I told ten women a day they had breast cancer, then I got diagnosed too
When breast cancer surgeon Dr Liz O’Riordan is asked to recall a case that that stayed with her throughout her career, she pauses, then says: ‘A young mum who was pregnant and diagnosed with metastatic breast cancer.
‘You know you can’t cure her…’
Having a metastatic disease – also known as secondary cancer – meant that the patient’s breast cancer was incurable, explains Liz, as it has spread to the lungs, liver and bones. The young woman sat in front of her had a few years left at most.
‘She had to make a decision about carrying on with her pregnancy or not and who would look after her child when she won’t be here in a few years time,’ Liz recalls.
‘She was distraught, everyone was – we were all in tears. But then you realise you’ve got a waiting room full of women, with another three hours to go, and somehow you’ve got to say “right, next” and try and give them the best of you, because they deserve that.’
Liz was a consultant surgeon for two years from 2013-2015, and personally operated on about 100 women each year. But she was the bearer of bad news for many more, being the one to deliver their breast cancer breast cancer.
‘It becomes normal to tell someone they’ve got cancer, because for most women it’s an operation, it’s radiotherapy and it doesn’t come back. It’s a relatively short journey.
‘But there are cases that stay with you. The women who are pregnant with breast cancer. The women who have stage four disease when they’re diagnosed. That’s really, really hard.’
Knowing the way someone would take in such life-changing news could differ wildly, too.
‘I’ve had women run out of the room screaming to come back two hours later,’ Liz explains. ‘I’ve seen women faint, had their partners faint or want to punch me. I’ve had women get out their phones, matter of fact, to put it in the diary.
‘You’re absorbing all of their emotion, as well as dealing with the impact you feel of telling someone, completely out of the blue “you’ve got breast cancer, you need chemo” or “I’m going to make you infertile” or “it’s come back”.’
Despite the sheer amount of women she had to say ‘you have cancer’ to, Liz never once thought she would be the one receiving a breast cancer diagnosis.
Having experienced a couple of benign cysts in her breasts in her late 30s, it was a summer’s day in 2015, when Liz felt a lump in her cleavage that hadn’t been there the day before, while she was showering. At first she thought ‘it’s just another cyst’.
But it wasn’t. Liz, then 40, went for a mammogram and ultrasound and upon seeing the screen she could see straight away she had cancer.
‘I didn’t need to wait for the results of a biopsy,’ says Liz. ‘My surgeon came in, who was a good friend who had trained me, and said “who do you want to treat you?”, because we both knew.
‘I think I was in denial, and a part of me still is, because I’ve looked after women who’ve died of breast cancer and I did not imagine that would be my future.’
After her diagnosis, Liz realised the true gravity of the news she had been delivering to her patients, and all the hardships that came with chemo, surgery and radiation.
‘It was interesting and terrifying to see what having cancer treatment would be like because I’d never had chemo and I’d never had to decide whether I wanted to have my breasts reconstructed after a mastectomy.’
In fact, Liz realised she had been ‘clueless’ as to what her patients had really been going through.
She says: ‘I knew you lost the hair on your head. I rang a nurse at my husband’s work who I knew had had cancer. I asked her when your hair falls out and she said well your pubes fall out day ten and I said “what the f**k?”.
‘I didn’t realise you lost all your body hair. I’d sat in clinics telling women they would lose their hair before they went to see the oncologist – I had no idea. I had no idea how cripplingly painful the constipation could be.’
Liz describes her nine months of treatment, saying: ‘I had chemotherapy, a mastectomy and radiotherapy. I had the hormone blockers, the instant menopause, thinking I’d wet myself in the night when I had my first hot flush.
‘I dealt with the impact on my sex life, loss of libido, a dry and painful vagina – all this stuff that young women had to deal with.’
Liz returned to work for a year after being given the all clear but found it hard to operate on patients because she’d had ‘chronic pain after [her] mastectomy’ and ‘didn’t want to give other people pain’.
‘When I was breaking bad news to patients I could just see them crumbling and I thought “god that’s what I looked like with my husband”,’ she says.
‘I wanted to say “yes this is s**t I get it” but I can’t because I’ve got to be the surgeon and be positive. It was really hard to not be a patient in the room with another patient.’
And battling cancer also changed the way she delivered the earth shattering news to her patients.
‘As a doctor, I hated that uncomfortable silence. I wanted to fill it,’ she recalls. ‘When you tell someone they’ve got cancer, as a doctor, we know. I’ve spoken about them in a meeting before, I know what the plan is.
‘I want to say “it’s breast cancer, this is what we’re going to do”. But having had it myself I would try and bite my lip and count to ten to let that news sink in.
‘Then they can then tell you the first thing that comes to their mind. Whether it’s “who’s going to look after my dad?” or “will I lose my hair?” or “what about the kids?” – the thing that’s worrying them that we really need to tell them to help them move forward.’
How to check for signs of breast cancer
CoppaFeel! offers these simple steps on how to check your own chest for signs of cancer.
- Look at your boobs, pecs or chest.
- Look at the area from your armpit, across and beneath your boobs, pecs or chest, and up to your collarbone.
Be aware of any changes in size, outline or shape and changes in skin such as puckering or dimpling.
- Feel each of your boobs, pecs or chest.
- Feel the area from your armpit, across and beneath your boobs, pecs or chest, and up to your collarbone.
Be aware of any changes in skin such as puckering or dimpling, or any lumps, bumps or skin thickening which are different from the opposite side.
Notice your nipples
- Look at each of your nipples.
Be aware of any nipple discharge that’s not milky, any bleeding from the nipple, any rash or crusting on or around your nipple area that doesn’t heal easily and any change in the position of your nipple
Sadly, continuing to help her patients was short-lived, because, after defeating breast cancer the first time, Liz had a recurrence in 2018 – the cancer was back.
‘Radiotherapy had turned my implant into a hard, painful tennis ball and I was planning to go flat,’ she explains. ‘My surgeon said “let’s just scan this little bit of scar tissue” which I’d had for a year underneath my armpit and it turned out that scar tissue was a three centimetre recurrence.’
That recurrence ended her career. The side effects of the treatment meant her left arm didn’t move properly and she lost power in her chest wall – she couldn’t operate.
Then, as if beating breast cancer for a second time wasn’t enough, in August this year, Liz announced she had a third recurrence.
Speaking on Metro’s brand new podcast, Dawn Butler Mammograms and Me, she told host Dawn: ‘All I wanted to do was to run out that room swearing and screaming and find a bit of private space.’
Liz also shared that she’s getting through her chemotherapy by writing about it to make it all seem real, but added, ‘part of me thinks I’ve not had it three times.
‘It can’t be real. I’m too scared about what might happen, so I just block it out and focus on getting through each day.’
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