‘Solve?’, Grace said bitterly. ‘Its cancer and it kills people.’
‘Grace’, ‘ the Doctor said, ‘we know that treating cancer at the early stages provides the best chances of cure.’
‘On occasion, we need to offer other types of treatment — called radiotherapy or chemotherapy to kill the cancer.
But look — we haven’t even carried out the tests to confirm what this is.’
In your case, we need to confirm what exactly is going on in the breast before we can decide on the treatment.
‘OK. What should we do next?’
The Doctor examined her again — she felt both breasts and her armpits, then her neck and her tummy.
Grace shivered again while she got dressed.
‘Ok, I think the lump is a little bigger from the last time I last saw you.
I checked your armpits to see if there was a sign of lumps there too, and in your neck — because sometimes when cancer grows it spreads to other parts of the body.
But I couldn’t find anything in those areas’.
‘So for now, you need a test called an ultrasound scan — that’s like taking a photograph showing the inside of your breast that will tell us what this lump is made of, and after that — we may need a biopsy.’
‘Doctor, I don’t understand.
What’s a biopsy? Will it remove the breast?’ she felt panicked, her heart racing.
‘Will I still be able to have children’, she wondered inside.
‘Listen’, the Doctor said.
‘A biopsy is the only sure way to identify if this lump is breast cancer.
Not all lumps are the cancerous types.
They may be breast cysts — which are not cancer.
In a biopsy, we take a little part of the lump and test in the lab to find out what it is made of.’
‘You will have anaesthesia so you do not feel pain during the procedure.’
‘Is that ok?’
She had nothing to lose. And the way this Doctor spoke made her feel confident.
‘I’m going to refer you for a scan and to see a Breast Specialist, a Doctor who deals in women with breast problems and can advise what treatments you will have next.’
‘Grace, listen — I think you’ve been brave to face this — many women end up in church or in the village getting ‘treatment’ and stay there till its too late.
Some even deny that there is anything wrong.’
‘But its good to have some support, a friend you can rely on. Your sister, perhaps?’
Grace smiled — ‘She’d like us to keep praying.’ I’m ok for now. I want to do the test like you said. Then we’ll see.’
‘Good girl’, smiled the Doctor.
‘So here are the details of our sonographer who will do the scan ……..’
Grace lifted her head dully from her pillow. She could hear her mobile ringing but she was weak and couldn’t reach it.
Soon the ringing stopped and an alert beep flashed. Probably her big sister.
Since the last time they talked, Stella had been cross with her for leaving the church when her miracle was so close and had been orchestrating her return for more prayer.
Her attitude had even worsened when she told her the outcome of her visit to the Dr. — the costs for the next set of tests she needed.
From seeing Dr. Sawyerr, she’d been led to the reception to await the details of the sonographer.
She would need to contact them herself to book the scan, but the specialist could be seen at the same clinic — she only needed to pay their consultation fees upfront.
This would cost N20,000.00, and she would be told of the cost for the biopsy when she saw the specialist.
She made the payment from her dwindling funds and left the clinic.
It was not too far to walk to the sonographer despite the heat; saving her the cost on an Uber.
She presented the form she’d been given at the clinic.
Breast scan cost N5, 000.00. She took a deep breath. So today alone, N25, 000.00 in addition to other costs she’d already had.
Nearly 2 hours later, she emerged from the scan lab, clutching her report.
The sonographer, a large, gruff man had stared too long at her breasts even though he had not touched her.
Grace felt unable to ask him what the result meant.
And – she was feeling slightly dizzy, having missed her breakfast and now being the late afternoon.
Stopping at the nearest Chicken Republic — she got a drink and meat pie and sat in a corner. She opened the report.
The words danced across the page, not really making sense. ‘……5cm localised solid mass in upper quadrant of breast’; she read — ‘biopsy recommended’.
Chapter Four – Destiny?
And this morning as she woke from restless sleep, the words continued to go around in her head.
It was the day of her appointment with the specialist.
It had all been arranged after she spoke with her sister.
The specialist had called herself to arrange the appointment and confirm what she needed to pay.
She was going to need a full day off work again — they’d agreed for the Friday.
Her house rent was due in 3 months and she had been putting a little sum away regularly.
Being a relatively new junior staff at the bank, she couldn’t yet access the loan facility available.
Her landlady was a strict woman in her mid-60s who was very religious about all things — especially her rent collection.
But she’d been there for 3 years now and there had been no major issues.
She didn’t want to think about how things may change if she defaulted.
So slowly, her little savings had been dwindling; and after today’s procedure, it wasn’t clear how she could proceed.
Stella had promised to meet her at the clinic and had been ringing to check she was awake.
She’d eventually come round though still reserving her feelings about this lack of faith that had led them away from her church healing.
‘I still pray every day, Sis’, Grace had said — ‘I believe God will heal me and He can use the modern medicine to do so.
After all, prayer can be said in and outside the church’
It was 9 am and they were at the clinic again, she’d come a little scared, but hoping that she’d be leaving in a few short hours.
The specialist, Dr. Atamano arrived on time. She was a consultant at the teaching hospital.
A tall, slim lady, she moved quickly and had a cool gaze every time she peered at Grace through her glasses.
She nodded as she went through the scan report; then indicated for Grace to undress behind a screen for her examination.
Her touch was gentle, though as she pressed and prodded around the breast, feeling the lump.
As all the other doctors had done, she checked the next breast, then the armpits and her neck.
It went smoothly from that point. Hours later, the procedure was done, she emerged with a slight ache in the chest, and a weekend to spend at home.
She preferred not to stay with Stella, and was actually missing some of her friends.
She thought of the last party she’d been to so many weeks ago, the evening she’d first found this lump that had now changed her life.
She’d stopped talking to a lot of friends -abruptly — and they had given up on her too.
But some remained puzzled, wondering what was going on.
She felt sad about that but just couldn’t find the word to explain to them.
She tried to put it off as work pressure; tried to put a brave front that sometimes worked.
There was nothing to do for 3 weeks, as the specialist had booked the appointment to discuss her results then.
Strangely, now she’d had the biopsy, time seemed to fly.
She got back into work, managed to start eating again, trying to keep her mind off the next appointment.
For her boss’s retirement party, she’d even put some money down for the Aso Ebi the other staff were planning to wear on the day so it wouldn’t look odd.
Attending was another matter.
As she sat in the consulting room with Stella, her mind was strangely calm.
She’d picked out a bright green Adire dress that was simply cut but always looked really nice on her. Somehow, the bright green had caught her eye this morning and relaxed her thoughts.
Dr Atamano looked cool and capable, just as the last time.
In quiet, soft words she said:
‘Grace, the biopsy results have confirmed early-stage cancer in your breast’.
It’s called an invasive ductal cancer.
I’m sorry. I know we were hoping for better news’.
She kept quiet, then watching her.
Stella was crying, but Grace felt as if she were another person looking on.
So all the fears, the weeks of waiting confirmed.
It was almost a relief, just to know for certain now.
Grace? — she could hear Atamano calling again and realised she’d been silent for a long while.
She shook herself — ‘What is the treatment now?’
The words felt strange — not like her voice. Her heart was beating fast, she felt dizzy.
The surgeon continued: ‘Since we’ve found it quite early, it would seem if we work fast to treat, we can get on top of this’.
Grace took a deep breath, forcing herself to listen as the surgeon went on:
‘In Nigeria, we can offer different treatments for cancer, though I will say we have some challenges with the cost and how speedily we can have access to some of the treatments.’
But we do the best we can with what we have.
She went on: ‘I’m part of a group of surgeons who have been calling for changes in the way we treat breast cancer here because, we are seeing so many more cases — and in young women like you, too.’
‘Some people who can afford to will travel abroad to the UK and US or South Africa and India, but they are few’.
‘We’ve set up a breast cancer NGO, trying to raise funds to assist women who have breast cancer get the right treatments.
We can talk about that later.’
‘I would recommend you have surgery with a course of radiotherapy and chemotherapy. With surgery, there are 2 options.
We would either remove the entire breast — and some areas in your armpit; or we would remove just the lump with a large area around the lump itself, leaving parts of the breast.
In both cases we would recommend radiotherapy and chemotherapy after.
Removing the whole breast increases the chances of taking as much of the cancer away so it is less likely to return for a long time.’
‘So even with all that, it can return?’ — Stella spoke for the first time.
‘Sadly, yes in some cases’, the surgeon returned.
‘In breast cancer we talk of survival.
For example, ‘5-year survival’ — that means — depending on the type of cancer, the chances of a person surviving 5 years from when it first happens.’
I have a list of the treatments here with their costs.
I think you should take some time over the weekend and go through then book an appointment again, so we can discuss and finalise.
Please remember — it’s at an early stage — I’m optimistic that if we start to treat quickly, we can expect a good outcome.
My personal mobile is included — please call if you need something explained.
‘But. Grace silently wondered — ‘what about my breast?
If you take it away — will I never breastfeed? Will I never have children?’.
She bitterly swallowed the questions for now — ‘what was the point; who would even marry a woman with one breast?’
Grace and Stella walked outside the clinic. It was still mid-morning and the heat was tolerable.
As she climbed into the car, she could feel her sister watching her.
But she said nothing.
Instead Stella spoke to her driver: ‘Joseph — please let’s stop at Rumuokoro market, before you take us back to the shop.’
Grace wasn’t paying attention to her surroundings.
Her thoughts were racing.
What could she do now?
If there was a chance she could be treated — how would she pay?
Travelling abroad was a dream and she could never afford it.
But glancing at the forms on her lap, she could see costs running into millions of Naira.
So, she never saw the large bus as it careened headlong into her sister’s car.
She only remembered hearing loud screams and an ear-shattering crash, and then a sensation of floating …… and when she looked down — chaos everywhere.
Her sister lying limp, on her stomach, covered in blood.
Their car was mangled under a bus, and there was so much blood.
Where was Joseph, their driver?
People scattered around — screaming.
As her thoughts faded she saw a bright green flash in the corner of her eye, was it a dress? but there was so much blood — she could see a body in green Adire — lying still, not moving.
Learn more about Breast Cancer
Got questions on this topic? Ask Here.
Editing by AskAwayHealth Team
All AskAwayHealth articles are written by practising Medical Practitioners on a wide range of health care conditions to provide evidence-based guidance and to help promote quality health care.
The advice in our material is not meant to replace the management of your specific condition by a qualified health care practitioner.
To discuss your condition, please contact a health practitioner or reach us directly through firstname.lastname@example.org