Feature: Women are empowered; breast cancer realities

 The sky is the limt. Pic by @jabberingjourno

Editor NICOLA ADAM is now just two years younger than her mother was when she was developed the cancer that would kill her.

Following film starAngelina Jolie’s revelations about undertaking preventative breast surgery, and on the anniversary of her mum’s death, she debates – is it better to know or not?

I’ve just turned 40.

A milestone in many ways, some more welcome than others.

In fact, I now find it a struggle to say my age out loud, largely due to extreme vanity.

But following the birthday celebrations, one unavoidable fact has been lurking in the recesses of my mind.

My mum was 42, just two years older than I am now, when she was first diagnosed with the breast cancer that would ultimately kill her.

I can clearly remember the day my still-young, sporty, outwardly healthy, mum told me the devastating diagnosis.

Just 16, I was young for my age, but because I was the eldest, she sat me down on the sofa after school and told me first. Then, she told my 14-year-old sister, then my nine-year-old brother.

Wrapped up in a self-centred bubble of teenage angst that day, I don’t remember crying or thinking about how hard this was for her, or dad.

“I thought I’d be OK,” she told me, “I breast-fed all three of you. And I don’t smoke.”

That was my first indication that the hardships of life were indiscriminate.

As I started my A-levels, my mum – her name was Anne and she was a swimming teacher and Open University student – underwent an initial lumpectomy, then radiotherapy and chemotherapy.

She suffered the horrors of the side-effects, including being forced rapidly and emotionally through an early menopause and developing life-threatening and painful shingles, while retaining a relatively normal home life for her family. Something I only appreciate now.

Then as the cancer spread to her lymph nodes, she made a radical decision.

“I’m having a double mastectomy,” she told me. “I’d rather have both my breasts removed than risk any further cancer.”

I accepted this at the time, only later realising what a remarkable act of bravery that was. Not only did she take the most radical and painful option, she also made the decision against opinions of others who considered it unnecessary.

“A waste of NHS money,” was one opinion I later had relayed to me.

And perhaps it was those opinions that saw her bravely opt out of reconstruction.

But I can absolutely assure you that, whatever the financial cost, the 15 years of life with her family I have no doubt this procedure bought her – was incredibly cheap at the price.

She eventually became cancer free, going on to study for a degree in French and watching her three children become adult. Only occasionally, in moments of regret, did I bear witness to her questioning “why me?” although I know she suffered some depression.

But it didn’t stop her getting back in the swimming pool.

Then a bad back, initially blamed on a dodgy mattress, indicated the return of cancer in her spine.

It was incurable.

I can clearly remember that day too.

This time I found out by phone call to the flat I shared with my then-boyfriend. This time, I did cry.

“I blamed it on the mattress but I knew really,” she told me. “I just didn’t want it to be real.”

Being mum, she then astounded the doctors by living for many more years.

Radical chemo made her horribly sick and lose her hair and the steroid treatments and use of morphine for pain saw her gain weight, which she hated.

She lived with the cancer and despite it, bravely agreeing to trial some new spinal procedures, becoming an accomplished artist and exhibiting her work locally as the cancer spread mercilessly through her organs.

She was a weekly visitor to her local hospice (St Catherine’s in Lostock Hall) and I remain eternally grateful for the care she received there.

Unknown to me, she kept cuttings of all my work as a trainee journalist, a file I had returned to me after she she lost her battle for life, and it was a battle, age 58.

Mum died at home on May 24 – eight years ago tomorrow – with all her family and just months before my little brother’s wedding.

Sadly she never got to meet the next generation, something she longed for.

So that, in far too few words to give her justice, is my mum’s story. But what will be mine?

Following movie star Angelina Jolie’s public declaration this week, the issue is back at the forefront of both my sister and I’s minds.

Of course we already knew it was possible be tested for the mutated gene that indicated you are likely to get cancer. I, perhaps in denial, had always voiced the opinion it is better not to know.

My sister, just having had her second child, is perhaps more conscious of the possible implications for her family.

“They may not even consider us a high risk,” she said. “But there is no harm in checking.”

But here comes the rub – is it better to know?

There is no doubt that Angelina Jolie is a very brave woman.

For what she has undergone personally, through the decision to have surgery, and for the painful months that must have followed. But also for telling her story.

A woman in her position, and with her experience, must have realised the publicity would not all be positive. And the nay-sayers do have a point.

Not everybody will have the cancer gene and even those with a family history like mine are unlikely to have the mutated BRCA1 version that has left Angelina in a such a high-risk category.

The already cash-strapped NHS may struggle to cope with the hundreds of thousands of concerned woman, including my sister and I, rushing to our GP to ask to be tested.

And the reality is that one in eight women will contract breast cancer.

Only 10% of breast cancer cases can be traced to a faulty gene. So it’s a lottery regardless.

For most people, having a family member with breast cancer does not increase the risk of having the disease. It’s just very common, so multiple occurrences in one family are not unusual.

However, procedures and the information campaign need to be in place to cope with such a surge in concern.

Gene testing is not the only answer – regular screening and information campaigns have a place in prevention.

There is also the danger that women may be rushing under the knife needlessly.

But for women like me, Angelina’s story reminds us that our future is unwritten.

It uncovers the possibility that we can influence whether we live or die, thanks to the wonders of science.

Our DNA need not be our downfall after all. People like my mum did not have such an advantage.

So for her, and for me, I won’t be rushing into surgery, but finding out if I need to be tested and what the options are. The point is, that in 2013, we have the choice to make the informed decision.

As women we are empowered and maybe we’ll be lucky enough to get an extra few years with our families.

To quote Angelina, and with thanks to the New York Times: “Life comes with many challenges. The ones that should not scare us are the ones we can take on and take control of.”

This appeared in the Lancaster Guardian on May 24, 2013. Click HERE