The Lump

In January 2021, I found a lump the size of a pea in my left boob. It was 4a.m on a freezing January night, I hate having my arms under the duvet normally as I get too hot but it was too cold to have them out, so I had an arm under duvet - hands out situation (think T-rex in a sleeping bag) at some point (thankfully) my hands were resting on my boobs which is when I felt this son of a b*tch.

Being a doctor I know that anyone over the age of 30 with an unexplained breast lump should be referred to the breast cancer team, this is because it should be treated as cancer until proven otherwise. Cancer is usually time critical, the earlier you catch it, diagnose it and therefore treat it, the better the outcome. Whereas something like a fatty lump, or a cyst (other common causes of breast lumps) can stay with you until you die aged 94 of something completely unrelated - in other words the fatty lump/cyst won’t kill you, but cancer if left untreated will.

However, you cannot 100% tell the difference between a cancer and a non cancer lump by feeling alone. You need a scan. This is why you should be referred to the suspected breast cancer team.

I rang my GP that morning, told them I’d found this lump and was booked in to see the GP 6 days later (it was the earliest day I could attend - if you find a lump anywhere I would always recommend getting it checked out within 1 or 2 days MAXIMUM). I clearly wasn’t worried about it at this stage.

I was asked loads of questions about my periods (which I don’t have as I’ve had the mirena coil in for contraception for 7 years and don’t have periods with it), about whether I’d had any other lumps, and any family history of breast cancer. After questioning and prodding, I was told it was likely a “benign” lump (nothing to worry about, a cyst, fatty lump, that sort of thing, as it felt smooth, you could move it around and I’m young with no family history), most likely related to my periods (which I don’t have…) and to leave it 4 weeks. If it’s still there in 4 weeks or increases in size before then to get in touch.

I was advised to pop a reminder in my calendar at 4 weeks as it can easily come and go and be forgotten about. This is great advice. If ever you’re told to keep an eye on something over a period of time, set yourself a reminder, because we forget, life gets in the way etc etc.

I left that consultation feeling pretty happy and confident that this was nothing to worry about.

I waited 3 weeks, then got back in touch with my GP as it wasn’t going anywhere and my mum and fiancé were nagging at me to get referred and double checked. I had started to convince myself it was getting smaller, and that I could only still feel it because I was poking it ALL the time.

I would always suggest being over cautious and going back to your doctor if you’re not happy - don’t downplay your symptoms!

I had a telephone consult and my GP referred me under a “2 week wait”, this is cancer until proven otherwise. Remember that time critical bit I was talking about, well 2 week wait means you will be seen within 2 weeks.

I received an appointment for the breast clinic 12 days later.

Off I went, on my own, convinced it’s nothing to worry about.

The breast clinic is a “one stop shop”, which means you’re seen by the breast team, have any scans (ultrasound scans and/or mammograms) and even biopsies if you need them. All in one place, on the same day.

I was seen by one of the doctors who spent more time examining my right breast (the one without the lump) and told me it was probably my rib but that they’d scan me anyway.

I pop back into the waiting room before being called to see the radiologist (a doctor who specialises in scans). He places the ultrasound scan probe (think pregnant woman jelly scan) on my boob where the lump is and says “oh”.

“Oh” doesn’t sound good.

He then tells me that they need to scan my armpit (they’re worried about cancer spread to lymph nodes).

Not good.

That I need a mammogram (you typically only have a mammogram under 50 if they’re worried about cancer).

Not good.

I was then asked if I had anyone with me today (which they’d only be asking if they were going to be delivering bad news).

Not good.

F*ckity f*ck f*ck f*ck.
I’ve got p*ssing cancer haven’t I?

They took biopsies from the lump and from a lymph node under my arm pit that looked a bit funky. For the biopsies they inject a bit of local anaesthetic which stings for a few seconds but then it’s all numb and you don’t feel any pain.

When they take the biopsies, you can’t really feel it (maybe a bit of pushing and moving but it’s not painful), but it makes a noise like a staple gun. This scared the crap out of me and made me jump as I wasn’t expecting it. But, again it wasn’t painful and even me jumping didn’t cause any problems.

After they’d stuck plasters and dressings on me we had a brief chat. I was given a piece of paper to take to reception to book my follow up appointment in 6 days time to see the breast team with the biopsy result.

I was told I could speak to the consultant the same day, but I said something like “well you clearly think it’s cancer because you wouldn’t have done the mammogram and biopsies” to which the radiologist replied “I’m sorry but it doesn’t look good”. To be clear, they knew I was a doctor at this point, so I think they knew I knew.

I handed the piece of paper in to the receptionist - tears streaming down my face as the realisation of what had just happened started to hit me.

The receptionist didn’t bat an eyelid! Classic.

It’s the weirdest and hardest 6 days I think I’ve experienced between the appointment and getting the results. You’ve basically just been told you’ve got the C Bomb BUUUUUT you’ve got to wait for the results as they can’t 100% confirm or deny. So you’ve basically been told we’re 99.9999999% certain you’ve got cancer BUT we can’t say for certain.

I was messaging my partner, family, close friends and my work family in-between the different scans and biopsies, updating them on what was going on. I’m so glad I did. Because I didn’t have anyone there with me it was good to be able to message people about it, but also by talking about it over text kind of removes a layer of emotion, so I was able to text about it without crying and being a big ball of emotions.

The support and love I felt and received was overwhelming. My work family were incredibly understanding and gave me the time off I needed to get my head straight (well as straight as can be when you’ve just been told you’ve almost certainly got cancer). I mean you would also expect this, we are all GPs and part of a team but some doctors don’t like each other and might not be quite so supportive.

I asked my friends to take the piss out of me, I’m not sure why I invited it but boy did they deliver (and continue to do so) which has definitely helped me to keep my head out of my ass and keep any pity parties to a minimum. They’ve also given me a ridiculous amount of love and it tears me up just thinking about how amazing they have all been and it would’ve been a real struggle getting through this without them.

Dan and I cried. More like sobbed. That super ugly contorted face sobbing. For quite some time. With lots of hugging, expletives and disbelief.

What The Actual F*ck?

How can this be cancer?

How can I, me, Annie, have cancer? I’m 32, with no history of cancer in the family. Like zero, nada, not even a whiff of any type. EVER.

I like to think I’m pretty health conscious. I eat well (Dan and I mostly stick to a vegan diet during the week), exercise on the regs (I was due to do a marathon this October which I rather naively/stupidly/idiotically thought I’d still be able to train for during chemo - Ha.. moron!), I don’t smoke, I’m slim (BMI, body mass index is 21), suuuuuuuuuuure I like wine, and beer, and cider, and gin, and rum and most spirits and on occasion I drink a smidge more than I should. But I swear Governor that is it.

So I repeat,

What The Actual F*ck?

My mind started going at 200mph. I started thinking everything, from this cancer will be everywhere and I’ll be dead in 2 months, to it’s only a small lump, I’m sure I’ve found it early.

Breast cancer can be curable, I see patients with breast cancer unfortunately more regularly than I’d like but as far as cancers go it’s not a bad one to have.

No cancer is good, sure, but it’s all relative. You can chop your boobs off far more easily than you can chop out a bit of lung, bowel, pancreas etc. Remove the boob, remove the cancer.

Eurgh, my head was all over the place. I couldn’t sleep, spending hours upon hours reading articles at night about breast cancer survival rates, types of treatment, post chemo fertility and everything else in between and then more articles and more and more and more.

Why?

Because you want to read something that’ll tell you it’s NOT as bad as you think it’s going to be.

That the survival rate of your cancer is close to 100%.

That treatment isn’t going to be as sh*t as you think it is.

And it’s all going to be okay.

People have asked me what I thought about when I found out I had cancer.

1. Thank f*ck I’ve got insurance (life and critical illness) so my partner should be fine financially if the worst was to happen.

2. If I die, people are really going to miss me.
   

Now, number 1, was because I immediately worried about Dan (my partner) but knowing financially he’d be sorted was a huge weight off my mind.

And, number 2, well it sounds quite egotwastical but I think that when you die that’s it. I’m not going to know I’m dead or have the ability to miss anyone, it’s the people that you leave behind who suffer and so I was mourning for them. If you remember from my intro - I’m a bloody legend so losing me will be tough!

My point being, after the incredibly hard year of restrictions due to Covid-19 in 2020 and also into 2021, I was desperate to see my loved ones - if only to remind them how great I am and how much they’ll miss me if I die!

The Great Escape

Due to Covid-19 restrictions I’d not seen one of my sisters, her hubby, my nephew nor had I met my brand new niece! So the first thing I wanted to do was to go and see them and my dad. (My other sister and my mum live near me so I had seen them socially distanced - there is no favouritism here before anyone tries to pull me up on it!). Due to “childcare” rules and “single people living on their own” rules a meet up was completely legal and above board.

Dan and I headed down to see them the next day or maybe 2 days later (who cares? It’s not important). Hugged my sister and we both start sobbing.

So. Many. Emotions.

Then my dad arrives. He’s not the most emotional man. I think I have seen him cry once - when his dad died. We hugged, more bloody sobbing (he started it), a beautiful moment of raw emotion amidst all the sh*t. My nephew started tugging at my dad’s leg “grandad, grandad, grandad!”.

Moment ruined, laughter ensues, ice broken and tension relieved.

It was a really bizarre feeling, lovely to be there and see everyone but we were there for sh*tty cancerous reasons. It was incredible to meet my niece and have ALL of the cuddles and play with my incredibly cheeky nephew, but it was also heartbreaking. I kept thinking this is the closest I’m going to get to being a mum, fully aware that chemo can nuke your ovaries making you infertile. I found it super tough, a lot tougher than I had anticipated.

It was a brilliant 3 days with them. The drive back was solemn. We didn’t know if we’d see them again during my treatment (chemo and no immune system, with snotty, germ ridden kids is far from ideal).

Reality escape over.

The C Bomb

Dan and I went to the follow up appointment the day after we got back from visiting the fam. I knew I had cancer. What I didn’t know was if it had spread.

Was it in my lymph nodes? Was it anywhere else?

Generally, the further the cancer has spread - the worse the outcome.

Of course by now I was convinced it would be everywhere and I’d be dead in 2 months, as that is of course what your stupid brain does, it takes something and catastrophizes it! I was pretty convinced of this though despite telling everyone else I thought it’d be fine - I really didn’t think it would be. Unfortunately I remember seeing patients in their 30s on the wards in various hospitals I’ve worked in who had metastatic (wide spread) cancer and who had been end of life. I was going to be just like those people. BUT I put on a smile and said all would be fine, probably to try and save other people from being upset and probably trying to stop myself from getting too upset.

So when I was told that I had grade 3 (aggressive) triple negative breast cancer, but my lymph nodes were negative (meaning no cancer in them).

I was over the f*cking moon!

No cancer in your lymph nodes means spread elsewhere is very unlikely. The less spread, the better the potential outcome.

I don’t think the doctors were expecting me to be so happy on being told I have cancer - but this was cause for celebration - this is a potentially curable cancer!

There are lots of different types of breast cancer, mine is triple negative. It’s called this because some breast cancer cells have receptors on them - oestrogen, progesterone and HER2. That means that the cancer cells can feed off these things, encouraging them to grow. This allows for targeted treatments either as part of your chemotherapy or after you’ve had treatment to reduce your risk of the cancer coming back by reducing the amount of oestrogen, progesterone and HER2 in your body. For more info on this click here.

Triple negative means I don’t have any of these 3 receptors. Which means no targeted therapies and no post chemo treatment to reduce my risk of recurrence. Triple negative breast cancers are normally aggressive, fast growing and fast spreading.. YAY!

BUT it’s not all doom and gloom. BECAUSE they are fast growing, they typically respond well to chemotherapy. Chemo kills rapidly dividing (or fast growing) cells. Fast growing cells include hair, nails and skin (amongst others) but it explains why some people lose their hair and often end up with dry skin and funky nails during chemo.

I was given the option of having chemotherapy or surgery first. I opted for chemotherapy because of my age they wanted to do genetic testing to see if I had certain genes such as BRCA1, BRCA2 and PALB2 (click here for info on BRCA genes). If my genetic tests came back positive, I was going to have a double mastectomy (like Angelina Jolie) and drastically reduce the risk of the breast cancer coming back or developing in my other boob. I figured it made sense to have chemo first so that by the time I had surgery we would know the result of my genetic tests. This would save me from having a lumpectomy, chemo and then having more surgery if I opted for a double mastectomy.

The Harvest

Dan and I don’t have children. We had been thinking about starting a family in the next couple of years.

One of the first questions we were asked after being given the diagnosis was “do you have any children?”.

Now I was expecting this, I know chemo can impact your fertility as it can damage your eggs/ovarian tissue. Dan and I had spoken about it but I don’t think he quite realised that it might not be possible to get pregnant the ‘good old fashioned way’ post chemo. We were referred to the fertility to clinic to discuss freezing eggs prior to starting chemo. I had said that if this would cause a delay in me starting my chemo that I wouldn’t want it.

Why? What’s the point in saving eggs for theoretical children if I’m dead because we delayed starting treatment? No point.

We were called the NEXT day (well done NHS, super speedy) and asked to come in for blood tests and an ultrasound scan. This is how they check your “ovarian reserve”, basically how many good quality eggs you have. Unfortunately if this is too low to start with they aren’t able to offer egg retrieval - which the doctor casually told me as the ultrasound probe went up my fanny.

Thankfully my ovarian reserve was good, so they made me an appointment to discuss and consent to egg collection. It’s a very lengthy document you have to sign, we went through it with the doctor at lightning speed. You have to tick a box to say you’ve been fully counselled - I don’t think I can say I was, but time is of the essence, let’s get this sh*t done.

We asked about freezing embryos as I’m vaguely aware that embryos are more stable to freeze than eggs. They politely said “No”. They only want to freeze my eggs as they’re mine and you never know what might happen in the future. I think also they’d have to do sperm samples and this could delay things. They’re also absolutely right, what if Dan and I did break up and I wanted to have kids in the future but was left with OUR embryos and no eggs of my own that I can use? That would be a whole debate as to who can use the embryos etc? But it didn’t stop Dan being offended - understandably.

I was given tablets to take and 2 different types of injections. The tablets were called letrozole. This works by tricking your ovaries into producing lots of follicles. Normally with a natural cycle you have ONE follicle that increases in size, maturing an egg. The follicle bursts releasing the egg. With egg harvesting you want to get lots of follicles that are big enough to mature lots of eggs and letrozole will do just that!

Side effects from letrozole, most menopausal symptoms, hot flushes, skin changes (acne and/or dry skin), vaginal dryness, mood changes etc, none of which I suffered from (thankfully).

The injections were daily and they were of menopur and cetrotide.

Menopur contains 2 hormones that are naturally present during your cycle and they help get these follicles up to speed too. The most common side effects with these include nausea, tummy pain and bloating. I didn’t get these side effects until the week before they harvested the eggs - then I suddenly felt bloated, sick and uncomfortable. I wasn’t able to wear any of my own trousers because they didn’t fit! I had to borrow my sister’s maternity clothes.

Cetrotide works by stopping you from ovulating (releasing an egg) too early. You want to wait until you’ve got as many follicles as you can that are at the right size and then release loads of eggs at the same time! The most common side effect from this drug is irritation around the injection site.

The whole thing took 15 days from first consult to egg harvesting. I had scans or blood tests almost daily. The scans are internal, which means they shove a probe up your vagina. Don’t worry - they pop a condom on first. Safe sex and all that. I had one doctor who scanned me 3 times in a row. On the third scan appointment I said “we need to stop meeting like this” which is freaking hilarious, so I assume he didn’t hear me or he was laughing hysterically behind his mask…

The scans are a bit uncomfortable, and when my follicles became like 2 big juicy bunch of grapes it became very f*cking uncomfortable.

Once you’ve got as many follicles as they think you can safely get between 18-20mm you inject yourself with a trigger drug and the next day - it’s harvesting time!

I didn’t feel nervous about this procedure, I just wanted the eggs out of me. You normally have one 2cm big follicle each month - I had at least 20. That’s 38cm of more stuff in your pelvis! This is the equivalent to an iceberg lettuce or being 27 weeks pregnant! Which has all grown in the space of 2 weeks!

It’s done as a day case which means you go to hospital that day (normally in the morning) and you leave later that day. I was given sedation, told to imagine it was like a big glass of red wine, and next thing I know I’m waking up. I was told it was a success and they’d managed to get 20 eggs - 19 mature enough, 1 a little immature.

For the immature egg they say they’ll remove it from the freezer a day or two earlier than the others. I’m not sure if this is legit or a joke, as it doesn’t sound very scientific…
They removed my mirena coil at the same time as my cancer team wanted it out. Yes, I had it in the whole time I was growing those follicles and maturing them eggs. It is MAD! My ovaries and womb must’ve been like what the frick?!

I had a bit of discomfort and the tiniest bit of bleeding for a day or two after. The bloating started to settle after about 48hrs - I could fit into my own clothes again!

Egg harvesting done. Tick!

The Pre Chemo

We’d been so focused on the egg harvest that I’d forgotten all about cancer and starting chemo… well until we went to the see the oncologist (cancer specialist).

I feel incredibly fortunate that I live in Manchester and we have The Christie hospital just around the corner. It’s a cancer specialist hospital, and a bloody fine one at that. So I knew I was in great hands and knowing I didn’t have far to travel was great.

It also means that everyone in there has cancer, so as soon as you walk through the doors you’re surrounded by other people who have all different kinds of cancer and are at different stages of treatment. You see headscarves, balding heads, frailty, wheelchairs etc which is a bit like looking into your own, seemingly grim, future. But then you also see the “normal” and “well” looking people and think well 🤞 I’ll be that kind of patient.

Seeing other people with cancer, made me realise, sh*t, this is real, this is happening, I’m here because I’ve got cancer too.

We’re shown to a consultation room and sit there waiting for a doctor to come in. She sits down, asks me how I’m doing. I’m optimistic, remember this is potentially a curable cancer. We then go through the history and a whole load of questions again.

She explains the chemotherapy regime I’m going to have,

PC (paclitaxel and carboplatin) and then

EC (epirubicin and cyclophosphomide).

She then walks us through an entire booklet of side effects, roughly the same size as war and peace. It feels never ending. I know they have to go through them to get your consent for treatment, to make sure you’re aware of ALL of the risks. But if I don’t have chemotherapy - the very likely, probably, I’d argue certain outcome, is death, so I don’t feel there’s any other option other than ploughing on. Knowing all the potential side effects isn’t helpful, makes it very real and sh*t, as if you’re on a very grim game show where your prizes are diarrhoea, hair loss, vomiting, skin rashes, potential cancer in the future…. the list goes on.

I was asked if I wanted to take part in a clinical trial because there’s one currently running with regards to my type of cancer. There are often clinical trials happening so if you’re interested in taking part in one it’s worth asking your cancer team. You can withdraw from the trial at any time, either before, during or after treatment.

I’m taking part in the PARTNER trial. Click here for more info.

By the time we were having this conversation about starting chemo it had been;

7+ weeks since I found the lump and 10+ days since my diagnosis.

My chemo was scheduled to start on the 30th of March… this would be;

10+ weeks since I found the lump and 5+ weeks since my diagnosis.

I was like woah woah woah….. I wanted chemo to start yesterday. No, actually, last week. No, actually, last month! Can we start now? Like right now? Now now now now?!

No.

But the team made me feel very relaxed. They were like chill, we’ve got time, don’t worry.

I know this might sound a bit odd, but because they said it I was like, sure, cool, that’s fine and definitely felt more at ease about the whole waiting thing.

I’m really glad we had the gap between egg harvesting and chemo as it had felt pretty hectic with constant appointments for bloods, scans, consults etc. and we hadn’t really had time to think about the cancer and chemo and what was to come, we’d been busy concentrating on getting the eggs.

We had 3 weeks to get ready for chemo.

We’d been renovating our house for the last 2 years and had been living with my mum. We moved back into our house just before Christmas so things were a bit of a mess. Rather than dwelling on the cancer and thinking about what to come, as that was pretty f*cking grim to think about, I threw myself into sorting the house out. I didn’t want to be doing this during chemo and I certainly didn’t want to be living in an untidy/unsorted house during chemo.

Tidy house, tidy mind as they say.

I also spent a lot of time with friends, having lunch and dinner dates almost daily. I had images of me being bed bound, so sick and weak from chemo I could barely move, let alone see people and with the Covid-19 pandemic still well and truly here, I wasn’t sure how much I’d want to see people and put myself at risk of catching something.

It was actually lovely, I’d never seen so many friends in such a short space of time especially due to the pandemic restrictions, which had started to lift. I was living in the moment, and treating it like a holiday - not thinking about what was to come.

I had a couple of scans before chemo. I was born with something called hydronephrosis of my right kidney. Basically my right kidney is a bit baggy and a bit lazy. The chemo/research team wanted to do a more detailed scan of my kidneys to check how well they’re working. This is because some of the chemo is processed by your kidneys, so they needed to make sure they weren’t going to overload me with chemo and knock off my kidneys in the process.

Another scan I had was an ECHO which is a jelly scan (think pregnancy scan again) of your heart. This was because in clinic and on the ECGs, my heart rate was between 45 and 50, which is fairly low. Most people will have a heart rate between 60 and 90. It turns out I’m just THAT fit that I’m basically an athlete 😉

I also took these few weeks to do all the pre chemo prep I had read was good to do;

• Dental checks

• Eyebrow tattoos

• Shaved my hair off

My fabulous, wonderful, amazing friends and family sent me lots of moisturisers, lip balms, herbal teas, bath and shower goodies, anti sickness sweets, books, colouring books, puzzle books, audiobook vouchers,podcast suggestions, film suggestions, TV suggestions etc. There was not a chance I was going to be dry skinned or bored.

If I didn’t have such generous friends and hasn’t received such a plethora of gifts I would’ve made sure I had some moisturiser, lip balm and some books at home.

The Fasting

I had read a rather disheartening but wonderfully honest article by Decca Aitkenhead about her breast cancer and treatment for it (if you want to read it click here, but I must warn you Decca does not mince her words).

Decca mentions how she had heard about fasting to help with side effects. She tried the first session without fasting and felt so horrendous, drained and zapped of any energy that she decided to fast for the next treatment. This involved fasting for 72 hrs before chemo and fasting for 24 hrs after. Decca was waiting for the wave of sh*tness to hit her, but it never did. She felt so much better than the first treatment session that Decca continued to fast for the rest of her cycles.. I was sold (and did not feel the need to trial it without fasting, I’d rather feel less sh*t thanks).

My mum told me about a woman at her exercise group who had recently had a run in with breast cancer and that this woman had been fasting for 24hrs before chemotherapy and felt it had really helped with her nausea too.

Well if a random woman at my mum’s exercise group says it works… it must do right? That’s all the evidence I need.

I did some reading around fasting and cancer/chemo. Most of the information I found was via Professor Valter Longo who has done lots of studies on mice and the results (in my opinion) are really astounding. Not only does he talk about how great fasting is for reducing chemo side effects but the amazing effects fasting has on the cancer itself, for diabetes, heart disease, Alzheimer’s, the list goes on. See his website here.

Fasting for 4 days out of 7 sounds so bloody hard and almost impossible, but it is achievable. I would drink water, sparkling water as well as black and unsweetened teas and coffee. If I felt really hungry I would have a bone broth or miso soup or if I was feeling particularly adventurous - a bag of salad leaves. For more info see my blog post about fasting here.

What helped me?

Well, staying out of the kitchen definitely helps, trying to keep yourself busy and preoccupied as we often reach for food when we’re bored. Making sure I had lots of drinks available, I had more herbal tea than you could shake a stick at (which is a lot). Trying to get your other half on board.. or at least making them aware. On my first night of doing it I was speaking to some friends via zoom (remember those Covid-19 remote meet ups) and Dan literally comes in with some mushroom bruschetta he has got for me with zero recollection that I was even fasting or why I was doing it. 2 of my incredibly wonderful friends decided to fast with me - for 24hrs each week, on a Tuesday, they day I had chemo - we set up a whatsapp group chat called “TuesFast Club”… like the breakfast club, get it? (It’s hilarious, trust me.) I found this super helpful, they mostly moaned about how hungry they were, but it got me through the day and there’s something about knowing someone else is suffering with you that makes it that little bit easier!

Did it get easier the more times I did it? No, but I knew what was coming, and that I guess made it easier.
My biggest piece of advice for fasting would be that the hunger comes as waves - and that’s all they are - the waves will pass.

The Chemo

I arrived at the Christie’s hospital, checked in and sat down waiting to be called up to the “chemo room”. I felt incredibly nervous but also keen to get going - I had been diagnosed an age ago (4 weeks) but yet we hadn’t started treatment!

I sat in a chair in the waiting room, looking intently for my name to pop up on the board. I waltzed on upstairs, and felt quite overwhelmed seeing lots of people in chairs with tubes coming out of them, hooked up to bags of fluid and syringe drivers. Not because I’ve not seen this before (I’ve been the one prescribing the fluid and putting needles in on wards during my hospital days), but because it was another smack of reality that I have cancer. That I’m going to be unwell because of this treatment - I’m going to have to essentially poison myself, to get rid of this sh*t.

The nurses and health care assistants were fabulous and walked me over to a spare chair and got me set up. It was a big lazy boy style recliner chair with a controller that had more buttons than I knew what to do with. Why a chair? I think they can fit in more chairs within the “ward” than beds, a chair is less effort to clean after (don’t have to change sheets), encourages you to move (reduced risk of pressure sores and blood clots), and if you’ve ever been in a hospital bed you’ll know that it does feel weird to be laying down in a bed when you’re not feeling ill or tired especially when people are coming round and talking to you, popping needles in etc.

My arm was inspected for veins. The aim is to use any good looking ones (straight, wide enough and palpable - they should feel juicy and squishy) as far down your arm as possible. Your hand is ideal, your forearm is okay - they don’t want to be popping needles in the inside of your elbow. I’ve always thought my veins were pretty good, I have donated blood countless times and it’s never been an issue. You could dart a needle in to my inner elbow veins from the end of the bed. My hand and forearm ones however, were a bit shy.

Thankfully the health team are well versed and it isn’t their first rodeo. They have means and ways - in the form of a heat pack that’s been blasted in the microwave for 30seconds. Once they were happy they could feel some top notch ones they popped a cannula in. I wish it was this easy every time, but we’ll talk about that later on.

They brought me some anti sickness, some steroid tablets and then I was hooked up to some piriton (anti allergy medication). I think the piriton is there to reduce any reaction you may have to the chemo, but one of the side effects is tiredness - so I do also wonder whether there’s an attempt to get you to sleep during the treatment. I fell asleep, every, damn, session!

The piriton took 30minutes to go through. Then it was chemo time.

I fell asleep, listened to music, did some French via Duolingo.

In total it took about 3-4 hours. When we were done, they disconnected me from everything and off I went. As I went to leave the unit, I had to make a quick dash to the bathroom. My stomach was a bit uncomfortable, a bit crampy, I thought that maybe a motion was in motion.

That motion, turned out to be a full colonic clearance.

I’ve never experienced anything like it. I imagine the results are similar to a colonic irrigation.

Once the mass exodus had finished - I got out of there, tout de suite! Got home and chilled for the rest of the day. I was still fasting, as I wanted to have a day after chemo of not eating. I felt a bit weird, it’s hard to put it into words. Woozy, whatever that means, and a bit spaced out. Dan came to pick me up after the treatment (he had taken me in the morning too) and I was glad, I wouldn’t have felt comfortable driving or making my own way home. It was comforting too knowing he was going to come and get me.

I was given a couple of days of dexamethasone (a steroid) and some anti sickness tablets to take home with me. But that was it.

First chemo done!

Full disclosure…

I haven’t been keeping up to date with this blog. At the time of writing this bit, it is August 2025… A whole 4 years since I was diagnosed and having treatment and had last updated this.

Why has it been so long? Well, I was busy with work and living my life. Probably trying to forget about cancer and what I’d just been through.

But I’m back baby!

Spoiler alert… Unfortunately, so is the cancer.

I’m going to finish writing my Cancer V1.0 story and then move onto the less fun, bit more life shortening, Cancer V2.0. Rereading through the above I don’t half whittle on so the next bits may be a bit shorter… maybe.

The Hair Loss

Okay, having to scratch my (bald again) head here to think back all those bloody years.

I thought it would be instantaneous - it is not. They do advise not everyone loses their hair. There I was - at 4 weeks, with a shaved head. Thinking, I’m the medical marvel who doesn’t lose their hair. Of course. And I’ve shaved it. What a muppet.

It turns out - after about week 4 of chemo it starts coming out. I noticed more and more tiny hairs on my pillow and then I had a shower and washed my head and it was all coming out in my hands. I thought I was mentally prepared for this. I had shaved my hair off after all, and I’ve never been that attached to my hair. Hair does not maketh the person.

However, it was pretty f*cking hard and upsetting. I cried. A lot. Proper blubbing, ugly crying - but too right. I’m gone from someone who was just going to a cancer hospital to now actually being someone with cancer. I was starting to look poorly. Nothing says cancer patient like a bald, or even worse, patchy head.

Now I know you all want to know - the arm pit hair was quick to go. Leg hair also. I guess it’s because I shaved them anyway so they just didn’t grow back. The arm hairs, they stuck around and I even had patches that had hung on for dear life and were still there when I’d finished treatment. The pubes - they hung around for longer than they were welcome. Eyelashes and eyebrows - it’s hard to say with my eyebrows, because I had the excellent tattoos I honestly didn’t realise they were starting to go until I properly looked. I think they were probably not long after I started losing the head hair (4 weeks in). The eyelashes, I believe I had one eyelash on each eye that clung on in there until the bitter end.

A few things I found odd about not having hair;

1. It’s bloody cold on the old noggin. Hats and scarves are your best friends. BUT silk scarves are ruddy useless. They won’t stick on your head and will slip off. Cotton with a slight stretch is best.

2. I never wore a wig - I couldn’t be bothered with the faff of it, I didn’t want to spend a ridiculous amount of money on one, and the best ones are spenny (£1k+). Weirdly I wore one when my hair was growing back post chemo, but only a handful of times.

3. I wore scarves if going out for dinner or events - not in the house. There are loads of really easy to follow YouTube videos out there. One that I remember using was this one.

4. The regrowth is different for everyone. I shaved my head again as it was growing back because the initial part was fluffy and patchy. It was then a bit wild and wavy. Thankfully came back the same colour, some people say it can come back a different colour and some people talk about chemo curls. I was looking forward to some ringlets - but wasn’t meant to be.
   It’s a good time to experiment with different short styles - you’ve got to go through the different lengths anyway, so why not embrace it!

The regrowth started within a couple of weeks of stopping chemotherapy - probably 3 weeks. I forgot how much of a faff shaving was but was very proud of my body for going back to the status quo once I’d finished poisoning my body.

Eyelashes come back stubbly and look a bit crazy as a stubbly eyeline is not something you’re used to seeing. I think it probably took 2 weeks for these to grow back to their former glory - but I may be misremembering (don’t come after me).

The Insomnia

This sucked. And is quite common. 2 reasons I suffered with it - well probably 3.

1. STEROIDS, these guys will keep you up and you’ll make random impulse buys at 2AM.

2. MENOPAUSE, I was put into a medically induced menopause to try and help preserve my fertility (we’ll get onto this). This can affect your sleep for a multitude of reasons, hot flushes, itchy skin to name but 2.

3. WORRY, I like to think I’m not a worrier, despite cancer, but I’m sure that I was waking up in the night because I was thinking about things. This is only natural and would be weird if I wasn’t. I might seem light-hearted about my mortality but I’m not a psychopath.

What the heck did I do about it? I don’t think I did much. I tried to stay active (exercise helps sleep when not done too close to bed time). I could’ve taken medications but I didn’t want to put anything else into my body - wasn’t it already dealing with enough?

I embraced the midnight shopping sprees and then would cat nap in the day when needed. Not a luxury everyone has I realise.

I have no real pearls of wisdom here, just that if you’re struggling with your sleep, you’re not alone. It sucks. At some point, it hopefully will get better. If you’re really struggling, maybe speak to your doctor about medications to help. Sleep is so important for all bodily and brain functions and cell healing. Knowing that when you can’t sleep is not helpful (sorry).

There’s a chap called Dr Matt Walker who does a fabulous podcast all about sleep. It’s got lots of useful tips and advice bits but he also has such a soothing voice, I struggle to stay awake if I pop one on. Find them here.

The Hand and Foot Syndrome

This was a fun side effect. It’s a side effect commonly associated with the chemotherapy paclitexal. It’s thought that in the little blood vessels in your hands and feet the chemo starts to leak out and affect the tissues. This causes redness, dry skin and pain.

The only way to stop it is to stop the chemo or reduce the dose. I knew this and didn’t want that to happen. I only developed it in the last 3 weeks of this type of chemotherapy. It had gotten so bad I could barely walk so was using crutches but then my hands hurt, so I ended up just hobbling around. Not fun. Moisturise, moisturise, moisturise. Will this help? Hard to say but you’ll have beautiful feet at least!

When the chemo stopped/changed to a different type the hand and foot syndrome disappeared. I think within a week. It felt pretty instantaneous.

I would not recommend persevering like me (maybe I am a psychopath), if you start to get symptoms, speak to your team. I thought I was wearing ill fitting/tight shoes, despite not changing my footwear and having worn the same trainers for years. I lost a lot of shoes to hand and foot syndrome God damnit. Was not engaging the brain. Don’t do what I did. It’s probably your feet - NOT the shoes.

The Menopause

I said I’d come back to this bad boy. I was offered Goserelin injections. These are hormone blocking injections. It’s actually a tiny hormone releasing pellet that sits under the skin.

The procedure involves a rather large needle that they pop into the skin in the lower abdomen, it goes in every 28days and I guess your body just absorbs the pellet after a while as they don’t need to be removed and I don’t have a collection of lumps under the skin to suggest they’re still there! It wasn’t pleasant, but no more painful than a blood test I don’t think. Read more about it on this website here.

Boy oh boy was I in for a shocker. The hot flushes were something else. It feels like someone has just put the car heater or an outdoor pub heater on full blast on you and you can’t escape. Layers are your friend here. Being able to whip off some clothes without exposing yourself is key. We don’t want anyone getting arrested. If I was to experience this again I think I’d invest in a small hand held fan and get that thing out at a whiff of a hot flush.

Itchy skin? Sure. Not able to sleep? You bet. Vaginal dryness, didn’t seem to suffer with, mood swings, I don’t think so and no-one seemed to tell me otherwise but then again telling someone who is undergoing treatment for any form of cancer that they’re being moody or hormonal - I think you’d be the a**hole for suggesting that, so maybe I was, we’ll never know!

The positive was that my periods upped and f*cked off. Huzzah! One less thing to think about. God it’s great being a woman.

03.09.2025

The Blood Counts

I’ve just realised that I’ve not been adding any dates on the above entries so it’s hard to know when I’ve added bits and when.

It turns out this is my first blog, and apparently my first rodeo.

The best gift I was given? I hear no-one asking, but I will tell you, was a chemo countdown calendar my friends made. I think it must’ve been an old advent calendar but they put weeks on the doors and behind each one were song suggestions - so I ended up with a killer chemo playlist, quiz questions, poems, little toiletries, anti sick sweets etc. It was incredibly thoughtful and something I looked forward to opening each week.

What else happened to me? It has been 4 years so is hard to remember now..

I needed 2 blood transfusions, 4 units of blood (that’s about 2L). This was during my second lot of chemotherapy. After 12 weeks of my weekly infusions we switched to an infusion every 3 weeks, this was standard and not because I wasn’t responding or had any issues with the first lot of chemotherapy.

I had epirubicin (nicknamed the red devil - named as such because it is red, turns your pee red and makes you feel pretty cruddy) and cyclophosphamide. These are known to reduce your blood counts, your white cells (infection fighting cells), red blood cells (causing anaemia) and platelets (important in blood clotting so increasing nose bleeds, bruising etc).

I went for a run - the first time in a few weeks, and I managed to get to the end of the road before I had chest pain, felt very short of breath and as if I was going to pass out. My heart rate had shot up to 130 and kept doing so even when I was just walking up the stairs. It turns out my blood count had dropped from around 120 to 70.

I am incredibly grateful for the blood donors which meant that I was able to have my levels topped up. I used to donate but am no longer able to because of having cancer and chemotherapy. If you want to read more about it or find your local centre click here.

Blood topped up, I was feeling great again (as great as you can do on chemo).

The Sepsis

We were gearing up to my last treatment. Dan and I drove up to the Lake District for a lunch date. I started to feel a bit weird on the drive… headaches, back was hurting, I felt cold - I thought I was just cold because the temperature had dropped a bit that day. I then couldn’t stop shivering.

Of course I hadn’t brought my thermometer with me - something you really should keep on you at all times as someone undergoing chemotherapy, as a temperature may be the first thing to indicate you’re unwell, and you need to act FAST.

Dan nipped into Boots, got a thermometer. It was reading 38.5, 39, 40.2’C.

Oh boy.

We quickly turned around and starting heading back to the Christie’s. We rang the hotline number and they saw us within a couple of hours. It turned out I was septic - this is a life threatening condition. One where your body has an extreme reaction to an infection and instead of your body doing all the things it can to fight it off - it goes into overdrive and starts causing damage to itself. You need fluids and antibiotics within 60minutes. Read more about sepsis here.

The infection was in my Hickman Line - this is a tube that goes into the main blood vessels that go into your heart. I’d had this fitted probably about half way through my treatment because they were struggling to cannulate me. I’ve got great veins on the inside of my elbows - it turns out they’re rubbish in my hands and lower arms. They don’t like to cannulate at the elbows or above because the chemotherapy is toxic, it can destroy your veins, making blood taking in the future a real issue and so they try and go for the ones in your hands/forearms. It was often taking 5 attempts to get a line in, so we decided to put a Hickman line in - this is a tube that is left in your body to allow quick and easy access to get blood, deliver drugs etc. Read more about it here.

The tubes of the line stick out of your chest, yes it is exactly as it sounds - these had somehow become infected and the infection had then got into my blood making me really poorly. I ended up being in hospital for a week, my temperature wasn’t going below 38.5’C, I’ve never felt so ill in my life, and thought that I was going to die.

After 48 hours of antibiotics my temperatures were still spiking. They decided to remove my Hickman line. They used lots of local anaesthetic but it still hurt as they cut into the skin, I’m sure because of all the infection, it was very unpleasant. Once loosened it essentially burst out of the skin because of the build up of pressure from the infected tissue. Gross.

Once removed, my temperatures settled within about 24 hours. It felt good to not be shaking like the proverbial dog anymore.

I got home after 7 days in the hospital - it felt great to be in my own bed. My last chemo was delayed because my liver needed a bit of time to recover from the antibiotics. I hadn’t realised but Dan was planning a surprise “end of chemo” party for me, but then of course freaked out because I’d ended up so unwell and thought having a party probably wasn’t the best idea.

We did a reduced version - meeting a few friends for a glorious afternoon in London.

The last session of chemo itself, I hadn’t really thought about it but I felt incredibly emotional the day before. Once you’re in it, I think you just put your head down and get through it. It was then on reflection, thinking sh*t, I’ve done it, and how much I couldn’t wait to stop having chemotherapy!

There’s a bell that you ring when it’s your last session. As it was Covid-19, I didn’t have anyone in with me, so no-one saw but I still rang the bell and people in the chemo ward whooped and cheered. When I hear it now, being sat back in those chairs - it makes me really happy and hopeful for the person who’s just rung it, fingers crossed they’ve just had their last ever treatment!

I, of course, won’t be ringing it this time round…

09.09.2025

The Surgery

I’d done the chemotherapy part - next stage was surgery. Let’s remove whatever is left of this little beggar and remove the funky looking lymph nodes in my arm pit.

This was a doddle in comparison with the chemotherapy. It was a day procedure. Meaning I went into hospital that morning, had the procedure done that day and went home after. I had a lumpectomy which means removing the lump only hence the LUMPectomy. They also removed 4 lymph nodes from my arm pit - the funky looking ones and some others for good measure.

The lump had shrunk so much that they weren’t able to feel it anymore, which was fantastic news. So they knew where they were going when cutting me open, they injected a MagSeed prior to the surgery. This is about the size of a grain of rice. This was done using ultrasound scan to ensure it was put into the centre of what was left of the tumour. When they were operating they used a magnetic probe to locate the MagSeed and hence the tumour, to make sure they were chopping out the right bit.

I had bought a front fastening bra specifically for people who have undergone breast/chest surgery. I would highly recommend this as you want something big and comfy, where you’re not faffing around at the back pulling things tightly across your chest.

The scars themselves were small, and relatively pain free - my arm pit was more sore than my chest. I was given some codeine (an opiate pain killer) to come home with, but I didn’t need to use much of it. I was back at the gym within a couple of days, not doing any chest, shoulder or arm work, but some gentle cardio to keep the legs going and heart pumping.

I must’ve had dissolvable stitches and/or glue because I can’t remember having them removed.

The results came back to confirm that the funky looking lymph nodes in my arm pit were just that, funky looking, no evidence of any cancer which was sweet music to my ears. This meant that the risk of it having spread elsewhere in the body and therefore coming back was low. The tumour base that they removed had shrunk and only about 10% of it remained active cancer, the rest was now scarring and dead cancer cells. This was a great result.

2 stages done. 1 to go.

The Radiation

The final piece of the puzzle. They’d poisoned me, cut me open and now they were going to fry me.

Getting prepped for the radiotherapy is the hardest part of it. They use these incredibly clever lasers to map out your body. This is to make sure that when they’re delivering the radiotherapy they’re delivering it to the right bit - i.e. breast tissue only and avoiding things like your heart or lungs. When you’re all lined up, they give you tiny little dot tattoos on either side of the breast so that when you go back to have it done, they line up your tattoos with the machine and away you go. Yes, these were my first ever tattoos, and yes I do feel badass.

The machine is big, and looks like something out of War of the Worlds but it doesn’t touch you and you’re laid on an open bed. If anyone was worrying about claustrophobia here I don’t think it would be an issue. The sessions themselves took about 20minutes. This was more because lining me up in the right position took some time, the machine would only radiate the tissue if the lasers matched up correctly. This as mentioned above is to try and limit damage to other tissues that don’t need the radiation. If you move whilst on the bed and get out of position, the machine will stop zapping. It’s all very clever.

I used aloe vera gel to moisturise my breast twice a day (it was only the one that had cancer in that was being radiated), this was to try and keep the skin happy and reduce the risk of any skin changes, redness or pain.

This was a tip from a friend of mine who had undergone radiotherapy herself. It turned out to be a top tip! My skin remained unscathed and painless. I had slight reddening of the skin, but it wasn’t painful and this settled after a few weeks.

I had 3 weeks of radiotherapy in total - these are daily sessions, with weekends off so it was quite intense. The plan is to radiate the entire breast and make the risk of recurrence the same as if I had had my breast removed (a mastectomy). To read more about radiotherapy click here.

On my final session, Dan came to pick me up, mini bottle of champagne in hand.

I’d fricking done it.

I’d beaten cancer.

Or so I thought…

17.09.2025

The Aftermath

I had been on this rollercoaster ride and it was finally time to get off. It’s very strange going from being seen weekly or every few weeks to suddenly once a year. I don’t feel it’s spoken about that much, the anxiety that lack of observation or appointments gives you. On the one hand you’re very grateful to be done with the hospital and regular visits - on the other, you’ve become a bit conditioned and the idea of not being seen regularly is rather scary.

I went back to work, which was glorious, I really do love what I do and feel very lucky to be able to say that and truly mean it. It took me about a month I’d say to get my head back in it properly. Talking to patients and making it a free flowing conversation is much harder than it may seem. I kept having to think about the next questions to ask, often repeating myself or asking the patient to repeat themselves because I couldn’t remember whether I’d just asked it or not. I was worried about forgetting to do things, so would double check my clinics at the end and go through every patient which is quite time consuming. I think once the chemo started to wear off and my ovaries started to kick back in (as I was no longer on the menopause inducing injections), my brain was going at full capacity again.

Did this experience change me as a doctor? I think so. It made me more self resilient. I feel before I would take a lot of patient baggage home with me. Which from time to time I think is important as it can help you to reflect, grow and change as a doctor, but too much of this will grind you down emotionally and drain your resilience. Without resilience, you can’t do your job.

It also made me realise that just because you’ve been diagnosed with cancer, it doesn’t mean you’re feeling any different, especially mentality wise, and therefore patients shouldn’t be treated any differently - I would like to think I didn’t do this, although I’m sure I did, asking how someone with cancer felt, and doing a sad concerned face. If this was done to me, I would find it patronising, although it’s come from a place of compassion and kindness, so I’m going to try and stop that.

I also feel having been unwell, and having symptoms due to the chemo - NOT from the cancer, remember, it was the drugs that made me feel tired, affected my blood counts, made me lose my hair etc not the cancer itself, it made me want to get people off unnecessary medications. Especially those that are addictive - such as opiate pain killers (if you haven’t seen ‘Dope Sick’ or ‘Pain Killer’ I would highly recommend).

I started doing this website - as I way for me to process what had happened but also to try and help others with tit bits (pun 100% intended) and advice that is science based and hopefully easy to digest. However when I got back into the swing of things with work, I stopped doing it. Time escaped me, and maybe, if I’m being honest with myself, I wanted to put this part of my life behind me. I was now cancer free, I didn’t want to be thinking about it all the time.

I tried to stop drinking alcohol, I reduced down for a few weeks, but it crept back up again. Do I think this made my cancer come back? It’s hard to say but it won’t have helped. Alcohol causes inflammation in the body which can increase your risk of certain types of cancer. Read more about it here.

I was offered fertility testing 9 months after stopping chemotherapy - I was given a number to contact. I got in touch, not because we were wanting to have a baby but because my contraceptive options were limited now, even though my breast cancer was non hormonal, no-one was going to prescribe me hormones, so it was the copper coil or condoms. The copper coil can cause heavier and more painful periods, after all the sh*t I’d just been through, this didn’t seem appealing. The other option being condoms, and nothing kills the mood like putting a rubber sock on your penis (but super important to protect against STIs as they are the only thing that do - ALWAYS use condoms until you and your partner have had an STI screen and got the all clear).

As part of the fertility work up they checked my bloods for my ovarian reserve and did an ultrasound scan. My ovarian reserve had reduced down by about three quarters. This meant that the goserelin injections had protected my ovaries a bit and there were still some eggs there, but that I would likely go through the menopause earlier than before chemo - probably 10 years earlier. The other issue I had was a very thin endometrium (lining of the womb). Now most women would think it’s a compliment to be told they’ve got a thin womb, but what it actually means is that it’s unlikely for a fertilised egg to implant as there isn’t enough there for it to bed into, and if it does, it’s likely to end in a miscarriage.

Okay, but why was this the case? I had a hysteroscopy - this is a camera test that goes into your womb through your cervix - my goodness this was painful. They gave me gas and air, which helped, I got through it and the pain settled quickly after. It’s like very bad cramping period pains (for any men reading, have a look at the videos of men using the period simulators, it is painful!). It turned out I had scarring of the womb. You weren’t able to see my left fallopian tube and the inside of my womb was very pale, when it should be a pinkish/reddish. Why was it scarred? Normally scarring, or adhesions (this is also known as Asherman’s Syndrome) form due to untreated STIs (I’ve never had one, thank you!), instrumentation (camera tests, removal of tissue from the womb etc), or radiation to the womb (which I hadn’t had either). By all accounts, it was a mystery.

The consultant rang me a few months later and asked what I wanted to do, the next step would be breaking up these adhesions - under general anaesthetic, then giving me hormones to see if my womb responds and grows as it should. I wasn’t sure if I wanted to do this. I wasn’t entirely sure I wanted children, and even if I did, I wanted to wait at least 5 years after my cancer diagnosis as my risk of recurrence massively decreased after this time. The thought of the cancer coming back and being pregnant, or the cancer coming back with a baby or small child is just hideous. I knew full well that if my cancer came back (40% chance) that it would not come back in the breast, but it would reappear in the bones, brain, lung or liver - this is where breast cancer typically spreads to.

This would mean stage 4 cancer, non curative, and ultimately dying from cancer.

I told the consultant we wanted to think about it and could she book a telephone follow up for 6 months time to rediscuss this. A month later, I missed my period, I thought I was becoming peri menopausal. I also started to feel quite sick, I though I had some low grade norovirus (it was winter time, so ‘tis the season). I felt very tired, I thought short days and the winter blues were getting to me. I even told my GP colleagues all of the above.

Not once did we think to pee on a stick.

Dan and I had been practising the natural family planning method where you track your periods and only have unprotected sex during your non fertile window. There may have been some confusion with my previous period as I had an abnormal bleed mid cycle, so I wasn’t 100% certain when my fertile and non fertile windows were a couple of months previously. Anyway, long story short, on New Year’s Day, I decided to do a pregnancy test just to be sure I wasn’t pregnant, as I had missed 2 periods now.

Still convinced I was peri menopausal.

Because I had basically been told I couldn’t get pregnant without help, and if I did, it would end in a miscarriage.

3 pregnancy tests later.

Holy. Corn. Balls.