Scans for Cancer: Playing Telephone

by Debbie Kerr

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There’s a reason why the thought of having any kind of scan/test causes you anxiety, also known as scanxiety. It doesn’t matter if your scan is to determine if you have cancer, if you have maintained your No Evidence of Disease (NED) status, or if your existing cancer has spread. All you know is that one test can allow your life to continue as it is or turn your life upside down so that it will never truly be the same again. And so I wait anxiously for the day of my tests.

My mind wanders and I realize that there are a lot of games associated with the cancer experience. That’s not to say that they’re fun, but they’re definitely challenging. There are waiting games and mind games. There are games of strength and endurance. Some games involve strategy. All games involve some element of communication and demonstrate that miscommunication can happen at any time, just like a game of Telephone, just like I experienced when I went for my tests.  

How to Play Telephone
First, to be clear, the game is about speaking (actually whispering) and listening and not about the telephone itself.  The game demonstrates how quickly and easily miscommunication can occur.  

The actual game of Telephone involves a group of people sitting in a circle so that they are close enough to each other to be able to whisper in the ear of the person on either side of them.  (It sounds much creepier than it is.) One person is the start of the circle and whispers a word or phrase into the next person’s ear. That person then whispers what was heard to the next person. This process continues until the last person in the circle says the word or phrase out loud. The person who started the game either confirms that what was said is correct or says the correct word or phrase. For example, “banana split” could have easily become “where I sit” or even “blanket”.  You get the idea. 

The Game versus Reality
In Telephone, miscommunication is what makes it fun. It’s almost a disappointment when what is said to start the game is the same as what is said at the end of the game. You want some miscommunication to occur and the greater the difference between the starting and ending phrase the better.  In real-life, the opposite is true. Miscommunication is rarely funny.      

Some Background
I had a mastectomy of my left breast in 2011 when I was diagnosed with Ductal Carcinoma In Situ (DCIS) and Invasive Ductal Carcinoma (IDC) breast cancer. My surgery was followed by chemo and radiation. I took Tamoxifen for about seven years. Technically I had done everything I was supposed to do to keep my cancer from returning yet, nine years later, I thought I might have to go through the cancer experience again.  

I asked for a mammogram to be done because something seemed “off” about my right breast. The nipple was not inverted, but it never protruded. My breast was lumpy, but it had always been lumpy since I had my chemo treatments. Each lump seemed suspicious, so it wasn’t like there was one particular lump that I thought might be a cancerous lump. Nothing seemed familiar about my remaining breast since I had chemo. I decided I couldn’t take any chances. I asked my doctor to send a requisition to the hospital so that I could have a mammogram. 

Game 1 – What tests?
My game of Telephone started when I called my doctor’s office and asked if a requisition for a mammogram could be sent to the hospital. The Registered Nurse Practitioner (RPN) repeated my request to the doctor, my doctor completed the requisition and the RPN called me back. 

Suddenly, I was not hearing what I expected. The RPN told me the doctor ordered not one, but two tests, a mammogram and a cone mammogram. I was confused. My scanxiety level quickly escalated. Why would my doctor order this additional test? Why would she order two mammograms? Was there something she suspected? For two days, I struggled with scanxiety as I tried to figure out what was going on.  I was already anxious about whether or not there was something wrong with me and now, with this extra test (a miscommunication?), my worst fears seemed to be becoming a reality.

Luckily, like a game of Telephone, a miscommunication can be corrected as information is repeated from one person to another. When I reached the hospital the day of my appointments, I was told I would be having two tests, but one would be my usual mammogram and the other would be an ultrasound. This made more sense. My doctor was just being cautious. I was grateful the miscommunication on the telephone was quickly corrected in person. 

Game 2 – Which breast?
My first appointment was for a standard mammogram. I changed into a gown. I answered the technician’s questions. She even copied information from my last visit so that I wouldn’t have to answer as many questions. Everything was going well until she told me she was doing a mammogram of my “left” breast…a breast I don’t actually have since my mastectomy. There had to be some kind of miscommunication. 

And then I remembered. My requisition didn’t actually say which breast needed the mammogram. I guess my doctor thought it would be obvious. However, the requisition did mention that I had had cancer in my left breast. Mystery solved. This wasn’t actually a miscommunication; it was an assumption that if my original problem was with my left breast then the same breast would be the problem this time.

My game of Telephone was lackluster. While there was some minor miscommunication it was resolved quickly…just like which tests I was having.

Between Games/Intermission
Since I only have one breast, I only need half the time for a mammogram. I was finished early. As I sat in my little booth to get dressed, I had to decide whether or not to put my bra and prosthetic breast (foob) on for the relatively short walk down the hall to my ultrasound appointment. In the end, I decided against it, got dressed, and carried my foob-laden bra in my hand. For those who know me, this action would not surprise them. This wasn’t my first foob-carry experience.

Game 3 – Which breast?
When I entered the room for my ultrasound and the technician told me she was doing an ultrasound on my left breast, I knew the “which breast” game of Telephone had not ended. She said left breast and I repeated left breast. The only difference was that I had a question mark after mine. I told her I didn’t have a left breast, but she chose to believe what was on the requisition. She reminded me that it was my left breast. We seemed to have mastered the repetition aspect of Telephone, but it didn’t mean that we were communicating effectively. 

Since the technician didn’t seem to want to listen, which is critical to play Telephone, I had to get a little physical. No, I didn’t get violent. I pulled the towel aside and let my missing breast communicate for me. 

My “which breast” game of Telephone had finally ended.

Game 4 – Where’s the problem?
The correct breast identified, the ultrasound technician asked me where the problem area was on my breast. I didn’t know what to say. Believe it or not she didn’t find it helpful when I answered, “I don’t know. Something doesn’t seem right”.

I just assumed that if I didn’t have a specific area to point to that an ultrasound would be done of my entire breast. I also assumed that someone would be able to look at the mammogram I just had and be able to point the technician in the right direction. Assumptions are not a good means of communication, as I learned during the two-part “which breast” game of Telephone.

My technician decided to introduce a “call a friend” aspect to our game of Telephone.  She went to talk to the radiologist. Ten minutes later she returned and did an ultrasound of my entire breast.  Enough said.

And now I wait for my test results. Will I get called back? What will I do while I wait? I assume I'll play a few mind games.

Watch for my next blog post to find out what happens next.