My nightmare all a `mis take'
Carenza Lewis lost both her breasts and three years of her life to fear because of a doctor's error, writes Judith Woods.
IN 1997, television archaeologist Carenza Lewis underwent a double mastectomy after she was diagnosed with cancer. Eight months ago, she was told a mistake had been made. There had been no trace of disease; her breasts had been removed for no good reason.
The consultant histopathologist who diagnosed cancer was James Elwood, currently at the centre of an inquiry over more than 200 misdiagnoses and a man whose work in Irish hospitals has had to be reviewed. Until last week, the Time Team expert had never seen the 78-year-old, who was employed by the Princess Margaret Hospital in Swindon, England. Her first glimpse of him was in a newspaper photograph of a man hiding from the press with a plastic bag over his head.
``Maybe if I'd known how old he was, or had met him face to face at the time, I might have got a second opinion,'' she says. ``All the other tests showed no signs of cancer, just the lumpectomy he looked at but that was the result we believed. It's ironic now, but I remember I actually felt lucky that someone had spotted the cancer.''
Carenza, 37, the mother of two children, eight-year-old Anna and Dominick, four, seems unnervingly calm. She admits that her archaeologist husband, David, feels more anger than she can muster.
``I spent so long believing I was a cancer sufferer that I still feel overwhelming relief that I have been given a reprieve,'' she says. ``When I was told of the error, I just felt my whole past unravelling behind me; this huge thing which had dominated my life for so long suddenly didn't exist.
``Maybe in six months' time I will feel more anger, but right now I just keep thinking it could be worse there are so many people out there who dream of being told their cancer was all a mistake.''
During her teens, Carenza had discovered benign lumps in her breasts, which were operated on. In 1996, after her son had stopped breast-feeding, she noticed a fibrous thickening on the underside of her right breast. Ultrasound and a fine needle aspiration test showed no sign of cancerous or pre-cancerous cells.
But then, some days later, the results of a lumpectomy came through. Carenza was called in to the hospital and told there was evidence of cancer.
``I felt absolute horror,'' she says. ``It was like being hit in the face; I was 33 years old with an 11-month-old son, and a daughter who had just started school. It sounds so melodramatic, but all I could think of was breaking the news to my daughter that her mother might die, and imagining my little boy, who would never even know his mother.''
Carenza was confused that the other tests had failed to find any cancerous cells, but was told that this sort of anomaly did sometimes occur.
She decided to have a mastectomy. ``I was desperately worried. I didn't care what happened to me physically, as long as I survived for the sake of my children.
``I was so angry that my breast had done this to me; I regarded it as a hideous part of my body which was attacking me.''
She describes the eight days between diagnosis and operation as the worst time of her life. ``I kept imagining the disease feeding away inside me. I couldn't eat or sleep or concentrate on anything. I just wanted rid of my breast.''
The mastectomy took place in January 1997. Skin was removed from her back for breast reconstruction, which took place during the same eight-hour operation. Tests showed no cancer, although the lumpectomy had apparently indicated the disease had spread into the breast.
Carenza awoke in great pain, but at first felt elated. Later, anxiety set in. Her trust in test results had been shattered and she was terrified further evidence of cancer might go unnoticed.
``I was reassured that the other breast would be monitored, but I had no faith in ultrasound or mammograms or any other tests, and I felt the only solution was to remove the breast,'' she says. ``My surgeon, who was superb throughout my treatment, was initially reluctant. But I fretted and worried for months; terrified that every ache or pain was a sign the cancer had spread.''
The strain took its toll on family life. Carenza describes waking every morning with a sick feeling of dread. Tense and irritable, she grew short-tempered with the children. Then, in November of that year, Carenza had her second breast removed.
As she and her husband sought to rebuild their family life, they abandoned hopes of a much wanted third child. Carenza gave up a full-time archaeology job she loved because of the effects of field work on her health. She continued her Time Team broadcasts, however, despite periodically suffering deep depressions.
But by spring 1999, she was coping better. She was about to undergo further reconstructive work on her breasts, when she was called in for a meeting with hospital officials.
``I was told that there had been a review of pathology, and that in my case it was `good news', and the pathology from the original lumpectomy was a mistake. It was as big a shock as being told I had cancer. I wasn't sure how to react - and I still don't know.
``Dr Elwood didn't come to the meeting. Maybe there were reasons, but I would have liked to have seen the person who had such a huge impact on my life.''
Dr Elwood is ``not prepared to discuss any patient with anyone else''. The Princess Margaret Hospital declines to comment.
Carenza intends to take legal action for negligence. Three years of her life were lost to fear. The fact that her breasts are reconstructed may be indiscernible, but they are numb and without sensation.
``I'm not the person I was three years ago,'' she says with equanimity. ``But I don't think my brain has yet been able to handle the fact that I'm no longer a cancer patient. Perhaps I'll feel different in the future; right now, more than anything else, I feel grateful to have a future.''
* The Daily Telegraph