Breast cancer - reaching to recovery

[ by Niall Hunter, Editor www.irishhealth.com]

View the full video version of this interview at...http://www.irishhealth.com/video_interview.html

Breast cancer services have been very much in the news for all the wrong reasons in Ireland recently, as the Government grapples with the need to improve testing, treatment quality and survival rates.

Irish women have a lifetime risk of one in 11 of developing breast cancer; there are around 2,300 new cases diagnosed each year and 604 women on average die from the disease each year.

However, many women survive following the dreaded diagnosis, and there are more than 250,000 women living in Ireland today following a breast cancer diagnosis.

The five-year survival rate for breast cancer is 72.8% in Ireland , whereas the European average is 77.4%.

But what is it like to get breast cancer and to survive it following treatment?  Marie O’Laoi, who is a trained cancer nurse, was diagnosed with breast cancer in March 2000 and after two operations, seven months of chemotherapy and 25 sessions of radiotherapy she was given the all-clear and is cancer-free eight years later.

In an interview with irishhealth.com, Marie talks about how she coped with the diagnosis and treatment, and how the experience changed her life and encouraged her to help others with the disease.

On getting the diagnosis.

"At first I felt a sense of disbelief and an internal panic set in. I was frightened. I was always someone who would have looked after their health. From there I moved to being very sad and angry; angry with myself, and I started getting angry with God. It was a case of initially not believing it was happening and then gradually realising that it was actually happening and that it was something I had to go through and face."

“Although I recovered from the original shock the feelings come and go. I found myself jumping ahead. The first thing I asked my surgeon was ‘am I going to die and will I see my children grow up?’ You suddenly see your whole life ahead of you and think that all your dreams and your aspirations are all gone."

“My husband was great; he grounded me a lot and kept saying to me we won’t cross any bridges we don’t have to cross, and to just keep focusing on one day at a time and on one thing at a time. So that helped me a lot because that’s what I began to do.

On first becoming aware that there might be something wrong:

"We were on holidays and I had this sensation in my left breast; I felt there was something small there. I had had breast surgery many years ago after discovering a breast lump in the same area; I had had that lump removed back then and had a scar there."

She felt the sensation could be due to the scar or something leaning on it but she was concerned about what exactly it was. On returning from holidays she went to her GP who examined her and sent her to hospital for tests.

“Even the surgeon said (before the biopsy) that he wasn’t too worried because the lump was so small, but when I was called back four days later they told me that it was cancer."

On her treatment regime:

I had surgery at the beginning; I had the lump removed with what is called a wide excision. While all the cancer was now gone, they told me when they came back with the results of the pathology that the margins (of the surgery) were not wide enough, so that meant I had to go for more surgery, which was a little bit hard at the time, but obviously I am glad it was done now."

“About four to six weeks after the surgery I started my chemotherapy. I think that was the hardest part for me. The worst part really was losing my hair and also I got sores in my mouth, which was very unpleasant, as a side effect of the drugs. You lose all body hair and it was a question of body image and not feeling feminine and not feeling good about yourself. There was fatigue as well, which was difficult too; there were days when I just had no energy so I had to curtail a lot of activities."

"I had nodal involvement under my arm; that meant the cancer had started to spread from the lump, even though it was a very small lump. I knew from my oncology experience that this meant I would have to have the full regime of chemotherapy. Going through the different stages there was new information you were being given and you had reactions to that so it was a roller coaster of emotion."

"I had 24 sessions of radiotherapy as well. I didn’t find that difficult really, although some people do find it hard. I was a little bit tired, that was the only effect I really had from it, and I did not have any skin irritation and a lot of women find that they do have that from the radiotherapy. The only thing about radiotherapy is that you have it at the same time every day, which takes a bit of time; driving in and out every day."

"I had my surgery at the beginning of April; I started the chemotherapy at the beginning of June; my last chemotherapy treatment was the end of December and my last radiotherapy was January 5. All those dates are set in stone in my head.”

On being given the ‘all-clear’:

“It’s a wonderful milestone to be over all the treatment. Your hair is starting to grow back again and things have started to get back to normal.  In a sense, there is also a feeling of an anti-climax, because you feel that, OK, the treatment is over, then you are still not feeling great. You are still tired and you are feeling the effects of the chemotherapy for a good while afterwards.  It took longer than I thought it would to fully recover. But it was wonderful to be over the treatment."

Marie said she had a ’hiccup’ after the treatment when she broke a rib playing tennis six months after her therapy ended. She had a bone scan done and she was worried the cancer could be back in the bone. “But I did not dwell on it and thankfully it was clear. For a good while afterwards, if you have a pain or an ache you do worry but that is normal. I don’t dwell on things like that now but if I was worried about something I would go straight to my oncologist or GP."

On the need for counselling:

Marie says counseling for women going through breast cancer is very important, but feels there is not enough staff working in that area. “There are wonderful people working in this area but we need more of these services right around the country."

“When I was going through my treatment there would have been times when I would have loved to have talked to somebody, outside my own family and friends, within the hospital vicinity. The nurses and doctors are wonderful but they are so busy. It would have been lovely just to talk to someone who would just be able to sit and listen, and if you needed to go further for, for counseling or whatever , to be able to do that.”
 
“They are, however, now introducing psycho-oncology services, which is fantastic.”

Reach to Recovery:

“I got fantastic support from a group called Reach to Recovery, which I am now working with now and that is a group of women who have been through breast cancer who give peer-to-peer support for other women who are going through it. The Irish Cancer Society trains these volunteers. We go into the hospitals, we do a lot of work on the phone or can meet the women one-to-one.”

“As a Reach to Recovery* volunteer, a lot of the time you are listening to people who just want to tell you their situation and they may ask you what it was like for you. Most of the time it is listening to their worries and just to be able to reassure them that it is OK to feel the way you do.”

“People will worry about things like telling the children; there are different worries and issues that come up for different women; women worried about going into a relationship, fertililty problems etc. We know the services that are available and we can refer them on to different specialties.”

“There are also other supports like ARC House** opposite the Mater Private Hospital in Dublin. I did courses there and I found that it gave me back a lot of confidence."

“If you have worries about breast cancer, the Irish Cancer Society (http://www.cancer.ie) is a very good place to start as they have all the information and all the relevant contact points.”

On breast cancer services:

“I think the way to go is with the centralised specialist units. You will get the best care within a specialist unit with all your treatment under the one roof with all the specialists in the relevant areas working for your benefit. I was looked after in a multidisciplinary specialist unit; and I have great confidence in it and it is a better service all round.”

“I don’t think the services are adequate around the country. I think there needs to be an awful lot more work done on it; more money injected into it , but I don’t think the eight centres will be enough to cover the country. Perhaps we need a few more units to cover the harder-to-reach areas. There is also a need for more back-up services in the community."

For further information click on… http://www.cancer.ie/action/

*Reach To Recovery                                
C/o Irish Cancer Society                 
Northumberland Rd
Dublin 4
Tel: FreeFone 1800 200 700
Email: reception@irishcancer.ie

**Arc Cancer Support Centre
65 Eccles Street,
Dublin 7
Tel: 01 830 7333
http://www.arccancersupport.ie