Hi Frankiemo,

A very warm welcome to our forum, although I'm sorry that you've had to join us.

As Dave rightly says, "this is complicated". Your surgeon obviously thought that your case was straightforward, but possibly with you expressing your doubts about radiotherapy and chemo, he wants to make absolutely certain that nothing has been missed. I was in a similar position to you 15 years ago. I had just lost my Mum to breast cancer and was absolutely terrified of surgery and treatment. However, my mammogram was not as clear as it could have been. Some cancers react in different ways and mine can be difficult to detect on mammogram or ultrasound. My surgeon was therefore keen to ensure that his initial diagnosis was correct, before he proceeded with surgery and treatment, so I had a CT scan and a MRI. I initially had a lumpectomy and removal of six lymph nodes. Fortunately, these were all clear. I took Tamoxifen for the first year year. This didn't work for me, because, almost a year later, I discovered a second cancer in the same breast. 

I then had a double mastectomy, followed by Letrozole for a further 6½ years. Not everyone gets side-effects with Letrozole - some people just sail through their treatment. Unfortunately, I had a number of side-effects, but I would go through it all again if I had to, because it has, so far, prolonged my life by 15 years. I know how frustrating it is when you think that you have had all the necessary tests, only to be told that you need some more. The doctors don't suggest these additional tests on a whim - they do so in the hope of giving us the best possible chance to overcome this hurdle. They have obviously discovered through the tests that they've already done, that your cancer feeds on the hormone oestrogen. The treatment for this type of cancer is to treat it with hormone therapy, to combat this. It sounds as if you are fortunate that your cancer has been picked up fairly early, and responds to hormone treatment. 

None of us want a cancer diagnosis, but treatments are continually improving. Doctors can advise you of the best way forward, but the final decision is up to you. Please don't lose faith in your team. These people are experts in their field. They are constrained by costs - so they cannot give you all of the tests to start with, as many people don't need the additional investigations. We feel disappointed when it takes longer than average to get an accurate diagnosis, but if the process of diagnosis is rushed, mistakes can be made.

A cancer diagnosis certainly messes with the mind and I can understand that you must find this even more difficult being bipolar and having nobody to discuss this with. There are organisations that offer counselling for people touched by cancer. I had to avail of these services, when I was first diagnosed and found them very helpful. Many of these are run by charities like Maggies, or Macmillan. If you have one of these centres near you, it would certainly be worth dropping in. You can also pop in for a chat with other people who have cancer and enjoy a cuppa at the same time. All of these services are free of charge and you might find that you benefit from them, when you're feeling so alone.

I am not a doctor, but I wonder if it is possible that your fatigue and lack of energy is caused by your cancer? If so, you could well find that this improves after treatment.

The end decision is yours, but please ensure that you are making it from an informed point of view. You will also find that it helps to talk to others on this forum.

Please keep in touch and let us know what you decide to do. Remember that we are always here for you.

Kind regards,

Jolamine xx