Writer, mother and grandmother DIANE TREMBATH lives in Exmoor. After being given the all-clear three years ago, she has recently been diagnosed with breast cancer for the second time.
She has agreed to write a diary about her experiences for Live Better With - sharing her observations and insights, both practical and emotional. Here's part 3...
It takes a while to fully process the significance of a second cancer diagnosis. If I’m honest, I don’t think I ever consciously or deliberately thought, ‘It will come back.’ I’m not a doom or gloom person and if things are ticking along, in more or less the right direction, I’m unlikely to ask the unanswerable question, ‘What if…?’
I’m not, by nature, an angry person, so no ‘Why me?’ handwringing and, in any case, the current soaring rates of cancer diagnoses suggest that ‘Why not me?’ would be a more accurate question. Guilt doesn’t fit into the frame either, so no anguishing over whether or not I did something that triggered this second bout nor, conversely, that I omitted to do something that might have prevented it.
But…I did have questions, questions that were sitting in my Massive Inconvenience Mark 2 notebook at home, at the time my surgeon, Mr J, gave me my detailed diagnosis. It was late in the hospital day, we were all feeling tired and a bit frayed at the edges, and, as I sat on the examination couch in my hospital gown, I couldn’t think of a single thing to ask – because my brain felt like cotton wool.
What, where, when, how…?
Over the next few days, I revisited the questions I had already listed and made a note of some more. Would my latest diagnosis mean taking an aromatase inhibitor prescription again? (I had struggled enormously with the side effects last time round.) How long does it take a mastectomy to heal? And did I really need a mastectomy?
I knew that I couldn’t have more radiotherapy but could I simply have wide angle excisions just to remove the two tumours – with nice wide margins – and preserve some of my breast tissue? And if not, why not? What difference would it make to a) the risk of recurrence and b) my prognosis? When would I be able to do yoga and Pilates again? Et cetera, et cetera, et cetera…
I knew that I could call K, my specialist cancer nurse at the hospital but, for some reason, I felt that I needed to get my mind and questions into some sort of order before that.
I know how incredibly busy our amazing NHS nurses are and was shocked to learn from Macmillan Cancer Support that, for many of them, giving up precious holiday time is the only way they are able to keep their professional training and development up to date. I didn’t want to waste their already overstretched time and, as I would be seeing at least two of them at my forthcoming pre-opp assessment appointment, I decided that this would be the best time to run through anything I was unsure about.
All the right answers and much more
Then I remembered the Breast Cancer Care helpline – 0808 800 6000 - which is free and staffed by the charity’s own team of specialist breast cancer nurses. I made myself a cup of tea, sat down at my desk, opened my notebook and called the number. As it turned out, it was probably the best decision I had made on the journey so far.
When you are anxious and facing major and, in some ways, life-changing surgery, you need a good listener with a calm voice, a reassuring manner, a wealth of knowledge and information – and empathy. You want someone who doesn’t think that your questions are frivolous or unimportant. You need someone who understands that this is tough stuff and that you are going to cry at some point and that it’s fine to cry.
You need someone who encourages you to rip open the emotional ragbag that comes with a cancer diagnosis. You need someone who understands that, even in one’s 70s, the prospect of losing a breast, which is such a fundamental part of a woman’s body and her identity, is traumatic – there is grieving to be done.
I may know and accept, logically, that a cancerous breast does not define who I am but, emotionally and psychologically – well, that’s another matter. We have history, my breasts and I, bound up with joy, passion, love, sexuality, motherhood and nurturing.
All the things that matter
I struck gold with Eve, the Breast Cancer care nurse who took my call. We discussed every aspect of my cancer history and my latest diagnosis. She answered all my questions in a clear and compassionate way; not only that, she gave me advice about aspects of the diagnosis, surgery, aftercare and life with a prosthesis - breast reconstruction not being advisable for me, even if I had wanted it, which I didn’t.
Eve talked about things that I had not thought about or had been unaware of; for example, asking my medical team whether an MRI scan - before surgery - of my ‘good’ breast might be indicated, given that the likelihood of both breasts being affected is greater with invasive lobular breast cancer than with invasive ductal breast cancer. We talked about what, when and how much to tell young children (I have an eight-year-old granddaughter to whom I am very close) and we even discussed the joy of dogs – and how they make everything better.
Eve made everything better too. I now had a more constructive and logical framework for the questions I would take to my pre-opp assessment appointment and I had some vital additional questions too. Those precious 45 minutes helped me to feel stronger, calmer and more focused than I had for many days. It was a huge relief and I cannot recommend this wonderful service too highly.
So many ways of helping
During my first bout of breast cancer and treatment, I made frequent use of Breast Cancer Care’s online forum and, as I am doing with this diagnosis, I read all of the charity’s information booklets that were relevant to my diagnosis, treatment and circumstances. I had also followed, to the letter and daily, Breast Cancer Care’s excellent – and essential - post-surgery exercise guide and am so glad that I did. The latest version is now pinned up in the room where I normally do my yoga practice at home, ready for me to start exercising and moving correctly as soon as possible on my return home, as this will support many aspects of my recovery. I had not, however, used the Breast Cancer Care helpline. It really is a first class resource, not only for anyone who has been diagnosed with, is being treated for, or is recovering from breast cancer but for their loved ones and carers too.
If you have ever donated to Breast Cancer Care, whether it was putting something into a collection box, attending a fundraising event, dropping off no longer needed items at one of the charity’s shops, or sponsoring a marathon runner, your gift is making a huge difference to thousands of women like me.
Women like your mother, your sister, your wife, your daughter, your aunt, your cousin, your best friend – and we are many. And let’s not forget that men can get breast cancer too; Breast Cancer Care is there for them too.
Breast Cancer Care is a UK charity providing support, nationally and locally, for people living with and beyond breast cancer. Find out how to receive support or get involved here.
To be continued
Diane with her beloved canine companion Pumpkin
Read all instalments of Diane's Diary here.
Live Better With has a range of online articles and expert guides on breast cancer diagnosis, treatment and beyond.
Visit the Live Better With Cancer Community Forum – for information, advice, and tips on how to cope with a breast cancer diagnosis and to share your own questions and suggestions.
