Everything you needed to know about cancer but were just too afraid to ask
Having battled the illness nine times in seven years, author Emma Hannigan says she has no regrets about drastic surgery, and is doing some myth-busting about living with the disease and its treatments
Her books have been bestsellers with women across Northern Ireland for many years, but few may be aware of author Emma Hannigan's own incredible story.
The popular writer and mother-of-two, who has penned 10 novels including Designer Genes and The Pink Ladies Club, has spent the last seven years fighting cancer, during which time she had her breasts and ovaries removed in a bid to halt the disease.
Emma was told she carried the faulty BRCA1 gene in 2005, which increases a woman's chance of getting breast cancer by 85%, and ovarian cancer by 50%. She bravely chose to have a double mastectomy and oophorectomy the next year, to reduce the risk.
Shockingly, though, the 42-year-old was still diagnosed with breast cancer two years after learning she carried the gene.
Since then, Emma has battled the disease nine times, including four bouts in the same year, and was receiving chemotherapy until earlier this year.
She says of her drastic surgery: "I didn't look at it like I was losing my ovaries or breasts. I looked at it like I was gaining my life.
"It wasn't a difficult decision. It was a no-brainer - I wanted to live."
Emma, aged 33 at the time, was told that the surgery hadn't saved her from cancer.
"I was tested because there was a family history of breast and ovarian cancer in my family," she says.
Having watched her aunt Helen die of breast cancer when she was 42, and great aunt Anneliese pass away following ovarian cancer, with another two aunts surviving breast cancer, Emma was determine to improve her chances against the disease.
"It was not difficult. I had seen Helen die. I had two young children. I only had to look at them and know I had made the right choice.
"Nobody ever wants to hear the words 'you've got cancer', unfortunately, one in three people in Northern Ireland today will develop cancer during their lifetime.
"It goes without saying that a diagnosis brings a myriad of emotions. But when I was first diagnosed back in 2007, once I dealt with the initial shock, I was plagued by questions. Not the usual medical ones. But the often silly sounding ones that nobody wants to ask.
"I am now a rather scarred and well-worn cancer vixen. Having beaten the disease nine times, I've probably answered many of my own questions by trial and error. Today I'm going to try and remember as many of these and answer them as best I can for anyone out there who finds themselves in this unenviable position."
What exactly is chemotherapy?
For the record, I thought it might involve a large machine and possibly a tunnel. Chemotherapy is cancer medicine that comes in either tablet or liquid form. It's usually administered by a drip using a needle in your hand. So for all-the-world it's a bag of cancer-slaying liquid that gets hung on a pole and drip-fed into your vein.
What do I do when I'm having chemotherapy?
I had visions of dry ice circulating the room, along with invasive probes. You sit in a chair or lie on a bed. The nurse puts a cannula or needle in the back of your hand and it slowly drizzles into your vein. It's long and boring, but not scary.
Will I definitely vomit after it?
My image of chemotherapy involved a person hugging a toilet indefinitely. There is no need to be violently ill nowadays. There are amazing anti-nausea medications on the market, but you must tell your doctor if you feel sick. Over my nine diagnoses I have never vomited due to chemotherapy.
Will my hair fall out immediately?
I thought I'd be bald by the time I got home the first night. No, not necessarily. Some chemotherapy medicines don't cause alopecia at all, while others only cause thinning. But if you stand to lose all your hair it can go at any time from three weeks after the first treatment. But it won't fall out in one go. It happens gradually. It won't leave your head and fall on the floor like a small furry animal.
Will all my hair fall out?
I was hoping for annoying body hair to go first. As luck would have it, all body hair goes, bar the hair on your legs. It will mean no bikini-line waxing or underarm shaving, but why oh why doesn't leg hair go, too? Eyebrows and even eyelashes can be lost, but not always. I only lost my lashes once and they grew back swiftly.
Does radiotherapy hurt?
This does involve a massive machine with a flying saucer, so I instantly feared it. In general, radiotherapy causes no pain. You lie on a bed and the machine doesn't actually touch you. It's a lot like having an X-ray. Unless the tumour is somewhere extremely sensitive, such as the back of the head, it shouldn't cause more than mild skin burn. There are also some types of internal radiotherapy, which are more invasive. But for most patients, it is a painless process.
Will radiotherapy make me sick?
I assumed it would, seeing as it's carried out every day. Radiotherapy causes fatigue and the effect is cumulative, so the tiredness builds up over time. But in my experience, it didn't make me actually sick.
Is it best to take to my bed during radiotherapy?
I dreaded the thought of being bed-bound for weeks on end. While it's always good to conserve energy during cancer treatment, I have found regular exercise vital. It can be the last thing you feel like doing, but it really helps to build energy.
Can I exercise during cancer treatment?
I would love nothing more than the answer to be a strict no to this question, as I'm so lazy. I know from experience that it is completely vital during treatment. The best way to avoid fatigue, sickness and a whole host of problems is to get up and move.
Can I wear make-up or fake tan ever again?
I don't go out in public without make up and feared I'd be banished to the darkness during treatment. Yes, of course you can still use your beauty products. In fact, I think it's doubly important to feel as good as you can. There are lots of organic or paraben-free products on the market now, so there's no need to go bare-faced even if you worry about chemicals.
Will I have diarrhoea all the time?
I genuinely considered buying a packet of pull-ups prior to my first
chemotherapy. Hearsay had me believing I'd be either leaning into the loo or sitting on it for my entire treatment time. I even considered having the bathroom done up, as I was planning on spending so much time in there. But side effects are different with every patient. Personally, my bowel thinks it's a skip while I'm on treatment and I suffer with dreadful constipation. But again, there is medication to help with diarrhoea or constipation.
Will I be exhausted and half asleep all the time?
I'd decided I would be like a zombie for six months. Although, there will be days when you feel really tired, many patients also suffer with insomnia. Regular exercise helps with this.
Will everyone I meet, even strangers, know I'm a cancer patient by looking at me?
I thought I'd look totally different and incredibly ill. I chose to wear a wig so my head looked "normal." I also wore make up and, of course, my usual clothes. Unless I told them, people who didn't know me had no idea I was a cancer patient. It's possible to be a vixen and not a victim.
How long does it take the hair to grow back, once treatment is over?
I assumed it would take months to even start. Almost as soon as the treatment ends, it's as if your hair has been waiting in the wings to spring into action. In some rare cases the hair doesn't return. But for most people it's very quick. It took a good 18 months for the hair to have a proper style again, but I was pleasantly surprised by how swiftly I could ditch my wig.
Will my hair look the same as before when it starts to grow?
I'm blonde, with poker-straight hair. I assumed the new hair would be the same. In a word - no. Your hair won't look anything like before at first. It will be curly and either dark or grey. I looked like a baby monkey for a while, but as it grew the colour lightened and it became straight.
Do I have to keep shaving my hair to strengthen it?
I was told this by so many people. I would've sobbed like a baby if anyone had shaved my head as soon as my new hair had sprouted. I simply let mine grow and with time had it trimmed regularly.
Can I use normal dye on my new hair?
I was told umpteen times that I couldn't. The first time I lost my hair I endured dark curls and looked like a Monchichi monkey from the Eighties. I assumed the only option was a vegetable dye. It was about as effective as food colouring. I found a hairdresser who agreed to use a non-peroxide colour. It lifted my spirits so high and my hair didn't fall out or break off, nor did my scalp disintegrate or bubble up in blisters. Result.
If I follow a special diet, will it cure my cancer?
I have tried many diets over the years. I gave up dairy, wheat, sugar, alcohol and smiling. The smiling disappeared organically, along with the exclusion diets. None of this worked for me.
I feel like a drug addict. Should I stop some of the tablets I'm on? I never wanted to take this much medication.
There were times when I feared I would rattle as I walked, I was on so many tablets. Try to keep in mind that all the drug taking will probably be transient. For most cancer patients, treatments only last a matter of months. Anti-nausea drugs, painkillers, sleeping tablets, anti-anxiety tablets, laxatives, diarrhoea tablets or whatever you need to take, were invented for a reason. If you take them when you are in dire need, they'll work and you will have a better quality of life while on treatment.
Can I take alternative medication alongside my chemotherapy or radiotherapy?
I did this, so I am speaking from experience here. Please do not ingest anything without clearing it with your doctor first. At one point, I was happily taking Chinese herbal medication, assuming it was helping my body to fight. At the time I had both cancer and an autoimmune disease. It turned out the substance I was taking was actually coating my cells and would have prevented the chemotherapy from working. It terrified me and it was a lesson well learned.
Can I have facials during chemotherapy?
I love the relaxing feeling of a facial and during treatment it can be an ultimate treat. In some cases it's safe to have a facial. But for many people with breast cancer or indeed, head or neck cancer, facials might not be a good plan. During a facial the therapist uses massage; this moves lymphs around the face, neck and decolletage. If there is cancer present in the lymph nodes, this is a bad plan. We don't need infected lymph nodes being stimulated or moved. So, ask your medical team before making an appointment.
I've read stuff online and it's not what my doctor said. Who should I believe?
I hold my hands up here, I am guilty of hitting Google, especially when I'm worried. Remember, every case of cancer is different. The only people who can answer your questions are your doctors and nurses.
Is it okay to laugh during treatment?
I genuinely worried about this in the beginning. I have always had a dark sense of humour and believe me, it grew legs when I started my fight. Laughter is the best medicine, right?
Can I drink alcohol while I'm having treatment?
I assumed it was a total no-no. Depending on the type of cancer involved, most doctors allow patients to drink in moderation. If I'm out for a meal or at an occasion I will absolutely enjoy a drink. Check it out with your medical team, but generally speaking it's not a problem.
Will I ever feel normal again?
This was probably my biggest fear. I was, and still am, astounded by how my body bounced back after treatment. When I was in the wars I worried that I would never be "me" again, but my body has regenerated.
It's impossible to cover every question, but I hope I've shed a tiny ray of light on some of the little niggles that could be bothering you.
Remember, there is no right or wrong way to deal with a cancer diagnosis. Keep fighting the good fight.
Emma Hannigan is a brand ambassador for Breast Cancer Ireland. Visit http://www.actioncancer.org/