Breast cancer stuff that every woman needs to know … by a breast surgeon who had it twice

Scared but hopeful: Dr. Liz O & R; Riordan, who was diagnosed with breast cancer in 2015

Scared but hopeful: Dr. Liz O & R; Riordan, who was diagnosed with breast cancer in 2015

Scared but hopeful: Dr. Liz O & R; Riordan, who was diagnosed with breast cancer in 2015

I never thought for a moment that it would be me. And, statistically, it should not have been. When I was diagnosed with breast cancer in 2015, I was 40 years old and in better shape than ever, with no history of the disease in my family.

In addition, I was a consultant chest surgeon, the woman who was sitting next to the doctor's desk and who was giving bad news and prescribing surgery and chemotherapy, not the patient crying and angry on the other side. But there I was.

I had everything to live for, my recent marriage to my husband Dermot, now 54, a fellow surgeon and, perhaps, fatherhood.

When I was not operating with breast cancer patients at Ipswich Hospitals NHS Trust, I loved walking my dogs, riding bicycles, baking sourdough bread and the sound of birdsong in my Suffolk garden.

I had had cysts in my breasts before, so when I noticed a new lump in my left breast, I was not especially anxious. I only checked it because my mother, who was a nurse, told me to do it.

The mammogram was normal. The ultrasound was not The radiologist and I were looking at the screen together when we saw the same big black mass: cancer. A subsequent biopsy would identify him as a mixed ductal and lobular cancer that was large and aggressive.

I usually give patients the details that I think they need at the same time, I think they can cope with them. In the blink of an eye, however, I knew everything that awaited me: a mastectomy, chemotherapy, the devastation about to break loose in my body, my marriage, my family and my career. Finally, I understood what it was like to have cancer and not just be an expert on it.

Right there, in that hospital room, I flipped a switch in my head and disconnected my feelings, to protect myself and my loved ones.

But later, my emotions continued to surface, and I gave them meaning in words. I started blogging about my experience, joining a club that nobody wants to belong to: cancer patients who tell the truth about the disease with honesty, warmth and wit.

The extraordinary Rachael Bland was another member. The BBC news anchor who co-sponsored the groundbreaking podcast You, Me And The Big C, died last week.

I know Rachael since her diagnosis in 2016: she had been blogging about my cancer for a year and she contacted me via Twitter to ask me for advice about treatment options and clinical trials.

BBC news anchor Rachael Bland, pictured with her son Freddie, died at age 40 after an inspiring two-year public battle against cancer

BBC news anchor Rachael Bland, pictured with her son Freddie, died at age 40 after an inspiring two-year public battle against cancer

BBC news anchor Rachael Bland, pictured with her son Freddie, died at age 40 after an inspiring two-year public battle against cancer

Her legacy is immense Rachael and her two co-hosts have made talking about cancer normal, especially for young women who still want to have fun, look good and live their lives to the fullest.

It is with this intention that I have written a book with Professor Trisha Greenhalgh, a family doctor diagnosed at the same time as me, directed to women like us and also to men, because they also suffer from it, with breast cancer.

Our mission is to tell women all the things we wish we had known from the beginning: the things I tell many of my patients now that I know what it is to be in their shoes.

It will be published later this month, when I recover from an operation to remove my ovaries.

In May, a routine examination of what I thought was scar tissue showed that my cancer had returned to where my breast was.

After an operation to remove it and more radiation therapy, I need to take a specific type of hormone-blocking medication. For the drug to work properly, I need to stop my own production of estrogen, the female sex hormone, produced by the ovaries, and that is why I eliminate them.

I'm shocked and scared, but it's still treatable and, hopefully, curable. And at least this time, I know a lot more than I did in 2015. With all this in mind, here are ten things that I think all breast cancer patients should know …

Do not be "brave"

My husband and I were still deciding whether to have children when they diagnosed me. But for young women, chemotherapy causes early menopause and, with it, infertility. When this hit me, I collapsed, suffering for the child we would never have. On another occasion, I was so anxious to drive from the clinic where I was an advisor in my own practice, that I almost vomited in the car.

You do not have to make a brave face, and it's better to openly treat these negative emotions. Feeling dark, angry, afraid or self-pitying is not going to make you less likely to recover. But if these feelings become overwhelming, you can seek the help of your GP or your team of specialists. The same applies to physical pain; Ask for all the relief you need.

You can keep your figure

Nowadays, most women with breast cancer do not undergo a mastectomy, which involves the surgical removal of the entire breast. Surgeons can perform a lumpectomy, remove up to a fifth of the breasts and remodel it to obtain a good cosmetic result. They have perfected the art of hiding scars around a nipple and borrowing adipose tissue from their side to fill the space left by cancer.

Very large breasts can also be reduced. Women have options. You can still look good naked, in a bra or with clothes on.

DR ELLIE CANNON: All doctors should be frank

As a respected breast surgeon, and then a breast cancer patient, Liz has a unique perspective that no doctor imagines she will have.

Of course, you do not need to have cancer to treat it. But I have followed his trip on social networks, during which he has traced the hard treatment he has suffered, and his advice is correct.

As a general practitioner who regularly treats patients with minor ailments who have been preoccupied to death by searching their symptoms on Google, it is comforting to know that commentators like Liz are giving sensible and personal advice that people really need, from an informed position. .

The treatment of breast cancer is better today than ever, with specific therapies for the patient and very good survival rates.

But as sadly illustrated by the tragic death of Rachael Bland, women still die of this disease and still face traumatic experiences such as infertility and disfiguring surgery.

It is so crucial that all doctors speak frankly about the real aspects of cancer treatment, in the way that Liz does.

It is important to deal honestly with issues such as sex, infertility and death, which even many doctors feel uncomfortable to address.

I think that Liz's blog and book should be obligatory readings, also for health professionals.

If you need a mastectomy, which I did because my cancer was large and had small breasts, you can perform a reconstruction with an implant or with your own tissue.

I decided to have a reconstruction. I did not want to change my dress. Because I am thin, I did not have enough skin and fat to take from elsewhere, so I had an implant.

These are operations that I do myself on a regular basis and once, I would have admired my work, telling the women that they had healed well.

But now I know there's more to it than they seem. The skin of the breast is numb and the implant is cold. Most women are happy with their appearance, but it's okay if you're not well, and doctors should be open to that.

I had to remove the implant when the cancer came back. Now I'm flat and with scars on one side, a & uni-boober & # 39; Nothing prepares you for how you look without your chest. I'm still reaching an agreement with that.

You may not need chemotherapy …

Only one third of people with breast cancer need chemotherapy. It is usually given if you are young, or your cancer is large or has spread to your lymph nodes. Most women will only need an operation to remove the cancer, probably followed by radiation therapy. If your cancer is sensitive to estrogen, you will also receive anti-estrogen tablets. We know that for these women, their chances of recurrence are not greater without chemotherapy than with it, so there is no need to administer it.

But you will face yourself if you do

Chemotherapy for breast cancer is given in cycles of one to three weeks and takes five months in total. You spend only a few hours in the hospital.

They gave me chemotherapy because of my age and the size of my cancer. It is manageable and there are coping strategies.

If you lose your hair, treat yourself at the Turkish barbershop or ask on YouTube about the great ways to put a headscarf on your head.

At first I hated being bald, but I did not want to wear a wig. Instead, I bought new and fierce glasses with the hope that people would look at them.

You must drink a lot, but the water tastes horrible, so use the pumpkin. Have a little Vaseline on hand for the inside of your nose, which will crack and dry.

If you have insomnia, a side effect of the steroid medication you are given, the online forums are great, as there is always someone more awake at 3 in the morning.

I also discovered things that your doctor does not tell you, such as that your pubic hair falls first, so get a free Brazilian wax in the NHS!

Dr. Google can be useful

I used to tell my patients not to look for breast cancer on Google. Naively I thought I could give them all the information they needed.

But it's the first thing I did when I got the result of my biopsy, and I'm an expert. Some of what you will find online will be frightening and inaccurate. But we live in a digital age, so it is impossible to ignore it. Look for safe and friendly websites, and applications that are approved by major cancer charities or NHS affiliates.

Two applications really helped me. One of them was the Macmillan My Organizer application, which is ideal for managing your life during chemotherapy, keeping up with medications, appointments and monitoring side effects. The BECCA application of Breast Cancer Care is also brilliant and presents publications in mini blogs of other people who have had it.

Do not end your sex life

Many women respond to a cancer diagnosis by thinking that their husbands should divorce them in favor of someone healthy. I do. It is a bad feeling of guilt to have made it through the test.

You may have to deal with an altered body image and a treatment-induced menopause, but do not let the cancer take away the physical connection.

Chemotherapy, ovarian suppression and hormone therapy can cause immediate menopause or worsen existing menopausal symptoms, such as falling estrogen levels.

Estrogen is a natural lubricant and without it, everything dries up, but your sex life does not have to be that way. There are products that can help: lubricants like & # 39; Yes & # 39; and small dilators and toys. I advise women to fill a bag with the top so they stay next to the bed. Partners may also need help, and it is important to talk about things.

Do not be like a woman I know who asked me if it was safe to have sex during chemotherapy because I was afraid of poisoning her husband.

Ignore snake oil

As a doctor, I had no idea of ​​the huge industry that is taking advantage of the vulnerable. As a patient I glimpsed it, but honestly, if it had been scientifically proven that turmeric and alkaline diets cured you, you would get them in the NHS. Free. However, there is evidence that exercise helps with fatigue and reduces the side effects of chemotherapy, so try to walk every day or do some yoga, and do more on good days if you can. It will give you faith in your body again. I went back to the triathlon training as soon as I could.

Cancer can return

Many people do not realize that their cancer can reappear, even after 20 years, and that when it does, it can not be cured. I'm not in that situation. My cancer is a local recurrence of my primary cancer; it has not spread anywhere. You may not be told what the symptoms of secondary breast cancer are when it occurs in the brain, lungs, liver, or brain. Therefore, get any new symptoms, such as cough, bone pain, headaches or vomiting, that last more than a month and have been checked by your doctor.

Expect the best…

… but plan the worst. Today, most women diagnosed with breast cancer will live long and healthy lives and die of something else.

But we must not forget that 30 British women die every day for it. When treatments fail, you should know if you want to die in your home or hospice, plan your funeral and put your affairs in order.

One of the most difficult things for me was writing a will and discussing the arrangements for my funeral with my husband. It cost me my local recurrence to finally face it, but you will feel calmer when you do it.

You are not a number

My probability of being alive in ten years is 60 percent. It could be in the six out of ten people in my situation that survive or in the four out of ten that die, but these figures are only estimates based on trials at least a decade old. New treatments are being developed all the time. You can not live every day as if it were the last.

Keep a jug of joy

This is an idea taken from the geriatric specialist Dr. Kate Granger, who died of cancer in 2016. Every time something good happens, write it on a card and put it in a jar. Bank of happiness. When you have a bad day, go to the jar and read some of the entries. Remove what is in deposit. It works, I promise.

The complete guide for breast cancer: how to feel empowered and take control, by Professor Trisha Greenhalgh and Dr. Liz O & Riordan, is published by Vermilion. Available to pre-order now at, £ 14.99.