Prostate Cancer: Symptoms, Causes, Stages, and Treatment
'Before My Diagnosis I Knew Nothing About Lymphoedema — The Nasty Cousin Of Breast Cancer Treatments'
Orla Brennan: 'I noticed swelling in my left arm and hand. I also felt a heaviness in my left arm so I contacted my breast cancer nurse.'
Being diagnosed with breast cancer is undoubtedly a very difficult experience, but coupled with a gruelling treatment plan, in addition to physical and emotional side effects, the whole journey can really take a toll. Of course, recovery or keeping the disease at bay is the end goal, but some people, while grateful to have survived the ordeal, are left with lasting side effects.
One of these is a condition called lymphoedema which causes swelling in the body's tissues and can be uncomfortable and painful.
Orla Brennan knows exactly what this feels like as, having been diagnosed with breast cancer in November, 2021, she underwent treatment which involved a mastectomy and an ancillary clearance of lymph nodes. "After being diagnosed with cancer in my left breast, I underwent treatment, during which I met Sinéad Cobbe (a physiotherapist, who has specialised for many years in the area of cancer rehabilitation), a week after my surgery to take my measurements in case of swelling.
She showed me some simple breathing techniques, exercises and manual techniques such as massage to get the lymph moving in the right direction
— Orla Brennan"Following this, a few weeks later, I noticed swelling in my left arm and hand. I also felt a heaviness in my left arm so I contacted my breast cancer nurse (BCN) and was referred to the Lymphoedema Early Detection Team."
Lymphoedema is a swelling which can occur in the arm, hand or trunk after cancer treatments including surgery, radiotherapy, chemotherapy and endocrine therapies.
Once Brennan had been diagnosed, the 50-year-old began treatment to try and reduce the swelling and give her some relief. "This all started fairly quickly after my surgery, but Sinéad explained what was happening and loaded me up with leaflets and links to educate myself on the diagnosis," she says. "She showed me some simple breathing techniques, exercises and manual techniques such as massage to get the lymph moving in the right direction. I was also provided with a compression garment to keep the swelling at bay.
"Before my cancer diagnosis I knew nothing about lymphoedema — or what I call, 'the nasty cousin of breast cancer treatments' — and when I was initially diagnosed, my world fell apart and I went straight into survival mode. At the time, the possibility of lymphoedema was shared with me by my BCN, Mags, who knew where my head was. I was focused on getting the cancer out of me, so she said that lymphoedema may or may not happen and we would deal with it, if it did. That was all I could take on board at the time."
The Clare woman, who is a swimming coach and teacher, is used to being active, so as part of her recovery and treatment, she made sure to incorporate as much exercise as possible into her daily routine. "Mobility is essential to me for work and my daily life.
"I had very serious injuries following a road traffic accident some years ago and spent time in a wheelchair learning to walk again, so I have an existing disability and my daily mantra, is 'If you can move, do move' — also, any form of movement and exercise helps to keep my lymphatic system moving.
"So, I swim as regularly as I can, and even started supervised weight training, after getting the go-ahead from my physio. I never thought this would be possible and I'm so grateful, as I believe it has made a huge difference, and I need to do it to strengthen myself and keep my much-fought-for mobility.
It's human nature for your nearest and dearest to move on (or become less concerned), if and when you're fortunate enough to have successful cancer treatment
— Orla Brennan"I also try and minimise symptoms by doing regular manual massage — it's great to guide the lymph to new pathways, particularly after a node clearance, as it doesn't know where to go for a while. I also moisturise much more regularly as it's an essential way to protect my skin — a natural barrier to infection, which can trigger reoccurrence of lymphoedema. I also carry a little tube of antiseptic cream everywhere I go to protect me from bites or burns and use Factor 50 every day."
Brennan has just undergone a second (elective) mastectomy and says she is determined to keep an optimistic outlook. "I'm a positive person and always on the go. But a cancer diagnosis changes you — and the addition of a lymphoedema diagnosis can be deflating — it's another bloody thing to be managed.
"It's human nature for your nearest and dearest to move on (or become less concerned), if and when you're fortunate enough to have successful cancer treatment. So because lymphoedema isn't cancer, they come out of survival mode and move on. But you don't. So it can be very easy to feel like you're treading this path alone — however, the lymphoedema team are always there, to educate, and provide you with the tools to manage.
"I think that education and awareness of the condition gives you power, and, so far, it doesn't affect my daily life. I try to make sure to remember all the advice, go back to my links and leaflets regularly, and know what to do if I notice anything different.
"I've just had a second mastectomy and I'm in a positive place during recovery. Fair Play to all the 'Uni Boobers' out there — but 'Going Flat' was my way to be happier and have symmetry on my chest. I had my visit to Sinéad last week and was delighted to hear that my lymphoedema is under control on my left side and no sign of it on my right."
The cancer survivor says that while having lymphoedema can be tough, she would advise others to take all the support offered and try to be positive. "I was very lucky that there is an Early Detection Lymphoedema Team in place at UHL," she says. "But I was shocked to find out that it is the only one outside of Dublin. Their support, information and knowledge has been invaluable and early detection clinics should be accessible to everyone all over the country.
"I would advise anyone who is going through lymphoedema to know that they are not alone — they should keep in touch with their breast care team, regardless of where they are. They should also educate themselves on the condition and reach out to lymphoedema professionals and clinics.
This is a crappy diagnosis after or during cancer treatments but it is manageable. You have been through, or are dealing with, cancer
— Orla Brennan"Much of the management of the condition is about what you do for yourself, so I would encourage them to make a list of the tips they are given and keep them up every day. Also, we have lymph all over our bodies doing wonderful work, but if you don't move it won't either — so make sure to hydrate, moisturise and protect the skin and most importantly, breathe.
"This is a crappy diagnosis after or during cancer treatments but it is manageable. You have been through, or are currently dealing with, cancer. Lymphoedema is just an unwelcome nasty cousin who can be managed when it first arrives at your doorstep. Putting into action your education and tools can close the door to that unwanted visitor."
Currently, almost halfway through the Irish Cancer Society's three-year pilot project at University Hospital Limerick (UHL) focusing on the early detection of cancer-related lymphoedema, progress of the scheme seems promising. Sinéad Cobbe says the project helps to empower people as well as giving them coping mechanisms to deal with the physical and mental issues associated with the condition. "The primary objective of this service is to educate and empower breast and gynaecology cancer patients in the midwest region, enabling them to attain expertise in assessing their own susceptibility to lymphoedema," she says.
"This is achieved by educating patients about the structure and functions of the lymphatic system. Patients are encouraged to engage in self-monitoring and manage their personal risk factors for lymphoedema. Strategies encompass physical exercise, weight management, skincare, and recognising the signs and symptoms of lymphoedema."
Initially, all breast and gynaecological cancer patients receiving treatment in UHL who are deemed high risk for lymphoedema will be referred to the service. Each patient will then have their Lymphoedema Index score measured by a lymphoedema therapist in the physiotherapy department of the hospital pre- and post-treatment. If required, patients will then be treated with compression garments, skin care and tailored exercise programmes and monitored for up to two years.
In general, there is very poor education for health care providers about lymphatics and lymphoedema
— Specialist nurse Kathy NugentThe programme also offers education and information sessions, online resources and support to patients throughout their involvement with the project. "In general, there is very poor education for health care providers about lymphatics and lymphoedema," says fellow specialist nurse Kathy Nugent. "Most doctors, nurses and physios get perhaps one lecture on the lymphatic system.
"It is hugely ignored by conventional medicine and a lot of patients have to seek their own answers. Also, there are a lot of scare tactics and misinformation about lymphoedema on the internet and people often get very fearful about it.
"So, the HSE working group has devised information leaflets, to give the best and most up-to-date information, empowering people to become their own experts in lymphoedema prevention and care and reducing the stress and fear associated with it."
Besides offering this service to patients in the midwest region, Nugent and Cobbe are involved in national initiatives, playing a role in creating lymphoedema prevention booklets and are presently working on an app for the early detection of lymphoedema. "We strongly believe that this information should be available to all individuals undergoing treatments that put them at risk of lymphoedema — this is why the phone app and information leaflets are so important."
Strictly's Amy Dowden Admits She 'gets Angry' Over Breast Cancer Diagnosis While Battling Crohn's Disease
Strictly Come Dancing professional Amy Dowden has said she does get "angry" and it will "take a while to accept" her cancer diagnosis at such a young age while also managing a chronic illness.
The 33-year-old Welsh dancer, who joined Strictly in 2017, announced her breast cancer diagnosis in May after finding a lump in her breast in April, the day before going to the Maldives on honeymoon with fellow professional dancer Ben Jones.
She had previously revealed in 2019 that she was suffering from Crohn's disease, and fronted the BBC programme Strictly Amy: Crohn's And Me, in which she spoke about her battle with the condition and met other people with Crohn's to hear about their experiences.
The Caerphilly-born dancer appears on the cover of the December issue of Women's Health UK and told the magazine: "Oh yeah… I always say I never asked (for) this to happen to me.
"I've always worked so hard. I've always been a good person. I looked after myself, I've exercised well, haven't smoked… I do get angry.
"I just think I've been dealt a difficult one… I think it'll take a while to accept.
"It took me a long time to accept my Crohn's. Until I'm back dancing and back to my normal self, I don't think I will accept it."
Crohn's is described by the NHS as a lifelong condition in which parts of the digestive system become inflamed, and Dowden was diagnosed at the age of 19.
People with the disease commonly experience phases of intense abdominal pain, severe vomiting, exhaustion and bloody diarrhoea, among other symptoms.
On her decision to appear on the magazine cover without a wig, she said: "Finding out I had Crohn's, I didn't ever have anyone in the public eye to look up to or to say to my friends 'That's what I've got.'
"And I just had a little moment – I imagined teenagers being able to go to school and being able to embrace (not having hair) or go swimming and just be like 'I'm like Amy who's off Strictly'.
"And that just gave me the confidence to go 'Yeah, let's do this'."
Earlier this month Dowden revealed she had fractured her foot, ruling her out of making an appearance on Strictly this year.
She was unable to have a celebrity partner on the popular BBC One show following her diagnosis and subsequent cancer treatment, but had planned to make an appearance on the dancefloor.
She said she wants to be "treated as normal", adding: "When I'm walking outside and I've got my headscarf on, I don't want looks of sympathy or feeling sorry for me – I'm Amy… Sometimes people don't know how to address it.
"Just ask how I am – I will answer you. We don't want you to feel sorry for us. We're embracing it. Stand strong with us… Don't give me that pity look – I don't need it!"
Since her diagnosis and subsequent mastectomy and chemotherapy, she has raised awareness of breast cancer and posted regular treatment updates on Instagram, including appearing on Channel 4's Stand Up To Cancer broadcast this month to celebrate a decade of the appeal for Cancer Research UK.
– Read the full interview in the December issue of Women's Health UK, also available as a digital edition.
(Women's Health)
I Have Breast Cancer: How One Woman's Facebook Announcement Saved My Life
One day at the start of 2023, I was scrolling and saw that one of my Facebook friends had been diagnosed with breast cancer. Despite the fact that we hadn't really talked since college, it still shocked me. She is my age with two young boys. People my age with two young boys shouldn't have breast cancer. So I texted a mutual friend who was closer to her and asked, "Do you know anything about this?"
She shared what she knew about her diagnosis story with me. Looking back at our exchange, I simply replied, in all caps, "NIPPLE CHANGES?!" I didn't know that was a thing.
So now I knew of this girl from college who was going through chemo, along with another close family friend who got diagnosed just two months after her wedding. That was two people my age — two too many — whose lives were just like mine until they weren't. I know the timestamp for a mammogram is 40 years old and I was only 36, about to turn 37, but I had a feeling of, If them, why not me, too? I couldn't wait any longer for a mammogram, so I didn't.
The good news is scheduling a preventative mammogram is free with insurance and easy (I literally did it online, on my phone, with no referral needed). While I did have to wait about a month for my screening appointment, that was fine with me because I had no concerns — just a bit of paranoia seeing young women around me seemingly getting cancer out of nowhere.
The day of my appointment — Monday, July 10 — came, and the mammogram was about what I expected, and also nothing like what I expected all at the same time.
Regardless, 20 minutes later, I was on my way. Results came back the next day — Tuesday, July 11. "Unremarkable" and "clear" were words I saw in the report. The other term I noticed? "Dense tissue." That said, all the faux worry that I had built up went away in an instant with my A+ report card. I texted it to my husband, and he replied: "Wonderful news!"
Two days later — July 13—I afforded myself the luxury of a late-night bath after wrestling with my toddler to go to bed for a good 45 minutes. I was lying down in the tub, scrolling TikToks and something caught my eye that wasn't a new dance challenge on my screen. It was actually…my nipple. My left nipple appeared slightly flatter than my right. I thought for sure my son had "squashed me" while he was laying on my chest making me sing the entire Trolls songbook for the last hour before he was eventually lulled to sleep. I decided to check on things in the morning when I was sure they'd go back to normal.
Friday morning — July 14 — I began my day by flashing myself in the mirror. Things looked…the same as they did the night before. At that point, I heard my brain whisper the phrase: "nipple changes."
I quickly chased that with a hearty "Nope. No way." I just had a clear mammogram a mere days ago. This must be "what my boobs look like now"—a little smooshed. That's motherhood and your mid-thirties for you.
Throughout the day Friday, "nipple changes" echoed more and more frequently in my head until I decided to call my OB's office to set up a breast exam.
The next available appointment was on Monday, which was fine with me — this was not urgent, if anything, it was silly. I went on to have a great weekend in Michigan with my family and thought exactly zero times about my nipple.
On Monday, July 17, I saw my wonderful doctor. I started my appointment like I do every time we see each other…by showing him recent pictures of Atlas, who he delivered, and waiting for some sort of quirky comment back.
"Oh, little surfer boy!" he said, right on cue. "So, why are you here?" he then asked.
"I feel so silly," I said, as I started to explain my situation. I even peppered in a few "I'm sure it's nothing" for good measure. All the while, he was looking over my fresh mammogram images, confirming they were, in fact, all clear.
A typical breast exam followed. A minute or two later he said, "Well, it's good you came in and that you noticed such a small change. Because you do have a slight firmness on the left side that's not on the right side."
The word LUMP was never used.
Still, I panicked. How did I miss "a firmness"? Like most women, I tend to feel around every now and again and nothing has yet to stop me in my tracks.
Moreover, how did the mammogram miss "a firmness"? If there was anything suspicious, wouldn't my X-ray be lit up like a Christmas tree?
He drew up orders for a breast ultrasound and more mammogram images. Even though I was caught off guard by this, we both were relatively unbothered as he posed that it could just be a benign duct injury or clog of sorts.
Two days later — Wednesday, July 19 — I went in for the follow-up imaging. I was very calm about things, even bringing my work laptop with me so as not to skip a beat while making "double sure" this was nothing.
I just had a mammogram. It was all clear. Played on repeat in my head. To me, that was worth hanging my hat on — along with the rest of my clothes, as I stripped down into a floral, oversized robe.
This time, the new mammogram images were centralized to my nipple — which is a sort of barbaric hell you shouldn't wish on your worst enemy.
Then, I moved on to the ultrasound portion of the appointment and was done five minutes later, with no complaints other than it tickled — especially when they imaged underneath my armpit. My next step was to wait in the lounge for my turn to meet with the radiologist, a standard practice for anyone coming in for additional views.
A few minutes later, a nurse came to the waiting area and said the doctor was ready to talk to me about what she saw in the images. I don't know why, but that choice of words didn't sit right with me. I figured, though, it was a neutral enough line as we made our way down the hall to her office.
The doctor joined us a few minutes later. The first word out of her mouth was "Unfortunately" — and that was the first moment of the rest of my life.
I blacked out immediately, and so the majority of the rest of the conversation was a bit muffled in my memory.
But I recall all of the following words and phrases: "solid mass", "abnormalities", "lymph nodes", "concerning", and "suspicious"
I don't know how, but I found my voice again — enough to ask two questions. (Okay, three. The last being: Can I call my husband?)
The nurse was standing by with big puppy dog eyes ready to help me get scheduled for the very next morning — Thursday, July 20. For those keeping track, it was just one week from noticing my nipple looked a little odd, to getting a solid mass and a suspicious lymph node biopsied. I'll spare notes on that procedure, but it's exactly as fun as getting a needle to the nipple sounds.
This brings us to Monday, July 24—the day the biopsy results were in.
Today is the day I find out if I have breast cancer.
That was my very first thought when I woke up that day. Not something I thought I'd ever say to myself, especially just a couple of weeks after my 37th birthday.
Not long after I got up from another sleepless night, around 9:30 am, my phone lit up with a call from my doctor — the same one who had done the in-office breast exam exactly one week before. He's a soft-spoken guy, but when he said my biopsy came back as Stage 2 Invasive Ductal Carcinoma breast cancer with a spread to my armpit lymph node, I heard him loud and clear.
But…I had a clear mammogram.
But…I don't smoke.
But…I barely drink alcohol.
But…I exercise almost daily.
But…no moms, grandmas, or aunts in my family have any history of breast cancer.
But…I'm only 37, not even the age they recommend starting to take breast health seriously.
But…
But…
But…
But none of that mattered. All that mattered was that I had breast cancer and was already set up to meet with an oncologist later that same day.
I can't stress enough how accelerated this timeline was.
July 6: My 37th birthday — not a care in the world
July 10: Preventative mammogram appointment — still not a care in the world
July 11: Mammogram clear — definitely not a care in the world!
July 13: Notice my nipple looked flatter than normal — a little odd, but not concerned (see above)
July 14: Call to make a doctor's appointment — feeling ridiculous, this is probably nothing
July 17: Breast exam — still feeling ridiculous (see above)
July 19: Breast ultrasound — feeling unbothered, but good to be safe
July 20: Breast biopsy — feeling surprised it's gone this far, but hopeful for a benign explanation
July 24: Officially diagnosed with Stage 2A ER/PR+ HER2- breast cancer with lymph node involvement — feeling utterly shocked
Talk about things escalating quickly.
"This is something we'll need to take care of," my doctor said matter-of-factly.
I paused to think of my son, not even two years old yet.
The source of all my pride. My biggest joy. My best work. The missing piece who transformed Matt and I from just a couple, into a full-blown family. At the same time I was taking this call in my office, Atlas was scribbling on my carpet with a yellow highlighter, none the wiser that the doctor who brought him into this world just set off a nuclear bomb in his mother's.
"I agree," I said back with quiet confidence.
Related Stories From YourTango:"Soon after we get off the phone, you'll be receiving a call from our Nurse Navigator. She will get you set up with your oncologist."
Like clockwork, when I hung up with him, the Nurse Navigator rang.
"I can get you in today," she said. "With the Medical Director of Oncology."
Despite this all happening really fast, and completely out of nowhere, I was so relieved to be paired — immediately — with such an esteemed doctor. I learned that same afternoon what my treatment plan would look like:
16 rounds of chemotherapy. I've completed 8 so far. If all goes to plan, I'll ring the bell on December 22, 2023.
A double mastectomy with lymph node removal in January 2024.
Several weeks of daily radiation treatments.
Breast reconstruction surgery.
A complete hysterectomy. I learned shortly after my diagnosis that I am positive for the BRCA2 genetic mutation, which gives women an incredibly high likelihood of breast and ovarian cancers.
10 years of drug therapy.
This is a lot. But I'm taking care of it, like I agreed to. No matter how devilish the treatment is, and it is, I will send every bit of it back to hell. Believe it.
I have kept this news mostly to myself for 98 days.
After telling a small group of close friends and family, it became evident how traumatic it is to share, how shocking it is to hear, and how difficult it is to process. But now it's almost the end of Breast Cancer Awareness Month, and I need to step up and share.
I can't stress this truth enough: it is only because of "some girl from college" (who has become my close friend now) deciding to "share on social media" that she had breast cancer, that I ever learned that a nipple change was a sign of malignancy. I would not — I repeat, I would not have gone to the doctor for a breast exam otherwise, especially since I had a clear mammogram just two days before.
Her sharing her story saved my life.
So, here I am, doing my part to spread awareness, and more importantly, spread action. Examine your breasts today. Look at them in the mirror. Have your partner look at you. If you don't know how or don't want to do it yourself, make a breast exam appointment with your OB-GYN. Schedule a mammogram, no matter your age. Waiting until 40 would have killed me.
Emily Belden (Emily Bond) is an author with Harlequin/HarperCollins. She inked a two-book deal and her starred-review debut novel Hot Mess came out via Graydon House—a select hardcover and trade paperback imprint dedicated to publishing book club-worthy fiction with strong commercial appeal. Her sophomore novel Husband Material is sold in bookstores nationwide, including mass retailers Target and Kroger. She lives in Chicago with her husband and toddler son.
This article was originally published at Emily Belden. Reprinted with permission from the author.
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