Metastatic Breast Cancer: “There’s a part of me that’s really angry, and I have to accept that. I let myself feel what I feel’
For 45-year-old mother-of-two Avril Tierney, being diagnosed with triple-negative breast cancer in 2019 was “terrifying.”
In those first few weeks, I felt like my world was turned upside down,” she says. “I was having panic attacks for the first time in my life and I felt completely out of control. It took me some time to collect myself, but one morning I woke up and realized that the only thing I could control was how I was in the situation. I could continue to panic or refocus, stay present and just keep going whatever comes my way.”
Avril, who lives in Laois, had previously trained as a counselor and psychotherapist and had privately visited clients alongside her ‘full-time job’ at Extern, a youth project in the Midlands. This training and the understanding it brought her was invaluable.
She underwent treatment that included chemotherapy, radiation therapy and a lumpectomy. After that initial treatment, a scan showed two cancerous nodules in her upper right lung. It was 2020 and the diagnosis was now metastatic breast cancer. The upper right lobe was removed, after which she underwent further chemotherapy. A second CT scan showed further spread in the same lung. “Unfortunately,” she says, “this time it was treatable but not curable, so I’ve now moved to a stage 4 diagnosis.”
That was two years ago, and since then Avril has been on a combination of immunotherapy and chemotherapy and has “made a conscious choice to live my life as normally as possible,” she says. “To adapt to the new change and move forward.”
She had stopped working after the initial diagnosis. “I was so overwhelmed and so tired of everything I was going through. But once I started the treatment I’m on now – it wasn’t that harsh in terms of side effects – I realized I needed to do something that would engage my brain and keep me busy.
“Externals were incredible. It was very difficult to go back at first – you are exhausted to the core from the experience of cancer. But I also knew that I felt better than before and that every little sense of normalcy mattered. The feeling of somehow finding myself again. And it was wonderful to be back here.”
She says it’s “difficult to juggle the kids, home, work and treatment, but I can do it.” Her daughters, Tamsin and Tess, are 11 and seven, respectively. How much did she tell you? “Tess recently asked me why I keep going to the hospital. She was only three when I was diagnosed, so she can’t remember a time without it.
“In the beginning I remember telling them I had to take a special drug and that it would make me look a little bit different. I was glad I prepared her because after two weeks I was bald. But they obviously had no real idea of what was going on, and neither did we. You were too young.
“This time I chose the cold hood so I don’t lose my hair. I think it helps them that I don’t look any different. Now I tell them the cancer is in my lungs and the hospital wants to keep it there and make sure it doesn’t go anywhere else in my body and that’s why I go back so often. I make sure to give them space to ask questions, and when I have a day when I’m upset, I try to be open with them about how I’m feeling. There is a balance between saying too much and saying too little. But the truth is, I have to keep doing this – even on the days they want me to be at their house. I can’t call in sick at the hospital,” she jokes wryly.
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Avril Tierney, with daughters Tess and Tamsin and rescue dog Bella, at home in Co Laois. Photo: Paul McCarthy
How much does she think her training in psychotherapy has helped her? “I would have dismissed that at first, but now I think so. I learned to practice what I preached. I would have told clients to “stay present” and that has become my mantra. This is how I live my life – not in a forward or backward spiral.
“Be mindful and in the moment. It’s hard to do, it takes work – I have to work at it every day and there are days when I can’t make it, but thanks to my education it’s part of my ability and I draw heavily from it. I made a conscious decision not to lose myself in it. Cancer is not who I am. I have kept that in mind and consciously try to be present in what I do.”
There are, says Avril, “Days when I wake up and don’t remember that I have cancer. I’ve learned to share. Sometimes I’m halfway through the day – even longer – before I remember.” But, she says, “there are other bad days that I can’t help but panic and have the worst thoughts. But that’s the deal – if you’ve chosen to be present, you have to accept the bad days with the good days. At first I would refuse to accept them. I’d say to myself, “It’s okay, you’re okay.” Until I realized that it actually made me feel worse. Because the truth is, part of me is really angry, and I have to accept that. Now I let myself feel what I feel. When I’m feeling down, I tell myself, “That’s okay. It’s not okay. This is a bad day, but it’s going to get better.’”
Between treatment and the scans — right now her schedule includes traveling to St Vincent every two weeks, which is a positive step from the previous regimen of once a week for three weeks with a week off — she wants to forget it everything. “I could waste a week worrying about a scan I had, but I’m not trying. I see the worry as a waste of time. It certainly doesn’t change the outcome, but not worrying makes a hugely positive difference for me and the people around me.”
Her latest scans were very good and showed that the tumors had reduced in size by half and remained stable. This means she now has a six-month schedule for scans instead of three months.
And yes, there is pressure at times to blame yourself for other people’s upsets and heartaches. “I understand that,” says Avril. “People are emotional. And they have the right to do so. My family is devastated. My husband’s life was also damaged as a result. But at the same time this is not the case East of; that is my life. It’s not a drama for someone else to go through. My family and friends remember it very well.”
Somehow Avril found “an inner strength” that keeps me going. “I lost friends because of it,” she says. “A woman who was diagnosed at the same time as me and she’s dead now. On paper that should be me and yet here I am and I’m fine. I am very grateful for that. And I choose to remember that feeling of gratitude.”
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Avril Tierney, with daughters Tamsin and Tess, at home in Co. Laois. Photo: Paul McCarthy
For the same reason, she has moved away from the initial guilt — the feeling that “I brought this horror into everyone’s life” — that will be familiar to so many who have had a cancer diagnosis. “I grew up to understand, ‘I didn’t do that. I didn’t want that.” I don’t feel guilty now. Most of the time,” she says, “I feel really good. I get up every day, walk the dog, take my kids to school, I enjoy those things and I’m grateful because maybe it’s not always like that. People think you should go skydiving or trekking to Peru, but my bucket list is taking my kids to school, picking them up, seeing my husband and going about my daily life.”
A metastatic diagnosis doesn’t mean life stops, says Avril. “Yes, it’s devastating at first, but you can move forward and live a full life with hope for the future, especially with advances in drug discovery and targeted therapies. There are always new studies, new drugs. That gives great hope.” There is, she says, “a lot to do living with cancer. But the keyword for me is “live”!”
Ahead of World Cancer Day on February 4th, Breast Cancer Ireland has launched #MetastaticMatters, a campaign focusing on people living with a diagnosis of metastatic disease. See Breast Cancer Ireland.com for more informations.
What is metastatic breast cancer?
- Metastatic breast cancer, also known as stage IV breast cancer, is cancer that has spread outside the breast to other areas, such as the bones, liver, lungs, or brain. This process is called metastasis.
- Breast cancer that spreads to the bones, lungs, or liver is still breast cancer and does not become bone cancer, liver cancer, or lung cancer. Under the microscope, the tumor cells still look and behave like breast cancer and are treated as breast cancer. Metastatic breast cancer is treatable, but not curable.
- Treatment is lifelong and focuses on preventing further spread of the disease and treating symptoms. The goal is for patients to have a good quality of life for as long as possible.
- Some people have minimal or no symptoms of metastatic cancer. If symptoms are present, they are based on the location of the metastasis.
Warning signs of metastatic breast cancer
After primary breast cancer, be aware of these secondary breast cancer warning signs:
- Lymph Nodes – Swelling, lumps, and pressure in the chest, armpit, and neck areas. Dry cough.
- Lungs – sharp pain in chest and back when breathing. cough and/or tiredness. Blood clots can cause shortness of breath.
- Spinal cord – pain or tenderness in the middle or upper back. Severe lower back pain. Back pain that gets worse at night or when you cough or sneeze.
- Liver – bloating, changes in appetite, weight loss, tiredness, weakness, or pain near the ribs on the right side.
- Bones – any new, unusual or increasing pain in the bones, e.g. B. arms, ribs or back. Dull pain or stabbing pain.
- Frequent headaches, vomiting, dizziness, blurred vision, seizures, mood swings, balance problems, or tiredness.
https://www.independent.ie/life/health-wellbeing/living-with-cancer/metastatic-breast-cancer-there-is-a-part-of-me-that-is-really-angry-and-i-have-to-accept-that-i-let-myself-feel-what-i-feel-42317462.html Metastatic Breast Cancer: “There’s a part of me that’s really angry, and I have to accept that. I let myself feel what I feel’