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Facing cancer: the patient and the partner

Peter and Emma quote
03-02-2023

The patient: Emma's story

The beginning
I saw it first, but a quick feel immediately confirmed my suspicion. I had a swift, instinctive reaction that the flattened nipple and lump underneath was not going to be a benign little oddity in my least favourite boob, but something nasty which needed a quick response.
Unfortunately, I was just out of the shower and getting ready to go down for dinner to celebrate one of Peter's colleagues retiring, and we were also in the middle of a family holiday in Devon with my Mum and Dad, so I decided to compartmentalise until we got home.
I'd thought that booking a GP appointment post Covid would be difficult but the receptionist was extremely helpful and so from a Friday phone call, I only had the weekend to wait before being seen at 9.30 on Monday.   
The GP quickly agreed the lump needed investigation and referred me to the Royal Derby Hospital. Soon after that I arrived for my first of several appointments: mammogram first, then back to the quiet waiting room, then ultrasound, where a lovely lady gently told me that what she saw was 'concerning'. The consultant confirmed they would want to do a biopsy so it was back to the busy but still silent waiting room before the biopsy, which was uncomfortable but not the worst thing. Cocooned by gentle and sensitive staff, it wasn't the best afternoon ever, but was made bearable by their care.
Peter, meanwhile, wasn't receiving my waiting room messages so I'm sure the time went more slowly for him.
I was told to expect to hear within a couple of weeks, but in fact was called back within the week and invited to bring someone with me - another indicator that I would not be skipping home carefree.

The diagnosis
Peter and I duly arrived, half an hour early as ever thanks to my hatred of being late, and sat in the waiting room of the breast unit with other ladies and couples of all ages. I felt strangely calm, even as I observed the volume of paperwork attached to my name. I remember half joking that the fact they'd allocated me a folder couldn't be a good sign.
In we went to see the consultant - a disconcertingly handsome Spanish gentleman who we later agreed could be one of the Strictly Come Dancing professionals - for the expected results. A grade 2 lobular invasive cancer, which was 'curable' (a lovely, if hard to believe, word). Grades are 1 to 3, with 1 being slow growing, 2 - moderately fast, and 3 - fast.
I would need surgery, radiotherapy, and possibly chemotherapy depending on the sample taken during surgery. The decision was mine to make about whether to have a lumpectomy, or full mastectomy and one of a range of reconstructive surgeries. We were introduced to Katie, my breast care nurse, who would be invaluable for offering information and recapping points from consultant appointments.
Sent away with a fistful of leaflets, a follow up appointment and MRI date, we departed to sit in the car and regroup.
We had quite a long conversation about who to tell, what to tell them and when. Our son was approaching his GCSEs, our daughter in her first year at Uni, and I had only begun working for my employer, Derbyshire Wildlife Trust, a couple of months before.

WhatsAppThe latter decision was easy - honesty being the best policy - I spoke to my manager and emailed HR, fully expecting as I was only three months into a six-month probationary period, they would take me up on my offer to resign. This offer was rebuffed, and they have been exemplary employers - understanding, supportive and positive throughout.
Although we'd decided to sleep on a decision about when to tell the kids, they'd spotted we were at the hospital thanks to iPhone, and had questions upon our return home.
Honesty again. They took the news well, both citing my Mum, who fought off breast cancer with style and no nonsense a few years ago, and friends' mums who had gone through similar and were still around - some of whom have since been huge sources of support.
We answered their multiple questions and then I went off to lose myself in a jigsaw for a bit - more restorative than crying, I find, and less devastating to mascara. Peter cooked dinner, as he often does, and life continued.

The surgery
Following the MRI, lots of reading, and talking with friends, I decided on the least invasive option of a lumpectomy, preferring to be 'wonky but well' rather than extending my recovery time or having further surgery to fit an implant. On July 15th, I was operated on by the same surgeon who had looked after our neighbour several years ago. She had been full of praise for him, as had another friend under his care, and the nurses on the breast care team. In fact, I only spent about five minutes (conscious) with him, but am ever grateful for the excellent job he made of my operation, and can only say his reputation is well deserved.
Recovery was hard. I am notoriously impatient, plus it was stiflingly hot, and we'd had to cancel our holiday, so there was no pool or sea to escape to. I read a lot, and slept a lot.
The kindness of friends and family helped immeasurably - a gang of 'food fairies' (mainly friends from toddler group days) cooked for us twice a week, which was delicious as well as thoughtful. Peter's colleagues sent flowers and a hamper of treats.
A couple of weeks after the op, I had the great news that they had removed all the cancerous cells and had clear margins. Even better, my lymph node biopsy was clear, so the cells had not migrated elsewhere.
The relief was immense, as there had always been the (unfounded) thought that the cancer was growing and spreading unchecked.

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The next stage
I had a few weeks back at work on light duties before the next stage, which began when I met my oncologist. One of the very few appointments Peter couldn't attend, my friend Emma came with me and helped ask all the right questions. The huge relief came that, on balance, chemotherapy would not be advantageous, but a boosted course of radiotherapy, plus hormone therapy and Tamoxifen, would offer similar levels of protection from recurrence.
When my course of radiotherapy started in October, our wonderful friends stepped in again with meals and moral support, which really helped - especially towards the end when the tiredness kicked in. Again the staff at the Royal Derby could not have been better, they were friendly and cheerful even though stretched.
At the start of December I returned to work again, but wasn't prepared for how tired I would be, and how much healing I still had to do. My lovely manager and the volunteers I work with did their best to make things easier for me, and were nothing less than brilliant - although I did get told off for trying to do too much!

Adjusting to a 'new normal'
Now, as Christmas and 2022 is over, I am adjusting to a new normal, like so many others. The injections have pushed me into early menopause, so sleeplessness, joint pain and memory lapses are all part of daily life - but they should settle down soon as I rebuild my fitness levels, and generally, I'm feeling good.
My paternal grandmother died when she was in her late 40s, leaving Dad without his mum aged just 18. She hated the family doctor, was embarrassed about having a lump in her breast, and so put off going to see him for years. By the time she was finding it difficult to walk, it was sadly too late.
How fortunate I am to have had cancer in 2022. The dialogue around cancer, as well as the treatments, research and care have all changed so much, and are still advancing at a great rate. Thanks to my family history, my daughter, sister, and nieces will all be able to have mammograms at 40 - the youngest is 5, so just consider how much more the science will have advanced by then.
If you find yourself in my position, don't despair. Get checked early, and try to keep positive.
Accept all offers of assistance from family and friends - they will feel useless, and want to help.
Stay off Google, but do look at Breast Cancer Now, Macmillan, and Cancer Research UK, and read the information your nurses will give you.
Remember that LionHeart can offer advice and support to you and your family, and are only a phone call away.
Make time for fun in between appointments, take a good book to the waiting room, and look after yourself.

The partner: Peter's story 

The beginning & diagnosis
Cancer had always been something that happened to 'other people'. That remained the case for me until 2022.
Events often seem to happen for a reason and in April, Emma and I were staying the night in London to host a dinner for a retiring colleague.  It was here, quite by chance and in a different bathroom in a different light, that she first spotted there might be a lump in her chest.  
She quickly got a GP appointment (throughout the process the NHS performed magnificently) and just three weeks after that dinner, we had the ominous news that the lump was "of concern".
We had expected to be called back to hospital for results some two weeks later, but when a week later Emma was asked to go back the following day, it didn't look good.
I tried to remain outwardly calm, but spent the night sick with worry. 
The following day the hospital consultant told us that Emma had Grade 2 lobular breast cancer. The plan was for an MRI scan, then surgery and radiotherapy, possibly followed by chemo.
It's difficult now, in hindsight, to adequately describe the effect of that news, no matter how calmly and professionally it was conveyed.
The mind naturally races and you must fight to hold down a nagging feeling of impending disaster.
Our son was shortly to start his GCSEs, and our daughter at university. I clearly remember Emma and me sitting in the car in the hospital car park, going through when or what to tell the children, and what else we might have to do.
When to tell work, what to tell our friends and family? How would everyone cope? 

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What next?
At that point of course we had no idea as to the extent of the cancer. Unsaid, even between the two of us (because I suspect neither of us wanted to form the words almost as if by doing so it would become real), what would we do if the diagnosis was really bad?
We decided to tell close friends and family, and our employers. It was both shocking and encouraging, in a way, quite how many people themselves, or their wives, sisters, etc, had had similar news and after treatment now had the 'all clear'.  
Breast cancer is far more prevalent than I imagined, not that I had thought about it much. This made me more hopeful that we could come through this. 
I say hopeful rather than determined because, for the first time I could remember, this was something that was out of our hands, and wasn't susceptible to our determination or obstinacy - which in the past had been able to sweep most problems aside when we combined forces!
Oddly, for me our tale of 2022 weaves around various LionHeart dates. 
Emma's MRI results were scheduled for 9 June, when I would be chairing our quarterly Board meeting in Birmingham.  
My normal practice of mentally compartmentalising was severely strained but just about manageable. I hope my colleagues didn't notice that I was regularly checking my phone for messages.  I managed to speak to her on the train back from Birmingham. 
In the end the news was as good as it could have been - there had been no spreading to the armpit and therefore could be treated locally with an operation. 
While still very serious, there was an overriding sense of relief. 
We now knew what we were dealing with. And it could be overcome.

Treatment and beyond
Emma's operation in July went successfully, and I was pleased to be able to take her home that evening to gradually recuperate over a long hot summer. 
Our families and friends were superb, going with Emma to appointments when I was away, and a swiftly arranged 'rota' meaning that twice a week during radiotherapy, when often we wouldn't get home until after 7pm, sumptuous meals on wheels would appear!
The LionHeart diary clashes continued, of course.  A little bit of Emma's tumour was sent to the US for testing, the results of which would determine what would happen next. 
We were both very keen to avoid chemotherapy if we could (although I'm told that it is no longer as fraught with side effects as was once the case).
Those results were due on 8 September, when I was chairing the LionHeart board meeting in London. 
As I write this now, I find myself querying why I didn't simply ask James Grierson, my very experienced and competent Vice Chair, to take these meetings in my absence. But Emma and I were both keen to adopt a "business as usual" approach throughout this process, and I think both work and LionHeart kept me going, mentally.
One of our close friends had gone with Emma for the results and, as a scientist, could readily understand, and remember, what they were being told. 
The test results were very good - about the best we could have hoped for.
N
o chemotherapy needed, and a limited course of radiotherapy and drugs would do the trick.
A bottle of fizz was awaiting us at home as Emma picked me up from the railway station that evening. 
But 2022 wasn't quite finished with us. Our daughter rang us in the car to tell us that Queen Elizabeth II had passed away, which took the edge off any celebrations.
At home, we raised a quiet glass to Emma, and to Her Majesty, who I was fortunate to meet during the RICS 150th celebrations, when she was very interested in LionHeart's work.

My advice for others
Looking back now, what might help others in the same situation?  My best advice would be to urge anyone who suspects a lump to get it checked as soon as possible - nothing is to be gained from waiting. 
Stick together as a family.  Your children will take the news more stoically than you imagine. 
Let your friends and family help - you won't be imposing on them, they really do want to do something.
There's no point in me saying 'try not to worry', but do try to keep a sense of perspective, and be aware of the very high survival rate. 
Stay busy at work if that helps you cope, but do tell your work colleagues - mine were a fabulous support.
And, finally, please do remember that the LionHeart team can hold your hand throughout it all, whether you are the patient or the partner.

Peter McCrea FRICS has been a trustee of LionHeart since February 2017, being appointed chairman of the board 18 months later. He is a surveyor member of the Lands Tribunal by day. Emma works for Derbyshire Wildlife Trust. The couple have been married for 21 years and have two children.

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