'Being young does not guarantee immunity from breast cancer... I had a mastectomy at 32'
Nicola Elmer was stunned when she was diagnosed with breast cancer and had to have a mastectomy. She says that she was particularly shocked because she was only 32 years old at the time
Being young does not guarantee immunity from developing breast cancer.
Therefore, it follows that every woman, whatever her age, should be vigilant and check herself on a regular basis for any sign of abnormality. Failure to do so could result in a late-stage diagnosis of cancer, which might greatly diminish the chances of recovery.
Someone who understands this only too well is Nicola Elmer (45). She was diagnosed with breast cancer when she was just 32 years old. At the time, she was a relatively new bride who was looking forward to an exciting future. "Straight after school in Johannesburg, I went to work for a major bank," says Nicola. "So my 30th birthday present to myself was going to college to do a BA in psychology." Two years later, she married Ewan Elmer, who works in IT. They had nine months of marital bliss, before their seemingly perfect world imploded.
"I was busy studying for an exam," she explains, "when I happened to slip a hand under my bra strap, which had become uncomfortable, and felt a sort of welt. I mentioned it to my doctor, who suggested, even though I tend to have quite tender breasts, that I have a mammogram." When nothing showed up on the mammogram, she was sent for an ultrasound scan and a lump was soon found.
"My first reaction was huge shock," she admits. "But still I didn't panic. It was more like, 'what's going on here?'" Nicola was then referred to a surgeon, who did a biopsy. The whole process only took a few hours, and by lunchtime, she was back home in Johannesburg. But that's when the impact of what was going on, began to fully sink in. "A sense of fear started creeping in," Nicola remembers.
Shortly after, the doctor had to break the news to her that she had cancer in her left breast. "I felt like my head was exploding," she recalls. "I thought this couldn't be happening. I felt so vulnerable. I left his room crying. A woman in the waiting area gave me a tissue, and to this day I don't know how I got home."
She then called Ewan, who rushed back, only to find his wife sitting on the floor crying. "Then we were both crying," she says. "Big tears. It was the very first time I had had to face my own mortality. We had just got married. The fantasy of my perfect life changed, just like that."
Shortly afterwards, Nicola had a mastectomy, without complications. During her week-long stay in hospital, a woman from a support group came to see her and showed Nicola her own mastectomy scar. "Seeing that scar was quite shocking," Nicola recalls, "but it helped normalise the situation to some extent."
Nonetheless, the psychological consequences were enormous. "The really hard thing was seeing my now-scarred body," she says. "When I went to have the stitches out, the doctor encouraged me to look when I was ready to do so. When I did, I didn't recognise my own body. There was a big scar across my chest and I didn't have a nipple."
Fortunately, she had Ewan to reassure her. "He went into protective mode," says Nicola. Soon after, she began cycles of chemotherapy, over a seven-month period. She says the whole experience was quite traumatic. "I didn't just lose a breast. Because of the chemo, I also lost my hair and my eyebrows. So that was another big challenge." She says she never wanted to wear a wig, but she did find hats and scarves useful. Friends brought her brightly coloured scarves, so she could indulge the more flamboyant or glamorous sides of her personality.
The fear that the cancer would come back was a significant additional burden. "I have always had a very positive attitude, but during this period I did have days when I felt quite miserable," Nicola says. "However, I allowed myself to mourn the loss of my breast and my changed life."
Given the loss, the scarring, the strain of treatment and the fears about the future, having good support was critical. Nicola certainly had that in Ewan, and the medical staff were also great. "The teams who work in oncology units are fantastic, and that really helps," she says.
A year after the mastectomy, Nicola elected to have reconstruction surgery. "While I didn't feel my breasts defined me, I decided to have an implant and I chose to have a reduction in my other breast at the same time, as I'd always been quite large. The reconstruction was the most physically painful part of my journey."
Not long after that surgery, Nicola moved to Ireland when Ewan's company transferred him to Dublin. They are now Irish citizens and well settled in Inchicore, on the outskirts of the capital, and have adapted well to life here. Nicola has just done her doctorate in counselling psychology, and plans to use her qualification to help other people dealing with a cancer diagnosis.
"When I first came to Ireland, I became a volunteer with Survivors Supporting Survivors, for the Irish Cancer Society," she explains. "They put you in touch with someone who was recently diagnosed with cancer. We then communicate on a one-to-one basis, usually by telephone, when we provide emotional and practical support."
Another way in which she is helping fight cancer is by participating in the ever popular Vhi Women's Mini Marathon on bank-holiday Monday, June 1.
"This will be my 10th year participating," says Nicola. "My fastest time was 1hr 6min. But I don't do it to break any records. We wear Cancer Society T-shirts and have an absolutely fabulous time. It's a great way of getting out there and doing something positive, and of course we all know how important exercise is."
Nicola has been cancer-free for 12 years and is immensely grateful that her GP took her concerns seriously, even though she was so young. She believes that early diagnosis saved her life.
A spokeswoman for the Irish Cancer Society says 24.4pc of cases of breast cancer are found in those under 50. "If cancer is found early, treatment is more likely to be successful. Get into the habit of looking at, and feeling your breasts from time to time. This will help you to notice if any changes do occur."
For further information or to speak to a specialist cancer nurse at the Irish Cancer Society, tel: (1800) 200-700, or drop into a Daffodil Centre in hospitals nationwide. To join Team Irish Cancer Society for the Vhi Women's Mini Marathon, see cancer.ie, or tel: (1850) 606-060
Sunday Indo Life Magazine