Living with and beyond cancer

Impact on friendships and family

Having cancer can be stressful and can impact on relationships with friends and family, not just at diagnosis and during initial treatment, but also after treatment has finished.
 
Many people are frightened of cancer and find it difficult to know what to say to people with it or how to show their affection and support without causing further distress to the person with cancer. It is therefore common for people who have had cancer to say that some friends had not been able to talk to them about it or to support them in the way they would have liked, whereas others who they hadn’t counted as close friends had surprised them in how much support they had offered. Norma was surprised that even friends who were health professionals had not visited her during her illness. Some people said these issues had resulted in lasting changes to friendships, saying that they no longer pursued close relationships with people who had not ‘been there’ for them during their illness, and invested more time and effort into relationships with those who had supported them.

Janet no longer counts one woman as a close friend since she failed to support her through her colorectal cancer, whereas she had unexpected support from others.

Janet no longer counts one woman as a close friend since she failed to support her through her colorectal cancer, whereas she had unexpected support from others.

Age at interview: 59
Sex: Female
Age at diagnosis: 52
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 So just reflecting on that, do you think having had cancer has affected any of your friendships or personal relationships?

 
I think it makes you know who’s really there for you, if I can use a horrible cliché, you know. One or two friends couldn’t cope with it and one or two friends over-empathised and I had to say, “Look. Go away until later please”. But, you know, one friend I thought I would be able to lean on and she just kept on saying she’d be there and then absenting herself, and eventually I said to her, “Look. You can’t cope with this. I recognise it. You recognise it if you’re honest, so let’s just not see each other until I’m better”. And I mean, you know, we’ve still got a friendship but I know how far that friendship goes, and I don’t condemn her, because that’s the way she is. But, you know, if you measure friends by how much they support you when you’re in times of trouble, you know, she’s not on the first rung, if you like. But a lot of people did, and a lot of people were surprisingly helpful who I, you know, hadn’t expected the help to come from.
 
While some people find it difficult to talk about cancer at all, others may be comfortable talking about practical aspects but not emotional ones, or vice versa; this applies to both people with cancer and their relatives and friends. Several people said that talking to friends about the emotional impact of their illness and its treatment had been helpful; some said friends had also provided practical support with housework and childcare. Talking to other people who have also had cancer can be helpful; Frances had met an old school friend who she hadn’t seen for years who’d had the same type of cancer as her and they now kept in touch.

She says her friendships and family relationships have strengthened because of the support she received during her cervical cancer; she now invests more time in those special relationships.

She says her friendships and family relationships have strengthened because of the support she received during her cervical cancer; she now invests more time in those special relationships.

Age at interview: 37
Sex: Female
Age at diagnosis: 32
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And has it had an effect on your relationships?
 
Certainly the ones with my friends it's made an awful lot stronger. I think it's helped me put more into the relationships, I know how important they are to me. I have an amazing network of friends that I appreciate and I will, you know, make sure that I wouldn't lose. I probably invest more time into them because I just know how important they are. And I think I always knew they were very special to me, but I think it's not until, again, something like that happens that you just realise that at the end of the day they are the most important things, certainly with my daughter, certainly with my husband and my immediate family. And then I think I've got a wonderful web of very close friends around me. So yeah, I think it has, it's deepened them. I can have conversations now that I wouldn't have probably had with them before.
Friends and family may not always understand how people feel after cancer treatment finishes; Jennie found it unhelpful when friends lectured her about getting on with her life when she still didn’t feel up to it. Olivia hadn’t told all her friends about her breast cancer because she had made very little fuss about it.
 
Friends and family can also experience strong emotions when someone close to them gets cancer, and people with cancer often say it can be difficult to cope with other people’s emotions as well as their own. Diane explained that she didn’t want people with glum faces around her all the time but neither did she want people to ignore her illness.

Diane likes to talk to people about her breast cancer but not in a depressive way and without making a fuss about it; however, she finds it weird that one friend has never even acknowledged it.

Diane likes to talk to people about her breast cancer but not in a depressive way and without making a fuss about it; however, she finds it weird that one friend has never even acknowledged it.

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So now that you’ve had cancer, and you’ve talked about talking to other people, do you find that you relate to people who’ve had cancer differently?
 
There does seem to be a camaraderie among people who’ve had cancer. We go to Ireland a lot more and one of the people we go and see over there has had it, and we always have a hug when we go over there. “We’re both still here”, sort of. We have a bit of a laugh about it, although he isn’t well at all. He’s quite an elderly man. The fellow down the road who’s been very ill with cancer, you have a chat because you feel you’ve been somewhere together, you know, you’ve come over the other side. And it enables, well I don’t know if it’s particularly me, but I think it makes you able to take it lightly, whereas I used to get quite wound up by people who’d come and put a very sad face on, “Oh, how are you? Are you all right?” Grrrr! But, you know, I didn’t like that. I think it was making you feel more and more negative about what was happening to you. So I mean with my neighbour down the road I can have a joke with him, and even my husband will joke, because you can get over it, hopefully, yes. And there’s no point in being miserable about it. If you have, like the man down the road, has only got six months to live, you think, well, you don’t want people around you with glum faces all the time talking about that. 
 
But the other side of it you don’t want people to ignore it. I had experiences of, well, people who never mentioned it. And that was creepy, you know, you’d have a whole evening out with them, and not that I wanted them to, but you think afterwards, “They never once mentioned”. But not in, I didn’t necessarily want them to be sort of sorry for me or anything like that, but just it’s a reality wasn’t it, and this was when I was sort of still having treatment for it. But they, and to this day there’s at least one person I know who I see fairly regularly who’s never ever mentioned it, which is weird. I think it’s quite funny, but it’s, and I think you do want people to acknowledge it but not necessarily make a great big fuss about it.
 
So has that changed the way that you relate to people, you know, depending on how they’ve reacted around that time?
 
Not really. I mean it takes all different sorts, doesn’t it. I know when my mum died years ago there were people who couldn’t talk about it and didn’t know how to speak to me. And it’s actually helped me when now I meet people whose relatives have died, I know they just want you to say that I’m really sorry, and that, you know, and that’s all. “Is there anything I can do?” But they’ll not really go into a very depressive mode of wanting to talk about all the details of it. I don’t want to do that, but I don’t want to go back through it all. 
Family members can find it difficult to cope when a relative has cancer, and some people who wanted to discuss their illness with other people said that certain relatives had not felt able to do so. Others said that talking about the illness with family had brought them closer together and strengthened relationships, particularly where they had thought death a probable outcome. A man who had testicular cancer said that talking openly about his illness had helped his children to learn that cancer need not be a death sentence.

Glynis says that having breast cancer had brought her closer to her husband and one of her daughters, but some family members hadn't wanted to talk about it.

Glynis says that having breast cancer had brought her closer to her husband and one of her daughters, but some family members hadn't wanted to talk about it.

Age at interview: 60
Sex: Female
Age at diagnosis: 54
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You mentioned about your husband and your daughters. Do you think that having been through cancer, has it affected your family relationships in any way, do you think?
 
Yeah, my son didn’t want to know. He’s twenty- seven now. He was twenty-one, and I told everybody about it the first day I was diagnosed, and I told my son when I came back from clinic, I said, “I’ve got…”, you know, “Everything’s all right”. He said, “Okay”. But he said, “I don’t want to think about… I don’t want to talk about it”. And I said, “Fine”. And he’d had a long-term virus from being eighteen, and his way of dealing with it, he’s all right now, but his way of dealing with it was, “Don’t talk about it, don’t think about it”. So he did the same with my illness. The girls were different. The eldest one lives in America. She’s had a cyst removed from her breast. She’s very aware of breast cancer. So she was very concerned and it was hard for her because she was so far away and we went to visit her as soon as I’d been diagnosed, before I had the treatment, we went to visit and spent a fortnight with her. I think she’s found it very hard being so far away but she’s not talked to me a lot about it. 
 
I’m sure she’s talked about it to her friends and her husband rather than me. Although we’ve talked obviously, on the phone a lot, and we are very close, but I don’t, I’ve kept her informed all the way but not talked about the outcome. The younger one, the middle one, had her first baby the summer that I was diagnosed. She’s now expecting a fourth, so despite the fact she lives fifty miles away, we see each other every week. I go every week and we spend a lot of time together, obviously, she’s been pregnant and had babies, we’ve brought the children up together, so we’ve probably become close. We’re a lot alike, so we’d have become close anyway but, as I say, she lives fifty miles away but she came to visit me a lot when I first had the operation. I think she was very frightened, having had her first baby and then suddenly I was ill, and she came to visit me in hospital, and even though I was only in a few days, she came twice. 
 
And then she just supported me tremendously, and I think it was just, no, it wasn’t just fear of losing me, but I think just when she found she needed me most she thought she might lose me. And I think that’s probably brought us close, but we might have been close together anyway, closer anyway because we both love little children and there is a lot of little children about. And but, yes, it has brought me closer, and closer to my husband as well, although he’s like my son. He doesn’t like to talk about it but he had to help me a lot. He supported me a lot. 

She says that her ovarian cancer experience has enriched her life and that of her family; they have become very close and appreciate their life together.

She says that her ovarian cancer experience has enriched her life and that of her family; they have become very close and appreciate their life together.

Age at interview: 46
Sex: Female
Age at diagnosis: 39
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When I first was diagnosed I felt I needed to read everything that was ever published about ovarian cancer and cancer in general and talk in chat-rooms to people and just immerse myself in finding out about cancer and peoples’ responses to it. But I found after the first couple of years I had the opposite reaction. I thought I knew intellectually all I needed to know and that my journey from there had to be more spiritual and finding what resources I had inside myself to live with this, because I don’t think about it. I don’t think about dying from it. I just think it’s a challenge to learn to live with it. And I would have to say that I think it has enriched my life, having cancer. And I know it has enriched my family’s lives; they’ve said that to me over and over again. Because all of us now just enjoy every day, every little thing from having that first cup of tea in the morning, to talking on the telephone, to each other, just everything becomes so precious when you’ve come so close to losing it. And it has opened our eyes, my whole family and myself, to how wonderful life is and how lucky we are to have each other. And it has also helped us put things in perspective; we say we don’t sweat the little stuff anymore. You realise what’s important and what isn’t, and because we see each day as a gift then we make sure that we don’t squander it. So it has been an enriching experience for us all, I think. 
 
But as the years have gone on they’ve realised that, as a family, what we have to do is just have a lot of fun together, a lot of good times, create lots of good memories. Not avoid the future; we do talk about death and they have seen me at death’s door. So we don’t avoid it but we live in the moment, and my son who’s still in Canada comes over twice a year for nice long periods, and we talk a lot on the phone. So I think the cancer experience has made us very close as a family, or kept us close when perhaps you may expect your children to have flown away a little bit more. Mine have flown but they keep contact and they’re very careful to do that. So I think we appreciate each other a lot. So…
 

Tim and his wife have both had breast cancer; he says that their cancer experiences have made them more sensitive and caring and they look after each other.

Tim and his wife have both had breast cancer; he says that their cancer experiences have made them more sensitive and caring and they look after each other.

Age at interview: 73
Sex: Male
Age at diagnosis: 60
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Have there been any other changes in your relationships since your diagnosis?
 
No I mean I think that, one should say that probably we are closer, that we somehow care for each other more. I would say it’s strengthened, particularly since [name of wife] had breast cancer as well. That we both are very close and think about each other a lot, and on the whole take great care of each other. And we have our little spats and we get on each others’ nerves here and there, but I think on the whole we have a very, very positive relationship. And probably that has been helped in a way by, you know, running the gauntlet, you know. It does make you more sensitive and more caring. Yeah. I think that a relationship works if you put more than fifty percent in, so each person should put sixty percent in, it makes a hundred and twenty, you know, that’s nice. It’s not a matter of counting up, I’ve done my share, you do your share, you know, it’s throwing things in all the time that makes it work well, yeah.

Some people said their close family had been supportive and looked after them while they were ill. People sometimes say they are determined to survive their cancer because of their family.
 
People who were in remission from cancer often said that their family worried about the possibility that it might recur, probably more so than they did themselves. Friends and family often raised the topic of the cancer in conversation and needed reassurance that the person was not about to die. Some found this annoying; Sandra’s colleagues frequently asked her if she was OK, so when she changed jobs she didn’t tell her new colleagues about her cancer. Pauline, who is living beyond colorectal cancer, said her family nag her when she smokes. Sometimes people felt guilty about the impact their cancer had had on their family, and believed it was harder for others to deal with. Other people said that family relationships had returned to normal.

Diane says her family often bring up her breast cancer in conversation; they seem to think it is still there 7 years on and can't put it behind them.

Diane says her family often bring up her breast cancer in conversation; they seem to think it is still there 7 years on and can't put it behind them.

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I think the trouble with cancer is it has got connotations for people, and I think it’s one of those diseases that generally people don’t think you’ll get over. It’s still there and that is always in the back of your mind that it’s there niggling away. And it’s my family, I think it has had more of an impact on than me in that sense. They still, I’m sure, think it’s still there. They don’t totally relax. It seems to come up in conversations when you least expect it. And that, I don’t find it hard but it does sort of bring it back and we can’t get over it. And I think it does shape a lot of our lives now, the fact that we’ve taken up skiing. My husband is determined to do everything in case, you know, I die. And he will often sort of talk about if I died what would happen to the money and things like that, and what he would do, and what he wouldn’t do, in a way he would never have done before. And in some ways I suppose it’s good, you know, accept that one of us will die eventually, but it’s me that’s really constantly saying, “But I’m not going anywhere”. And I think nobody really in the family expects me to live a long life. When we talk about retirement you think, “Well, will I get five years? Will I get…?” And I suppose it does affect my thinking but I like to think it doesn’t, and I’m determined that it isn’t going to have a long-term impact. 
 
But I think there’s always this nagging doubt in their mind that something is happening, and if I say I’m not well you can see them looking and they can’t, the mention of cancer seems to come up fairly regularly in their conversations and my husband’s conversations when I was ill, is a sort of favourite thing, not in a negative way, I just think it’s always there in their heads now when I had cancer. It’s not that I go on about it, it’s them that will always bring it up. 

Only his wife and daughter know the full extent of what he went through with his lymphoma treatment; he feels guilty about the impact it has had on them.

Only his wife and daughter know the full extent of what he went through with his lymphoma treatment; he feels guilty about the impact it has had on them.

Age at interview: 41
Sex: Male
Age at diagnosis: 28
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You haven’t really told me about the emotional impact of the diagnosis and the illness on you and your wife. Do you want to talk about that at all?
 
For me, from my point of view it really, and a lot of people were quite surprised by this, to me it’s a non-event other than that time when I felt lonely when I was going in for my transplants. I don’t want to sound blasé about it but I just, to me it’s just another problem, get on with it, crack on with it. My personality is, I’m sure you can tell from how I’m talking, is one where I just' I see something, what needs to be done? Let’s do it, let’s do that then, get on and do it, right that’s now done, what else do I need to do? Don’t need to do anything else, okay fine. I just get on and do something. 
 
And I’m really, at no stage was I scared for me. I was terrified at times about the prospect, you know, the effect it had on my family. And even today, you know, it’s six years on nearly, and I still occasionally sort of think back and think, “What have I done to my daughter? What have I done to my wife?” We’ve only been married eight years; for six of them I’ve been putting her through all sorts of nonsense. So that’s the biggest impact, and it did affect my wife, you know, it has affected her definitely. But I can see a change now for the better. I’ve returned to flying and that really has helped her in her sort of recovery from the whole thing. She sees that I’m now doing something, back doing what I love doing, which is flying. I’m well, I’ve still got a long way to go to get properly better, because having a bone marrow transplant the immune system’s, they said, you know, for the next five years it’s going to be a case of building and getting it right again, and that will take time before it’s fully sorted. Well I don’t think it will ever fully function properly but it’ll be a lot, you know, it’ll be a lot better than it is now. So there’s still a bit of physical repairing to be done. 
 
But yeah, it did affect my wife, and that can’t, that really can’t be, I mean that’s something that is really not considered to a great degree in the whole process, is the impact on those really close to you. And it really is only my daughter and my wife where this really heavy impact, because even your parents, even my parents and my wife’s parents, we sat down at length, talked about this, my wife and I, you see nobody, not even my closest friends really know what we’ve been through, because when we saw our friends in between treatments, and saw our family in between treatments, that’s the only time we saw them, I was in between treatment and actually okay, and feeling okay. When I was really unwell and poorly with treatment we were like hermits, we just stuck ourselves away and get on with it. 
 
And my wife was helping me and my daughter too, and every, I used to think about it when people said “Oh you’re looking so well”, you know, “You’re looking much better, you’ve got no hair but you’re looking well”, and I’d say, “Yeah well that’s right. The reason you’re seeing me is because I feel okay at the moment. When I’m not well, not feeling great, I’m not going to be around”. And that used to sort of bring a little wry smile to my face when I saw my friends and family, because they never really, nobody outside of my wife and my daughter knew the real impact of what was going on for any of us.

Some people told us they were concerned that their sons or daughters might be at risk of developing cancer by inheriting a genetic predisposition to the condition, particularly where they knew of cancer in other relatives. Others said that their sons or daughters were themselves worried and were seeking tests. At present only 5–10 percent of cancers are thought to be caused by an inherited faulty gene. Inheriting a faulty gene does not mean that you will develop cancer but that you are more likely to do so than someone who doesn’t have that gene.

Diane was upset that one of her daughters believed that she would inevitably develop breast cancer because Diane had had it.

Diane was upset that one of her daughters believed that she would inevitably develop breast cancer because Diane had had it.

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And it’s also, and I didn’t realise until fairly recently, about a year or so ago, that it had left my elder daughter with the feeling that she would get breast cancer. 
 
It was inevitable, was more or less her response one day to a question, “Well, I’m going to get it”, and that worries me a lot. I think she shouldn’t be thinking like that. She’s got her life ahead of her and I don’t think how to convince her really that that isn’t the case. But that worries me. That’s one of my concerns. 
Many people living beyond cancer had advised their offspring to get screened for cancer. For instance, Alan (Interview 33) and Jim, who both had prostate cancer, advised their sons to have PSA (prostate specific antigen) tests. Carole, who had had breast cancer, urged her daughter to have mammograms and her granddaughters to self-examine their breasts. A woman who had ovarian cancer told her daughter to ensure her ovaries were removed if she ever needed a hysterectomy. Thomas’ daughters were both doctors, so he assumed they would get appropriate checks. Derek’s daughter had a benign (harmless) breast lump found on a mammogram. Two people who had had colorectal cancer had sons who had already experienced bowel symptoms which had been checked out.

Alan's son had a rectal examination by his GP following rectal bleeding; Alan wished a more thorough test had been done because he fears his son might develop colorectal cancer like he did.

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Alan's son had a rectal examination by his GP following rectal bleeding; Alan wished a more thorough test had been done because he fears his son might develop colorectal cancer like he did.

Age at interview: 60
Sex: Male
Age at diagnosis: 53
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Actually, my son has been losing some blood, and I said to him, “Get to the doctor”. And he went to see his doctor, it’s only a couple of weeks ago, this is, and I said, “You want to insist on an examination”. He did internally examine him up there and said there’s nothing wrong. But, can I just go a bit further, I’ve got a niece, sorry, a niece, yes, a niece, she lives in California. 
 
That’s nice.
 
And she comes in to see her mum, which is my eldest sister, and she was telling her that in America if a member of your family has bowel cancer or any other cancers you automatically get a scan, whether you’ve got the symptoms or not, you have a scan, which I think is good. And I would have liked my son to have had a scan or at least a colonoscopy, you know, so put the camera right into the bowel and have a look, but he didn’t. The doctor did internally examine him and said, “There’s nothing there”, and the symptoms, what you do and what you do and all of that, but of course initially I was asked all that and you say, “No, because I go swimming”. Because he goes swimming and he keeps fit, just like I did, and I think, well, you know, if there is something very small there, like there must have been in me before it grew. So I think that, especially if it’s in the family, if you get any slight symptom, like he’s got, he should have, in my opinion, he should have had at least a colonoscopy.
 
But he hasn’t, so the only thing I would say to doctors is if somebody comes to you with those symptoms and it’s in the family then I think they should have a proper examination. 

She had bowel and breast cancer and her offspring are all screened for it but they don't make a big thing of it as a family; one of her sons had a bowel polyp discovered and has regular check-ups.

She had bowel and breast cancer and her offspring are all screened for it but they don't make a big thing of it as a family; one of her sons had a bowel polyp discovered and has regular check-ups.

Age at interview: 65
Sex: Female
Age at diagnosis: 49
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Are your children going to be screened for bowel cancer?
 
Well my son already had a polyp in his colon and he's 42 now. This must be about 6 years ago and he has to be, you know, monitored every 3 years. He has an endoscopy or a colonoscopy.
 
How was the polyp discovered?
 
I'm not quite sure, he only told me at the last minute that he was going in to have it seen to.
 
Are your other children going to be screened?
 
Well they all know about it and my daughter, they both, both of my daughters have had endoscopies, or gastroscopies but, and colonoscopies they have been, you know, screened for it, but we try not to make a big issue out of it in the family. They know about, don't forget on side I've got breast cancer too and they have been screened for that as well.
 
And do you just leave it to them to decide how they want to handle that?
 
Yes they're adults, they're aware of it. As long as their GPs are aware of it and, you know, that they sort that out. We don’t want to make a family that's surrounding illness, because our family are generally quite optimistic and we don’t want to have, you know, them thinking all the time about cancer, cancer, cancer. Yes, we want them to get on with their lives.
 
Do you manage to do that as a family, just be a normal family?
 

Yes, yes we do, absolutely, yes absolutely. 

Some people had been tested for the presence of a faulty gene. It can take months to get the results of genetic tests, so some were still waiting to find out. Others had tested positive and had encouraged other family members to be tested. People with a strong family history of certain cancers can be referred by their GP for genetic counselling and testing, but tests can also be obtained privately. A woman we spoke to who had ovarian cancer, and relatives with breast and ovarian cancer, paid £1600 to have samples sent to the USA for testing; she was found to have a faulty gene but her son and daughter were found to be clear.

She has ovarian cancer and her sister colorectal cancer; both are being tested for a faulty gene and their children will need to decide if they also want to be tested; her son has declined.

She has ovarian cancer and her sister colorectal cancer; both are being tested for a faulty gene and their children will need to decide if they also want to be tested; her son has declined.

Age at interview: 63
Sex: Female
Age at diagnosis: 52
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Was there any history of cancer in your family at that time?
 
Well, we are more of a cancer family than anything else, but there was only one person that we knew that had died in their 50s, everybody else had gone on to their 80s, 70s and 80s. But it is a great sorrow I felt when my sister was diagnosed last summer at the age of 58 with colon cancer. I think it is extremely unfortunate that it’s happened to us both so comparatively young. And in fact it had progressed and already she had spots on her liver, so it’s more shocking, and in fact I felt more stressed at her cancer than I had with my own. I think possibly because you’ve got resources in yourself to buoy yourself up, but you feel very helpless in the face of other people.
 
But, touch wood, nothing so far has appeared in the children. They might possibly be monitored, it’s up to them, but my sister was quite keen to have a genetic test done and that’s in train at the moment. We don’t know whether they’re going to follow it up or not, because when I first raised it at a clinic they said they were actually more concerned with people who got it at a younger age than we had. People who are under 50, possibly even under 40. So it’s up to them. 
 
My sister who lives in [city], they seem to be extremely keen on their research and they actually followed her up with the ovarian thing. She had, what are they called? The scans that you have when you have a child? 
 
Ultrasound?
 
Ultrasound, yes. She had ultrasound scans every so often, and although she never complained of it being stressful, she did mention that they’d picked up cysts which then disappeared. And I’m really not sure about this constant monitoring. I had started having mammograms myself. I felt the lump in between the three years that you have it. I do know a couple of friends who are eternally grateful that they had mammograms because they were caught, and one fortunately is as cured as you can ever be, and she’s still going strong after 15 years. So, you know, it worked for her. My sister was in fact offered a laparoscopy, or they wanted to do a laparoscopy, because there was one particular big cyst, but because of my little accident she refused and that big cyst also disappeared.
 
You said you had this genetic test yourself as well.
 
Yes, I had it yesterday. 
 
Right 
 
So they’re freezing it. As my sister said, for some reason, I don’t understand why, but I had to have the test before she did. So it actually sounds as though I instigated the whole thing. And the lady who saw me said, you know, she was going to see her consultant next Tuesday and they’d decide themselves what to do, whether to carry it forward or not. But my sister will presumably have hers and, you know, what she does with it and what her children do, I asked my children beforehand because it was their reactions that I was keen to know, and they seemed quite positive about it, although my son told me yesterday he didn’t think that he wanted to be followed up, on further reflection. But that’s totally up to them.

 

​Last reviewed October 2018.
Last updated August 2015.

 

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