Susannah takes me to the pelvic scan appointment. The first thing the technician asks is Do you know why you need this scan? No, I say, I don’t. Apparently neither does he. The referral requests a check for fibroids in my uterus however I had a previous scan in late 2022 that confirmed fibroids in my uterus. So he is tasked with checking for what has already been established. Great. We agree that it is a virtual waste of time, but as I’m already there we go ahead. And, surprise, surprise – I have fibroids in my uterus!

Next up is Oncology with Dr Sk at the Harbour Cancer and Wellness Center. This is the same hospital where I was seeing Br for Physio and Dr Kt for surgery consultations. When we arrive at 5pm the clinic looks closed. The doors slide open to a quiet and empty waiting area. Dr Sk has extended her day to see us and I appreciate that. There are no nurses so I am weighed in with my height taken and recorded by the receptionist, and then we are ushered in to see Dr Sk. The first thing she asks is How are you? To which I reply, I’ve been better. 

I’m so sorry this happened to you, she says. At first I think she’s talking about the mismanaged appointments but then I realise she’s talking about the cancer recurrence. I don’t know what to say. I swallow hard and try not to cry. Dr Sk firstly goes through my health, any symptoms, pains or issues and then sets about explaining my test results. She is very thorough and by the end I have a good understanding of my situation. It’s not good. I’m Stage 4, incurable. While Dr Sk refrains from giving me a precise prognosis, she indicates that the length of time left for me could be less than a year. Maybe months, depending on how the cancer responds to treatment.

Treatment. It’s chemo again, but a different mix. Betty’s bitches have morphed once again, this time becoming Triple Negative, no longer hormonally driven, thus eliminating some forms of treatment. Not only that but the histology of my lymph node sample indicates neuroendocrine differentiation – a rare cancer type that also only responds to some types of chemo. It is possible that Betty was a neuroendocrine carcinoma all along but just not identified. Dr Sk assures me that treatment would have been no different so I do not feel cheated by misdiagnosis, just incredibly unfortunate.

I agree to start chemo as soon as possible. This time it’ll be two weeks on, one week off and, if successful, it will be ongoing, as long as I can tolerate it or until it becomes ineffective. I’m praying for success. Nothing has worked so far but perhaps this will be the right cocktail?

Dr Sk wants to order a PET-CT in part to establish a baseline to be able to track whether the chemo is effective or whether the cancer continues to progress, but also, as I have been having headaches, to see if Betty’s bitches have settled in my brain. I would probably not be able to get this scan very quickly in the public system so am grateful once again for my workplace health insurance. I’ll need to check if the scan is covered, but at this stage I’ll do it regardless. 

It feels like we are on a very tight timeline now.