First Talks to A Specialist Breast Cancer Nurse

31-01-2007 10:05

Living with breast cancer, the most common cancer in the UK is never going to be easy and surviving five years is a reason to celebrate. 8 out of 10 women now reach this five-year mark thanks to the success of breast cancer treatment with women all over the country still living life to the full.

The five-year point is even more of a milestone for those taking tamoxifen, the five-year hormone treatment known to be the gold standard for women with breast cancer. Yet with the relief of getting through treatment, it is easy to become complacent and forget to be extra vigilant at this stage. In fact, more than half of all cancers that return occur after women have completed their five-year course of tamoxifen treatment.

There is a surprising lack of knowledge amongst women who have completed their five-year course about the risk of recurrence. 1 in 4 post-menopausal women who have survived the past five years of breast cancer claim not to know if the risk of recurrence is higher for them than other breast cancer patients. More information is clearly needed for patients.

To combat this, a new website called www.lifeafterfive.co.uk launched today provides a support base for women five years after their diagnosis offering information about the disease and the risk of recurrence. The Life After Five website looks at how patients are now survivors living full and vivacious lives. With help on coping with the disease and patients’ real life experiences to read and download, The Life After Five website is an ideal online destination for people to learn more about life after breast cancer.

FemaleFirst managed to have a breast awareness chat with Vickki Harmer, the clinical nurse specialist for breast care at St Mary's Hospital London.

Can you tell us more about the five year point and your very own personal involvement with the Life After Five website?

It is a critical time. It’s important to say that more than half of all cancers that return are for women who have completed five years of tamoxifen. So whereas normal pubic perception you may think is that after five years you’re cured – that’s it, that’s a landmark, a milestone – actually you’ve still got to vigilant to see whether your breast cancer is going to return or not.

What medical options have women got after the five years has passed: for instance – they can switch to complementary medicines can’t they?

Absolutely. There are lots of treatments that you can have. If your breast cancer sadly does return and it does return to the breast, then it’s usually surgery. For other parts of your body, it’s either medical treatments like drugs and chemotherapy. I think you can also use certainly complementary - I prefer to say complementary rather than alternative, cos I think once you saying no to something then you’re probably on shaky ground.

But certainly with all of these – again with breast cancer we’re quite lucky with these complementary therapies. There’s massage, aromatherapy, acupuncture etc, because if anything makes you feel better then that’s got to be a good thing and that’s got to be encouraged.

What about breast reconstructive surgery for women?

The majority of people that had reconstruction certainly where I work in London last year had them immediately – so they had them at the same time as they had their mastectomies. I think there was only about two or three that had delayed reconstruction but it’s whatever. It’s just so the treatment is individual to the patient.

There appears to be a huge amount of information about what actually causes and how best to avert breast cancer. Have you any extra tips or guidelines to staying healthy – breast wise?

Basically eating healthily is important – staying within your normal weight, not drinking too much alcohol, looking at stresses in your life, keeping active and being breast aware.

Being “breast aware” – even after five years – the notion of knowing what’s normal for you, not being fastidious and checking the whole time but just knowing what’s normal for you, even if you’ve had breast cancer surgery – knowing what your scar feels like and just reporting any changes very promptly. And also going for your regular mammograms or taking up your invitation to the NHS screening programme and reporting any worries early, I think, is the key.

Implants, underwire bras, deodorants, abortions – as factors for causing breast cancer – that’s all rubbish. There are a few risk factors, for example if you start your menstrual cycle early, if you have a late menopause and it increases with age if you have your first child after the age of 30.

Have you any advice for families and friends on how to support a friend or family member with breast cancer – reoccurring after five years or otherwise. People are often unsure of how to act around sufferers aren’t they and there can be intimacy issues with spouses?

Absolutely! There’s much information out there, and also on this website www.lifeafterfive.co.uk there is a section on what to do if you are a relative or a carer. There’s also five real life stories of women who have experienced breast cancer with photos, and there’s also information leaflets which you can download and re-read later.

As a medical professional Vickki, what made you specialize in cancer?

I’d kinda been brought up with it to be honest. My parents are both cancer doctors and I just love it. I think you’ve got to find your job interesting, because you’ve got to spend so long at work, so much time. I’m very lucky - the opportunity to do things like this for instance. I write a lot, I’ve written books and I just think I’m so lucky that I’ve found this and found a good team to work in.

Many people follow the line of thought that cancer won’t occur to them and if they do find something suspect choose to put off going to their GP – any cautionary comments for them?

Oh yeah. You know one in nine women get breast cancer. It’s very, very common, basically two main factors – the older you are the more likely you are to get it and if you are a woman. So be aware.

What’s your opinion about the lack of uniformity with breast cancer care from one region to another? It’s quite scary reading Press reports of people battling to get treatment and trying to convince their GPs of their concerns etc – but people shouldn’t be afraid to ask questions should they?

It is scary. You talking about inequality of health care and the postcode lottery aren’t you…I think with patient choice now – people can choose where to go, if they’ve gone somewhere and had a diagnosis of breast cancer then they can certainly go back to their GP and get a second opinion or ask to go to somewhere where they’ve heard of or they’ve known someone that’s gone through it. The NHS now – you have to show everything through your annual reports. You have to prove your worth almost – prove your service and show what you’ve got really because everyone is entitled to see where they’re going. So in one sense those who do choose to search out and research their treatment and what they’re going to do will probably benefit maybe more than someone who would just go down to their local place. Although I’m not saying their local place would be bad at all or under par.

Janice Monk is a 54-year-old mother and Fashion Production Manager. She shares her story with us several years on after her first diagnosis to talk about her treatment, recovery and life now, with the desire to help others with breast cancer and explain what it means to have it and survive.

I was diagnosed six years ago with breast cancer. I found the lump myself so as Vickki says you must always try and be aware of any changes in your body. I went along to my GP who referred me to the Royal Marsden hospital. I had a mammogram and was diagnosed as having it. I had a lumpectomy then followed on with chemotherapy, radiotherapy and drugs for five years which I’ve just finished two weeks ago.

The Life After Five website is very good because you’ve got people’s real life experiences. Here I am after five years and hopefully I will just kept positive and stay away from it.

Try to carry on your normal life if you can. I’ve got a family and I’ve actually kept to as I was before – I’ve kept on working and I think it’s important not to take things for granted. Take each day as it comes.

If I could give somebody else with breast cancer some advice: It does seem to be a very long tunnel but there is an end to it. Hopefully you will have your family for support - but if you don’t, you have got places to go to and patient support groups to contact, so you’ve got people to talk to. I really do think it’s important to talk about it, not just to keep it inside you.

My ambitions really now are to see my children grow up and for them to fulfil their life ambitions.