Thursday, 25 February 2016

Stage IV and beyond... ~ Vicky

12 Comments so far

June 19th 2006 is one of those dates I’ll never forget. I was dragged kicking and screaming into the world of cancer when at the tender age of 31 I was diagnosed with a grade 1, stage 1 primary breast cancer.

In a nutshell, I had surgery, was told to go away and have the family we so desired and in the nicest possible way, never to darken the doorstep of Oncology again!  I took on the mission and welcomed my children in 2008 and 2010, and over time and with optimism, cancer was relegated to lower leagues while I threw myself into family life.

Fast forward to early 2015, I developed difficulties with my usually trouble-free back, and at the same time was called for investigations on a suspicious axillary lymph node that had reared its head on a routine check-up. 

And so it came…the first strike…the cancer was back!

Then June 16th 2015, the big C bomb dropped…it was stage IV/metastatic breast cancer.

There is no stage V.

So there it is…40 years old with a metastatic cancer diagnosis. Let’s leave that hanging for a moment.

~

So, what is stage IV/advanced/metastatic breast cancer?

Millions of cancer cells form a tumour. The original cancer in the breast is known as a primary breast cancer.  People do not die from cancer that remains in the breast area.

Secondary breast cancer occurs when breast cancer cells spread from the primary cancer in the breast to other parts of the body. This may happen through the lymphatic or blood system.

You may hear it referred to as:

  • metastatic breast cancer
  • metastases
  • advanced breast cancer
  • secondary tumours
  • secondaries
  • stage 4 breast cancer.

The most common areas breast cancer spreads to are the bones, lungs, liver and brain. When breast cancer spreads, for example to the bones, it is called secondary breast cancer in the bone. The cancer cells in the bone are breast cancer cells. 

A diagnosis of secondary breast cancer means that the cancer can be treated but cannot be cured. The aim of treatment is to control and slow down the spread of the disease, to relieve symptoms and to give the best possible quality of life, for as long as possible, but this can vary significantly between individuals.

Information about metastatic/advanced breast cancer can be found at www.secondhope.org.uk

~

So here I am now living with an illness that will cut my life short one day when the treatment options run out, but I suppose tomorrow is never a given to any one of us. However MOST people will grow old with their loved ones and live to see their children/nieces/nephews move on through their lives, careers, get married and have their own children.

We should perhaps live in the moment more and less emphasis should be put on milestones, but the uncertainty of living with a life limiting illness is not the same as the general uncertainty of everyday living. Nobody knows what might happen when they leave the house each day, but this is different. You do find yourself looking ahead; wondering if you’ll be one of the lucky ones who make double figures, if you'll see your young children hit milestones, guide them through adolescence and less likely into adulthood.

While wading through a sea of uncertainty, I read a comment on a forum about traumatic events happening in our lives for a reason, to make us stronger or help us grow, but this just doesn't sit right with me. Almost immediately I stumbled upon a blog by Tim Lawrence examining the topic of resilience in the face of adversity. He lives with cerebral palsy and epilepsy and believes no one should face adversity alone. He published a post entitled 'Everything Doesn't Happen For A Reason', which really struck a chord with me.

I have never questioned why me? Because I suppose why not me? But like Tim, I cannot accept that there is an underlying reason for the hand I have been dealt. My diagnosis may give me more focus but will taint my life in other ways. Our children may be encouraged into a purposeful life as a result but it will destroy our family unit, and where's the reason in that?  My family, friends and our incredible children do not deserve this, and neither do I.

There is often expectation that the only option in these circumstances is to always think positive but the post reinforced that I can give myself permission to be sad and grieve for the life I had and for my young family's future...this is normal behaviour in the face of adversity.  So between my own abundance of positivity, strength, resistance and even normality, I am allowed to feel the way I do now and again when the waves of grief and devastation crash over me and sometimes continue their onslaught all day. What I have learned though is that on those days I know I can make it out of the other side and pick myself up, and that as long as I do, our family unit will lso will tarnish my life in others. My children may be encouraged into a purposeful life as a result of this but the other side is that it will destroy our family unit, and where's the reason survive for now. Slowly, quietly, never giving up.

I cannot fix this but I will carry it.




http://www.timjlawrence.com/blog/2015/10/19/everything-doesnt-happen-for-a-reasonnnot accept that this needs to happen to me in order for me and my family to grow.


This article has helped confirm that I do not have to think positive all the time as is often expected and unfortunately this is me now so if people can't handle me having negative, down days I cannot use energy on this. I am allowed to grieve for the life I had, the life I want, which is not to be embroiled in stage 4 cancer, and to grieve for my young family's future. In between my positivity and strength I am allowed to feel the way I do on some days when the waves of grief and devastation crash over me and sometimes continue their onslaught all day. What I have learned though is that on these days I know I can make it out of the other side and pick myself up ready for battle again and as long as I do, our family unit will survive for now. I cannot fix this but I will





Sunday, 21 February 2016

A - Z of my year with breast cancer – just for fun…… ~ Tracey

5 Comments so far

A – is for Apple everything – iPad, iPhone, iMac! Don’t know what I would have done without them all. Also for crazy curly Afro hair – seriously it’s just growing out and I’m going to look like a member of the Jackson Five if it doesn’t calm down soon! And Adventures yet to happen!

B – is for Boob – just hope to have a matching pair at some point! Blue Butterflies, Blankets, Bed and Beach! love the beach – I need to get there soon! Blogging and Blogs! Both writing mine and reading a lot of other amazing people’s blogs really help.

C – is for Cuddles with Clover, Coconut, Chocolate, Candles, Cake, Cinderella (my favourite fairytale) and Courage – you need a lot of this with cancer!

D – is for Doggies and Daffodils – both make me so happy!



E – is for Eating, Exercise and E-bay – all of these make me feel good!

F– is for Friends and Family as I couldn’t be doing this without all of your support and help. Also cosy Fires, Fairytales – love a happy ending, Facebook, Flowers, Florida (as you know we hope to get back there – always good to have a dream!), Faith that I’ll get better, but also Fear of the unknown.

G – is for God (I really hope there is one and he can get me through this) and Garden because it makes me happy!

H – is for HER2+ and Herceptin – bad as it is, I’m also lucky I can have this treatment. Crazy Hormones too! But best of all Happiness and Holidays!

I – is for injections – lots – I am like a human pin cushion and my veins ache! Also for Implant of new boob, and Italy as we hope to visit!



J – is for Juicing! Beetroot and spinach literally saved my bloods last year!

K – is for Keep smiling even when it’s really bad and Keep going. Kindness that has been shown to me and my family, and for Kale – which is helping to keep my bloods good – it’s amazing!!

L – is for my Love of Life – cancer does that to you! and of course Lemons! I am totally addicted to lemons – and they’re meant to be good for you too!

M – is for Mermaids, Miracles, Music, Massage, Muga Scans, Making Memories and of course my lovely March Marvel 2015 gang! love you girls!

N – is for NutriBullet and New – as in new me, new boob, new way of thinking, just new!

O – is for One step and day at a time! It’s the only way to do it now! Also for Odd – I feel and look odd – I’m an ‘even’ person so this is difficult for me!

P – is for Phil (my hubby – he’s been amazing), Positive thinking, Pizza and of course Photos and Pictures!

Q – is for Quilts – to keep me busy! always good to have a hobby and to give the children a keepsake.

R – is for Reading, Relaxing and Resting.

S – is for Swimming which helps me to cope with the pain, Sunshine which never fails to cheer me up and warm my bones and Strength to deal with this.  Also Sewing, Socks to keep my feet warm, and Spinach which I eat every day like Popeye!

T – is for Tattoo – which I hope to get to decorate my new boob, and for Turkey – what an amazing family holiday we had there!

U – is for Universe and the Unknown – cancer makes you think a lot!

V – is for Vows, which we hope to renew on a nice beach – not sure when or where yet though!

W – is for Warm (it helps with the pain), Work which I love and gives me a bit of normality and routine and of course Weddings! I love a wedding!

X – is for X-rays and scans – all sorts – have to have lots of these!

Y – is for Yoga which helps the mind, body and spirit – everyone should try!

Z – is for Zoladex – bit of love and hate here but it has allowed me the option of having other medication to keep the cancer away so it has to be on the list.

Z is also for Zombies! ha ha.  May sound crazy but we’ve just started watching the Walking Dead.  I hate horror movies but this is absolutely brilliant! It reminds me that things could always be worse (bit like watching Sky news too!) – you see the world could be over run with Zombies chasing us which is much worse than cancer!! I also love the special effects – really should have worked in the movies!





You can read more about Tracey's experiences at her blog:

https://battleofbritten.wordpress.com/

Monday, 15 February 2016

Who do you think you are? ~ Tamsin

11 Comments so far

When I was growing up, the word ‘cancer’ was always said in hushed tones. Although I knew that my aunt had developed breast cancer in her fifties and that my nana died of breast cancer, the C-word was not something that we talked about openly in my family. My sister and I were referred to a genetics specialist in our twenties and we both remember the doctor’s parting words - “You have nothing to worry about. Go, live your life!” So we did.

I won’t ever forget the Spring day in 2009 when I realised I had breast cancer. It was not long after my fortieth birthday and I was in my step-dad’s garden in Wales. He had died a few weeks previously and I was thinking about how much he would have enjoyed having me and my sister at home. It was during his illness that I noticed a change above my left breast, a few centimetres below my collar bone. Lying back in the grass, I was alarmed to find that the crab-like shape had grown without me noticing. I made an instant decision to return home to see my GP and it came as no surprise when, two weeks later, I found out that I had breast cancer.


My Oncologist asked about my family history and suggested a referral to a Cancer Genetics Clinic when I finished chemotherapy - he thought it was too much to deal with during treatment. I completed a detailed questionnaire about my family history over Christmas, contacting my father - who I am not in touch with - to complete the forms. He told me that I had a half-sister. With a growing sense of fear, I discovered that there was a history of cancer in my father’s family. Although fewer women were affected, their cancers had been deadly. I was desperately sad to learn that my paternal grandmother had died of breast cancer a few days after my birth. We had both been diagnosed at the same age.


In March 2010, the Genetics Consultant explained that all cancers are genetic in that they arise from the action of damaged genes. However, only 5 - 10 per cent of these damaged genes - mutations - are inherited from our parents. In the other 90 per cent or so of cases, the damage in the gene occurs in body cells across our lifetime, a so-called ‘acquired mutation.’ She said that I appeared at a very low risk of having an inherited mutation and I was not eligible for genetic testing. I was offered the chance to take part in a research study looking for other mutations which involved being tested for the BRCA1 and BRCA2 mutations. I agreed readily, wanting to do my bit for science.  


In the year I waited for the results, I began to ‘move on’ as they say. My hair grew back and my body recovered. There were even days when I wondered whether I had actually had cancer at all. I tried not to worry but I think it’s only when you’ve had a cancer diagnosis that you really understand what it’s like to wait for test results; the sick fear that sits like a toad in the pit of your stomach, the bargaining that goes on in your head. My strategy ‘to prepare for the worst and hope for the best’ sounds glib but in reality I end up in a kind of madness, swinging between wild optimism and hopeless despair!


Finally, the day of the appointment came around. Apparently against all the odds, I had a BRCA1 mutation. The news came as a terrible shock. I felt physically sick. All I could think about was my daughter and my sisters. I felt like having the mutation was my fault. I felt cursed. It terrified me.  


In the following weeks, I thought about the positives - ‘At least that explains why I got breast cancer’ or, ‘No one else in my family will have to go through breast cancer.’ It took a long time before I appreciated that I too faced ongoing risk - overall, women with a BRCA1 mutation have anywhere between a 60 - 90 per cent chance of developing breast cancer and around a 60 per cent chance of developing ovarian cancer. Just because I had got one breast cancer didn’t mean I wouldn’t get cancer again, in fact I might be more likely to develop another cancer. I felt like a cancer-bomb ready to blow up.


If your views about what women do when they find out they have an inherited mutation are based on the brave account given by Angelina Jolie Pitt, you might reasonably expect that once I found out I was a cancer-bomb, risk-reducing surgery was a no-brainer. Not a chance! I found I did not want to have a bilateral mastectomy. I had developed a deep fear of hospitals after my first brush with cancer. And anyway I liked having breasts, even if they might kill me. But, I rationalised, I didn’t want cancer again either. I found myself trapped in a Mobius strip of indecision. 


I tracked down other women with inherited mutations to find out about their decisions. Counselling helped me explore what my breasts meant to me, as a woman, as a mother, as a lover. I realised that although I would never ‘want’ to have my breasts removed, I could go ahead with risk-reducing surgery because it was the ‘least worst option.’ Over time, I began to feel empowered by my knowledge; unlike my aunts and grandmothers, I had the opportunity to give myself a chance of living a long and healthy life.


I did go on to have a bilateral mastectomy about 6 months later, but unfortunately, not without complications. A second breast cancer was discovered in the tissue removed from my breast. It was a particularly sneaky cancer because it had not shown up on any scans. The discovery that I would need another course of chemotherapy was devastating and I felt more alone and more frightened second-time around. I focused on making sure I was as well as I could so that I could manage the challenges ahead. I realised how lucky I had been - my decision to have risk-reducing surgery may have saved my life.


I eventually found out that I had inherited the BRCA1 mutation from my father. I had never spoken to my half-sister but after my first diagnosis we got in touch. By the time I was due to get my test results, I had her email address and was very much aware of her waiting in the wings. It wouldn’t be right to share my sister and half-sister’s stories, but it’s been incredibly hard to watch them grapple with their own genetic heritage. Just before Christmas me, my sister and half-sister met for the first time. Our developing friendship has been one positive thing to come out of everything.    


It’s hard to believe that so many women in my family had breast cancer and yet I know nothing about their experiences. I wonder how they coped. I wish that I knew how they had felt and what they thought about their illness. It’s this silence that has motivated me to share my story. I can hardly bear to imagine my daughter dealing with our family history. My greatest hope is that if and when the time comes, I will still be here to support her. I dedicate this blog to her.   





Sunday, 7 February 2016

Annie's Song ~ Annie

5 Comments so far

The Oxford English Dictionary defines resilience as the capacity to recover quickly from difficulties; toughness.  I don't think having cancer requires toughness, because when that breast cancer diagnosis hit me,  I didn’t have a choice.  I went into shock, put my feelings into cold storage, and got on with what needed to be done.  Resilience makes a difference after treatment ends.   That's when the physical challenge diminishes (though it's never over - ongoing medication and the aftermath of aggressive treatment continues) and the mental and emotional challenge begins.  This is my story so far. 

Every morning I wake up to two thoughts:  1) my mother is dead and 2) I've had breast cancer.  Some days they greet me in reverse order. I have not yet found a technique or tool to stop these thoughts appearing as I come round from another poor night's sleep, disturbed by hot flush tossing and turning, discomfort from scars and rib damage, and unpleasant anxious dreams.  But I’ve learned to live with these thoughts, and I let a few tears fall in the shower most mornings, as I wash away the night’s terrors.

Having cancer brought together every negative emotion I've ever experienced, and placed them in a tangled mess spread between my head and my heart.  All my fears came together, all my sadness in one big whoosh, all my anger and grief leering at me, every loss I’ve ever experienced flooded in and stayed, beginning on the day I got my recall letter following a routine mammogram.   

It's probably nothing, the letter reassures, but we would like to see you in a week's time to run some more tests.  I stood still with the letter in my hand, turned to stone, for who knows how long.  It was November 5th 2014, bonfire night.  That evening I cried as I told my husband. 

After that things moved very quickly, and that's when the numbness and disbelief set in. This was happening to someone else, not me. At first the cancer was just a tiny blip of nothing that could be removed by local anaesthetic; next came a biopsy which confirmed lobular breast cancer and then an MRI showed it was much larger than had been picked up on the mammogram.  I was given a date for surgery, December 2nd, and my Wide Local Incision somehow became a Therapeutic Mammoplasty.  The surgeon removed a quarter of my right breast.  I felt violated, un-whole, let down by my body, and I was convinced that I was going to die.

Telling my mum and dad was the worst. In fact I chickened out of doing it, I asked my sister to tell them and I visited the next day to reassure them that I'd be fine, they'd caught it early, there was nothing to worry about.  I painted them a cheery picture I didn't see myself.  I wanted to save them from whatever a parent feels when their child is diagnosed with cancer.

My mum has always been my best friend and never more so than during my treatment.  She was there the day after surgery, so that my husband and son could go to work.  She accompanied me to check-ups and radiotherapy appointments, brought me tea and cake, took me out for lunch, and held me while I cried, like I was her little girl again.

As my date for radiotherapy drew near (I did not need chemotherapy) I developed an infection and I went to my hospital for checks twice a week for 7 weeks before I was allowed to lie on the zapping table.   At last the wounds mended, with the help of the strongest most debilitating antibiotics I'd ever taken, and it was Happy Birthday to you, please come for your first radiotherapy session on your 55th birthday...

By the middle of March 2015 active treatment was complete and I was left with sore burnt skin, scars that seared with pain and tender to touch ribs.  Also a ten year sentence of oestrogen inhibiting medication, meaning I'm suffering menopause symptoms over and over again, along with other side effects such as joint pain and weight gain. 

I went for a meal with my hubby and sons on the day I finished radiotherapy, to celebrate.   I was supposed to be happy, but I was in shock and completely exhausted.  I couldn't eat or engage in conversation.  Every ounce of energy I had was spent, used up on the treatment I'd just endured, and I had nothing left.

This, then, was the beginning of my new life, my cancer journey was over.  Now I could get back to normal.  Ha!  How I wish someone had prepared me for the fallout that came post treatment, the total desolation of constantly being told how glad I should be that it was over, I'd survived. How lucky I was that it was caught early, how fortunate that I only had to have radiotherapy and not chemotherapy.  I didn't feel grateful, I didn't feel full of the joys of spring, ready to jig through my bucket list and to live each moment like it was my last.  And as I didn't feel as everyone was telling me I was supposed to feel, I thought that I was doing something wrong, that there was something wrong with how I was feeling. 

I worried constantly about the cancer returning, I bothered my GP and specialists about every little niggle, I slept in the afternoons and was generally lethargic and unenthusiastic.  I had by now found an online support group, and by interacting with the wonderful ladies there I found out that how I was feeling was normal and ok, and that was the beginning of my recovery.   I attended a HOPE course,  I joined an exercise class, I was offered counselling and Reiki and when the freebies finished I sought out private treatments.  I realised that I had to look forward, not back, and build a new life.  I wasn't going to be able to return to the old one. I wasn't the same person, physically or mentally.   I had already left my stressful job, so I didn't have that to go back to. I was doing a bit of training, meeting friends for lunch, spending a lot of time alone, reflecting, ruminating.  Slowly I was emerging from my winter cocoon, but I was a long way from becoming a butterfly. 

Then two big things happened:  my youngest son left to go travelling and the empty nest blues hit me, and then my mother was taken ill, and so my focus shifted away from my own troubles and I was looking after her.  I think perhaps this saved me from spiralling into depression. Mum died a few weeks later, suddenly and unexpectedly, and I was overwhelmed with grief.  But I had a role to play, stuff to do, supporting dad, sorting out the funeral, looking after my sisters. Just as I had done when my cancer had been diagnosed, I got on with it, and cried a great deal when alone. Mostly in the shower.  My mother's death helped me to deal with all the emotion that I'd held in during my cancer treatment.  I'd had cancer, and my mother had died, and I was still alive.  How amazing, how incredible, how was this possible? 

When I have bad days I sometimes wish that the cancer would return so that I can slip away from this world, because I don't ever want to lose anyone again.  But a precious friend has gone to join mum, and I am, by some miracle, still here.  My feelings have not overwhelmed me, they have not finished me off, I am still able to get out of my bed every morning and show up to wherever I need to be.

Right now I am one year cancer free. There isn't much on my bucket list after all : I'm no sky diver or bungee jumper, my two beautiful boys are my greatest achievement and they are grown up now,  I've had a rewarding career, and I'm a nervous traveller so I'm not too worried about seeing the world.    But I do have a lot more books to read and I have a lot more love to give to the people in my life, and  I hope I can hang around awhile to do that.

Thursday, 4 February 2016

The other side of fear ~ Naz

2 Comments so far

Little did I know that the thought of writing about my fears and anxieties as they related to my breast cancer experience would make me apprehensive. After all, I was an academic specialising in the cognitive and neural underpinnings of emotional vulnerability. I had spent many years of my life studying the brain mechanisms of attention and cognitive flexibility in anxiety and depression, and had become interested in how we could target and influence those mechanisms to reduce the impact of anxiety and depression and boost resilience towards psychological well-being. As the idea elaborated, my fears exaggerated and the whirlpool of mixed emotions was what I experienced – they in fact felt very alive. ‘It will be liberating’ one of my friends said, and while I cherished the idea of that thought, the anxiety about how I would do justice to the description of the many roller coasters I experienced, their effects on my young daughter, on my work and to the person that I am now, concerned me. I broke the ice by putting pen to paper and relished the thoughts that raced through my head, the sensations that rushed through my body, and the tears that found their ways to the surface. Three years ago, at the time of my breast cancer diagnosis on the 2nd of January 2013, I would have never been able to see this day, me: alive, at work, vigilant, and eager to tell the story. And yes, in a strange way, it felt rather liberating.

Resilience has been defined as the process of adapting well in the face of adversity, trauma, tragedy, and injury. Resilient people are flexible and able to regulate their emotions as necessary. They are able to embrace their feelings and thoughts and not fight them. Emotions signal to us what is important, and as such should not be ignored. They are what makes us human, dynamic and insightful. Resilience is also dynamic and fluid and a much desirable thing to have when confronted with a breast cancer diagnosis. 

It is estimated that every 10 minutes a woman is diagnosed with breast cancer in the UK (Cancer Research UK, 2014). With medical advancements, a large proportion of sufferers live years beyond their diagnoses. However, the negative psychological impact of diagnosis and treatment on cognitive health, predicts the development of anxiety and depression in a significant proportion of women.  Diagnosis at a younger age is a risk factor for vulnerability, cognitive impairments and their consequent impact on career and responsibilities of a young family. Survivors face fear of recurrence, loss of fertility and early menopause due to medication, altered physical image due to major surgery, changes in sexuality and fear of mortality. Psychological interventions are sparse and the effectiveness of the existing treatments highly limited. Many women continue to doubt their abilities in the jobs they once used to hold and suffer enormous insecurities in the work place.

Every year 2.6 million women with a breast cancer diagnosis are told that they should be grateful for a second chance to survive. The experience of fear and hope are very much mixed for a patient diagnosed with breast cancer. She is fearful of the consequences of cancer diagnosis and treatment, but also hopeful that with appropriate treatment she can get better. ‘I have a treatment plan’, I thought. I was confident that I could cope well. Multiple major surgeries, extensive chemotherapy for four and a half months, and a long course of radiotherapy took just over a year to complete. The depression, the exhaustion, and the side effects of treatment were overwhelming. Chemotherapy had left me suppressed emotionally, physically in agonising pain, brain dead, fatigued and dissociated from the self I knew. I was hospitalised with Sepsis three times with heavy antibiotics and blood transfusion. If chemotherapy was killing the cancer cells, it was killing billions of good cells to achieve that aim. Ella, my daughter, who was only 3 at the time was my inspiration to fight, but what if I could not make it? what if I could not be there for her? How will she cope? I am everything to my daughter and she is everything to me. How do you explain the implications of breast cancer to a child who is 3 years of age? ‘Mummy you will get better’ she kept telling me with fear in her eyes. ‘Mummy, I had breast cancer too, but now I am better and my hair has grown back and my breast is not sore anymore’. As treatment continued I was hopeful that I would regain my life and my confidence. I will be able to think clearly, to get rid of the chemo brain and mental fog, the fatigue that crawled on every inch of my body, the emotional roller coasters. Little did I know that my journey would start only after my treatment had ended.

‘You are looking so amazing, Naz’, ‘you can now put that chapter of your life behind you and move forward’. ‘Move forward’ was all I heard from everyone. You have fought so well Naz, even managed to write articles during chemotherapy. You are a role model for everyone.’ Yet I felt at rock bottom with a mixture of fears, compassion for others, smiles and confidence. Alone in an ocean trying to find my way to the shore. The waves were high, they were scary, and kept pushing me back to the deep end, no matter how hard I fought. Perhaps I need to fight harder, I thought. Why am I depressed when I should be happy and grateful for a new life? Someone like me should know better. Who am I? Am I the same person, or a different one, a stronger person or a weaker one? Expectations for regaining what was lost were overwhelming. I wanted to scream as I wanted to many times during chemotherapy but couldn’t find my voice due to emotional numbness. I was looking at myself through a glass that could not be broken, I could not touch me, I did not know me, I did not know how to reach me.  Everyone knew me as a positive and optimistic person, always smiling and strong, full of opinions and vocal. But in a paradoxical way, the fear, the agony and the pain felt somehow to my strength, I could identify with them. They seemed to lessen when I listened to them and accepted them. They are part of me, but they are surely not me. I am a changing person.

What does it mean to survive? We live with the assumption of being immortal even when we know we will one day die. Yet the fear of our own mortality in a paradoxical way makes the battle for survivorship harder. Fear has the power to numb our feelings when we fight it, and it has the power to make us stronger when we embrace it. It can guide us when helpless. It signals what is important to us, and as such should not be ignored. How can we foster resilience in the shadow of cancer? To keep going amid the fears fuelling every breath, for our loved ones, despite knowing we will have to let go of what is no longer ours.

As time passed by, Ella began to understand more about breast cancer and she now writes stories about it, she is five years of age and a rising star. She has told us that she wants to be a teacher, so that she can teach doctors about cancer. I cherish my moments with her with great intensity, the emotions are overwhelming and exciting when I am with her, because I am aware that I am not guaranteed tomorrow. I somehow have to believe that she will be OK. As time passed by, I became determined to translate the neurocognitive interventions I was developing in anxiety and depression research to targeting emotional vulnerability and promoting resilience in breast cancer. Through our efforts we were successful in obtaining some funding to pursue research into building resilience in survivors of breast cancer. Jess Swainston, my PhD student, is pursuing this work under my supervision. The research prospects are exciting yet scary. I recall my oncologist saying: ‘Is it too close to home Naz?’ But that made me more determined. After long deliberations I decided to set up the Centre for Building Resilience in Breast Cancer where I founded the private and closed support group: Building Resilience in Breast Cancer. We grew from two members to over 290 members in just three months. Along the way, I met the two sisters I never had: Tamsin and Vicky, who run this educational support group with me. In addition to psychological support that our members provide for each other we engage in research led debates on advances in the psychological aspects of breast cancer research. I have spent a life-time in education but for me the wonderful ladies I have met through my breast cancer journey, as well as my the many thousands of students that I have taught and the numerous that I’ve supervised, have taught me far more than I have ever learned as a teacher, a student, and child. There is a silver lining in everything we experience.

I have high hopes for our centre to expand, flourish, and reach out to the thousands of ladies affected by this deceptive silent disease. And I am somehow confident that we will achieve this aim.