As a breast cancer surgeon, I made a terrible patient. I was diagnosed with the disease I had devoted my life to treating in 2015, aged 40, and again in 2018. Throughout, I felt that given my profession, I should know what to do – which is crazy, because I’d never been a cancer patient before. After those two experiences, and a local recurrence in my left breast two years ago, I’ve learned that you really don’t know what it’s like until you are in the middle of it.
Going through cancer treatment can be unbearable, but there’s a real impact on a patient’s loved ones, too. My husband’s also a surgeon, and when I was recovering from chemotherapy, and he had to leave me to go to work, he said: “I feel impotent because I don’t know how to help you. I don’t know how to make you better, I can’t take this away.”
I think it’s almost harder for your partner, because when you’re going through treatment, you have no choice – you’re on this rollercoaster. But your partner is watching on while everything becomes about the patient. You’re the one getting the flowers and the letters and the gifts, while they’re often alone on the outside. Quite simply, they don’t – can’t – understand what you’re going through.
The loneliness you feel as a cancer patient can be overwhelming, but I found an incredible support system via a group of doctors who were having treatment at the same time. It was like we were in our own secret tribe, texting at three o’clock in the morning when we couldn’t sleep. While helpful for me, it made my husband feel left out. While to my mind, he couldn’t understand what I was going through because he didn’t have cancer, confiding in those friends was pushing him further away. All the while, the same questions were running through his head that were filling mine: what happens next? Am I going to die?
As a breast surgeon, I knew that my risk of developing metastatic cancer (which spreads from the original location to other parts of the body) was high; that my prognosis was bad. I kept that from my husband, reasoning that he didn’t need to know information he couldn’t do anything about. But the weight of that – and just hoping he’d never have to know – made me feel terrible.
The physical side of things wasn’t any easier. I had chemotherapy at first, which left me with a lump on my breast, and a bald head – coupled with a treatment-induced early menopause, causing night sweats and hot flashes.
When I then had my mastectomy, I wouldn’t let my husband look at me for six months because I hated how I looked; without my hair and eyelashes, I felt like an alien. Every time I would get used to the “new” me, something else would change, and push me right back to square one; I’d look at my flat chest and ugly scar and tell myself, “This isn’t me.” My coping mechanisms were to avoid looking at myself below the neck, or letting my husband touch me.
I found it very, very difficult to articulate this loss of my sense of self. I would wait until he’d gone to work before I’d sit in the shower and cry about how miserable and scared and frightened I was. I couldn’t bear for him to see that I was so down; I wanted to protect him from the pain I was feeling.
When you say your marriage vows, you promise to be there for your partner in sickness and health, but it’s really hard when you’re the one who’s ill. I felt guilty for what breast cancer had brought to my marriage, and its role in killing my sex drive. I told my husband: “You should divorce me. Go marry someone with two breasts and a libido to match because you deserve better than this.” He said, “Don’t be silly, I love you. I’m not going anywhere.”
But that guilt, over how radically our relationship had changed, was really hard to deal with. On top of the day to day shifts in my physical and mental health, the elephant in the room for us both was that I could die.
It took about a year before I would walk around with my shoulders back. At that point, I finally realised: this is me, the scars and signs of what I’ve been through are not going to change. I don’t need to have long hair and eyelashes and a cleavage to feel feminine or to feel sexy.
This acceptance helped to get my sex life back on track, and it was important to me to share what I’d been through with others, so they didn’t feel as lonely as I had. When I spoke about the subject, so many women got in touch to say they were going through the same; that their partners didn’t understand, and they didn’t know what to do.
My mum thought I’d shared too much – but I was so moved by the women who wrote to me saying, “I listened to your podcast about sex with my husband in the car, and we cried, and we’re going to start dating again; he now gets it.” Sex problems – from loss of libido to vaginal dryness – are completely normal after cancer, and if the goal as medical professionals is to help people get their lives back, sex is a part of that. It’s a basic human need.
I’d like to say that as time goes on, the scans and medical checks get easier; that you learn to cope better with the difficulties of treatment, the anxiety of waiting for a scan, or the survivor’s guilt.
In many ways you don’t. There have been dark days: the illness has robbed me of my breast, my fertility, my libido and my job, as following surgery I can no longer use my left arm in the same way. Through it all, knowing those around you are there, no matter what, has made the difference.
As told to Charlotte Lytton
The Cancer Roadmap by Liz O’Riordan is published today (HarperCollins)
