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Mike - Interview 09

Age at interview: 59
Age at diagnosis: 59
Brief Outline: Mike first noticed a cyst on his left breast in 2006. He was diagnosed with breast cancer in 2008. He had a mastectomy, chemotherapy, radiotherapy and tamoxifen. His radiotherapy was ongoing at the time of his interview.
Background: Mike is a taxi driver. He is married and has 2 adult children. Ethnic background' Jewish.

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 Mike had been experiencing problems with his breast for some time before his diagnosis. He first noticed a lump on his breast in 2006. They appeared on a Friday but had disappeared by the Monday. Then in 2008 he noticed the lumps again and they were painful lumps to lie on. He dismissed them at first. However, the lumps became more persistent and he eventually saw his GP after his wife’s persuasion. 

 
He felt ‘totally stunned’ by his diagnosis was a complete shock and he felt his life was at risk. It was a particularly difficult time because he was faced with redundancy at work. At first he only told his close family but is now open about his diagnosis and is willing to talk about it with anyone who asks. 
 
His mastectomy wound healed well after being drained a few times at the hospital. He found his first few chemotherapy treatments with Taxotere ‘a doddle’ but he had serious side effects with his later chemotherapy. He had extreme tiredness, swelling to both his legs and neuropathy in his feet that made walking difficult. Although this is resolving he is still bothered with pain in his feet. He had to battle through his treatment with the support of his family, Constipation was also a problem and his last dose of chemotherapy was at a reduced dose because he did not feel able to cope with a full dose. He is finding radiotherapy much easier to cope with and had only recently started tamoxifen.
 
He has a very supportive, close family and he is concerned about having a genetic fault that may have been passed on to his sons. Genetic testing may be something they will look into when he has finished treatment. He found phone calls from family and friends particularly comforting. They boosted his morale when treatment was difficult. He received a lot of breast cancer information, but none of it was relevant to men. 
 
Hearing his ‘cancer’ diagnosis had really upset him. He requested some counseling and found that talking to the counselor had helped him to focus on the positive rather than the negative; had had initially felt very angry about getting cancer. He has no hang-ups talking to people about his illness. He feels that his scar was still a bit unsightly. However, now with the end of his treatment in sight he is starting to think about life beyond his treatment and considering how he is going to move forward from his breast cancer diagnosis.
 
 

Mike had recurrent cysts which repeatedly flared up then disappeared. After a while he went to...

Mike had recurrent cysts which repeatedly flared up then disappeared. After a while he went to...

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 I think I made the biggest mistake that… I never really contacted the doctor earlier on. I think last year was obviously 2007 so it must have been 2006, I had sort of problems, slight problems with my left breast or my left nipple, as… I do vaguely remember that I was sort of getting, like, cysts come up, well… always happened on a Friday, always, excuse the expression, it’s Sod’s Law, it was Friday night and it used to become rather painful Saturday, Sunday would be great, Monday disappear. I took no notice of it. I thought it was like a cyst, like a spot you get on the face and it flares up and it must have been some time later, I took no notice of it, just forgot about it. Then I suppose come to 2008, February, March, April, it started to flare up again, the same cyst, and it always happened on a Thursday, Friday, I could not lie on my chest, it was painful, but couldn’t feel anything there. Then… I dismissed it. And then round about, I think, April or May, I can’t remember the exact date, I sort of felt something. Shall I, shan’t I? Then I went to see the doctor in May.

She examined me, she couldn’t find anything, and then a couple of weeks later, May, that’s the end of May, so beginning of June, it flared up again and then I could feel something. Then my wife said to me, “Look, you know, instead of leaving it, go and see the doctor, you seem to have a cyst there, it keeps going.” It may be, what, my wife had suffered always with cysts on her breasts and she’s always had it looked at and always had them drained. I thought well, possibly it’s the same sort of problem. Go along to the doctor and she examined me and she said “I don’t want to frighten you, but I don’t like, you obviously, there is something there, I’ll send you to the hospital.” 

 

Mike was stunned, upset and angry when he heard he had cancer. It was a ‘double whammy’ because...

Mike was stunned, upset and angry when he heard he had cancer. It was a ‘double whammy’ because...

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I remember looking at my wife and we were absolutely stunned, totally stunned. I didn’t know what to say. I think the first words that I uttered, “How bad is it?” Not such as, “How long have I got?” “How bad is it?” So he said, “Well, I need to tell you, it’s grade two.” So I said, “Well, what’s grade two?” “Well, grade one is so big and grade two is so big and it’s also gone to your lymph.” So… I was, well, I was deeply distressed, deeply shocked. There was a breast cancer nurse there and she was very good. Obviously, you know, the whole world suddenly fell underneath me because I was also put in a position with my place of employment where I’d been working for 16 years and they were, in the early part of the year were, you know, discussing redundancy for me. This was a family business but we won’t go into that, and I didn’t need both double whammies one on top of each other.
 
Can you still remember that raw emotions that you had at the time?
 
Yeah, very much so. It felt like my stomach had… it’s like you’ve been on one of these ghost train rides and suddenly something like that, my stomach suddenly sort of hit the floor. And I was speechless. I didn’t actually burst into tears. I just, that was just… didn’t know what to say. I did burst into tears a few days later with the shock of it, and of course, I think what it is, I’ve had counselling for some time, is that yes, you are angry, you are emotionally upset, you are very angry, why me? Well… it’s, that is, I suppose that’s nature. That’s the way it goes, but yes, you do feel anger, yeah. What have I done? What have I done to deserve it? Why hasn’t that murderer who’s committed, who’s spending time, you know, 25 years in prison, the one… the Yorkshire Ripper, why hasn’t it happened to him? He’s killed and done all these terrible things, what have I done? I haven’t done anything to anybody, but you can’t dwell on that. It is an emotional thing right at the very beginning, and I think also talking to the counsellor that I have been talking to has got me through it, has really sort of put my mind at ease, whereas basically just stop thinking of the negative side of things, you’ve got to start thinking of the positive, and this is what I have been trying to do, and sometimes you can’t help… going back and regressing back into the negativity. It does happen, it’s just human nature, but I haven’t got to a point that I’ve had to go and see my doctor and have antidepressants. No. I’ve had to combat it the difficult way. My wife’s been, my family’s been very, very supportive, and if you haven’t got supportive families then, you know, that’s… that’s very difficult.
 
 
 

Mike experienced side effects like nausea and a metallic taste after his first four sessions but...

Mike experienced side effects like nausea and a metallic taste after his first four sessions but...

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 I was very, very nervous for the first course of chemotherapy cos I really didn’t know what to expect. It was… most sessions were two hours in time length. They injected the… the drug and all the other drugs that go with it to combat nausea and so on and so forth, and… I think the worst thing was that they didn’t warn me, when I talked about constipation, I know it’s not a subject that one wants to talk about, but had they warned me prior to… well, he actually gave me senna tablets. He said, “Well, take them if you need them” but… on the first time round it was just… I can’t believe it. It was just unbelievable. I mean, I thought the whole world, I thought that was worse than having chemotherapy, but I learnt after that, you learn and you pick up certain things that when they give you the anti-nausea tablets, which are very strong, and the combination of the chemotherapy does tend to bind up your works, and I found that prior to having the next chemotherapy that if I were to take the senna in the morning, in the evening, and then the following day morning and evening and carried on that I wouldn’t have… and after that episode, fortunately enough, I had no problems right the way through to the end, but the first lot of chemotherapy was to me was a dawdle. I was on taxotere for the first four, which I tolerated it quite well. I had a little bit of side effects, a little bit of a nausea and a little bit of sort of gastric reflux and, you know, the taste of the metallic… but when it came to the next four, which was the docetaxol, that was, that I found very, very hard, because… it would kick in five days or six days after the chemotherapy. It made me extremely lethargic, tired, loss of appetite, just wanted to sleep. Your mouth becomes, you know, with sores… and then afterwards your eyes start to stream and your nose starts to stream and that carries on, but then I was getting these… pains in the knees, in the knee joints… and I’ve forgotten what it was called. I don’t know, it was nephritis, I’m not sure if I’ve got the right expression for it, but it attacked my toes, the pain actually attacked both, as soon as it hit this foot, it would hit my left foot and then the pain would be excruciating. I mean… I just, it would just come on [clicks fingers] just like that and I, I just didn’t know where to put myself and the only thing that actually worked was paracetamol. Nothing else would touch it. Volterol wouldn’t touch it. I…

 
Was it neuropathy?
 
Neuropathy, yeah, sorry. What did I say? I called it nephritis. No, neuropathy, yeah, and… I learnt again with that how to control it. I knew as soon as, I always used to carry the paracetamol close by me. I knew as soon as my knee, I’d get the pain, I’d take the paracetamol. The trouble is, the paracetamol would take an hour to kick in but it was the only thing that sort of calmed the pain down, nothing else would, you know? 
 

Mike describes how he still has some ongoing symptoms a few months after finishing chemotherapy....

Mike describes how he still has some ongoing symptoms a few months after finishing chemotherapy....

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 I still have the problems now but not so bad cos they seem to be gently beginning to ease off, slowly, so my left foot is beginning to come to with my right foot is still… my toes, underneath my toes are very, very numb still and my toenails have gone discoloured, my nails are all fallen off partly, I bang them, a bit falls off here and a bit falls off there, but I’m not particularly bothered about that, and the same with my feet… but I suppose on the whole… a lot of people have said to me, “You know, you’ve combated it, you know, pretty well.” I’ve avoided, yes… I’ve had depressed days but I look at it this way is – thank God I don’t feel ill. I might have lost weight but I don’t feel ill cos I can now walk properly whereas at the beginning of December I couldn’t walk up the stairs. I just couldn’t walk up the stairs. My muscles still hurt. It does affect the backs of your muscles and the tops of your muscles on both legs, and if I do sit down for long periods of time I can’t get up until, until I actually start to flex my leg muscles.

 
I don’t think they warn you enough about the side effects. I know my oncologist writes down everything I say. In fact, I have to see him tomorrow evening and week by week he says, “Well how are your muscles” and I say, “Well, they’re not really that improving but they’re marginally improving but it’s not quick enough.” He’s sort of, he’s saying, “Yes, well, Rome wasn’t built in a day”, so I said “Well, that doesn’t make me very happy because I’m very uncomfortable. I can’t stand up, I can’t do, you know, I can’t do certain things that I want to do, and I’m stuck”. He says, “Well, you’ve just got to be patient. So I had to take his word for that, I’ve got to be patient and, you know, in a few months’ time these symptoms will disappear.
 
But you feel they are getting better?
 
I feel, yeah, slowly getting better. I know my left foot’s a lot better than… my right foot is, is marginally, I’m not having one of the… one of the symptoms where my feet would go very cold. I can have the heating up very high here and my feet would be like ice and it would take a couple of hours when I get into bed for my feet to become a normal temperature.
 

Mike attended counselling provided by a Jewish organisation.

Mike attended counselling provided by a Jewish organisation.

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Did you ask for the counselling or was it something that was offered to you?
 
No, I asked for the counselling. There is a Jewish organisation that I go for the counselling, it’s not a National Health thing, because I knew it would be all Macmillan counselling. It’s just that this particular organisation, about 15, 20 years ago when I was doing charity work, we used to support them in their days when they were pretty small and they would counsel, it was solely for cancer people, nothing else but cancer people, and over the years I suppose we’ve supported, I can’t remember, five or six years, and then obviously I left the committee and then I decided to, you know, try them, voluntary group, if you want to donate, you donate. If you don’t want to donate you don’t have to donate, you know? It’s not asking for any money at all, they don’t. I’ve found them very, very, very good.
 
Was it like a course of counseling or was it something that you can dip in and out of?
 
Well, no, she… funnily enough, she… the lady who I see, she wants to see me every couple of weeks and quite honestly, I keep saying to her, people are gonna start talking about us, because I really don’t know what now to talk about. I feel that, you know, I’m over the worst. I don’t know why you still want me to come along. She says “well, I know, we’ve still got things to discuss.” I said “well, if you don’t mind me coming along, I don’t mind going”, because one, it takes up a couple of hours of the day and, you know, at least I can talk to somebody and it just makes me more aware of things.
 
 
 

Mike thinks that other terms such as ‘chest cancer’ would not be helpful.

Mike thinks that other terms such as ‘chest cancer’ would not be helpful.

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And I was just wondering if you have an opinion on the term “male breast cancer”?
 
No. I think “male breast cancer” is quite adequate to use. When I’ve mentioned it to people they’ve all, you know, “male breast cancer, no.” What else can you call it? You can’t call it chest cancer. You can’t find another name for it.
 
So do you feel it sort of defines that men can get breast cancer?
 
Yeah, yeah, absolutely. 

 

 

 

Mike still feels a bit self-conscious about his scar but is getting over it. It is red and not...

Mike still feels a bit self-conscious about his scar but is getting over it. It is red and not...

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 Obviously a mastectomy in a woman is far greater than a mastectomy in a man. It’s much more traumatic. I mean, I am a bit self-conscious when I have a shower… and I said to my wife, “I don’t know whether I want to go swimming anymore.” “Oh, you can wear a vest.” I said, “Look, a grown man, you know, 59, 60, going in the swimming pool wearing a vest?” You know… “Well, you can wear a wet suit.” Where am I gonna buy a wet suit, you know? Don’t be silly, you know? So… I am a little bit self-conscious of that, I think that’s the only thing I’m a little bit self-conscious cos I’ve got quite a big scar across, across my chest there and it does look… and sometimes it’ll just remind me of somebody who’s had a stroke because it’s not quite a straight one, it just gives you that kind of impression, but… I’m slowly getting over that. I’m slowly trying to, you know… but whether I, you know, if I ever go sunbathing but I shouldn't think I’ll ever take my top off. I don’t know why, maybe.

 
I was interested by your comment, you said that for a woman a mastectomy would be so much worse, but it seems to have affected you as well.
 
Yeah, I… it’s affected me, I suppose because the scar is quite prominent still, it’s sort of sore at the moment to touch. It’s also, underneath my arm it’s still very numb and I suppose once the numbness and soreness has disappeared, so will it disappear in my mind and my thinkings about it. I think because at the moment I can’t put my arm down properly because it just feels like I’ve got a golf ball under my arm. There’s nothing there. I mean, it’s the way, I suppose it’s been cut the nerve endings that the surgeon said it could take up to a year to repair itself. It is a little bit unsightly. It’s not, you know, it’s quite red. In fact it’s a bit more redder now because of the radiotherapy treatment. And I suppose it makes me just self-conscious a little bit. But… actually sort of… I think it’s also the same thing if you go out, you go out in the street and somebody sees… sees you, there are certain people that you know, oh, I know that fellow’s got cancer, by just looking at the face. I do this, and sometimes when I’m sitting waiting to see my oncologist and he’s got patients prior to me, and all the same thing, bald, you know, I mean, fortunately I didn’t lose my eyebrows. But they all have a… as I said before, a typical look, and you sort of, some people say to you, you know… yeah, sometimes I think… they’re talking about me. That’s how I think somebody would perceive, you know, if they saw me lying out on a deckchair doing the same thing, it’s… I’ll probably get over it. And I mean, I’m not that self-conscious of it. I mean, I’m self-conscious when I see myself in the bathroom sometimes because I think it’s… it isn’t a particularly nice thing, so when you have a friend who’s actually a doctor, a retired doctor, and when he speaks, his face tends to go [gives example of the way in which the retired doctor speaks] he’s very well-spoken, his face sort of goes slightly upwards and that just reminds me of the scar, and I don’t know why. My wife finds it very funny, and so do I find it funny. And I suppose that’s how I perceive it at the moment. Yes, a little bit self-conscious of it, yeah, but I think in time, I’m not-self-conscious that I’m vastly depressed about it… had you not brought up the subject I wouldn’t have thought about it, but no, I suppose going away, going away on holiday obviously I can’t expose myself to the sun anyway. Yes, I would like to go swimming but I can’t see myself going swimming wearing, you know, a top.

Do you, does your wife see it all the time? You don’t hide it from her?

No, no, I never hide it. If I’m in the bathroom when I wash in the evening I’m always stripped to the waist. No, she often looks at it, sometimes looks at… hmm, seems a bit more redder today. I thought well, I’ve had radiotherapy, I mean, you know… you’re lying sitting underneath the sun for 24 hours, you know? 
 
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