‘It was hard not to break down’

I DO NOT think I will ever forget the dreadful feeling of shock and fear I experienced that morning in mid-October last year, while waiting for a biopsy following my first mammogram.

I realised it was likely to reveal a breast cancer and that realisation filled me with intense dread.

I had found a lump in my left breast towards the end of August and immediately saw my GP. I had learned through sad personal experience of loss and seeing loved ones suffer not to take any chances with changes in my breasts.

The lump was not round, like a pebble or a marble, it was not hard, nor compact. It was an oddly shaped mass. I was immediately referred for a mammogram with the Breast Clinic and while awaiting my appointment my affected breast started to swell and become tender like mastitis.

Despite what I had heard and read about breast cancer not hurting, I was in pain.

The mammogram and scan had revealed a mass with two tumours with a total span of 5cm.

I had cried quietly through the biopsy as one doctor took a sample of tissue and placed titanium markers in my breast. I had cried throughout the conversation I had with the surgeon and specialist nurse as they tried to comfort me. I cried all the way home knowing I had to share the news with my husband.

I wondered how I could share this awful news with my family and what their reaction would be. Two close relatives had suffered breast cancer and while one was successfully treated and survived, the other lost her struggle with the disease. Her death had left us traumatised for years.

My biggest fear was for my children. The prospect of leaving them motherless was, and still is, horrifying. Like any parent, I want to see my kids finish their education, grow up and fly the nest before I go anywhere.

Telling my children of my diagnosis was really hard. It was hard not to break down, but I did not want to be too controlled either. It was good for them to see me emotional so that we could comfort each other. Once I got the words out and we stumbled through the shock, we were able to talk in a factual way. It is a big subject to understand for adults, let alone our children.

Up to this point, my health was always good and for that I feel blessed. Life and routine changed quickly once I had received my treatment plan. My cancer was an aggressive type: oestrogen receptive, HER2 positive, graded Stage 2. It was highly treatable but needed hard-hitting treatment, which for me was a blend of chemotherapy, surgery, radiotherapy and hormone treatment. It would take a year out of my life, but my chances were considered good to survive the disease.

It is a real conversation-stopper announcing you have cancer. Initially when I was sharing this news I was getting choked up, but by the time I had told the 100th person some months later, it felt like telling them I was suffering from a cold.

My family rallied. It was all hands to the pump for pre-treatment preparations. We scurried around in the same way we had preparing for the arrival of a new baby. Ensuring that the kids’ routine was as normal as possible, that we had enough food in the freezer, getting the family planner up to date, lift shares and sleepovers organised for days when I was in hospital.

My husband stepped up not just to be the primary parent for when I was most poorly – he would at times be my carer, my cheerleader, my home nurse and always my very best friend. Our preparations were for a test of endurance which we went through together and while I would suffer the physical effects, mentally it was my whole family, not just me, who was affected.

My daily mantra became: ‘It could be worse.’ For my family to cope, my approach and mindset to treatment would have to be positive and solid. I am by nature a positive person – though during my worst days, this was difficult to maintain – and I am blessed with a loving and supportive family, amazing friends and colleagues who have helped immensely.

I scheduled my chemo cycles into work and put these into our team diaries, ensuring I had cover for the days I was likely to feel at my worst. The cyclical nature and certainty of the treatment schedule gave me strange comfort and I was keen to start, to stop the cancer from growing.

The medical preparation for the chemo was intense – scans of the heart, MRI of the breasts, tests of the bloods and what felt the most brutal to me, the insertion of a PICC line into the vein of my left arm into my chest wall. This would remain with me for the entirety of the months of chemotherapy.

This caused me discomfort for the most part and limited my mobility by some degree. It is not the same for everyone – I hated my PICC, but it is an amazing innovation, a silver lining reducing the number of unique injections I needed over the months.

Imagine being pushed off a high diving board into the deep end of the pool not knowing if you’ll sink or swim – this was how I felt beginning my six rounds of chemotherapy. The toxic cocktail of four different drugs was given intravenously over a few hours every three weeks. In the few days after each treatment, I sometimes felt so awful I did not know what to do with myself. By the time you start to feel better some 10 days later, it is time for another round.

I decided to wear a cold cap to reduce my hair loss, as at least two of my drugs caused alopecia. Being subjected to wearing a hat which looked silly to protect my hair follicles by taking my scalp to minus five degrees seemed to be a small burden in the scheme of things.

The ebb and flow of chemo lasted from November to February: I would feel wired for the first few days, poisoned, wretched and weak for the next few days, then starting to climb out of the hole suffering the effects but getting back to an adjusted normal for the remaining days of the cycle. I found it very difficult to eat and drink when I felt at my worst, but it’s hugely important to keep up your strength and keep hydrated.

Not all breast cancer patients have chemo and not everyone who has it tolerates it through to the end of their treatment – there is a long list of very unpleasant side effects. It is a very harsh cocktail of drugs and a systemic regime designed to kill the fast growing cancer cells, but it also damages healthy cells.

Chemo has put me into complete menopause, resulting in significant but not complete hair loss, my nails are damaged – some are falling off, my muscle tone and strength has reduced, my skin is thinner and drier, my teeth are constantly sore, and my taste buds have been damaged – all of these things are worth suffering if the outcome is good.

I compartmentalised my treatment into different phases. This approach has helped me to cope. I put aside thoughts about my surgery until I was nearing the end of the chemo. I had been told I would need a mastectomy and that was something I had not wanted to think about in too much detail at the beginning.

Being a first-time surgery patient, I was inevitably going to be like a rabbit in the headlights and even more so when my operation was brought forward by four weeks, meaning I was only a month clear of my last chemotherapy session and at my weakest. I had a mastectomy and immediate reconstruction with an inspection under the arm into my lymph nodes. All the diseased tissue was successfully removed with clear margins and the two investigated lymph nodes found to be clear.

The treatment has been a success – a complete pathological response. In my case this means that I avoid radiotherapy but will continue to receive targeted Herceptin infusions regularly until the end of this year, in addition to a daily hormone suppressant for five years.

Will the cancer come back? We do not know. I was not a high-risk candidate in the first place, I have always watched my weight and eaten a balanced diet, kept fit and active, I am a non-smoker and light drinker, but I am female and getting older therefore I am automatically in the risk category.

So why am I sharing my story? Well, I want to help raise awareness to make sure that people are checking their breasts and chest area regularly – men can get breast cancer too – and that any lumps found are medically checked, not left. I have been shocked at the number of ladies suffering just here in Guernsey, but I should not be. According to Cancer Research UK statistics, one in seven of us will get the disease. The informal breast cancer support group I am part of – some 10 ladies, under 50 years old – are a stoical lot, bearing up with humour, love and openness. There has been a significant number of ladies under 50 being diagnosed recently and we are just a snapshot of many others suffering with breast cancer locally.

I do not want to scare people, but a high degree of awareness will remind us to check regularly and prompt us to take quick, decisive action if we find anything unusual.

The other reason for talking about my health and treatment is because I want to publicly heap praise upon our health service here in Guernsey. The professionalism, compassion and support I have experienced from every person involved in my care has given me the confidence to meet my treatment head-on with strength and get through some really difficult times.

Any cancer diagnosis stops the sufferer in their tracks – it is a word that we associate immediately with a swift, painful demise and our emotional response is deep. Cancer is an umbrella term used for a myriad of cell mutations which equally can receive a myriad of treatments. Breast cancer treatment can be particularly harsh, but it is well researched, and the results speak for themselves.

Please get yourself checked if you find anything unusual in your breast/chest area. If the news is the worst for you, it is highly likely your condition is treatable with good long-term prospects.