‘I fear for those still unaware of their cancer’
GP Kate Hattersley found she had breast cancer after missing a regular mammogram test
‘Six weeks after my cancelled check-up, my husband found the lump’
Ihave been a GP for 32 years, so I am no stranger to giving people a diagnosis or two. But even a career in medicine can’t prepare you for how devastating it feels to be on the receiving end of a bad one. In June last year, three months after my routine mammogram was cancelled as a result of the pandemic, I found out I had breast cancer.
It was picked up by chance, after my husband found a lump in my breast. I am fortunate that the delay didn’t have an impact on the outcome of my cancer in the long term – yet I am painfully aware that things could have turned out very differently, and that other women might not be as lucky as me.
Nearly 11,000 people in the UK could be living with breast cancer that has not yet been diagnosed due to the disruption caused by the pandemic, according to research by Breast Cancer Now. The charity says that, in the worst cases, women can die as a result of a delay to diagnosis. As lockdown starts to lift, it warns that a backlog of missed cases and an overstrained healthcare service could create a “perfect storm” for breast cancer.
I never thought that breast cancer would happen to me. I only have one case in my immediate family, my grandmother, who was diagnosed when she was 80. Given my line of work, I have always religiously attended my mammograms. I know how important they are at detecting early cancers.
Mine was scheduled for the end of March last year but then cancelled due to screening services being temporarily paused to free up emergency NHS resources as the first wave took hold. At the time, I didn’t think much of it. I was working long hours at my surgery in Exeter, and assumed I would have another screening once things had settled down a bit.
But six weeks later, my husband found the lump. He asked me: “Did you know that was there?” Most people would have panicked, but I remained strangely calm and played it down. I’ve had cysts before, so I told him that it was probably just another harmless growth. I know that breast cancer lumps are usually hard and tethered, and are often accompanied by skin changes. My lump felt rubbery and mobile, so I brushed it off.
Looking back, it is hard to believe I acted so casually. I think I was in denial. I didn’t want to let my colleagues down or put any more pressure on a healthcare system that was stretched to its limit. At 59, I was also aware that I had limited years left in a career that I loved, so the thought of taking time off didn’t feel like an option.
Yet as the weeks went by, its presence began to niggle. After a month, I eventually agreed to get it checked out and booked an e-consultation with a doctor. As a GP, I knew exactly what to say in order to get referred to a specialist breast clinic.
I told them about the size of the lump, its location, texture and the skin changes I had around it. Sadly, other women won’t have this knowledge, and some might not have the confidence to say that they need someone to examine them.
Others might put off going to see a specialist because they are scared of catching Covid-19. Worryingly, between March and December 2020, there was a 90,000 drop in referrals to a specialist for patients with possible symptoms of breast cancer in England.
After the consultation, I was referred to the breast clinic at Torbay Hospital, where I was forced to face what I had been denying for so long: I had cancer. Grade 3 invasive ductal carcinoma, to be precise.
I was completely shocked, and let out a rude word or two. It was so surreal, and I couldn’t shake the feeling that it was happening to someone else, not me. I thought maybe they had made a mistake, and would come back and tell me they had got it all wrong. But once the biopsy results came back, there was no more denying it.
The next few weeks were terrible. My feelings fluctuated between fear, sadness and anger. I kept thinking: “Why me? Why now? I’m far too busy for this.” I was also terrified about the impact the delay would have on my diagnosis.
In those first few weeks I was determined to carry on working, but the surgeon was very firm: working when I wasn’t thinking straight meant that I could make a mistake, and put someone else’s life in danger. I knew she was right, but being forced into early retirement was still a bitter pill to swallow.
It felt like being one of the first to be shot down in a battle, and having to watch from the first aid tent as your troops fought on without you. I also had to break the news to my three children, aged 25 to 29. It was never going to be easy, but the pandemic meant they couldn’t even be there to give me a hug.
I started chemotherapy three weeks after the diagnosis, and had a complete response to it, so there was no cancer left by the time I finished in November. But it was a rough ride.
I was incredibly poorly throughout and in a lot of pain, with every side-effect imaginable: hair loss, numb fingers, sickness and a metallic taste in my mouth, to name a few.
Near the beginning of the treatment, I was even admitted to the hospital with suspected sepsis. It was a huge learning curve, as I had never realised quite how much my patients who went through chemotherapy had suffered.
Alongside the chemotherapy, I had surgery to remove 29 lymph nodes, and a course of radiotherapy to make sure the cancer had fully gone away. It’s been the hardest year of my life, and yet I know I am so privileged to be in this position.
I fear for those living with a diagnosis they still don’t know about; it is absolutely critical that people realise that cancer screenings, and GP services, are operating as normal with extended safety measures in place. If women are in any doubt, they should go and get lumps checked straight away. I am considering myself cured because, psychologically, it feels like the easiest way to cope. However, I still have lots of treatments ahead of me: Herceptin injections every three weeks for the rest of the year, bone protection infusions for three years and hormone blockers for five years.
I never saw myself retiring early but, in the grand scheme of things, that doesn’t seem so bad any more, particularly now I’ve had my first vaccine dose. It is just a joy to still be here, as clichéd as it sounds.