The past few weeks have been a whole world of crazy. Individual days have felt like an eternity at times, in no small part down to the stress of waiting to meet my oncologist for the first time and find out what lies ahead. It was four weeks post-surgery when I could finally climb again (yay!) and a few days later when I was given my treatment plan. Knowing that chemotherapy is recommended to quite a large proportion of young women with breast cancer I had prepared myself for being told that chemo would be next on my agenda, but that didn’t happen. Instead, when I met my oncologist she told me that the risks were larger than the reward in my case. I went through so many emotions that day, but relief, guilt, and uncertainty were by far the most prominent. Relief for obvious reasons; guilt because I felt like I was cheating the system by not having to go through what so many others do; and uncertainty because in my overwhelmed state I forgot to ask what the benefit (if any) of chemotherapy would have been for my long-term outlook. I want to do whatever it takes to live a long life, and in good health, so not having chemo is, in some ways, actually a little scary… Have I covered all my bases? Will my prognosis be the best it possible can be? Ultimately I’m putting my trust in the experts now and hoping it won’t come back.

The medical (and emotional) merry-go-round… from being able to climb again post-surgery to starting daily injections of fertility meds, from finding out I don’t need chemo to undergoing an egg retrieval procedure that left me blown up like a balloon!

Looking ahead, I’ll be having four weeks of radiotherapy likely starting at some point this month, followed by at least ten years of hormone therapy since my greedy little cancer feeds on hormones. While the side effects of radiotherapy (most commonly skin problems and fatigue) are nothing by comparison to chemo, I’ll be taking time out from work to focus on looking after myself. A dose of fresher’s flu probably wouldn’t be all that helpful during treatment! My main worries moving forward, however, are the side effects of hormone therapy. I’ll be having monthly injections of a drug called Zoladex, and taking a pill called Aromasin daily. This medication can have side effects including hot flushes, joint pain, mood changes, and a decrease in bone density. As an active, sporty person the latter is a particularly scary proposition, so I hope that my oncology team will be able to offer some options to offset damage caused to my bones. While not needing chemo is certainly a relief, how my body will cope with these other treatments in the short and long-term plays heavily on my mind.

The other perhaps unexpected side effect of cancer treatment, which I touched upon briefly in my last blog post, is changes in fertility. Had I needed chemotherapy it could have damaged my fertility irreparably; this is thankfully no longer an issue. The remaining worry is that after ten years of hormone treatment I might struggle to get pregnant naturally. Women in their forties often have more difficulty in getting pregnant due to a decrease in egg number and quality over time; not to mention any unforeseen complications from cancer treatment, or the possibility of cancer recurrence. To make sure I have a back-up plan I’ve spent the last couple of weeks going through ovarian stimulation and IVF, which has thankfully resulted in the successful freezing of embryos for future use should I ever need them. I can now completely sympathise with other women who need to go through IVF for one reason or another; it is not the most pleasant process! Multiple daily self-injections, some less-than-dignified appointments at the clinic, a not entirely unpleasant dose of sedatives and fentanyl during a slightly painful egg retrieval procedure, followed by the worst bloating I have ever experienced. I put on 1.5 kg and 5 inches round my waist due to fluid build-up following egg collection, and I’m writing this from the sofa two days after the procedure, hoping that I won’t have to wait much longer for some relief. Perhaps the most frustrating thing for me is that I now have another two week wait until I can climb again, to avoid literally getting my ovaries in a twist!

The last thing I want to touch upon today is support networks and quite how important they are… The Mustard Tree Macmillan Cancer Support Centre, and particularly the wonderful Becky who spent the best part of two hours with me when I finally broke during a visit to the fertility clinic last week, walking through Derriford hospital in a flood of tears that wouldn’t stop. My fellow cancer patients on the Breast Cancer Care forum who remember which days I have appointments, ask how I’m doing, and talk just the right amount of nonsense. And finally the online community who make me laugh, cry and feel like I’m not alone. I’m absolutely heartbroken to have read while I’m writing this that the beautiful Rachael Bland has died aged 40 from breast cancer. The contribution she made to talking about cancer openly and honestly has been incredible, and I am so grateful for the support she has given to me and so many others through presenting the “You, Me and the Big C” podcast. If you haven’t listened to it yet, why not give it a go?

Caroline

5th September 2018