Haydn Shaughnessy was beginning to feel as if he was some kind of Jonah when it came to breast cancer. But he was quick to realise the focus is not on him
When consultant surgeon Mr Kelly drew a pencil picture of a breast, as my wife and I admired the likeness but sat, apprehensive, in a breast cancer suite at the South Infirmary, Cork, I began to feel like Becky in the old Jewish joke.
Breast cancer is no laughing matter of course but we find that the odd chuckle helps our sanity since the diagnosis six months ago.
An old Jewish man is contemplating the end and he turns to his wife who stands dutifully by his bedside.
"Becky," he says, "when we lived in the ghetto and the Nazis came and took everything, destroying our home, taking me to the camps, you were there by my side. When I was starving from lack of food and sick after they beat me, you were there by my side. After the war when I started my business again but lost everything when my customers went bust, you were there by my side. I'm dying now Becky and you are still there, by my side. Becky, you are a fecking jinx."
I call that joke to mind nearly every day and the reason is that while Mr Kelly described the first operation he would perform to remove Roos's tumour, I thought: "I've been here before."
Roos, I thought, is the second intimate friend who has been diagnosed with breast cancer. Am I a jinx?
On reflection though she is not the second. There's my sister as well. And Roos's sister. And her mother. And her aunt.
None of these is thought to be genetic cancers. It's just that breast cancer seems to be breaking out all around us.
Though the official figures are that in western society one in nine women will contract it, the figure has reached more like one in five in my intimate circles.
And why I feel like Becky is that somewhere deep in my own psyche I can't help feeling responsible for it, in some small way. Whether through encouraging women to use the contraceptive pill, to suit a more sexually permissive lifestyle, or having children later to suit our career needs, or subliminally playing my part in the weight yo-yo of dieting, we are unconscionably decimating the female population.
We're doing it at twice the rate of road deaths. Whereas we advertise the effect of speeding cars, we've yet to grasp the responsibility we all bear for the agonies women are going through.
Cancer treatment is painful and lasts for months. The security that comes with health is gone forever. And if the treatment fails, Dr Evil could not have contemplated a worse end.
Yet women somehow come round to seeing the positive.
I have watched women in various stages of treatment, recovery, and those for whom hope is irrational, provide each other with unselfish comfort. They are going through something we cannot easily understand.
Understand it or not though the man has a role.
There is nothing that I have found to explain what the man should do or how he might feel, even though he might be the main pillar of support for months, if not years, to come. And the effects of cancer are pervasive because it invariably gravitates around stress.
In our case a house half built with a builder who'd walked and an architect who refused to take responsibility meant Roos has been staring through the window at our future home for two years, unable to get the children in there as one insurer refused to pay up and the other gets tough by counter-suing while Roos fights for her life.
Through stress, cancer affects every aspect of life and demands of the husband or partner to work at improving... just about everything.
This is what I've found to be necessary:
1. It's not about the man but men have to face up to their wives' illness and start planning. You are part of a life-saving operation, perhaps the only one for whom the role becomes permanent.
2. Being positive is vitally important but in reality it means acknowledging the danger and honouring your wife's way of dealing with it. There is no such thing as an undignified response to cancer.
3. Never let her go to appointments with the surgeon, oncologist or radiotherapist, or to treatment, alone. If you can't go, make sure somebody else does. Once your wife finds a lump, you are no longer early, and nobody should be left to face that reality alone.
4. Seek out psychological and related support services. For example, where can your wife get the best wig coupled to a sensitive handling of hair loss and regrowth? Versacchi (www.versacchi.com) offers a perfect service. Psychological support is available at Ark cancer support houses. Home help, travel subsidies and a wig subsidy are all on offer. Use reputable information sources like www.cancerbacup.org.uk or www.breastcancer.org. We avoided alternative therapies but we use alternative wisdom to support chemotherapy through diet.
5. Doctors talk in percentage terms but to go from one meeting where they quote a survival rate of 85 per cent, to the next and hear 75 per cent and the next 50 per cent is disturbing. Try to personalise the process rather than thinking in numbers. This is your wife, your family. What are you going to do?
6. Try to ensure that your wife's treatment is properly agreed between the different specialists and that they are being consistent. The more questions you ask, the more chance you'll make an informed decision when the chance arises. We found we were able to take control of operation schedules and the timing of radiation, when the doctors disagreed.
7. Chemotherapy can be traumatic. From the first signs of hair on the pillow a woman's confidence goes down and the feeling that this is a punishment grows. Nausea, headaches, weight gain, loss of eyelashes, eyebrows, pubic hair and toe nails are possible. Learn to love it.
8. Doctors are still ambivalent about the value of diet, yet they acknowledge poor diet can contribute to a range of illnesses including cancers. We devised a diet based around some juicing of carrots and apples, plenty of fresh fruit and vegetables, low fat intake, milled flax seeds, avocado and smoked salmon for Omega 3 content, and plenty of probiotics (as in yoghurt and sauerkraut). It has helped, particularly with a surprisingly rapid recovery from surgery.
9. Cancer treatments lead to weight gain yet women need to lose weight. Sunshine helps in recovery but women in treatment have to avoid it. Exercise is beneficial but women can be too tired. I find my role is to make sense of these contradictions and find the right compromises.
The doctors use their expertise to prescribe medication, but I tried to ensure Roos treats sun, exercise and diet as importantly as the chemotherapy.
10. We left telling the children until we knew exactly what we would be saying, until we had the full diagnosis and knew also our own responses. We told them Roos had breast cancer, that breast cancer is not a death sentence, but that the treatment would go on for a long time. I spend more of my time with them now than I've ever done, making sure they never feel neglected.
11. All women should have critical illness insurance and life insurance. Once diagnosed you can't get either but the hidden cost of treatment, loss of income, yours and hers, are stresses you can do without. We found Wintrust, www.wintrust.ie, helpful.
12. And when you think you can't go on, remember it's worse for the people around you.
Keep well.