There’s a lot of living to do in your 20’s, the last thing you expect is a breast cancer diagnosis. Ali Moore, 28, was spending time in the chemotherapy ward when most of her contemporaries were out partying. As a young person, her experience of breast cancer was vastly different from the mainstream and her McGrath Breast Care Nurse, Alex Lawless, tailored her care to ensure Ali felt supported all the way.
The diagnosis
Ali wasn’t in the habit of checking her breasts, but when her mum’s cousin was diagnosed with breast cancer in her 40s, Ali saw her post on social media. She checked her breasts, they felt strange so she looked into it. “I was watching Sex and the City, it was the episode where Samantha gets breast cancer and I thought, maybe I should get this checked out,” she says. “Lucky I did, but I would’ve gone anyway because my breast was hurting.”
The results of the first ultrasound came back as lumpy breasts, the second one a few weeks later progressed to a biopsy which found the breast cancer. Once she got the diagnosis, it was a whirlwind. “I was shocked, but also felt immediately supported,” she said
“It all happened in one day. My parents were there, my boyfriend came to the GP, I was in with the oncologist by the afternoon and Alex was there as well. It made me feel safe because I got clarity very quickly.”
Fertility and breast cancer
For young women, loss of fertility is an issue they have to face. Having that discussion with a partner is a tough call, do you freeze your eggs or opt for embryos, which have a better success rate? Will you still be together in the next five years?
“We got straight onto IVF,” Ali says. “Kids have always been the plan for us, so Henry and I froze embryos. We already knew that’s where we were headed, so it was a no brainer.”
IVF wasn’t an easy process for Ali. “I found it worse than chemo. I was so nauseous, dizzy and vomited. I had to inject so many needles and found it very overwhelming,” she says. “In comparison, I tolerated chemo quite well. The steroids were awful, I had sleepless nights and my heart was racing, which was pretty intense, but it was nowhere near as bad as I thought it would be.”
The physical aspects of breast cancer treatment
Ali found one of the biggest challenges was looking like a cancer patient. Not only did it impact her self-esteem, but it changed how people treated her. “The hair and eyebrow loss is brutal,” she says.
“The hardest part about the double mastectomy was the emotional side of it, not the physical, because it’s such a symbolic part of yourself as a woman. I had to grieve the fact I won’t ever be able to breastfeed.”
She found it incredibly hard to come to terms with, so she commissioned a portrait of herself before the operation. “I found a woman in Melbourne that does nude art, I sent her photos and she will do a painting. I wanted a memento, it was a way to remember what I was like before and immortalise my previous boobs.”
Ali’s McGrath Breast Care Nurse Alex’s care went beyond the medical, to the practical elements a young woman needs. “She told me where to get wigs and gave me information on getting my eyebrows tattooed and what skincare I could use, all those things that are important to you in your 20s,” Ali says.
“As vain as it is, hair loss and the physical effects were hard. Everywhere I went, people would ask me questions about my medical condition because it was obvious I was having chemo – you wouldn’t talk like that to someone with diabetes.”
Sexuality and cancer
A less discussed aspect of cancer care is sexuality. It takes on greater significance for young women as chemotherapy often puts them in medically-induced menopause. Going through hot flushes, loss of libido and night sweats in your 20s is very confronting. Ali was comfortable talking about it with Alex. “Alex has a Master’s Degree in sexual health and talking to her about it wasn’t embarrassing. It wasn’t like talking to a doctor, it was more like talking to a friend,” Ali says.
Alex wants more patients to know their sexuality shouldn’t be an afterthought. “Whether its areas such as body image from the visible effects of treatment and surgery, to a sense of loss for your breast, to the management of menopausal side effects induced by chemotherapy, I want patients to be aware that these are areas that we can address to ensure their quality of life is optimised during and after treatment,” Alex says.
“Feeling like yourself is important during cancer treatment and is often hard to maintain. When a sense of our own sexuality, which makes us who we are, is taken away we can feel at a loss. I want to assist patients to hold on to what’s important to them or help them in creating a new normal.”
What Alex’s care has meant to Ali
Ali gives her whole medical team a 10/10 score. Alex gets an 11/10. “Alex has been amazing. She was there from the first appointment. It was overwhelming, but she booked all my appointments for me and she always arrived at appointments when I was anxious, it’s like she knew,” Ali says. “I would’ve had a lot more anxiety without her. She filled in the gaps of my knowledge and made things very manageable.
“The power of her care is like having a friend in your corner. She could’ve done the bare minimum, but she didn’t. It really did feel like I had a friend with me the whole way, discussing things like haircare and eyebrows that’s not strictly medical but a big part of the journey.”
On Ali’s part, it felt like Alex just knew what she needed. Alex says that sense of ease comes down to the relationship between nurse and patient. “Building a rapport is understanding the patient’s needs, knowing when to contact patients is having an understanding of who the patient is and when to leave them in control of initiating that contact,” Alex says. “Caring for Ali is knowing what is most important to Ali and being able to appropriately provide the specific care she needs.”
McGrath Breast Care Nurse Alex on Ali
Alex has had an important impact on Ali’s life, but in this case, it worked both ways. “I am not sure if Ali is aware, but there is much I have learnt from her and try to instil in my own life,” Alex says.
“Her strength and positive outlook on life allowed her to respond to things in a positive way. It has a knock-on consequence in terms of making things easier for oneself. When I reflect on Ali’s outlook and her ease in the process, it’s because of her disposition and response to tough situations.”
“Although Ali’s treatment is nearly complete, the power of care continues. It is making her aware that she can continue to contact me if she requires. It is discussing the exciting future that awaits her and providing her with information that she requires to have a handle on things. I will always be a point of contact for Ali should she need it.”
