Mel’s story: “I couldn't do this without Alison”

“My mother’s mother had breast cancer twice, post-menopausal and my mum had breast cancer when she was about 43, so I’d been getting regular checkups and ultrasounds for years,” she says.   

After returning from a holiday to Japan in 2016, Mel noticed a lump in her left breast and that her breast appeared to be getting bigger. Her GP sent her for a mammogram and ultrasound, and a biopsy of her lymph nodes.   

“That weekend we went off and had my 40th birthday party. I wanted to cancel my party, but my husband Matthew said I wasn’t allowed to, so it was sort of like, just smile and nod and have a good time, and then on the Monday we got an urgent call from the doctor and it came back that it was HER-2 Positive but hormone negative breast cancer.”  

“To hear those words is quite devastating,” she says. “My main concern was that I wasn’t going to be there for my children, because they were only nine and 11 at the time (Mel’s eldest son Jonah is now 19, and her youngest son Thomas is 17). You think ‘Are my boys going to grow up without their mum around? What are my husband and my boys going to do? How am I going to explain this to my children?” she says. “Then you just go into a flight or fight mode: ‘What do I need to do to beat this and to make sure that I’m around for my boys?’”   

“It was so much worse than the first diagnosis.”

Following a year of treatment, Mel was given the all-clear in November 2017. At a routine appointment with her oncologist three months later, she casually mentioned she’d been suffering from a nagging headache. “I just changed from a nursing job to a desk job, so I thought it just a bit of stiff neck,” says Mel. Her oncologist sent her for an MRI, and in February 2018, Mel learnt that the cancer had metastasised to her brain.    

“I ended up with seven brain metastases,” she says. “Of course, going to the brain, I just thought, ‘Well, that’s the end of it now.’ I spent a lot of time crying. You don’t want to be crying in front of the children because that might make them more upset, so there was a lot of crying at night. Metastatic cancer is just horrible anyway, but in your brain, I just thought, it’ll be the end of me.”  

Days later, Mel had the first of four craniotomies to cut three of the tumours out, followed by radiation and chemotherapy. She’s now on trastuzumab deruxtecan, which was recently added to the PBS, and has brain scans every three months. Her last scan came back clear.   

Throughout both her diagnoses and treatment, Mel has been supported by McGrath Cancer Care Nurse Alison Szwajcer.   

"Alison has been absolutely amazing"  

Mel says Alison has been a vital emotional and clinical support throughout her cancer experience.   

“She helps me with all my appointments, and she’s just there for me no matter what I need. But she doesn’t just check on me, she checks on my husband and checks in on how the boys are going as well – because it’s not all about me. She’s just an overwhelmingly supportive person.   

“I think she was a bit shocked when the cancer had gone to my brain so fast. There were lots of hugs and cuddles on the lounges in cancer therapy. She was always there if I needed to chat about how I was feeling.   

“But, also from a clinical point of view, Alison has been invaluable. Whenever I’ve gone on new medications, it’s obviously explained by the oncologist, but Alison always prints out the information and tells you what you’re supposed to do and checks in with me to make sure I’m ok. She makes sure I’m on top of my symptoms and side effects and makes suggestions to help manage them. And she collaborates with doctors about treatments so I can continue to be feeling as normal as possible.   

“As a nurse, I’m the first to admit I’m not the best patient. But being on the other side of health care has certainly shown me a different side of it and made me more appreciative of the services out there. And to have someone like Alison is phenomenal. I don’t think I could do this without her being there for me.”  

Alison on caring for Mel  

When Mel was first diagnosed, she was a regular young woman with a husband and two sons. It was just a few days before her 40^th birthday and it obviously came as a shock. I did what I would do for anyone I was seeing: I found out where she was at, what her needs were at that time, and what sort of support she needed. Throughout Mel’s treatment, we talked about the cancer, but it was also a lot about finding out who Mel was as a person. I got to know her for the year or so that she had her treatment and was able to answer any questions that she had.  

It's always a shock when someone you’ve treated and cared for has another cancer diagnosis come back.  But in Mel’s case, it came back very quickly – it was only about 18 months since she had first been diagnosed. When people are told they have metastatic or advanced cancer, often their first thought is ‘my time is limited’.

Mel wanted information, so we talked about what different options there could be, which means working in conjunction with the whole multidisciplinary team, whether that’s radiation, or surgery, or targeted therapy. But I also remember there were a lot of tears.  

A lot of my role is about meeting people where they’re at. Sometimes Mel and I would talk about the everyday things, and then some days we would talk about her cancer, and the impact that it has on her not just physically, but emotionally and mentally as well. And then we’d talk about family issues and how it was affecting the family.  

My role as a McGrath Cancer Care Nurse is to support and care for those affected by breast cancer – not only the patient, but also the family as well. And that can look different for each person. It can be providing evidence-based information, carrying out assessments, helping to coordinate appointments, or acting as a point of contact so I can refer to different services as needed. And it’s also about being able to give psychosocial care. Care is the great factor in all of that - making sure that someone gets through their treatment the best way that they can.