“The words ‘you have cancer’ never leave you,” reflects 59-year-old British writer, cut-flower grower, and breast cancer survivor Juliet FitzPatrick, of hearing her diagnosis for the first time. According to the World Cancer Research Fund, breast cancer is the most common cancer in women worldwide (rarely, breast cancer can occur in men and accounts for less than one per cent). In fact, it is the second most common cancer overall—so much so that in 2018, 2 million new cases were recorded globally.
As part of a global effort to combat the disease, every October, major cancer charities around the world unite to increase awareness of breast cancer and raise money to fund its treatment. We spoke to four women: Juliet FitzPatrick; Algerian partnership and development manager for Hestia charity Rime Hadri, 40; British teacher Emma-Louise McAuley, 27; and Turkish-Cypriot and founder of Wigs for Heroes charity, Kaz Foncette, 34 — all of whom appear in Behind the Scars, a new photography project by British photographer Sophie Mayanne that aims to challenge the stigma surrounding scars— about their breast cancer journey and what we need to do to increase awareness.
Can you talk a little about your breast cancer journey?
“I was diagnosed with breast cancer when I was 54 in January 2016, following a routine mammogram. My treatment plan was a lumpectomy and radiotherapy. I was told that they hadn’t been able to remove all of the tumour and that I’d need a mastectomy and chemotherapy.
“After my mastectomy, I continually asked my breast surgeon to remove my remaining GG-cup breast so that I could be symmetrical. It took 18 months, but he finally agreed and I had my second mastectomy in November 2017. That signified the end of my cancer treatment in my mind and the start of a new way of living.”
“My breast cancer journey was made 10 times harder as I am bipolar. In May 2017, I noticed my nipple inverted inwards and I felt a lump—I contacted my GP, who immediately referred me for scans and biopsies. I went through a right breast mastectomy with an immediate reconstruction, which sadly failed in the end and it had to be removed. Then I had lymph-node clearing as the cancer had spread, then several months of chemotherapy followed by radiotherapy, and then I ended up in a mental health ward.
“I had a referral made for my lymphedema in January 2020 and I am only just being seen. My chemotherapy treatment and the drug Tamoxifen that I have to take every day for 10 years has triggered early menopause, although I’m currently going through some investigations as I seem to have my periods back after nearly three years. It is never-ending, but at least I’m clear of the cancer for now.”
“I was diagnosed with breast cancer at 24. My mother had died from the same disease three weeks earlier, except hers was a different type that had spread throughout her body. Her experience with breast cancer made me more aware than most people my age. It only took a graze for me to feel the lump, I could see the changes immediately and was diagnosed early.
“I had months of chemotherapy, over a year of targeted therapy and hormone treatment, which I will remain on for a few years and has put me in a medical menopause. I had a double mastectomy with immediate reconstruction too, which removed my breast tissue with implants, my nipples and every last cancer cell.”
“I was diagnosed with cancer in May 2017, when I was 31. I had chemotherapy, radiotherapy, a lumpectomy and immunotherapy. I lost all my hair, eyebrows and eyelashes too, and it totalled almost a year-and-a-half of treatment before I was granted a remission status. Sadly six months later, I was diagnosed with breast cancer again—I had to do it all over again. This time though, I would need a mastectomy.”
How did you stay positive through your journey?
“The honest answer is that I didn’t, much of the time. My husband had open-heart surgery at the same time as my first chemotherapy session and that was challenging. We kept each other positive. I tried to go for walks and keep active when I could.”
“I was very anxious and depressed, but I worked to keep hope alive. The small things had the biggest impact for me: visits and video calls from my family and friends, watching my favourite films and TV shows, cuddling my dog, having a cup of tea in bed. Wearing a nice outfit and some makeup to chemotherapy always made me feel better. Red lipstick became my superhero cape!”
What was the biggest challenge throughout it all?
“Managing my mental health was extremely challenging. In addition, there is a financial cost to breast cancer. I had to take many months off work during treatments and recovery where I didn’t get paid. Fortunately, I had family who supported me.”
“Friday nights out became Friday nights in. Avoiding crowds due to germs, being isolated a lot of the time was hard. As a bubbly and outgoing person, it was probably the hardest part. But I’d say the most challenging part was how physically different I looked. Looking in the mirror without my wig and makeup on really was the sign that I wasn’t well, that I did have cancer.”
How do you feel about your scars today?
“I have completely accepted my scars, they’re part of me. They show the trauma I’ve gone through and I’ve come out of the other side as a stronger and more beautiful woman—both inside and out.”
“Some days I completely forget I am a one-boobed woman, but I will on occasions catch my naked body in a mirror and get reminded that I went through nearly a year of hell but fortunately I survived it and I’m very much still alive. My scars are a reminder of how far I’ve come as it was one hell of a bumpy road.”
What was it like to be photographed for Behind the Scars with photographer Sophie Mayanne? What do you see when you look at your portrait?
“I’d found out about Sophie and Behind the Scars when my team and I began discussing surgical options. I knew I wanted a double mastectomy to minimise the chances of recurrence as much as possible, so I was squashing any doubts about scarring. When I came across Sophie’s project, all my fears were gone — the portraits were powerful. I became protective of scars I didn’t have yet, and those feelings remained when I had surgery. Sophie empowered me; she doesn’t make you feel like a victim or that your trauma is being used for sales. I see what cancer tried to take from me—power.”
“I felt empowered. I felt like it was closing the chapter on cancer and it was the time to start forgiving my body. We had a lot of making up to do. So much time has passed since these photos were taken and I’m sad for that girl in the picture because she thought she was in remission. When taking the photo, I didn’t even know I had cancer growing again. I’m reminded of my strength and how much courage and resilience I have in me. It helped when going through it again.”
What advice would you give to other women about how to remain positive?
“I’d say to focus on today. It’s okay to not be okay. Accept the good and the bad. If you feel negative, ill, or sad, then that’s okay—spend the day watching rubbish TV or whatever makes you feel better.”
“Going through breast cancer and now Covid-19 has highlighted more than ever the importance of enjoying life every day with your loved ones. Life is fragile and can be taken away at any moment. We could die tomorrow in a car accident, so make the most of every day. Positiveness and gratitude are powerful tools for remaining strong and staying hopeful.
“You don’t have to remain positive. Feel free to be sad, angry, cry, scream, grieve. It’s okay to smile, laugh and find beauty in the world, while dealing with something so ugly. You aren’t alone. There’s a whole community who understand what you’re going through because we too are forced to join the cancer club against our will. We’ve got you.”
“Do something memorable each day because those are the moments you’ll remember. I tried to do things that sparked joy and when I look back now, the awful days are fading and the days where I did something funny or spontaneous remain. Also play dress up and experiment with different looks—it’s funny, but I feel so much more stylish after having gone through cancer. Cancer made me trendy! Don’t give in to what it can take from you.”
What are your thoughts on breast cancer awareness? Should we be doing more and if so, what?
“More should be done to raise awareness of secondary breast cancer. It’s a hard message to communicate. People don’t want to hear it, but it’s an important subject.”
“There is always more that can be done. Financial support from employers during treatments should be the law, more investment in mental health services and in cures rather than investing more in improving current cancer treatments just because they’re far more profitable in the long run. More investment in alternative non-toxic treatments and lymphedema, improved and targeted screening programmes for people from deprived areas and in particular BAME communities where breast cancer prevalence is the highest and is diagnosed far too often at a later stage.”
“The current style [of raising awareness] is outdated. Creating a pink product or sticking a ribbon on something doesn’t amount to awareness. Where is the information on the signs of the disease and what to do if you find one? It oversimplifies it and makes people think it’s an ‘easy cancer’. We also need to go beyond the use of only older, posh, cisgender, straight white women in awareness material and cancer literature.”
“We need to raise awareness around men and breast cancer, too. My father-in-law passed away from it and still to this day people don’t realise that it affects 1 in 1000 men. We need to stop using healthy celebrities for brand marketing, or always highlighting cancer losses and instead we should focus on people’s [survival] stories, because when I was diagnosed I thought I was going to die.”