Today we’re welcoming Ruth Barry from North Dublin to share her story with us. Ruth gives some fantastic first-hand advice for a breast cancer journey, we hope you find her story helpful and inspiring.
Your name, age and where you’re from
My name is Ruth and I am 37 years old. I live in North Dublin with my partner and two beautiful children aged 17 and 5. Over the last 18 months, we have all been through the trauma of a cancer diagnosis. When your life is threatened you go into a bubble and it is only when you come out the other side that you start to take control of the effects that cancer has had on your emotional wellbeing and close relationships. Although, it is not always easy to adopt healthy attitudes, the positivity of family, loved ones, good friends and work colleagues has gotten us all through the last year and a half. That is what is important in a diagnosis is seeing that you are well loved and cared for. This is my story.
Your diagnosis story
In January 2018, I had a car accident and thankfully I was okay. But when I got back home that day, I noticed a small hard lump in my right breast. I was concerned and it was Sunday evening so I rang up my GP surgery the following day for an appointment. My GP has a system where if as a patient you need an emergency appointment it is usually after 3.30pm. The locum doctor was there as my GP was on annual leave but it didn’t matter to me because of the concern I felt for the presence of the lump. I told myself that not all lumps can cancerous but looking back now, I was in total denial. I was really scared but I tried not to worry about it. I was referred to my local Breast Health Clinic in Dublin for a triple assessment within a two week period as the Locum Doctor was concerned. I have no prior medical history of breast cancer but there have been cancer deaths on my fathers’ side. That is the emotional space you go to straight away; cancer = death. But I decided that I couldn’t allow fear to control how I was going to respond so I buried the worry of it until I went in for the triple assessment. I was still completely in denial so I decided that I would go in on my own. I turned down four offers to accompany me, including my partners. I thought it was going to be good news. But it wasn’t. The day of the triple assessment arrived and I was really nervous. I am studying an Arts degree in DCU ConnectED, a distance learning program for adult learners at third level, so I had plenty to keep me occupied. I was there for the whole day from 9.30am to 3.30pm. I filled in the triple assessment form, and after about 15 minutes I was sent in to see the doctor to examine me. The doctor, whom I later found out was a breast augmentation surgeon, examined me and said she would be back in to introduce me to a breast care nurse. When she came back with the nurse, she was concerned and told me that I need to go for mammogram. While she left the room again, the breast care nurse gently explained what this procedure involved and that it was like an x-ray but of your breast tissue. I was sent back out to the waiting room. And again, my coping strategy was to completely ignore the voice that kept telling me that this was not going to be good news. So, I waited for the mammogram and at this stage it was 12.30 so I was starving and I asked the secretary could I go and get something to eat. The secretary said that It was fine but then my name was called from a lovely radiologist who said I needed to take a seat downstairs to wait for the mammogram. I had the mammogram and I asked could I pop off to get something to eat in the hospital café and she said that I could. I had been there since 9.30am and it was likely I would be waiting for another 45 minutes. I was really worried at this stage but I ate and went back to the clinic. I was called in for the mammogram and the radiologist said that I couldn’t leave the clinic just yet that I needed to get a biopsy done and that after that the doctor wanted to talk with me before I left. It was after the biopsy that the breast surgeon who examined me broke the news. She was so empathetic and I could have imagined this, but I think there were tears in her eyes as she was telling me. I was completely shocked. I reacted like as if she has just told me I had a cold. But on the inside, I was really scared and felt like a small child. The surgeon and the breast care nurse explained at this stage that they did not know what they were dealing with but it was definitely some type of cancer that needed surgery. So, I went back to work and I couldn’t tell you what I did. I rang my partner and told him that I had had a biopsy done but I was leaving work early to get home. I just wanted to be around my children and my partner and I didn’t even want to tell him; the word cancer had not been mentioned until I spoke with him face to face. Really, if I had have said it out loud, I was afraid that it was real. But you do this to protect yourself. I didn’t break down and cry until two weeks later when I got the results and I landed at the door of ARC house after work.
How did you feel when you were first diagnosed?
To be honest, I did not know at the time how I felt exactly because I think I experienced every emotion in the 8-week period before I had my surgery. But the biggest emotions I felt were fear, anxiety, grief, loss and anger. I felt alone. Vulnerable and like I was labelled. I felt lost and my life was threatened. So, I was really stressed but because I have children, I couldn’t break – not an option for me. I had to keep strong for them because I am their Mam. I decided I was going to survive this. I kept strong and then I cried privately. That’s what you do being a parent. I had many a cry and scream into a pillow when no one was at home. It is how I coped. Other people cope differently and that’s okay too. My partner and I didn’t talk about the emotional impact but we did discuss all the practicalities like child-care, finances and he re-assured me that those things he would take care of. He asked me to trust him to care for me and support me and I completely surrendered to that. I feel it’s important not to allow pride to hold you back from support because your family only want to help you and it’s important to entrust that they will. So, all the negative emotions I experienced had left me by the time I had my surgery. I say left me, I parked them so I could get through my treatment plan.
Your treatment plan
Two weeks after the triple assessment I received the results at the clinic. My Breast Surgeon and Breast Care Nurse are amazing people and I am so thankful they supported me and my partner that day. My surgeon explained that my breast cancer was stage 2 with a possible invasion to the lymph nodes, what is called a ductal carcinoma in situ, and that it was estrogen positive. It needed a full mastectomy with marginal clearance surgery. All this sounded like gobbidly gook to me but I knew that I couldn’t focus on exactly what cancer I had. All I wanted to know was what the surgery and treatment plan were going to be. So, my nurse explained to me exactly what was involved and that the next step was to get a PET/CT Scan to be able to grade the cancer a little more thoroughly. She was so gentle and I felt like I was in really good hands with my surgeon and breast care nurse. My treatment plan involved a total mastectomy with lymph node axillary clearance, 6 months of chemotherapy, 6 weeks of radiotherapy and hormone treatment. All of this would take a period of at least a year and Sinead explained to me that it would be pretty intensive so it was medically recommended to me that I take time off work to complete the treatment.
How did treatment go for you?
It wasn’t easy, the treatment. First, I had 3 months of Adriamycin and Cyclophosphamide (AC) and then 12 weeks of a drug called Taxol. I lost my hair and had some issues with nail discolouration. The hair loss wasn’t so bad for me but it was really shocking for my family to see. But what kept me going throughout it was that I knew it was only temporary. I listened to the cancer nurses about taking medication for managing the side effects, drank plenty of water, ate as best I could and went to bed when I needed to. I also exercised as best as I could. I like walking so I didn’t stop doing it, I just changed the pace so I could get a bit of fresh air each day. I didn’t experience too many side effects and only had a temperature once throughout the chemotherapy. Eventually I got to the end of my chemotherapy in December 2018 and started the radiotherapy sessions in January 2019. This lasted six weeks. I had a small radiotherapy burn but it healed up. It got pretty tiring towards the end of the treatment but that soon came to an end also. I started the hormone treatment in March 2019 with Tamoxifen. This did not agree with me so I was switched onto a different medication called Exemestane with Zoladex injections. This is to suppress the estrogen in my system because my cancer was ER positive. I can honestly say the effect these drugs have on your mental health should not be underestimated. I spoke with my GP about how I was feeling and she explained to me that I was feeling so down because the estrogen in my body had decreased and women usually go through what is known as the peri-menopause period gradually over time. My doctor said that depression is a very common symptom of the menopause and a lot of women find taking a mild anti-depressant helpful. So, she prescribed a 15 mg dose of Mirtazapine. I take this at night time and I have to say the difference has been amazing. I sleep the whole night now whereas before I would wake up with night sweats and was really tired during the day. I felt that it was the right decision for me and the difference in my quality of life is noticeable. I would recommend that anyone experiencing symptoms of depression to seek medical advice. The oncology teams are amazing but they really only look after your treatment plan. Your wellbeing is mostly up to you to take care of. That is one thing I have learned in being ill is that most of the resources are there, you just have to reach out to them. I found the Daffodil Centres, Arc and my GP fantastic supports for me through treatment.
Worst/best part of treatment
The worst part of treatment is not having access to psycho-oncology services. You are very vulnerable and lonely – even though you meet other people who are going through chemo, radiotherapy etc – public health policy needs to change to provide wrap-around services to people experiencing serious illnesses. I attend one of the largest hospitals in the country but yet there is not one psycho-oncologist there. I am lucky I have a really good GP who is able to refer me to community mental health services but not everybody has access to these services. After you finish the intensive treatment you go through a separation anxiety almost because you don’t have your medical team there every week or every three weeks. You feel a little isolated and it is then that you need your people around and extra supports to increase your sense of wellbeing. The best part of the treatment is the sense of empowerment you feel when you are done. You feel like you’ve conquered and achieved something. It’s very complicated because you also feel guilty for surviving but it’s important that you realise these are very normal feelings. They usually pass. It’s important to tell yourself and that you are capable of feeling what you feel and not try to suppress or influence your feelings. Having a channel for your feelings is a really good idea whether its’ gentle exercise or spending an afternoon with a friend. Do what makes you feel good as long as your safe and the people around you are.
What got you through treatment?
My family, friends and loved ones were amazing. Arc House in Dublin was instrumental in how I looked at my cancer experience. I was put in touch with the Look Good Feel Better program which empowered me to take care of myself. If there is a program near you, I recommend you attend it. I also did the Stanford University Thrive and Survive™ course with Arc House. It is a six-week program designed for people who have been through cancer treatment. It has given me so many tools to be able to thrive. I also discovered Happy Magazine and it has opened up a world of supports for me. Knowing that my cancer was gone during the operation and that my treatment was preventative treatment helped. A cancer nurse told me that that is the best news to be told your treatment is preventative. That really gave me hope that I could survive this cancer.
Single best advice that helped you
Drink plenty of water and soak your feet in diluted apple cider vinegar to prevent nail damage. Doing the Look Good Feel Better program. An Arc service user told me that he looked at his cancer as being a way to get to know who he was. He was right. I found that I discovered who I am. And who I am – I love. I used to put myself down a lot but I don’t do that so much anymore. I learned from this man I met that self-care and self-compassion are very important in cancer recovery.
Where are you now/how are you now?
At this time, I am in a vulnerable space but also in a time of re-discovering who I am. I feel hormonal all the time. But I’m starting to use resources to help me through this period. I have found that taking the Mirtazapine really helpful as I am able to get a good night’s sleep and it has eased the menopausal symptoms slightly. I am happy that I have survived but I also feel angry with certain elements of social policy that have led me to draw upon my resourcing skills. I am working on this all of time and tell myself that I am doing my best.
How do you feel about your cancer experience now?
I feel like I have just stepped through the other side and have escaped. Sometimes if feels like I have been sucked into a jet engine and have come out of it with minor cuts and bruises. My cancer experience could have been more serious if I had not have gotten to the GP at the time that I did. I have had many beautiful people say prayers for me, offer very kind words and have been there for me in the truest sense of the word. I am very thankful that I have entered survivorship. I live each day as it comes to me and no longer worry about small things.
Has cancer changed you, if yes, how?
I used to be a very stress prone person and I am no longer a beacon for stress. I am tuned into my body more than I used to be. My relationship with myself has changed and so this has led to my personal relationships changing also. Most of this has been positive. I look at myself as having a new identity and I am really happy with the person I am. I don’t rush around so much anymore. I do get angry quite easily which is something I am constantly trying to improve on through Cognitive Behavioural Techniques. I would recommend talking with a trained psychologist, psychotherapist or psychiatrist if you are finding it difficult to manage your emotions after cancer treatment. A sense of loss of control is very common after being through a trauma so never feel ashamed or embarrassed by strong emotions. We can always re-learn habits and feeling emotions is a very human response, including anger. One thing I do is take deep breaths and count to three when I come across a situation where I start to feel angry.
Have you changed anything in your life as a result of cancer, if yes, what and how?
I eat a lot healthier than I used to and exercise a lot more. I am no nutrition or fitness fundamentalist but I certainly question the sources of food more. I also tend to be cautious about beauty and skincare products as my skin is quite sensitive. I also delegate tasks a lot more. I don’t take on other people’s burdens anymore either. Having cancer has taught me that you only have one life and it is best not to worry how things will work out. It is best to just plan a little and allow whatever to take place and deal with issues as they arise instead of trying to control every eventuality.
What helps you now if you have a difficult day?
I find that taking time for me and being gentle with me very energising. I also listen to calming music and take warm baths with lavender and neroli oil. I find sitting in candle light or being out in nature wonderfully therapeutic. I also write down a lot of my feelings in a journal. The pen and paper don’t judge me and don’t talk back. I also find watching a comedy with my partner, Comedians in Cars Getting Coffee is something we watch together. Also playing and being with my children helps. Reaching out to someone you trust helps – telling someone you’re having a difficult day can help people to see that you need a little time for you. Most supportive people will ask what they can do for you, so try to accept help when it is offered.
Single best purchase that helped you through cancer
My ID brow shaper and pencil. My chemo hats from a website called hairlessbeauty.ie. A hand-held fan. A blank journal and pens.
If you could give one piece of advice to someone recently diagnosed, what would it be?
Listen to your medical team and cancer nurses about managing side effects and tell them everything that you are experiencing in between appointments. Writing down and scoring your symptoms can help the Oncology Team see a pattern if you’re experiencing particularly hard side effects. Your Oncology Team can help you with side effects and many other issues that you experience with a cancer diagnosis.
Our sincere thanks to Ruth for taking the time to write this excellent piece for us.
Great story Ruth. Thank you for sharing. Yes, it’s sad that Psych-oncology is lacking in Ireland but there are some good qualified therapists specialising in this area, like myself, in all mental wellness disciplines. Your GP should be able to make a referral to a therapist.