When all you hear is ‘can­cer’

Over 3,000 Ir­ish women are di­ag­nosed with breast can­cer an­nu­ally but the num­ber of sur­vivors is ris­ing

The Irish Times - Tuesday - Health - - Front Page - Ar­lene Har­ris

Breast can­cer is the most com­mon ma­lig­nant tu­mour di­ag­nosed among Ir­ish women – more than 3,000 ev­ery year. And while these sta­tis­tics are alarm­ing, it is re­as­sur­ing to note that the num­ber of breast can­cer sur­vivors is also ris­ing, with 83 per cent of those with a breast can­cer di­ag­no­sis liv­ing five years or more.

Oc­to­ber is Breast Can­cer Aware­ness month, when we are asked to pay at­ten­tion to breast health, and money is raised to help fund breast can­cer re­search and ser­vices for pa­tients through ini­tia­tives such as the Cups Against Breast Can­cer cof­fee morn­ing.

Cru­cially, we are re­minded to seek med­i­cal help if we have any con­cerns.

Kath­leen O’Con­nor did just that and, in 2014, when she was 41, she no­ticed a lump on her left breast. She vis­ited her GP a week later and was re­ferred for fur­ther ex­am­i­na­tion, which lead to a can­cer di­ag­no­sis.

“I wasn’t par­tic­u­larly con­cerned when I found the lump as I had a his­tory of fi­broade­noma in that breast in my 20s,” says Kath­leen, who is mar­ried to Niall and has two daugh­ters, Sad­hbh (14) and Grace (12). “But it did feel a bit dif­fer­ent, so I de­cided to make an ap­point­ment with my GP who hap­pened to be on hol­i­day, so I was ex­am­ined by a locum who im­me­di­ately re­ferred me for fur­ther tests.

“I didn’t for a minute think I had can­cer and af­ter drop­ping the kids to school, I went alone to the breast clinic where I had a phys­i­cal exam and then was sent up for a mam­mo­gram. But sit­ting there in the blue pa­per gown, a sense of dread de­scended as the in­ves­ti­ga­tions con­tin­ued and I was told I needed an ul­tra­sound and biopsy – I knew things were get­ting se­ri­ous and when I was asked to stay on to see the con­sul­tant, I wished I hadn’t come alone and called my hus­band.”

Dur­ing the con­sul­ta­tion, the spe­cial­ist men­tioned the pos­si­bil­ity of can­cer and Kath­leen, who works as a learn­ing and de­vel­op­ment con­sul­tant and ex­ec­u­tive coach, said the fam­ily was booked to go on hol­i­day to France so any treat­ment would need to take place on her re­turn.

“This might seem crazy, but at no time did I con­sider not go­ing – it was our first fam­ily hol­i­day in a num­ber of years – so the con­ver­sa­tion turned to if and when they would call me and how soon I would be back,” re­calls the Dublin woman.

“Need­less to say I was in deep de­nial and there was a cloud over me on hol­i­day as it was hard to be present, but I filed it away in my mind as much as I could. When we re­turned, I got a call [to get the re­sults] and both knew and didn’t know what was com­ing. Niall and I re­ceived my di­ag­no­sis to­gether – a stage 2 in­va­sive lob­u­lar car­ci­noma and although it wasn’t re­ally a shock, it was still a bit of an out-of-body ex­pe­ri­ence, as if they weren’t ac­tu­ally talk­ing about me at all.”

Treat­ment plan

As soon as Kath­leen (now 45) re­ceived the news, doc­tors told her that treat­ment would need to be­gin with­out de­lay. “We didn’t know if it had spread to the lymph nodes at that stage and an MRI re­vealed an­other lump,” she says. “So we had an­other anx­ious wait un­til a sub­se­quent ul­tra­sound fine nee­dle biopsy re­vealed a be­nign fi­broade­noma. Which was a re­lief but with so many lumps be­ing re­vealed, I wanted to ex­plore the mas­tec­tomy op­tion and I took some con­vinc­ing that this wouldn’t be nec­es­sary.

“My sur­geon was very pa­tient and even­tu­ally I ac­cepted his treat­ment plan and a wide lo­cal ex­ci­sion [lumpec­tomy] was sched­uled at which time they would ex­am­ine the lymph nodes to see if the can­cer had spread. Thank­fully the nodes and tu­mour mar­gins were clear and I was more emo­tional that day than at any other point be­fore­hand as it felt as if I had been hold­ing my breath up un­til that point and the re­lief was in­de­scrib­able.”

Fol­low­ing this news, the mother of two had to wait to see if a tu­mour re­cur­rence was likely and then, hav­ing de­cid­ing against the need for chemo­ther­apy, her con­sul­tant pro­posed a pro­gramme of ra­di­a­tion and a five-year course of hor­mone ther­apy.

The di­ag­no­sis and treat­ment was un­doubt­edly tough, but she says pa­tience and hon­esty were the best poli­cies to get through the or­deal. “My friends, fam­ily and ex­tended fam­ily were bril­liant dur­ing that time,” she says. “They all sup­ported me in many dif­fer­ent ways – a shoul­der to cry on, long phone chats, lunch and pam­per­ing treats or tak­ing the kids away while I re­cov­ered from surgery.

Hard­est part

“In fact, the hard­est part at the di­ag­no­sis stage was telling my daugh­ters. My fre­quent ab­sences [trips to the hospi­tal] were soon no­ticed and I had to tell them. The el­der girl was very wor­ried and wanted to know if we had to keep it a se­cret, while her younger sis­ter was in­trigued about the idea of me hav­ing a hole in my breast when the tu­mour was re­moved. I told them ev­ery­thing I knew and promised to keep them in­formed as I thought it was bet­ter that then let their very ac­tive imag­i­na­tions run away with them.

“I also re­alised that re­cov­ery is slow and I had to be pa­tient as the treat­ment phase is a well-man­aged process. When that part is over, you can feel a lit­tle vul­ner­a­ble, be­cause it’s not over – it’s on­go­ing. But once you ac­cept that it’s a chronic con­di­tion that needs manag­ing and mon­i­tor­ing, you learn to live with it and move on.”

Four years since her di­ag­no­sis, the mother of two says it is vi­tal for peo­ple who are newly di­ag­nosed to be hon­est, ac­cept help, com­mu­ni­cate and get plenty of rest. “Peo­ple close to you will want to talk and to meet you, or share ex­pe­ri­ences by way of of­fer­ing sup­port but be pre­pared to tell them if you’re not up to it,” she ad­vises.

“Be straight with your kids and tell them as much as they can han­dle. Also reach out to places like the ICS Daf­fodil Cen­tres which are par­tic­u­larly help­ful at the early stages of the jour­ney as they have spe­cial­ist can­cer nurses, or peer-to-peer sup­port.

“Fol­low­ing my di­ag­no­sis, they or­gan­ised for me to have a chat with a sur­vivor of sim­i­lar age and cir­cum­stances and I think it helped to share the bur­den with some­one who had been through it and is out the other side. Also the ARC cen­tres are an oa­sis of calm and re­lax­ation and of­fer a va­ri­ety of treat­ments and sup­ports which are an im­por­tant part of the re­cov­ery process, par­tic­u­lar af­ter the acute treat­ment stage is over.

“Don’t be afraid to ask ques­tions – I’m sure I drove the med­i­cal staff mad, but that was my cop­ing mech­a­nism. Treat­ments are chang­ing all the time and new ther­a­pies are emerg­ing so I wanted to know ev­ery­thing about the dis­ease and my prog­no­sis.

“So if re­search­ing your di­ag­no­sis helps you to get to grips with things, then do it; if you’d rather not, then don’t. But most im­por­tantly take all the help you are of­fered, par­tic­u­larly af­ter the treat­ment ends as the de­bil­i­tat­ing fa­tigue goes on for a long time.”

The hard­est part at the di­ag­no­sis stage was telling my daugh­ters. My fre­quent ab­sences [trips to the hospi­tal] were soon no­ticed and I had to tell them

Kath­leen O’Con­nor: “Don’t be afraid to ask ques­tions – I’m sure I drove the med­i­cal staff mad, but that was my cop­ing mech­a­nism . . . I wanted to know ev­ery­thing about the dis­ease and my prog­no­sis.”

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