Why Jennifer Saunders is wrong about breast cancer

I’ve spent Christmas trying not to think about whether I’m going to die soon, and have been quite successful, on the whole. Just over a year ago, I was diagnosed with invasive breast cancer, since when I have undergone a lumpectomy, 5 months of chemotherapy, 3 weeks of daily radiotherapy, and am now taking the anti-oestrogen drug Tamoxifen every day. My body – and mind - have taken quite a battering, but the cancer has been attacked with all the current state of the art oncological weaponry: I have been mutilated, poisoned and burned, and now the ‘wonder drug’ Tamoxifen is playing havoc with my hormones. The cancer should have been beaten into submission, and my prognosis is excellent, but…

Two weeks ago I found another lump in my theoretically now cancer-free breast: a small, hard, irregularly-shaped lump very close to the scar where they removed the sentinel lymph node near my armpit during the surgery. Blue dye is injected into your breast beforehand, and the first lymph node in which the dye appears  is called the sentinel lymph node. If the cancer has spread beyond the breast this is where it will go first – so they cut it out, and check. My sentinel lymph node contained a tiny clump of cancer cells – what they call a micro-metastasis – which is why I had to have systemic chemotherapy treatment as well as local radiotherapy on the affected breast: the cancer had just begun to spread beyond my breast into the lymph nodes.

It’s hard to describe what happened in my brain in the seconds after my fingertips found the new lump; something like a car engine flooding, I imagine.

‘THECANCER’SBACKANDI’MGOINGTODIE,THECANCER’SBACKANDI’MGOINGTODIEANDALLTHISTORTUREWILLHAVEBNEENFORNOTHING’

I had always thought that if the cancer came back, it would be by metastasising to my bones or my brain, which are generally the places where breast cancer likes to go next once it has escaped from the confines of the breast; it never for a moment occurred to me that it might return in the same breast, what they call a ‘local recurrence’. My big fear was of ‘circulating tumour cells’ managing to escape into my blood stream, dodge the chemo, and then swim off to colonise pastures new. 

Lumps were no longer on the agenda, until two weeks ago.

Once I stopped panicking, I emailed the news about the new lump to my Breast Cancer Care Nurse, Vanessa, saying that although I knew it was probably just scar tissue, I was a little alarmed, and asking what she advised. She emailed straight back saying that of course it was probably scar tissue, but that the lump should be investigated; she had booked me an appointment at the Breast Clinic for Saturday 28^th December. I would see a surgeon and, if necessary, have a mammogram, ultrasound and biopsy.

Again.

Naturally, I googled.

It is overwhelmingly likely that the lump is either just scar tissue that I simply hadn’t noticed before, as I have left the sentinel node scar alone, for the most part, or the charmingly titled ‘fat necrosis’, i.e. a random little lump of fat. It's too hard to be a cyst, I think. Sometimes, however, new tumours do appear near scar tissue, and that lymph node did have some cancer cells in it. The consequences, should it turn out to be a recurrence of the cancer, don’t really bear thinking about: probably a mastectomy, a complete lymph node clearance with attendant risk of lymphoedema and loss of arm movement, and last but not least more chemotherapy.

I repeat, MORE CHEMOTHERAPY.

Imagine that.

I can’t imagine more chemotherapy, actually. The horror of the FEC chemotherapy remains with me still, and whenever I see that photograph of me in the pink helmet, or even just think about it, I shudder, my stomach contracts and I want to vomit. My mind just can’t encompass the idea of more chemotherapy, but the terrible thing is that if this is a recurrence, it would still count as being part of the same early stage cancer, and the prognosis would be good – so long as I had the treatment. Again.

It would be stupid not to, right?

But after a year of feeling like a tortured lab rat, it’s almost impossible to contemplate the idea of going through all that again, including being properly mutilated this time.

You may be wondering what all this has got to do with Jennifer Saunders. A couple of months ago, in an interview with The Times to publicise her autobiography, Saunders took it upon herself to criticise fellow breast cancer sufferers for saying that you can never put the disease completely behind you.  These women liked the attention they got from having breast cancer, she said, wore the disease ‘like a badge’, and were probably sorry when their hair grew back; she herself always got lots of attention because of her career, and did not feel the need to hang on to her breast cancer as a way of getting attention. The doctors had told her she was not going to die of it, and she believed them; she had no more chance of getting breast cancer again than the average person.

Well, good luck with that, Jennifer.

Perhaps you have superhuman mental self-discipline, and never think about what might happen if the disease comes back, as it all too frequently does; cancer treatment is still not very effective. My chemotherapy treatment theoretically increased my chances of survival by about six per cent, but they still can’t distinguish in advance who will be helped by chemo and who won’t; similarly, Tamoxifen theoretically increases my survival chances by 8 or 9%, but there are some people who can’t metabolise Tamoxifen. Again, there is no way of telling if it is actually working.

My cancer is not’ cured’, and the chance of it coming back is very real. The treatments may have mopped up all the cancer cells, or they may not; you can never know, unless and until the cancer comes back. That’s why you are never free of breast cancer, Jennifer, and if you think you are, then you’re living in a fool’s paradise.

You don’t think about it all the time, though: just as all humans, even healthy ones, know they’re going to die sometime, but get through life by not thinking about it. During the last couple of months I was getting on with my life again, treatment over, and hardly thought about cancer at all, until two weeks ago.

Tomorrow I will find out if I have anything to worry about – or rather, anything out of the ordinary to worry about.  If the surgeon deems there is something to worry about, and they give me a biopsy, then the results will take another ten days.

Happy New Year.