Getting it off your chest

Jolie: Considered the odds
and made an informed choice

Breast cancer treatments, and specifically mastectomies, have been in the press a lot this week.

It was prompted by Angelina Jolie's very well-written piece in the New York Times, in which she explained her decision to have preventative surgery after discovering that she had one of the BRCA genes that give a much heightened chance of developing breast and ovarian cancer.

However, as she also points out - and which has largely been missed in the wider reporting of this story - the genetic BRCA cases account for a tiny proportion of breast cancer diagnoses as a whole.

So while it is true that carrying the BRCA gene increases your risk to between 50-90% chance of developing one of the several different breast cancer diseases, the vast majority of breast cancers are random and sporadic and down to sheer (bad) luck.

Angelina's piece is very honest and does allude to the complexity of the surgery and the mental and physical impact that mastectomy can have. It is not a straightforward process; it is protracted, painful and, while the cosmetic outcomes can be very good, your breasts will never look or feel the way that they did.

Indeed, they could look better! Mine probably do. But I would be lying if I said the implants feel natural under my skin and I'm not conscious of them every single day. Of course, not everyone has implant reconstruction and many use their own fat and body tissue. This probably feels quite different to implants but it is still a very complicated and uncomfortable process.

Which is why I get REALLY annoyed when people make mastectomies sound like they're simple or straightforward. It's bloody insulting. Especially when, like mine, it was a life or death necessity not a choice.

Heaton: Shut yer cakehole

Take, for example, Michelle-Liberty-X-Heaton. I really do wish that woman would shut her big shiny face. And, yes, I know she's had a preventative double mastectomy; we ALL know, it's all she ever talks about. She's become a cancer-free-rent-a-quote, resurrecting her flagging career by constantly harping on about her, and others', 'media mastectomies'.

And was it really necessary to give interviews from her hospital bed, bleating on about how easy it all was? Maybe it was for you, love, but I'm nine months in and still not finished! She seriously gets on my tits ... Grrr.

*deep breaths*

On the plus side, however, it does allow the breast cancer charities to stay in the public eye; they just need to ensure that the information given remains realistic and objective.

One in eight women will get diagnosed with breast cancer and the vast majority of cases will have no genetic link. So stay vigilant and check. I would never have thought I could get breast cancer at 38, but I did, and I'm hearing more and more cases of women in their 20s and 30s.

That's not to scaremonger but please be aware that the risk is there and that you don't need to have a family link for breast cancer to occur. Once diagnosed though, the treatments are good ... and you might even get a perky new pair out of it!

The icing on the cake

Saw one of my breast surgeons at the 'Marsden today and she was very pleased with my "excellent result". So pleased, in fact, that she dragged in another colleague to have a look.

Mr P: Boobs and cake. What's not to like?

To be fair, my boobs do look great. Far more balanced in shape than I had anticipated and quite natural in texture due to the earlier fat transfer.

The next and final stage is nipple reconstruction. A lot of people don't bother with this but I really don't need to decide until I go back again for my review in eight weeks.

Nipple-wise, they can either create one out of scar tissue or mould a prosthetic one that you stick on with skin glue, presumably for special occasions ...

The argument for creating one from scar tissue is (a) it's permanent and (b) it looks realistic "from a distance". Now, call me old fashioned, but I generally only display my nipples in close proximity, so I'm not sure that this is a massive selling point. However, it would be nice to complete the process and feel that I'm finally finished.

Mr P. and I still wanted to mark the occasion though. And so we did, with coffee and cake ... OK, quite a few cakes, care of the Hummingbird Bakery.

It was also an important day for another reason. Eight years ago today, I lost my lovely Dad to bowel cancer. It simultaneously feels like both a short time and a long time, but I think of him often.

So here's to you, Dad. Thumbs up! x

"I must, I must, I must improve my bust!"

And I finally have! Yesterday, I was back for surgery at the 'Marsden for the fourth time in less than 10 months to get my implants. Even one of the day ward nurses commented: "I recognise you. You've been here loads!"

It's true I have. Never mind the surgery but all the assessment, review, counselling and nursing consultations have been pretty numerous.

It was quite nice though to see my surgical team again, Gerald Gui and Ana Agusti, who have looked after my case for exactly a year. They also brought another member of the team in pre-op to assess my 'breast volume'.

I thought this was quite funny and asked him, "so doctor, your job is to look at naked breasts and guess what size they are?" He looked a bit embarrassed and then, when Mr P. asked for a business card, the poor bloke didn't know what to say!


It's been a right old 'Carry On'
but Mr P and I are pleased with the outcome

However, he obviously judged well because I'm very pleased with both the sizing match and the symmetry in my clothes. I really don't think anyone else would know the difference but it does mean that I don't have to pad out 'lefty' any more and can start wearing my nice bras again instead of mastectomy ones.

That said, I have received a few texts from people asking how it went, including a very direct one: "Let's see 'em then!" All in good time, ladies, all in good time ... ;-)

I'm still very taped up and sore. The left hand side is particularly painful as I hadn't had surgery there before, but both sides are very tender. I can lift my arms up above my head but can't reach up yet so will definitely need next week off work to recover before I brave the Tube for my post-op assessment next Friday (10th).

Anyway, Mr P is staying with me today to help me do things and the weekend will see my boobs' first outing (not literally) at a big family gathering in Oxford, with all of Mr P's extended clan.

It's going to be quite a celebration.

Positive moves

Three weeks into my new job and I feel like I've been there three months; it's certainly been a baptism of fire!

Given that I hadn't worked (at least, not properly) since January 2012, I was amazed how quickly and easily I jumped straight back into things; writing plans, managing staff and fielding calls from aggressive international media. And that was just my second day!

So while it has been tiring, and stressful, it has also been enormously confidence boosting. I took this new role because I felt I needed a fresh start, an opportunity to reinvigorate myself both personally and professionally. And that's exactly what I got.

For the first time, in many years, I feel like the old Kate. While I loved my old company and all my colleagues, this change was much needed. I had become lazy and complacent and had forgotten how much I could love my work, and be bloody GOOD at it!

Next week: A nice new pair

Of course, next week I will also have another big change: my new boobs. Finally! After eight months of discomfort and 'tissue expansion', I will have my fourth operation and get my permanent implant. 'Lefty' is going to get a makeover too, or augmentation, so that I get an (almost) matching pair.

And lastly, fertility. The NHS have confirmed funding and I'll be undergoing 'fertility preservation' in the next week or two. There are no guarantees of success, given the changes caused by my chemotherapy treatment but, just to have the opportunity to try, feels a very positive step.

My life is good. :-)

Spring forward

Apparently, it's now British Summer Time. Certainly the clocks have gone forward but the weather is taking its time to catch up.

For me though, life is definitely on the move. Today we went to IVF Hammersmith and got all the info and drugs I need to undergo the 'fertility preservation' treatment.

It won't start now until early May and will probably coincide with my surgical recovery (post-op at The 'Marsden) but that's possibly a good thing and could minimise any disruption with work etc.

Because tomorrow I start my new job. I'm obviously apprehensive but I'm looking forward to getting my teeth into something new.

I've definitely got a spring in my step!

Celebrations all round!

Today is Mr P’s birthday and we’ve both taken the day off to lie in bed, drink Bucks Fizz and be very, very lazy. And tonight we’re off to a ‘Sports Dinner’ with friends to enjoy some nice food and some great company before I leave my job (of over 12 years) tomorrow.

As I wrote in my last post, it’s been an interesting couple of weeks. Things have definitely started to fall into place, in a way that has truly surpassed all my expectations.

Specifically, I have been told this week that I can definitely start hormone treatment and freeze MY OWN eggs! I could start taking the drugs as early as Easter (although the end of April is more likely).

I’m still pinching myself about all of this. Eight weeks ago I felt completely crushed and let down by the system. I felt that I had been cruelly deprived of life options but didn’t feel that I had the energy to fight the NHS bureaucrats.

But, two months later, and the situation is very different. Hot on the heels of being told by the ‘Marsden’s Oncology team that I could stop Tamoxifen for a month and take hormone treatment, I got a random phone call from Queen Charlottes’ IVF Team which resulted in me going in for more tests and getting their agreement that I can start the drugs for egg stimulation ASAP.

I don't know if my 'letter of concern' to the Primary Care Trust's CEO has accelerated any of this but I'm not going to look a gift horse in the mouth. It all feels brilliantly surreal.

Of course, I know it’s not going to be an easy process, far from it. And the timing could be better: who wants to start a new job dosed up to the max on hormones(!) but, f*ck it, I'm just going to go with the flow. By the end of June, IVF and surgery should be finished and I can start my 'naughty forties' with perky new boobs and some frozen eggs in the bank. ;-)

So tomorrow, when I leave AAT, it will be with a real sense of optimism. I'm enormously grateful for all the support that I've received over the last 15 months (and indeed, 12 years) but I do believe that everything happens for a reason and that my life is now moving forward in an incredibly positive way.

I'm also looking forward to meeting up with some ex. AAT friends who will be celebrating with me. Onwards and upwards, as they say!

All change!

Crikey, a lot can happen in two weeks.

Firstly, I’ve got a new job and resigned from my current role. I’ve been with the company for 12 years, so it is a big deal (for me, at least!) but I think a change will do me good and give me a renewed sense of purpose. I need to feel that my life is moving forward again.

Ironically, I wasn’t really looking but I saw the post advertised in January and speculatively applied. Getting it though, did make me feel a bit guilty. My current company, AAT, have been amazing in their support of me over the last year and had been trying to revise my role. However, I do also think that the right things happen at the right time and I will wave farewell on Friday 22 March and, following a short break, start my new role after Easter.

Secondly, I have submitted a letter to the North West London Primary Care Trusts regarding my cancer treatment (and specifically the lack of fertility guidance/support) and have been advised that my GP will need to make an individual funding request in order to secure funding for any fertility-saving treatment for me past the age of 40. You have to be able to cite exceptional circumstances, which I think we can (and he has agreed to do), so we’ll see how that goes …

Thirdly, and related to the fertility issues, I met with the oncology team at the ‘Marsden. It was a very informative and positive meeting because (a) I am definitely not menopausal, and (b) they do not see any reason why (if Queen Charlotte’s Hospital thought it could be successful) I would not be able to take the necessary hormones for egg harvesting myself.

This is, of course, a big ‘if’ as my ovarian function has been significantly diminished by chemotherapy. However, the fact that they do not see an issue in the short-term application of hormones, and stopping my Tamoxifen for a month or so, was a very pleasant surprise. They would also prefer me to do this sooner rather than later as then I can have a much longer, uninterrupted period on the medication.

Lastly, I have seen my surgical team. They seem happy with the results of the ‘Coleman Fat Transfer’ so it’s full steam ahead for my implant operation on Thursday 2 May and a new pair of matching boobs, which were ordered today.

So, all in all, it’s been a very positive start to 2013.