4 Body + Soul

THE TIMES Saturday July 23 2011

Red lipstick, a bespoke wig and dark nail polish got me through
Breast cancer at 31
New statistics show that breast cancer among younger women is on the rise. Sophie Beresiner, a 31-year-old beauty editor, describes her shock diagnosis last year and how wigs, black nail polish and red lipstick got her through it
enough to have swiftly and calmly taken charge of the situation. While I’m glad that he broke the news, I spend a lot of time trying to imagine what it must have been like for them. They were, outwardly at least, calm and composed. At the hospital within the hour, they have continued to make me feel measurably better at every low. During a period of tests to establish what stage I was at, scans to see if the cancer had spread, countless needles and anticipation of results, I was consumed with worry about the possibility of losing my hair, even then. This could have been an effort to blank out the scarier stuff, it may be because I work in the media, and the media portray canceras a bald episode with vomiting and sadness. Or it could be because I am a beauty editor and a woman, I should point out, who was always all about the hair. If you were to describe me to a stranger, it would always start with “long, dark hair”. It was happily curly or wavy, depending on its mood. I had just fully mastered curling tongs and then, bam! I’m losing it. This is not something I had ever contemplated, except when considering Gail Porter on the odd occasion and wondering how she copes now that her hair is falling out a second time. Chemotherapy doesn’t always involve hair loss, but, in my case, the strong cocktail of drugs meant that there was no point even trying the hair-saving cold cap — a helmet to cool the area and restrict chemo-carrying blood flow to the follicles. I developed a habit of tugging at my recommended new pixie crop to check that it wasn’t falling out. One evening, soon after my first cycle of chemotherapy, I tugged out a worryingly large handful of strands. Cue immediate meltdown. I somehow didn’t believe that I would be so textbook as to suffer the predicted side-effects,
JON ENOCH FOR THE TIMES; HAIR AND MAKEUP BY FIONA FLETCHER

Sophie Beresiner at her home in North London

B

eauty is my business so to be peering at my post-chemotherapy, naked eyelids in the mirror every morning, willing on the reappearance of my loved and lost lashes, is a world away from my ordinary life. This is what I now know; no amount of mascara can help when thinning lashes turn into no lashes, but a simple imprint of the brush can cheat them from afar. Even nails do not go unscathed where chemo is concerned — it attacks all fastgrowing cells, cancerous or not — but dark nail polish is a good camouflage. And my knowledge of rehydrating parched skin is second only to a Harley Street dermatologist, or a Crème De La Mer PR. In December last year I had breast cancer diagnosed. This followed a fourweek period of initial referral by my GP (no inkling of anything scary just yet), ultrasound at hospital (still fearless but secretly enjoying the sympathy opportunities that “biopsy” presented), then results one week later with a consultant surgeon (glimmer of fear the night before, but nah, couldn’t happen to me). The fact that it did was such shocking news for a 31-year-old that my GP called to tell me how shocked she was — her initial diagnosis of a cyst was a far more likely scenario, considering my age, my lack of family history and the size and symptoms of the tumour. It was so shocking, in fact, that my memory of being told is terrifying but somewhathazy — a protective brain mechanism where everything fades out. My boyfriend and I had taken the day off work and planned anice lunch afterwards. Needless to say, that didn't happen. Instead, December 6 became the first and hardest of my long list of cancer milestones. Part of that day was taken up in a quiet room at the hospital, being consoled by a rushed nurse, with a requisite head tilt and knitted eyebrows. “The next few months will be a rollercoaster ride, with extreme highs and lows.” Highs? There can be only lows, I thought. If I think about what still haunts me today, it is telling my mum and dad. We have always been a close family, comprising a still happily married set of parents, my sister, Amy, and me. We grew up in Claygate, Surrey, among a succession of Siamese cats and inappropriate boyfriends. I feel funny if I don’t speak to my parents at least every other day, so it was unsurprising that my first thought was “I need them”. My boyfriend Raja went to make the call — I don’t think I could have got the words out, and he knows me well

‘‘

My boyfriend shaved my hair off, cuddled me and told me that I looked beautiful

so although I should have been prepared, I was beside myself. There followed a lengthy discussion with boyfriend and Google on what to do next. It turned out that Google was not so helpful, but my boyfriend was infinitely more so. He shaved my hair off, cuddled me and told me that I looked beautiful; I avoided mirrors for the next 24 hours or so. He cleverly developed some endearing, topically relevant pet names that I should have taken offence to — Garry Baldy and Mr Magoo taking particular precedence — but, when delivered right (he is a funny man), had me laughing when all the signs pointed to melancholy. This is a common and important thread throughout my cancer experience, and highly recommended to keep you peppy when peppiness is pretty much medically advised. My wondrous and comedic partner has been more effective than chemotherapy, which I can say in all truthfulness because the ineffectiveness of the drugs led to another unexpected low, a full mastectomy. In the end my tumour-to-tit ratio was such that a lumpectomy wasn’t an option. I’ll be honest, as a beauty editor and young woman (in cancer terms at least, 31 is young), how I look is of significant importance to me. Once I stopped feeling guilty that I was consumed with worry about being bald — how superficial of me — I realised that, of course, I would worry. I am a woman; the effect on my looks is a tangible aspect of a runaway disease that I have zero control over and little understanding of. My shifting reflection in the mirror does feel important ahead of everything else. I was constantly aware of this terrorist taking up squatting rights in my left boob, but with everything happening so fast the only handle I had on what was going on in my body was the physical change in my appearance. And the baldness was only the beginning. I eventually conquered that with the help of my hairstylist and dear friend Claire with her social-life-saving advice on wigs. Claire’s wig philosophy champions bespoke rather than off the peg, so she cut “me” styles and coloured each wig differently, according to my progress. Basically, the less feature-defining facial hair I had, the lighter the wig. What the movies don’t focus on is disappearing eyelashes — a screamingly obvious cancer beacon and more difficult to cheat than a wig — yellow-tinged skin or ridged and dying fingernails. My beauty industry experience does not cover these eventualities, so I learnt from scratch that dark nail colours are the best camouflage, wearing bright red lipstick (Rouge Dior in Red Premier) is happymaking, and there is nothing doing for yellow skin other than a colour-processing app, so photographic evidence will for ever be altered in history. A life, body and wardrobe-altering mastectomy, however, was the cherry on the cake. Or off it, as it were. I am a natural optimist. But during the eight months of treatment so far I had a series of disappointments that rewired my brain to become rather more pessimistic. These ranged from “It’s a cyst; no, it’s fibroadenoma; no, its unquestionably cancer”, to “It hasn’t spread, we’ll just triple-check that it hasn’t spread; Oh, wait, yes, it has spread”. The acceptance of the surgery came in the five weeks between chemo finishing and breast going. I spent it in a purgatory

‘‘ ’’

If anything, this experience has taught me more about the strength in other people than in me
where nothing was happening. I wasn’t being treated, had an overactive imagination and a very large dose of anxiety. This being a commonly acknowledged occurrence in this in-between stage, I kept well away from the internet, hospital literature, well-meaning friends, with friends-offriends stories, and spent my time failing to imagine what life would be like with one boob. I particularly failed to imagine what it would be like to wake up from the op without all of my body parts, and so vowed to never look down. When it came to it, I was surprisingly OK. This was, in part, down to my distracting and loving hospital entourage of parents, boyfriend and best friend Katie, in part the morphine, and in part the betterness of reality over anticipation. If anything this experience has taught me more about the strength in other people than in me. I do what the doctors tell me, hold my breath and get on with it because, really, I have no choice. I don’t feel brave or special, but I really, really notice it so much in the people around me. It was these people who breathed the biggest and most heartfelt sigh of relief when I received the news that the cancer was gone, it hadn’t spread farther than two measly lymph nodes, and I could finally look forward to the future — a cancer-free gift of epic proportions. Their collective happiness made me realise that by loving association they had been as affected by my illness as I had, so I’m as proud of them as I am of me, which is a lot. That particular news preceded the purest happiness I have ever felt, which, I have to hand it to the cancer, I wouldn’t have experienced had I not started leading a life less ordinary. The pure excitement at watching the progress of my 2cm-long hair and tentative appearance of frizzy eyelashes is almost worth losing them for. My recovery will be apparent in my appearance, just as my illness was, and I’m hugely looking forward to the day when I can go to the office resplendent in pixie crop and mascara rather than a brown wig and false eyelashes. I’ve been hoarding a redundant collection of mascara the whole time. Oh, and superficial doesn’t even come into it. At a time when huge importance is placed on keeping a positive attitude, the confidence-crushing effect that cancer can have on appearance is definitely not something to be glossed over. Lip-glossed over, maybe . . . Sophie Beresiner is the beauty editor at Look magazine. sophiefeelsbetter.blogspot.com, lookgoodfeelbetter.co.uk

Why are we facing this tide of cancer?

A

t some point in our lives, two in every five of us, the highest proportion yet recorded, will hear the words “You have cancer”. Alarmingly, this figure is going to rise. Respected international research has predicted that the number of cases worldwide will more than double from 12.5 million in 2008 to 26.4 million in 2030. Statistically, you’re most likely to hear the news later in life as the average age for diagnosis is 68. (There’s an old oncologist’s joke that when we all live to the age of 200, then we will all die of cancer because we’ve escaped everything else.) Yet cases among younger people are also on the rise. The latest figures from Cancer Research UK show that rates of cancer in people aged 40 to 59 (young for cancer) have increased by 20 per cent since the 1970s. Why this is happening is a matter of intense debate — only this week scientists at the University of Oxford reported that taller people were more likely to suffer from a wide range of cancers. Cancer Research UK believes that it is a combination of modern lifestyle factors such as obesity, lack of exercise and increased alcohol intake that can increase your chance of getting certain cancers, especially of the breast. But others claim that it’s not the whole story and that at least part of the answer lies in our testing and screening programmes. Some experts believe that it is telling that the top two cancers — breast for women and prostate for men — have increased by 60 per cent and 55 per cent respectively since 1979. These are also the two cancers covered by either a test or screening: all women over 50 are screened for breast cancer, and men can request a PSA test for prostate cancer. It doesn’t tell you whether you have cancer, but it does reveal if you have high levels of the PSA protein in your blood, which is often (but not always) an indication of cancer. It also doesn’t tell you how fast or slow-growing the cancer is; many prostate cancers grow so slowly that they would never cause a problem if left untreated. “There’s good evidence that if you do screening, then you prevent deaths,” says Professor Martin Wiseman, medical adviser to the World Cancer Research Fund. “But I think we are also picking up

‘‘

Even taking all the snippets of information together does not explain the rise in breast cancer

cancers that never needed to be picked up in the first place.” Baroness Delyth Morgan, chief executive of the Breast Cancer Campaign charity, says there’s no doubt that screening does push up the numbers diagnosed. About 11 per cent of the 50,000 cases diagnosed every year have only pre-cancers, or ductal carcinoma in situ (DCIS). “At the moment it’s just not possible to know if these will go on to develop into life-threatening cancer, which is why women are offered treatment for cancer. I know people say that’s overdiagnosis, but if you’re that woman with DCIS, how do you know it’s not going to develop into cancer? We would love pre-breast cancer to be much better understood, which is why we fund research so that so many women don’t have to have treatment they may not need.” She believes that the huge rise in breast cancer among middle-aged women is because of earlier and better diagnosis and partly because of modern lifestyles. “The lifestyle changes are quite profound. It was not long ago that women had more children and were more active — those differences are quite pronounced.” Professor Peter Johnson, Cancer Research UK’s chief clinician, agrees that screening has brought more cases to our attention but doesn’t think that we are overdiagnosing. “I don’t think it’s a big issue, although in prostate cancer it does mean that many more cases of early cancer are being discovered, which may never have been a problem for the men concerned,” he says. He believes that lifestyle is important: obesity and lack of exercise are factors for many cancers. And for breast cancer, you can add alcohol (one drink a day increases the risk by 12 per cent), having children later in life and not breast-feeding. Professor Johnson says that it’s accepted that about 40 per cent of all cancer cases could be prevented by lifestyle changes. Not all are convinced. The veteran oncologist Professor Gordon McVie, now at the European Institute of Oncology in Milan, thinks that lifestyle can’t explain this huge tide of cancer. “There’s no doubt that increasing alcohol consumption in women is associated with an increased risk of breast cancer, but it does not go anywhere near explaining it. It’s the same with having babies later and not breast-feeding. Yes, this might account for a 1 per cent risk, but these are all little snippets rarely validated in larger trials. Even together it does not explain the rise in breast cancer. None of the usual culprits adds up to enough.” So, why the increase? “I think we have to put up with the fact that we don’t know all the answers yet,” he says, although he and Professor Johnson would like more research into the interaction between our genetic predisposition to cancer and our environment and lifestyles. “It’s the old question: why doesn’t every smoker get lung cancer?” McVie says. “Maybe there’s more of a genetic story than we understand.” Rachel Carlyle