The breast cancer survivors' club: The diagnosis every woman dreads

The breast cancer survivors’ club: It’s the diagnosis every middle-aged woman dreads. But as these writers movingly reveal, thanks to astonishing advances in treatment most women now emerge exhausted, scarred… but alive

  • Last September, I was diagnosed with an aggressive form of breast cancer 
  • A few weeks ago I was discharged from the clinic and told ‘go and live your life’ 
  • My story is not unusual – scientific advances have transformed breast cancer

By Leah Hardy  

Just over a year has passed since I became part of the club no woman wants to join.

Last September, after noticing my right breast was sore and firmer than the left, I was diagnosed with an aggressive form of breast cancer.

I had multiple large tumours and the cancer had already spread to nearby lymph nodes in my armpit.

I felt perfectly healthy, so the shock was incredible. I wept as my kindly consultant said: ‘I bet you feel this has come out of nowhere.’

I was certain I was going to die, leaving behind my husband and two children, then aged 16 and 19.

Through my panicky sobs, I asked: ‘How many years can you give me?’

He peered at me over his glasses and said: ‘Oh no, you don’t understand. We intend to cure you.’

Leah Hardy: ‘I was certain I was going to die, leaving behind my husband and two children, then aged 16 and 19’

At the time, I hardly dared believe him. But over the next two weeks a cancer treatment plan was constructed, which lasted a year.

And now, incredibly, it looks as if my consultant — plus all the brilliant NHS doctors and nurses, and the global scientists who have contributed to my treatment — may well have succeeded.

A few weeks ago — October is Breast Cancer Awareness month — I was discharged from the breast clinic and told ‘go and live your life’.

I feel lucky. I am lucky. But my story is not unusual because scientific advances have transformed breast cancer outcomes. Survival rates have soared in recent years.

The greatest minds in breast cancer research are now focusing on innovative treatments with the ultimate aim of being able to cure all cases of breast cancer.

We aren’t there yet, but according to Cancer Research UK, ten-year breast cancer survival rates in the UK have nearly doubled since the 1970s, from four in ten women surviving their disease beyond ten years to around eight in ten now.

Of course a diagnosis of breast cancer is something many of my contemporaries — I’m 59 — live in fear of. According to Cancer Research UK, as many as one in seven women will develop the disease in their lifetime — 80 per cent of them aged over 50.

And, sadly, some women do die. Just three days after my diagnosis, Girls Aloud singer Sarah Harding passed away, aged only 39, from the same type of cancer I had, HER2-positive.

Tragically, Sarah was one of the fewer than 6 per cent of women who are diagnosed when their cancer has become metastatic — meaning it has spread to other organs in the body and is incurable. Mine hadn’t.

The day I discovered that the scans to check whether the cancer had spread to other parts of my body were clear was one of the happiest of my life. Only at that point, two weeks after my initial diagnosis, did I feel able to tell my children I had cancer.

In fact, breast cancer death rates in the UK have dropped by 18 per cent over the past decade and are projected to fall by a staggering 26 per cent between 2014 and 2035.

New treatments are appearing with dizzying speed and we’re also discovering that cancers eradicated by the latest drugs are less likely to come back.

Just this week, the couple behind the Pfizer Covid vaccine said they hope that a cancer vaccine could be available within the next decade.

Of course, I didn’t know this when I was diagnosed. In fact, I’d never even heard of HER2-positive breast cancer, or how it would be treated. And yet my version of the disease illustrates perfectly the giant steps we have made in treatment.

Just 20 years ago, HER2-positive breast cancer, which accounts for around 20 per cent of all cases, was often a death sentence.

HER2 is a normal protein on the surface of breast cells which regulates healthy cell growth.

But, in some women, a genetic blip within the cells causes the proteins to multiply by up to a hundredfold, which triggers explosive, abnormal cell growth in the form of tumours.

In the 1990s, scientists developed a new drug called Herceptin, which could block the action of these rogue proteins and in many cases cause the tumours to melt away.

This wonder drug reached the NHS in 2006. In 2020, it was given in combination with another, Perjeta, to increase its effectiveness.

Two more new drugs — Kadcyla and Enhertu — have also been approved for HER2-positive cancers in the past two years.

These are antibody-drug conjugates which can lock onto HER2 proteins and deliver a dose of chemotherapy right into the heart of a cancer cell.

Given alongside chemo and surgery, anti-HER2 drugs mean that women like me, who once had a woeful prognosis, now have an 88 per cent chance of living for at least six years — and a growing chance of being cured entirely.

Other types of breast cancer are seeing similar advances with the introduction of immunotherapy drugs and advances in genetic testing of tumours, which can help doctors identify women who don’t need chemotherapy at all and spare them its gruelling side-effects.

My own treatment was intense, involving five different drugs given at the highest doses. A dispiriting halfway scan showed the cancer was ‘stable’, which wasn’t what I wanted to hear. The spectre of death haunted me again.

But I picked myself up, had a double mastectomy and another round of drugs, this time including Herceptin and Perjeta, which this time proved devastatingly effective.

When I was tested in March this year, after my double mastectomy, there were no traces of cancer left. I’d had what scientists call a ‘pathological complete response’. It felt like a miracle. We must never forget the estimated 35,000 women living with metastatic breast cancer, or the 32 women who die prematurely every day.

For them, new treatments are still needed as they fight to stay alive long enough for the next scientific advance. But most of us will emerge from our encounters with breast cancer scarred, sometimes emotionally traumatised and exhausted — but alive.

I had a primeval fear that my life was about to end

By Barbara Davies

I was 42 when I was told I had breast cancer.

I’d been paranoid about such a diagnosis for a while because my mother had been treated for the disease twice, once in her early 50s and then again in her 60s, and so I had the nagging feeling that I was waiting my turn.

Because of my fears, my GP put my name forward for the Royal Marsden Hospital’s ‘family history programme’, which offers annual mammograms to high-risk women.

My second mammogram, in 2015, showed irregularities — and further tests revealed a 5cm tumour deep inside my right breast.

Fear does strange things to your brain. While an oncology professor tried to explain that it was a fast-growing, aggressive cancer and that I would need chemotherapy, surgery, radiotherapy — the whole shebang — I kept saying that I really shouldn’t be there, that my family history really wasn’t that bad.

Barbara Davies: ‘I will never forget the first few weeks which followed my diagnosis; the almost primeval fear that my life was about to end’

Mentally I was trying to back-pedal, as if I could turn back the clock, reverse out of the consulting room and un-hear the horrifying things he was telling me.

The professor said the crucial thing was that they’d found the tumour early. When I asked if that meant the cancer was curable, he replied that it was ‘treatable’.

At first his careful choice of word struck fear into my heart.

I was a single mother with a 13-year-old daughter. I will never forget the first few weeks which followed; waking up drenched in sweat, adrenalin charging through my veins; the almost primeval fear that my life was about to end.

But today, seven years on, ‘treatable’ serves as a reminder that when it comes to breast cancer, doctors have an extraordinary and ever-expanding armoury of weapons at their disposal, several of them ingeniously tailored to target specific cancers. 

In 2015, the Royal Marsden, in West London, was running a five-year clinical trial for a new drug called pertuzumab — also known by its brand name Perjeta — which was already having almost miraculous results on my form of breast cancer in the U.S.

Eight months of conventional intravenous chemotherapy alongside pertuzumab followed in a bid to shrink my tumour before surgery. Between each three-weekly round, I was scanned to check the drug was working. And it was.

By the time September came, the tumour had virtually disappeared. I underwent minimal surgery to remove a few lingering rogue cells and then radiotherapy.

A year later, in 2016, thanks to the success of cases such as mine, pertuzumab was finally made available on the NHS.

Seven years on from that trial, I am cancer free. In June, I celebrated my 50th birthday and just a couple of weeks ago went to the Royal Marsden for my annual mammogram, which showed all was well. 

Of course, cancer outcomes differ with every individual. In what was a particularly horrible twist of fate, a close friend of mine died of breast cancer on the very day I received my diagnosis.

But when her cancer had been discovered six years earlier, treatment options were, tragically, far more limited.

Today, there is so much to be grateful for; above all, the painstaking work of scientists, doctors and cancer charities.

It is thanks to them — and to NHS screening programmes — that breast cancer survival rates are higher than ever before.

I take a ‘magic potion’ that keeps me well

By Alexandra Shulman

I regard myself now as somebody who had breast cancer. Note the past tense.

A year ago I discovered that an intermittent pain under my left breast was caused by a 2cm, moderately aggressive tumour.

It was a shock — although like most women, one I had half expected every time I had a mammogram — and I was frightened. But one of the things you don’t realise about breast cancer, until you are diagnosed with it, is the range of treatment for different tumours and how there are an ever-increasing number of options.

I had a lumpectomy and a lymph node biopsy and although I was in private care, it took a nerve-rackingly long time — about three or four weeks — to learn what kind of treatment I would need.

The tumour was genomically tested to work out how it would react to the different treatments. I was mightily relieved when I learned that my particular tumour would not benefit from chemotherapy and would be very receptive to hormone therapy.

Alexandra Shulman: ‘One of the things you don’t realise about breast cancer, until you are diagnosed with it, is the range of treatment for different tumours’

After a course of radiotherapy I was prescribed letrozole, which my oncologist explained was now regarded as the more effective alternative to tamoxifen, the drug which had been the standard hormone therapy.

It is approximately 20 per cent more rigorous at preventing reoccurrence if you are a suitable case for it, which involves being post-menopausal with an oestrogen-fed cancer, as mine was.

I will need to take it for many years — five, seven, ten, it isn’t clear — but as someone who happily took the contraceptive pill for a great many years, that kind of long-term medication has never bothered me.

Letrozole removes any of the youthful oestrogen still left in my body, the hormone that my HRT had been so happily replacing as I went through menopause. Not a welcome prospect, clearly. But if it was going to prevent the recurrence of my breast cancer, I had no problems with the directive to stop taking the HRT immediately.

I avoided reading the side-effects for ages but eventually succumbed: night sweats, tiredness, weight gain, painful joints, potential osteoporosis and so on.

Nearly a year into my letrozole, a little brown pill I take first thing each morning, I have suffered hardly any of these.

I choose to think that this little pill is a magic potion that will keep me well. The fact I’ve gained 10lb might be due to letrozole. Or it might have happened anyway!

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