Breast cancer: living life after treatment

BBC editor Carly Appleby was diagnosed with stage three breast cancer in 2017. At the time, she had no idea how grueling the treatment was going to be. Now, looking back – and to the future – she reflects on how it changed her life.

If you had told me six years ago that I still wouldn’t be done with my cancer treatment, I wouldn’t have believed you.

I was 37 when I was diagnosed and as a young mum my main concern was to stay alive for my then three year old daughter and my husband.

Now, after years of hospital appointments and treatments, I don’t look sick anymore, but that doesn’t mean that everything is fine and that everything is back to “normal”.

At 43, my body thinks I’m a much older woman than me.

I still suffer from fatigue and aches that wake me up at night and my memory is terrible.

The veins in my arm will never return to normal after chemotherapy and it’s a painful struggle to get a cannula through my veins after years of treatment.

But I’m proud of everything I overcame with the support of my family and friends and it made me realize how remarkable our bodies can be.

My daughter is now almost 10 years old and I hope to see her grow up.

Each passing year is a privilege and I will never take my current good health for granted.

It was a beautiful day in the Cotswolds when I received my diagnosis and my husband and I were amazed. We had no idea what was going to happen.

Cancer treatment was not quick for me.

This included six cycles of chemotherapy, 15 daily radiation therapy sessions, a year of targeted therapy of the miracle drug Herceptin, 18 months of injections into my stomach of Zoladex; several breast operations, reconstructions and surgery to remove my ovaries.

All of this led to two years of hair loss and being thrust into surgical menopause.

I also take a tamoxifen tablet daily and will do so for another four years. It is used to reduce the risk of recurrence of early breast cancer.

When I had cancer, I didn’t know that the disease would prevent me from having other children.

I still feel incredible sadness that I was taken away from that choice. We had wanted another child to complete our family and that will never be possible.

I didn’t get a chance to freeze my eggs because my cancer treatment needed to start immediately and according to the fertility doctor who was referred to us, the process would have contributed to the growth of my cancer.

It always hurts when people ask me if I only have one child. But I’m so grateful for my daughter and the opportunity to be a mom.

Now that she’s older, she’s stopped asking me why she doesn’t have a sibling. I feel guilty for not being able to provide this for my husband and my granddaughter.

But I’m still alive and in remission, which means I no longer have cancer — or “no evidence of disease” — a term oncologists prefer to use.

I know I am extremely lucky. It’s no longer the first thing I think about in the morning or the last thing I think about before going to sleep at night.

However, the fear that the cancer will come back, become incurable, and undergo active chemo and radiation treatments again never goes away.

I’ve lost many young friends to illness and it’s hard not to make comparisons. So what did I learn?

It may be the most common cancer in the world, but breast cancer is not pink and fluffy or the “easy cancer” to diagnose. We need more awareness.

There are around 56,000 new cases of breast cancer every year in the UK, or more than 150 cases a day.

More than 11,000 women die of breast cancer every year. Men can also get breast cancer, although the numbers are much lower.

I no longer have regular appointments, only annual mammograms on my good breast.

Some well-meaning people would tell me about colleagues or friends they knew who had had breast cancer in the past and survived.

These stories are good to hear but they really don’t make sense because no two diagnoses are exactly the same.

Sometimes I was too exhausted to explain this.

Life after cancer is delicate and brings its own challenges. Many people live with the pain and side effects of treatment.

Depression, anxiety, fatigue, weight gain, loss of confidence and sleep issues are common and I have been through all of these.

Lack of confidence is a huge factor and many people don’t recognize their bodies after treatment. For some women, this can be especially difficult.

My eyebrows never came back, so I had them tattooed, and my breast cancer nurse was brilliant at tattooing a fake but extremely realistic 3D nipple. These two made me feel better.

I remember feeling both confused and amused by all the different colors of inks – bottles of pinks, creams and browns.

Halfway through the procedure, I started to feel the needles on my numb chest. The nurse asked me if I wanted to continue?

I laughed and said, “You can’t leave me with a half-colored circle, so yes please”.

The other thing I quickly realized was that Cancer can be extremely lonely.

I felt out of place as a young mom on the playground with cancer despite the incredible support from my friends and family. You stand out when you have no hair and look sick.

Despite the many niceties people have regularly shown us, unless you’re going through treatment, it’s hard to fathom how scary and stressful the process is – you’re constantly wondering if you’re going to live and succeed.

You also feel like you can’t do the things you love because physically and mentally you can’t.

Our world has become very small in an attempt to protect me from infection. I was protecting myself at home long before the pandemic hit.

It’s hard to know what’s normal after cancer, so I attended a brilliant Where now? class organized by cancer charity Maggie’s, to talk about life after treatment.

It was so helpful to meet people who had different types of cancer, but were all struggling with similar issues.

We also did Nordic walking, which can be particularly beneficial for women who have had breast cancer.

Your family and friends may expect you to go back to how you were before treatment, but for some people the fear of cancer and death can be overwhelming.

I didn’t know many diagnosed women under 40, so I looked for people who understood.

I also attended an ABCDiagnosis Cancer Retreat. It’s led by the amazing Jo Taylor, who lives with incurable secondary breast cancer and raises awareness through her website and campaigns.

The retreat encourages exercise, holistic therapies and peer support and I am still in touch with many of the women I met there.

I also get support as a member of the Younger Breast Cancer Network on Facebook.

Reflecting on everything I’ve been through, my cancer diagnosis has made me a stronger person. I am able to cope with almost anything.

Living with a serious life-limiting illness makes you realize how precious and short life is.