Menopause AND Breast Cancer Awareness Month
And why, this year, I'm banging the drum about both
October is both Menopause AND breast cancer awareness month.
Menopause and breast cancer will be utterly unique experiences to each individual going through them but as someone who has now had exposure to both, I thought I’d share a little about what I’ve learnt along the way.
Awareness (noun)
knowledge that something exists, or understanding of a situation or subject at the present time based on information or experience
If you’ve sat in my salon chair since 2017 then the probability is, at some point, our conversation has likely turned to cancer.
I’ve experienced breast cancer myself, as well as subsequently discovering that a genetic mutation I have carried since birth (BRCA1) was at the root cause, also putting me at risk of ovarian cancer.
Ever since, I’ve become passionate about sharing my experiences and knowledge in the hope that it raises awareness and encourages others to be vigilent. It almost feels like a duty of care to keep these conversations going, especially with a female based clientele.
(although it’s important to remember that breast cancer isn’t exclusively a female disease!)
A BIT ABOUT BRCA
75% of the general public have never heard of BRCA mutations.
If you’re in the remaining 25%, there’s a good chance that you might know about it due to Angelina Jolie speaking publicly about testing positive for BRCA1 back in 2013, or perhaps you already have the knowledge that it runs in your family.
The name ‘BRCA’ is an abbreviation for ‘BReast CAncer gene’. BRCA1 and BRCA2 are two different genes that have been found to impact a person’s likelihood of developing cancer.
Every human has both the BRCA1 and BRCA2 genes. Despite what their names might suggest, BRCA genes do not cause breast cancer. In fact, these genes normally play a big role in preventing breast cancer. They help repair DNA breaks that can lead to cancer and the uncontrolled growth of tumours. Because of this, the BRCA genes are known as tumour suppressor genes.
The problem is, that in some people (around 1 in every 400) these tumour suppression genes do not work properly. When a gene becomes altered or broken, it doesn’t function correctly. This is called a gene mutation.
The gene mutation is not capable of carrying out the normal repair process to DNA when required so in the event of any cells becoming abnormal, cancer may begin to form and find an opportunity to grow without intervention.
BREAST CANCER DIAGNOSIS & GENETICS TESTING
After discovering a painful lump almost 6 years ago, visiting my GP and being referred to a breast clinic, I was diagnosed with breast cancer just days before Christmas. I was 33.
Due to my young age I was immediately referred for genetics testing which concluded that I did in fact carry a BRCA1 genetic mutation.
This means that completely unbeknown to me or my family, since the day I was born, a seemingly healthy baby girl, I had secretly been carrying a ticking time bomb of increased lifetime risk of breast cancer by up to 90% and ovarian cancer by up to 60%.
This was a major discovery for our family. My Dad lost his Mother to breast cancer when she was in her early 30’s too but to our knowledge it was an isolated case.
Dad was tested - his result, positive. Parent carriers have a 50% chance of passing the mutation on to their children.
I am one of 3 siblings and guess what?! All 3 of us tested positive, a hereditary hat trick!
A genetics test is not compulsory and is a very personal decision. Some people may simply not wish to know but for me, the discovery has meant that I’ve had choices in terms of managing health care and family planning options and thats why BRCA testing is so valuable.
Knowing your BRCA status can affect your treatment pathway if you are diagnosed with cancer and provide a significant opportunity for preventing future cases of cancer, for both you and your family members.
You can discuss your family history of ovarian, breast and other cancers with your GP, or oncologist or CNS and ask to be referred to a cancer genetic centre. Most centres offer testing to families with at least two people affected by ovarian or breast cancer from the mother’s or father’s side.
When chemo ended, I was jubilant to discover that it had been successful, the tumour had all but disappeared and a lumpectomy was the minimum surgery now required to gain clear margins, however, the BRCA1 factor meant that things didn’t quite end there.
There is no way to ‘fix’ the faulty gene. So the options are, you either sit tight and be vigilant, look out for any changes and attend screening* where possible
(*Interesting fact: As of yet there are no screening practices in place to check for ovarian cancer! A smear test cannot detect this disease! Symptoms can be hard to spot, so by the time it is diagnosed, it has often progressed to a later stage)
Or alternatively, remove as much of the ‘risky’ tissue from the body as possible to reduce the chances of a new cancer forming again down the line.
I opted for the latter.
RISK REDUCTION SURGERIES
On the one hand I wanted to be proactive and give myself the best possible chance of avoiding any further cancers but these risk reduction options are not without their own complexities.
It’s been a delicate balancing act of weighing up pro’s against cons and trying to choose the right time to complete each procedure.
Shortly after my breast cancer treatment, I opted for a bilateral mastectomy with immediate implant based reconstruction.
More recently in August, I completed a bilateral salpingo-oophorectomy to remove my ovaries and fallopian tubes, a life changing decision that means I no longer have to worry about developing ovarian cancer but the trade off is instant menopause and accepting that I will now never have a baby.
Accept it I have. We’ve had 5 years since treatment ended to think everything over thoroughly and even though a life without kids was not one we had initially planned, we are definitely getting used to the idea of how our new future looks and I’m completely at ease with our decision. (I think in part, this is due to the fact that it was still our decision to make, rather than being robbed of fertility during cancer treatment.)
SURGICAL MENOPAUSE
So what does being 39 and menopausal look like? Well so far, speaking personally, it’s not too bad. It’s very early days but my symptoms aren’t too severe at the moment (and I’m crossing my fingers that it stays that way)
Although that’s not the reality for everyone.
A surgical menopause literally happens overnight, one day you aren’t in menopause and wham! the next day you are. No gradual decrease in hormones, no easing in gently, it all happens within 24 hours.
The biggest area of concern for me right now is how I can protect my bones, brain and cardiovascular health, as who knew?! removing your ovaries puts you at increased risk of things like heart disease, osteoporosis, early onset dementia, anxiety and depression and now this degeneration because of surgical intervention is starting around 12 years prematurely for me which is far from ideal.
SEEKING SUPPORT
So where do you turn for help with menopause after cancer? Good question!
Signed off from oncology and surgery it’s back to the GP, but not all GP’s have specialist menopause training and even if they do, a complex history of cancer can cloud the water with opinions on HRT and traditional advice.
Here lies a massive gap in care post cancer treatment.
A gap that wonder woman Dani Binnington has recognised and attempted to single handedly fill since launching her website Healthy Whole Me, her not for profit MenopauseAndCancer.org and her podcast of the same name. This has all been an absolute godsend to me in recent months!
CHARITY WALKING CHALLENGE
Sadly, since my diagnosis, as statistics would have it, a number of salon guests have also subsequently been dealt the cancer card themselves. 2 of them also in their 30’s, both also now in menopause.
On Sunday 3rd December 2023, a team we have created together ‘The Salon Stompers’ will be completing a walking challenge, a half marathon distance of 21 km along the Thames to raise funds for Dani’s not for profit Menopause and Cancer.
I love walking! It helped me a lot during treatment and recovery and exercise can help reduce your risk of cancer recurrence by up to 30%.
Menopause and Cancer aims to bring together a community of people with a community of experts for a more supported, better informed and empowered menopause experience.
The money raised will help support programs, workshops, resources and events, both online and in person, for anyone facing menopause after cancer.
If you would like to consider making a donation please follow this link to our fundraising page. (*no longer active)
Thank You for reading, I hope you have learned something new!