Thursday, 1 October 2015

Breast cancer awareness month: Inconceivable outcome

Author: Miranda A
Miranda also writes a blog at Black Chick Tit Cancer.

I got diagnosed with Stage 2 Grade 3 breast cancer on Thursday 21st August 2014. To say it was a shock is, clearly, an understatement. My father died unexpectedly in February, so I thought nothing else as devastating as that could possibly happen, never mind so close together in time.

I was with my mother in the hospital when I got the news. I remember being told by my breast consultant, Miss P, "You seem very quiet" "It's just a lot to take in, that's all" I replied. If you know me, being quiet is very unusual behaviour from myself.

My head was swimming with thoughts of death, funerals, mastectomies, tests, chemotherapy, hair loss, weight gain, weight loss and other equally negative thoughts. At the age of 32, I couldn't believe I had to deal with breast cancer. Even though it runs in the family, (both my maternal aunts in Ghana have had it) I never expected it would get to me. I probably hoped it wouldn't more than anything.

Early on, I was asked, due to my age, if I wanted to have eggs frozen as chemotherapy affects your fertility. Before my diagnosis, I was in two minds whether I wanted children or not. Now, because the choice had potentially been taken away from me, I developed a burning sensation of wanting the chance of being a mother. There's nothing like being forced to make a decision that crystallises your mind. It reminds me of the episode of Friends when Rachel takes a second pregnancy test to see if she really is pregnant. She isn't sure what to do and if she wants to have a baby. Phoebe looks at the test result and tells Rachel she isn't, which makes Rachel sad, but Phoebe reveals that she was lying in order for Rachel to confront her true feelings and decide what she truly wants.

I was referred to the fertility consultant, Mr. B in order to discuss the collection and freezing of my eggs. The day before my appointment, I received a phone call from the hospital. They told me that freezing my eggs would not be a problem but they could only be frozen for five years and because I was single, if I wanted to use them in the future, I was ineligible for free IVF and would have to pay for it. So not only was I being punished for getting breast cancer in the first place, I was also getting punished for being single. Or at least that's what it felt like. It wasn't like any of this was my fault, but through circumstances beyond my control, I was being kicked when I was already down.

The day of my appointment came and I was in a waiting room of expectant mothers and couples. I felt like a bit of a fraud being there and thought everyone in the waiting room was thinking, "What is she doing here?" When I got to see Mr. B, he had a look at my cervix, womb and ovaries to make sure things were okay for me to progress for egg harvesting. Through the examinations, it transpired that my ovaries were larger than normal, which indicated that I have Polycystic Ovary Syndrome (PCOS). So, on top of breast cancer, I find out I have this. I suppose you could look at it as if I didn't get diagnosis with breast cancer, I wouldn't have found out when I did that I have PCOS. But it did feel that the universe was conspiring for me not to have any biological children as PCOS makes it difficult to conceive.

The examinations also found that I was at the stage in my cycle where I was nowhere near ovulating, so I would have to wait about a month before attempting to extract any eggs. However, I was told that eggs have better odds of surviving the freezing and thawing process if they are fertilised first, so I had to consider possibly using a sperm donor, which brings up a whole different range of emotions and questions. "If I meet someone, would they be okay with not being the biological father of my potential child even though they could be perfectly okay to have biological children of their own?" "Would I be able to meet someone if I'm a single parent?" "How would I feel about the father of my child being someone I don't even know?" "How would I even start to explain to my child the circumstances behind their birth?"

All this became a moot point the next day when I went to the cancer hospital to speak to my locum oncologist, Dr. S. She explained to me that my tumour was a fast growing one and hinted that waiting a month to start egg extraction might not be a luxury I could afford to take. She told me that due to my age and great level of fitness (I'd just done the Great North Run three days before), even though chemotherapy does affect your fertility, the odds were more in my favour than not of it coming back. In addition, it had been established that my type of breast cancer was ER+. In order to stimulate egg formation, you have to be given hormones. As hormones made my tumour grow, it wouldn't be a good idea to pump my body full of hormones, even though I would have been given more drugs to stop any cancer cells trying to attach to the hormones. I decided there and then to press ahead with starting chemotherapy without having any eggs frozen. It showed how urgent I needed to start treatment as it was arranged for me to begin chemotherapy the very next day.

I ended up having 8 cycles of chemotherapy, a lumpectomy, auxiliary node clearance (11 lymph nodes near my arm pit removed) and 20 sessions of radiotherapy. At the moment, I'm nearing the end of receiving Herceptin, taking beta blockers to counter the damage the Herceptin has done to my heart and on Tamoxifen and Zoladex. As the big meaty parts of my treatment have finished, a lot of people wrongly assume that everything is over and done with. They don't see that there are on-going ramifications. I'm at the age where my friends and family are getting married and having children of their own (I've been to three christenings/baptisms this year alone) but that part of my life seems beyond reach for me due to my diagnosis and treatment. When I explain to people about my issues with fertility because of the breast cancer, I'm usually met with the same response, "Oh, I didn't realise! I didn't even think about that side!" It's hard being surrounded by people going through that next stage in their lives while you are unable to do the same through no fault of your own.

I was lucky that I've been offered some form of fertility consultation and examination, some women in some parts of the country don't even get that chance or offer. It seems to be a bit of an after-thought, which makes an already emotionally fraught situation even worse. Not every woman wants to have children or have any more children, of course. But, for those, like myself, that do want biological children, we're being left behind. I do have to keep telling myself that motherhood isn't completely a pipe dream; there's always adoption, being a step-parent, godparent, surrogacy and egg donation. It's just a long line of difficulties that you go through when you deal with breast cancer. But you can come through it. That's the main thing.

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Write for the blog! This blog is one of a series being shared on the Young Women's Breast Cancer Blog UK during October, breast cancer awareness month, but the blog is here year round. If you are a young woman in the UK who has/had a breast cancer diagnosis and you would like to be a part of this blog, please have a read of the additional information here.

Check your breasts
Breast cancer can happen to any of us - regardless of age. Information about how to check your breasts can be found on the Coppafeel and Breast Cancer Now websites.

Further information and support:
Younger Breast Cancer Network UK - an online chat and support group for women under the age of 45 in the UK who have had a breast cancer diagnosis.
Baldly Beautiful - a YouTube channel with make up demonstrations, created by Mac makeup artist Andrea Pellegrini who went through chemo herself in 2014.
Take A Moment - This is a group for women (all ages) who have/had breast cancer who want to explore, reflect on and express their feelings and experiences through photography. This is a link to the public page - to join the group, send them a message.
The Osborne Trust - Providing children of parents with cancer the opportunity to access time out recreational activities whilst their parents undergo operations and treatments
Jen's Friends - Free heart-shaped pillows for women (and men) with Breast Cancer. Designed to provide comfort and protection after a Mastectomy operation.
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