T Behind Enemy Lines: A Personal Perspective PersONAl reFlectiONs FEA

Behind Enemy Lines: A Personal Perspective
by Tracey Moffatt
he doctor nods to me, as he excuses
himself from the pastel-coloured
examining room and pulls the door
tight behind him with a piercing double-click of the latch. It is a mystical
door that changes lives in an instant;
a door you step through as an individual seeking consultation, and one you
exit as a person living with cancer. I sit
in silence and wait, as Jane, a single
middle-aged woman, struggles with an
accumulation of unspoken thoughts
and emotions. I hesitate slightly, and
roll my stool closer to her in an effort
to fill an emptiness. I am acutely aware
of Jane’s trepidation, as my fingers fidget with the ballpoint pen secured to my
lanyard. I know she needs to hear she
is not alone. Jane looks to me with fear
welling in her eyes, and desperation filling her voice, “What would you do?” she
When I first began working in the
melanoma department, as a research
nurse in clinical trials, I joked with my
colleagues that I was the poster child
for melanoma: red hair, blue eyes, fair
skin, multiple moles, and vulnerability
to sunburn easily. As a young healthy
woman, the thought of having skin cancer had never crossed my mind; that
is until the freezing from my biopsy
started to wear off. For as long as I could
remember, I had a dark mole in the centre of my chest, just under my bra line.
After being introduced to the melanoma department and learning I was at
an increased risk for melanoma myself,
Tracey Moffatt, RN, BScN,
MHSc(C), CCRP, Princess Margaret
Cancer Centre, University Health
Network, 610 University Avenue,
Toronto, ON, M5G 2M9
[email protected]
I decided to have it biopsied. “I would
rather have a biopsy scar,” I said, “than
have melanoma.”
Unfortunately, I ended up with both.
“I’m so sorry, it’s melanoma” stopped
me in my tracks. My thoughts scrambled, “How can I tell my dad I have melanoma? Mom died nine years ago today
from breast cancer!” as I spiraled into a
sobbing mess.
My melanoma experience was a
whirlwind that left me with little time
to process my thoughts. Less than a
week later I was on a friend’s couch with
a fresh railroad of stitches stretching
across my chest; the anesthesia gently
wore off as I struggled to pretend I was
dressed for Halloween.
The days after surgery felt like an
eternity, as I awaited my pathology
results. The news finally arrived only
a few days later: the cancer was caught
early. I was lucky. Even so, the diagnosis left me trapped inside my head,
having difficulties focusing on anything else. I saw myself mirroring my
mother’s fate. Diagnosed with cancer at a young age, dying a few years
later; I believed her destiny would soon
become my own.
I promptly became fearful that cancer was not finished with me and had
further moles removed. To this day, I
continue to find it difficult to appreciate how a piece of me could have been
cancerous. It had been a part of me for
as long as I could remember, yet this
mole penetrated my defense system. It
betrayed my body like a spy infiltrating
enemy lines. It was especially devious
because my dermatologist’s well-trained
eye had not been the least bit persuaded
the mole was suspicious.
Going back to work was horrible. I
would see my patients’ biopsy reports
and ruminate over comparisons
with my own. Around every corner I
would glimpse reminders of my own
Canadian Oncology Nursing Journal • Volume 26, Issue 4, Fall 2016
Revue canadienne de soins infirmiers en oncologie
Four years later I remain cancer-free and have come to terms with
my diagnosis. Returning to melanoma
clinical trials, with a new perspective
and first-hand experience allows me
to advocate for my patients’ best interests. It offers me a powerful motivation to ensure they receive the care
they deserve, as I know what care I
might want in the future. I find inspiration in knowing the tables can be so
easily turned.
“Jane, I understand that you are
scared and would do almost anything to
fight this cancer, you need to ask yourself what is right for you.” I explained
that, “Melanoma is a very deadly skin
cancer, which, until recently, did not
have many treatments and results were
almost always poor. But now there are
options, with improved outcomes,” I
reassure her.
“Jane, I’m sorry I don’t have the
answers you are looking for,” I say, as I
place my hand softly on hers, “I wish I
did.” I counsel Jane to decide what risks
she is willing to take and strongly recommend she consider her own personal
My key message is simple and I
press it further, “Jane, even though I’m
sitting here with you, please don’t feel
obligated to accept treatment because
we’ve presented a few options. It’s
important for you to choose because it’s
the right thing for YOU to do.” Our society focuses on fighting and conquering
cancer, but it is rare for patients to hear
that it is okay to step back to focus on
their priorities.
I may never reveal the true intimacy
when asked, “What would you do?” but
I will support Jane’s decision-making
process; ensuring she has the information to make a well-informed medical