Reading about Angelina Jolie’s decision to have her ovaries removed has made Tracey Cheetham reflect on her own journey through surgery.
My first mastectomy was because I had breast cancer, my second because I didn’t want to live with the risk of it occurring again. My ovaries and fallopian tubes were removed – at my request – because of my family history of ovarian cancer.
The first operation was easy to agree to. When the consultant told me I had five tumours in my left breast, I would have jumped on the bed and let him hack it off with a rusty pair of scissors right there and then. From then on, I was suspicious of my right breast. I didn’t trust it at all; it also felt a bit strange to me, having one quite large breast and nothing next to it. In fact I just wish having the second breast removed had been an option when my first mastectomy was performed.
More traumatic was the reconstructive surgery. My husband Tim tells me that post-surgery, I had more wires coming out of me than the back of the TV. I had wounds on my front and back, was in a lot of pain and wasn’t well for a long time.
Managing risk is something that is becoming ingrained in all of us and genetic testing is a brilliant development that allows women to know if their cancer risk is high. Thankfully, unlike Angelina, I tested negative for both BRCA1 and BRCA2, but there is still research looking for mutations that are as yet unknown, so the team will keep my samples and if they find another, I will be automatically checked for it.
This process gives a woman, who knows she has the mutation, the option of taking radical action to reduce her chances of actually developing the disease. It shifts the balance of power away from cancer in favour of the woman.
My risk is higher because my Mum had ovarian cancer and then I discovered my breast cancer at 35 – who knows how long it had been there? To me booking in to have my ovaries removed just a few weeks after my second masectomy was both logical and simple.
At least it did right up until the operation. I had been thinking about being a woman, having babies, (I have three, they were all still quite young) and all of the things that go along with that.
I still had the trademark chemo-cut, remained very bloated from the after-effects of the steroids and emotionally, I had been through an incredibly damaging time, facing my own mortality, the fear of leaving my husband and children. In truth, I was in no state to make such a huge decision. I remember asking a nurse, “I have no breasts, if I have my ovaries removed, how am I a woman?” Thankfully, she recognised that I needed time to come to terms with what I had been through and the potential consequences of what I was planning to do.
Now, obviously, Angelina Jolie is still a woman, I am still a woman, it is not just a couple of appendages and egg sacks that make a woman. Being a woman is a complex mix of genetics, hormones and attitude; but at that moment in time, that fear was so real. The mental recovery from cancer is far more difficult than the time it takes to physically heal. I sometimes wonder if it ever is completely possible.
It took a recurrence of my cancer to make me determined to have the operation, so three years ago, I had a prophylactic bilateral salpingo-oophorectomy, the same operation as Jolie. I do admire her for having the procedure, because the consequences of the operation are huge, permanent and the risks are not to be dismissed lightly.
For most women, they go into menopause gradually. Oestrogen production reduces and your body adapts to cope with that. For someone who has had their ovaries removed, full menopause is achieved immediately. BANG! The shock to the system is immense.
All of those menopausal symptoms you know or read about, rush in; hot flushes, mood swings, for me also migraines, joint stiffness and so on... There’s also no oestrogen therapy to relieve it, because my cancer used oestrogen to grow; then there is the heightened risk of osteoporosis, so I have to have bone density scans too.
It isn’t a case of having the op and then everything is ok, because on some level it will never be ok. Like Angelina, (oh, I have said it again!) I have a daughter. This means I am fearful of passing my risk/faulty genes on to her. Yes, I know it is a quirk of nature, but as her mother, I should be able to protect her from anything and this, I cannot.
After reading about Angelina’s surgery, it made me think about the choices I have made on this journey that I never asked to take. Along with all of the awful, negative things, there have been some positives too. Last year, I did an evening of stand-up comedy where I joked about my NHS boobs to raise money for Weston Park Hospital, where all of my cancer treatment was managed. I have met amazing people who have also been through similar experiences and I surprised myself with how strong I really am.
Removing my breasts and ovaries has not made me less of a woman; it has made me a tougher, more bolshie warrior and that is a good thing.
I hope my own daughter sees these positives and when she grows up, understands that she is a strong, resilient woman too, no matter what is in her genes. I hope that she too will make well-informed, logical but personal choices about what is right for her.
It is easy with cancer to scream “IT’S NOT FAIR!” because it’s true. The impact it has on the patient, their families and the rest of all of their lives is profound, but by managing risk when we can, we take a little of that control back.