Acknowledging that breast cancer has a significant impact on the patient, their relatives and their friends, we, the editors, decided to ask Sue to share her story. We spent an evening with Sue and her husband, Colin, to explain about this book and what we wanted from them. They readily agreed to help and during that evening, with the help of Colin, Sue told us her story. It was riveting and moving. Sue and Colin then spent the next few weeks reflecting and making notes, ready for Sue to write her story – the big journey.

Sue’s story is a good starting point for this section of the book, as it provides a real example of a patient’s experience, prior to diagnosis through treatment and her return to work. With Sue’s story in mind, subsequent chapters highlight psychological theories and concepts that might prove valuable in caring for patients. Here is Sue’s story…

I would say that life was going particularly well. I had just completed a gruelling interview and been appointed as the Head of one of the largest schools in the borough, my husband was doing well following open-heart surgery 3 years previously, we were established in our new home and my daughters were settled in school and University respectively. I was fit and healthy and we were enjoying life.

I suppose that at the back of my mind I always had a nagging thought about getting breast cancer- my Mum and Aunt both died of the disease and I had first hand experience of its impact. I did think that, like them, I had until my ’60s until I was really at risk, however!

It was on New Year’s Day 2010 that I discovered a lump. It felt quite hard and unlike the surrounding tissue. As a trained, registered general nurse I suppose I was always a little neurotic about lumps and bumps. With a high level of anxiety, I decided to go to my general practitioner (GP) doctor. I initially saw a male doctor who told me he wouldn’t examine me and that I should see a lady doctor the following week. When I saw her she examined me and said that it “Definitely isn’t cancer” and that I should return in the future if I was still worried as it might be hormonal and may alter with my periods. This was music to the ears and, I admit, I did try to forget about the lump, convincing myself that that part of my breast had always been rather lumpy.

Three months later I was having a break in a touring caravan busying myself with a spot of vacuuming when the machine bellowed out copious quantities of dust- this made me extremely wheezy and I ended up in the local accident and emergency centre on a Salbutamol nebuliser. This restored me to the joys of normal breathing and I was advised to go to my GP to discuss my diagnosis of Asthma. This event, indirectly, started the treatment for my breast cancer. When I saw my GP I mentioned, almost in passing, that the lump in my right breast was still there. She examined me and reiterated her opinion that it wasn’t cancer. However, she did suggest that I visit the Breast Clinic at our local hospital.

The appointment was made and I attended on my own as I was sure that there wouldn’t be a problem. My visit took the form of a series of experiences. As I was just 50, I had never had a mammogram before and this was the first stage of the visit. I approached the machine with trepidation. The lady performed the procedure in a fairly perfunctory way and I was amazed at the level of pain that the procedure caused. I was so relieved to leave the room and I went out to wait for the next stage – the meeting with the Registrar. She was delightful! She examined me and said she could feel a lump but she was unsure about whether it should cause concern. She said the only way to be sure was to have a biopsy. What was to follow was, I think, one of the worst parts of the visit beaten only by the diagnosis.

I went into a darkened room and was asked to lie on the couch. The radiologist used ultrasound to establish the location of the lump and he let me know that he could see it on the monitor. He told me that he was going to take some core biopsies and that he would give me a local anaesthetic. When this took effect, he cut me (no pain- phew!) and at this point I realised that I was becoming frightened. I asked the nurse who was in attendance if I could hold her hand which she did. I feel that I might have coped better if I had been distracted by small talk rather than waiting and having time to reflect on how awful this experience might be. The nurse merely watched the procedure. The radiologist then pushed a needle (much larger than I imagined – I thought it would be the size of an injection needle!) into my breast and then he told me that there would be a loud click. I think this was a vast understatement. I thought that I’d been shot – the force was quite startling and by the third shot, I had become a little more relaxed, if that was possible. When I was dressing, the nurse told me that I had been very brave. I thanked her for her support.

I went back out into the waiting room. As I sat there, I realised that this trip was far more of an ordeal than I had hoped for and I wished that I had someone with me – even as a distraction to talk to and to put on a brave face for. I read all the booklets I could find (I found a magazine of mastectomy wear particularly disturbing). After what felt like an age, I was called back into one of the Consulting Rooms. I sat on my own in a small room waiting, trying to read as many notices in the room to keep my mind busy. Eventually, the knock on the door came and the very pleasant Registrar came in accompanied by a nurse. They both looked rather sombre. I felt the bottom fall out of my stomach. She said that they were very concerned about what the investigations thus far had shown. She said that I was to return in 1 week for the results and that I should bring someone with me. She said that they could do wonderful things nowadays and that “Our ladies do particularly well at our hospital.” I remember thinking, “But I don’t want to be one of your ladies!” The rest of what was said was something of a muddle. I heard mention of using chemotherapy before an operation, mastectomies, lumpectomies and reconstructions. I felt totally overwhelmed. I asked how fast things would progress in terms of treatment and she replied, “Very fast.”

Bizarrely, my main thought was, “What am I going to do about the new job I’ve just accepted?” I actually shared my concern with the two staff sitting with me in that room. The registrar simply said, “Let’s just wait until we get the definitive diagnosis next week.” What followed was the longest week of my life.

On leaving the clinic in something of a daze, I phoned my husband on the way to the car and told him that the doctor was concerned about the results of tests. I don’t know how I travelled home along a busy A-road with tears blurring my vision. When I arrived home, I fell into a heap of uncontrollable sobbing feeling that I was the main character in a nightmare. I was still totally fixated on what I was going to do about my new job- it seems amazing that I had such concern for something so relatively trivial but I suppose deep down I wanted my life to be as settled around me whilst I concentrated on the battle ahead. I phoned my good friend from work and told her the news and then I contacted my school Chair of Governors. I explained that I needed to see him urgently. Being the lovely man he is, he immediately told me to come straight over to his house with Colin, my husband.