My cancer has come back for a third time... Liz O'Riordan writes about her thoughts on Breast Cancer

My cancer has come back for a third time – 8 things I wish I’d known at the start...

Breast surgeon Dr Liz O'Riordan was diagnosed with cancer for the first time in 2015 aged 40. Eight years later, this is what she wishes she had known then

See the full article by Liz O'Riordan from her book here: 

Under the Knife: Life Lessons From The Operating Theatre, by Dr Liz O’Riordan (Unbound, £12.99) is out now

"There’s one moment that stands out from my surgical training. I was a trainee at a conference and an eminent surgeon said to me: “I can’t wait until they find a cure for breast cancer and I’ll be out of a job.” As he went on to present tragic cases of advanced disease, I realised that breast cancer wasn’t as simple as I’d thought. I could feel the anger in his eyes that even with all his surgical skills, he couldn’t save some women. Breast cancer can be cruel, robbing women, many young, of their identity, their fertility, and even their life.
In 2015, after two years of working as a consultant breast surgeon myself, I was diagnosed with breast cancer. I was 40 and fit with no family history. To say it was a shock is a total understatement. My life changed overnight. I went from a confident doctor in the operating room to a terrified patient in a chemotherapy chair, watching drugs sneaking into my veins.
I returned to work after 18 months, thankful that I could put the cancer behind me. But six months later it was back. They found I had a nodule on my chest wall – a regional recurrence. More treatment followed. The side effects meant I could no longer operate and was forced to retire. I was only 43.
Then, just a few weeks ago – five years after that second recurrence – my cancer came back for the third time. At the time of writing this, I have just had yet more surgery to remove the new recurrence (which is near my mastectomy scar), and yet again, my life has been put on hold.
Back in 2015, before I was first diagnosed, I thought I knew everything there was to know about breast cancer – I was a consultant breast surgeon after all – but I couldn’t have been more wrong.
The decisions that I had asked my patients to make in a matter of days seemed simple to me. Mastectomy or lumpectomy? Reconstruction or stay flat? I told them that radiotherapy was like having an X-ray and that the menopausal side effects of drugs like Tamoxifen would wear off in a year or two. I was clueless.
In all my time as a trainee, I had never had the time or the inclination to really see what the other side of the coin was like. I was too busy learning to operate to spend time in the radiotherapy department. I had never scrolled through a breast cancer forum to find out what questions patients were asking when they left my room. And now I was on the other side, I had so many questions. And for most of them, I had no answers.
But now I do. I’ve spent the last eight years learning how to be a patient. These are the eight things I wish I’d known before I was diagnosed.

1. The fear of recurrence never leaves you

Every day for the first three years I would wake up thinking: “Is this the day my cancer comes back?”. Every cough meant it had spread to my lungs. Sore legs after the gym meant it was in my bones. But as the years have passed, instead of worrying about what the future might hold, I tell myself that it’s out of my control. All I can do is keep fit, eat well and try not to take things for granted."

2. I don’t need breasts to feel like a woman

When my breast was removed, it took weeks before I would look in the mirror. I refused to let my husband see me naked. I felt ugly. I didn’t want him to see me, let alone touch me. But time is a great healer. I’ve realised that it’s what is inside that counts. Nothing can take that away from me. It doesn’t matter what I wear or how I look, I’m still Liz.

3. Memories are more important than shoes and handbags

One of the first things that haunted me was how long I had to live, and what to do with the time I had left. I spent a year in tracksuits during treatment, my handbags and heels gathering dust. And although I’m a sucker for a yellow coat, it’s the spontaneous day trips with my husband and going wild swimming with friends that mean the most to me now.

4. Friends will come and friends will go

I was not prepared for how my friendships would change once the word got out. A couple of close friends distanced themselves. A girl I hadn’t spoken to since school sent me a knitted Wonder Woman outfit for a Barbie doll. Some of my followers on social media went from fans to friends whereas others started trolling me. I’ve learned to take it all in my stride and cherish the wonderful people who support me today.

5. You can reinvent yourself

When I could no longer operate because of my treatment, I was lost. I faced years home alone. I felt I had no purpose, and without my salary I was guilty that I couldn’t contribute to the bills. I’d dedicated my life to becoming a surgeon, and without that, I didn’t know who I was.

I started a blog which opened up a floodgate of questions from cancer patients, and I discovered a new way to help people. I’ve created a whole new look, learning how to dress my lopsided shape and experimenting with bold glasses and bright colours. Remember that every set-back is a chance to try something new.

6. Chemotherapy is tough, but you won’t remember it

I’ll admit I was scared walking into the chemo day unit, nervous about how bad it would make me feel. The symptoms kicked in after 24 hours – a combination of the worst hangover of my life with the flu, as well as mouth ulcers, altered taste and the menopause. It was other patients who told me how to cope – all listed in my book, The Complete Guide to Breast Cancer.

Things like using a baby toothbrush when my gums were sore, drinking lemon and ginger tea when I felt sick, using Lanolips salve to stop my lips splitting and having hand cream in every room of the house. It was the hardest five months of my life, but now it seems like a distant memory.

7. There are alternatives to HRT to help with menopausal side effects

I had no idea how hard the instant menopause that comes with drugs like Tamoxifen could be, until I thought I’d wet the bed and realised I was having a night sweat. If your cancer is ER+ve, like mine, then HRT is not recommended. But there are lots of things that can help.

Acupuncture, hypnotherapy and CBT can reduce your symptoms. Some drugs that are used to treat depression and epilepsy can also help with hot flushes. Lubricants like Yes and Sutil can help with vaginal dryness.

8. Exercise should be the first treatment you have

I was a triathlete when I was diagnosed and carried on exercising during chemo because it made me feel good. Many cancer patients told me to walk every day as it helped them cope with the side effects, and there is now good evidence to back that up. If you start working out in the weeks before you have surgery, it will speed up your recovery time.

If you keep fit during chemotherapy and radiotherapy, it will help with the physical and mental side effects. Guidelines now recommend three 30-minute aerobic sessions and two 30-minute resistance-based sessions each week after a cancer diagnosis, and this can reduce your risk of a cancer recurrence by up to 40 per cent.

Best of all – whenever I’m out on my bike or walking the dog, I forget I have cancer and I’m just Liz.