In October 2017, mother of two, then aged 40, Andrea Clarke noticed a lump on her left breast. After going to her GP, she was referred to the Mater Breast Clinic. “I thought it would be nothing, just a cyst or something, but better to get it checked out for peace of mind.” Following her mammogram and her ultrasound, she was referred for a biopsy. “That’s when I started to worry and was trying to prepare myself for bad news. After my biopsy, I needed to go for an MRI to confirm my diagnosis and about 10 days later, my diagnosis was confirmed. I remember the day I got the call because it was Friday, 13th of October 2017.”

She discussed treatment and surgery options with her medical team and underwent a lumpectomy. “The lump was removed but my doctor was very upfront with me that he didn’t think we should do multiple lumpectomies, meaning if the cancer was still there after this surgery his recommendation would be to go straight for a mastectomy. We later found out that the cancer had spread, not to my lymph nodes, but to my margins. My doctor said his preferred approach was mastectomy and breast reconstruction all at once. I went ahead as suggested and I think it is the best thing I could have done because instead of having two surgeries, mastectomy followed by reconstruction, you get it all over and done with in a day.”

Following her surgery, Andrea’s mother was diagnosed with pancreatic cancer in November. “It happened very quickly for my mum. I was just over my surgery and then she was diagnosed. Just over a month later she was gone. She died in January 2018, and it was just a very difficult and challenging time for me. That summer, my relationship broke down and between how complicated that became and losing my mum, I took some time off work. I finished up with work around September 2018 to deal with everything and I didn’t go back until May 2020. Throughout, I was able to access counselling through my job, which I still make use of today.”

Following her return to work, in September 2020, Andrea attended a roller disco one evening with friends and work colleagues. “What I was doing in my early 40s at a roller disco, I don’t know! I ended up having a bad fall. I attended my physio the next day who said they suspected a hairline fracture in my hip, and I went to get an x-ray. After reviewing my x-ray, my GP said it needed further investigation, but he worried about some of the shadowing. He feared cancer. After being referred for more tests, in mid-September I got the news that the cancer had spread to my bones. I had no idea. It just showed up by chance in this x-ray from a fall at the roller disco.”

Test results revealed the cancer had spread to Andrea’s pelvis and was in her hip. “I needed an emergency hip replacement. There was also a small bit of cancer on my left hip as well, but my medical team were satisfied that it could be dealt with by radiotherapy. I ended up needing radiotherapy on my hip, my spine and parts of my neck. After radiotherapy, I was onto an oral chemotherapy treatment, but after about 2-3 months, I began developing very bad side effects with toxicity in my liver – the only way I can describe it is that it was like having a permanent hangover, I just felt awful. In June 2021, I came off those drugs and took a break to let my liver recover before starting a new oral chemo which thankfully, I’ve been on since and don’t have any side effects from.”

Reflecting on her diagnosis and cancer experience, Andrea says “I am living with advanced, incurable cancer but I have to say, the medically induced menopause has actually been more difficult to deal with. It has hit me like a train. That began in October 2020, and I still go every month to get those injections into my ovaries. The joint pain, the hot flushes – it’s been very difficult to cope with and while my medical team have been fantastic throughout, I feel like there’s nowhere really to turn to talk about the menopause and the impact this has had.”

Throughout her diagnosis, Andrea has faced many financial challenges as she came to terms with the cost of cancer. “I am fortunate that I have been able to keep my job and my employer has been very understanding, but when I’m out of work, I’m on a reduced salary. But everything, all the bills don’t suddenly stop – you have your normal weekly and monthly outgoings, I have two teenage kids and then you have the additional costs of your treatment on top of that. The costs build up everywhere. Putting petrol in the car to get to and from your appointments. Carparking charges at hospitals. Thankfully they’ve been done away with now, but I think I must have paid over €1,000 in in-patient charges. I have to pay €470 annually for the rest of my life to get a bone scan – the doctors suggested last year that I needed another scan, so that was nearly a €1,000 on those scans alone. Thankfully, I have a medical card, so the cost of my medication is discounted, but I still have to pay for that. This is all money I don’t have. When I separated from my husband, we sold the family home, and it is only through that windfall and inheritance from my mother’s passing that I have been able to cope financially. I can’t get a mortgage because of my diagnosis, I can’t afford rent in Dublin. I am incredibly fortunate to be able to stay in my sister’s home while she lives abroad in Germany – otherwise I’d be in a homeless hub.”

Andrea is sharing her story because she wants to highlight the financial burden that can be associated with a cancer diagnosis and the impact her diagnosis has had on her mental health. “Nobody really talks about the financial impact of cancer, and I have found that part really challenging. As well as the practical and financial toll, there is also the mental toll and I think I have gotten to a point where I just feel quite alone. I feel lonely and I feel isolated. And while I have had amazing support from family and friends, and I have accessed supports—you name the organisation, and I have probably been there and tried to make use of their supports—but ultimately, it is just me having to face this and there’s a limit to what people can help you with. I still need to get myself up and get myself out of bed in the morning and keep moving forward. Maybe I just need to meet somebody. I’m thinking of setting up a dating app – some sort of Tinder for cancer patients! It’ll probably never take off.”