Same but different

“You’ve done it once, you can do it again!” That is what a lot of people have said to me when they heard I got breast cancer again. I have told myself the same thing at times too, but this time is different.

There are a few parallels between the two occurrences. It is the same ‘type’ (grade 2 breast cancer). Yet again, I’ll need surgery followed by treatment. And, bizarrely, each diagnosis occurred alongside the royal wedding celebrations of Prince William and Harry, respectively.

Aside from these basic (and slightly random) similarities, my experience of dealing with breast cancer  each time has been poles apart . For me, this time has been radically different for so many reasons. I have so much to say about each reason (more to blog about in due course!) but here is a summary:

1.      More significant treatment. Last time I had two (lumpectomy) surgeries followed by radiotherapy. Perhaps it was because I was seven years younger but I recovered very quickly from the surgeries and I didn’t have any adverse side effects from the radiotherapy or hormone therapy. This time I needed mastectomy which will be followed by chemotherapy and hormone therapy. I’m grateful my second diagnosis of cancer was caught at a stage it could be treated but it has been much more traumatic this time, both physically and emotionally, and I haven’t even started the chemo yet!

2.      Bigger concerns. Last time people commended me for being positive, brave and strong but I believe that perhaps then, being younger, I was slightly naïve by not considering the potential risks. Getting cancer again has raised additional concerns. I’ve gone from having a positive ‘beating cancer’ story to finding out I hadn’t defeated cancer after all. Now as a parent of two, it is engrained in me to consider all outcomes for the sake of my children. The hardest part was thinking about what and how to explain this situation to my six and two year olds. They’ve both been amazing in their own way and I’m so proud but also gutted that they have to experience this. I have chosen not to tell my mum who has early onset Alzheimer’s and so I pretend all is jolly when we speak. I feel bad for the deceit but it is the right thing to do. 

3.      An unfamiliar healthcare system. My recent diagnosis was just two months after we moved to Australia from the UK (awful timing but there is no ‘good time’ for these things!). My husband was ready to put his logistics expertise to use and get us back home to familiar surroundings but we decided to stay here. I had to get to grips with the processes of a new medical system. This task was on our ‘international move checklist’ but I hadn’t anticipated needing to get familiar with the healthcare processes within months of landing. Both healthcare systems are, in my opinion, excellent but having to navigate a new (and complex) one in a short space of time has been a steep learning curve.

4.      Fertility considerations. It’s a discussion that comes up with young women with breast cancer because chemo affects fertility. This wasn’t a consideration last time because I was pregnant so it wouldn’t have been possible and, thankfully, chemo wasn’t part of my treatment plan anyway. If we didn’t have children already there would be no doubt we’d be opting to freeze eggs/embryos. We always liked the idea of three children but we have been blessed with two wonderful children and chose not to pursue this for a number of reasons.

5.      Financial considerations. Like most people, our biggest costs are mortgage (plus household bills), childcare and travel. Last time we were in a fortunate position as we didn’t have a big mortgage to worry about and had no childcare costs. Our finances were simpler. This time, we have had to consider the implications of me not working as we have a mortgage, childcare for two children and some uncertainty on the exact amounts and timings of household bills having only just arrived. The exclusion of existing medical conditions within private health insurance policies also added another financial consideration – was it worth paying the full price of private care? I ended up doing a mix, getting the initial diagnosis privately and then moving into the public system but it was a complicated decision-making process!

6.      A fragmented support network. The nurses I met all asked whether we had a good support network we could use to help, particularly with the kids. The sympathetic look on their faces when we explained our situation of only just moving and not knowing people here was enough to bring on the tears! Last time, I had a support network close by and ready to call on but I didn’t need or want it as I bounced back from treatment quickly and didn’t feel the need to talk anyway. This time has been more emotionally draining for the reasons I’ve listed. I knew it would be difficult for family and friends on the other side of the world to support me as they can’t see reactions on my face to gauge if they are saying the right thing or give me a hug (the virtual ones are nice but not as cosy as the real thing). However, somehow they have found ways to show love and support and put a smile on my face. I’ve also had a huge amount of support from work colleagues and the local community. And of course my super husband and children. The prospect of facing this without a strong support network was enough for us to consider returing to the UK but, having decided to stay, we’ve ended up with a fragmented but wide reaching support network. We hadn’t anticipated any of this but are extremely thankful for such love and support.

Overall, this time has been more complex and uncertain, more painful (physically and emotionally) and it has affected more people. On the surface, it is the same but, even at this stage, it has been a radically different experience.