Metastatic breast cancer may not be much discussed and information on the disease is lacking. Stephanie Fsadni meets Doris Fenech, who has been living with metastatic cancer for the past six years. Despite her failing health, she is intent on helping others in her situation and has co-founded a support group.
Cancer may be a traumatic experience and its recurrence can only be described as “devastating”, as Doris Fenech puts it.
Doris, 55, has metastatic cancer, meaning that her primary cancer spread from the area where it originally started to other parts of the body (metastasis).
She was first diagnosed with breast cancer in 1996 at the age of 37, when she was still a young wife and mother of a two-year-old daughter. The cancer disappeared after a few years of treatment.
But her battle with the disease was not over – in 2008 she was diagnosed with metastatic cancer. ‘Luckily’, the cancer had only spread to one spot in the bones. She started treatment in the form of Zometa, an injection that helps reduce and delay bone complications.
This therapy seemed to be working and Doris felt well, but three years later, she found out, much to her disbelief, that the cancer had also spread to her lungs.
“It was a big shock,” Doris says as she recalls the day when she got the results.
“I thought ‘there must be some mistake, these results couldn’t possibly be mine’...
But she soon realised there was no mistake and the truth hit her like a ton of bricks.
“It was devastating... I think it’s the worst thing that could happen to you.”
Doris, who is a nurse at Mater Dei’s Breast Clinic, knew well what the future held for her: continuous investigations and treatment.
“Even though you kind of expect that cancer will return one day, you certainly don’t like it. You know that you will need treatment for the rest of your life and that you will never be cured.”
She started chemotherapy and Herceptin, which is a targeted therapy for metastatic breast cancer, besides Zometa. In the beginning, she underwent treatment once a week at Boffa Hospital but nowadays she has it once every three weeks.
Doris says that the worst aspects about cancer are not only the effects of the disease, but also the side effects of treatment, especially pain and tiredness.
Fatigue is starting to take its toll on her. She still works full-time but by the time she arrives home, she is physically exhausted.
“I feel my energy is seeping away. I can barely do any house chores anymore. And it’s very frustrating for someone who’s used to being so independent and always on the go.
There’s no escaping reality. You are constantly reminded that you’re sick
“People may wonder why I still work. But why should I stop working because of this disease,” she asks, her voice tinged with anger.
She adds that her job requires more mental than physical exertion.
Her family is very supportive and her two daughters, both in their 20s, are a pillar of strength.
Something else which Doris finds very annoying are the constant appointments, which keep reminding her of the disease.
“There’s no escaping reality,” she says as her eyes turn watery. “You are constantly reminded that you’re sick.”
Despite these feelings and health issues, Doris is intent on helping others in her situation. Last year, together with two other women, she set up the Metastatic Cancer Support Group within the Breast Care Support Group Europa Donna Malta.
“When you’re diagnosed with cancer, you get a lot of support, but when it develops into metastatic, people, even professionals, are sometimes at a loss of how to help you or what to tell you.
“No one used to talk about it until recently, even abroad. And information is certainly lacking.”
The group is thus working on a booklet with practical advice for patients such as how to apply for a Blue Sticker and what incentives or schemes are available for people who have to stop working because of their illness.
They have also translated into English the European Guidelines for Metastatic Breast Cancer which were published in French only recently by the European Society for Medical Oncology. Professionals worked hand in hand with patients for three years to draft these guidelines.
Guidelines for patients
Doris had the opportunity to give her own input when she was invited to Lisbon last year to share her experience and give her views and advice.
“These guidelines are not only important for professionals but also for patients, because it gives them a good idea of the treatments available and they can make a more informed choice.
“However, one has to keep in mind that not all treatments mentioned in the guidelines are available in all countries.”
Earlier this year, Europa Donna organised a conference on metastatic breast cancer for health professionals in Malta, where they hosted Fatima Cardoso, the director of the Breast Unit of the Champalimaud Cancer Centre in Lisbon, Portugal, and the Breast Cancer Programme coordinator of the European School of Oncology. Cardoso is also the brains behind the metastatic breast cancer guidelines.
The group also set up a Facebook page, Metastatic Breast Cancer Malta, with updates on research and activities being held in conjunction with Europa Donna Malta.
The team aims to lobby on a number of issues, one of which is special leave entitlement for therapy purposes.
“Why should I take a day’s leave to go for a day’s treatment at Boffa? This kind of sick leave is already available in some European countries,” Doris claims.
Anyone can attend the meetings of Europa Donna which are held the first Thursday of the month at the NGO’s drop-in premises in St Anne Street, Floriana.
Europa Donna holds many activities throughout the year, especially during October, which is Breast Cancer Awareness Month. October 13 is Metastatic Breast Cancer Awareness Day while October 15 is Breast Health Day.
Doris encourages others like her to make their voices heard and share their experiences.
People with such conditions find strength in numbers. Living with cancer is certainly not easy and reality may be hard to accept... even for Doris. She admits that she still has not applied for a Blue Sticker herself even though walking is becoming a tiresome feat.
“Perhaps I haven’t accepted my condition yet. You know, it’s a hard pill to swallow.”
For more information, call 2148 2602 or helpline 9999 4666; visit www.europadonnamalta.org.mt or the Europa Donna Malta and the Metastatic Breast Cancer Malta Facebook pages.
Upcoming activities
Europa Donna Malta
• October 15: Hilda Schembri Memorial Lecture at the Phoenicia Hotel: A public lecture with guest speakers Elizabeth Bergsten Nordstrom, president of Europa Donna – European Breast Cancer Coalition; Prof. Christian Scerri, clinical and molecular genetics specialist; and breast cancer survivor Anne Micallef.
• October 18 (Breast Health Day): Valletta activity in St George’s Square, Valletta, between 9.30am and 2.30pm under the patronage of President Marie-Louise Coleiro Preca.
• November 2-14: Awareness Through Art exhibition at Palazzo de Piro, Mdina.
For more information, visit the Europa Donna Malta Facebook page or www.europadonnamalta.org.mt.
Action for Breast Cancer Foundation Malta
• October 20: Opening of foundation’s new premises in Mosta.
• October 9, 16, 23 and 30: Ladies Rock at Hard Rock Valletta Waterfront: Gigs featuring leading female artists as part of Breast Cancer Awareness Month.
For more information, visit the Action for Breast Cancer Foundation Malta Facebook page or www.actionforbreastcancer.com.