THE slogan was “lumps aren’t the only sign of breast cancer”. Eight little words which Clare Smith was proud to shout about.
As chief marketing officer with the Scottish Government, she had been heavily involved with the high-profile Detect Cancer Early campaign, which saw Elaine C Smith half naked on billboards and televisions, showing real images of breasts with cancer and urging women to get checked if there were any changes in theirs; a campaign which led to 50 per cent more women going to their GPs in 2012 to get advice on breast cancer than in the same period the year before. She had every right to feel proud.
Pride is supposed to come before a fall. In Clare’s instance it has, perhaps, saved her from falling, crashing and burning.
For it was that slogan and that campaign – which saw her pick up numerous awards on behalf of her marketing team – that made her concerned about a shadow on her left breast.
“It wasn’t going away. I thought at first it might have been a bruise I’d picked up from playing hockey or tennis,” she says. “Then my bras – which had always fitted fine – started to leave red marks on that side as if my breast was swollen. If I hadn’t worked on the Detect Cancer Early campaign I might have ignored it, but instead I knew that any change could be a sign of breast cancer, so I thought I’d better get it checked out.”
Clare was in New York as part of the Government’s Scotland Week cohort when she told her husband Frank O’Donnell – editor of the Evening News – about the bruise. They agreed she should visit her GP when they got back to their Dalkeith home.
However, it wasn’t just the campaign which had her alarm bells ringing. Her mum, Isabel, died at the age of 60 in 2002 after a ten-year battle with breast cancer. That it could possibly also happen to her had always lurked in Clare’s subconscious. She just didn’t think it would happen when she was just 38.
More than 40,000 women are diagnosed with breast cancer every year in Britain, but the vast majority are post-menopausal – fewer than five per cent of the total are women under the age of 40. Yet cancer in younger women, doctors believe, grows faster, spreads quicker and is harder to treat.
“My GP was great and thought that something was potentially amiss and referred me for a mammogram, but that’s when things got a little scary,” she says. With her husband in London that day, Clare went to the Western General on her own for her scan. So there was no-one to hold her hand when things stepped up a gear.
They sent her for an immediate ultrasound, and then Dr Mike Dixon – the hospital’s top breast surgeon – appeared. “He said I was a very interesting case, because of my age,” she says. “But then you know something’s up. I was to have an immediate biopsy, but he told me it was cancer, he knew it without having to wait for the result.”
Clare went home to an empty house. When her husband got home that evening, she had to break the news. “I hadn’t expected it to happen, so it was a shock in terms of the speed of the information. But in a way not having the time to wait for results and sit and think, just getting on with it, was better. I like to get on with things.
“I think Frank was in a bit of denial when I told him, suggesting it could still be something else, but I knew it was cancer. Mike Dixon is the expert – he told me no man in the UK has seen as many breasts as he has,” she says with a laugh. “He said he was rarely wrong.”
As Clare talks of her cancer in the sunshine on the terrace of the Sheraton Hotel, she is full of life. She looks tanned, fit and healthy. The only sign is her shaved head – a decision she took when her hair began to fall out after a dose of chemotherapy.
“I went in on June 19 for chemo – the same date ironically that my mum died. I never really saw her going through chemo because I was away at university at the time and I think she tried to protect me from the worst of it. So I didn’t really have any reference about it.
“I went in feeling so healthy and was looking at these other people who were obviously further down the road, looking ill and grey . . . and I realised that’s what’s in front of me.
“I can’t control that. I can’t control the fact that I’ve got cancer, but I’m determined to do what I can – so I am eating better than I ever have, lots of juicing of vegetables and fruit, not drinking alcohol or coffee – and sleeping properly. In a way I’ve never felt better.
“I had my head shaved as I’d rather that than continue to find hair falling out. When that first happened Frank said, ‘Now we know it wasn’t just Ribena they were pumping into you’.
“What it’ll be like when even the stubble goes, and my eyelashes, I don’t know. But I’ll deal with that when it happens. I still feel well at the moment but I know that’s likely to change, but again, I’ll deal with it when it happens. I don’t want to think too far ahead.”
She stops talking, then quietly adds: “I don’t know why this has happened at my age. It could be hereditary so I’m going to find out if I have the cancer gene. And I guess if someone had told me years ago that if I drank one fewer glass of white wine every weekend I wouldn’t get cancer, I’d probably have done that, but you just live life the way you live it.”
The biopsy showed that Clare has oestrogen positive and HER2+ breast cancer, a particularly aggressive form. But her tumour was so small, it was decided treatment should start with chemotherapy to shrink it to nothing – markers placed in her breast and lymph nodes make sure the surgeon would know where to find the cancerous cells. A lumpectomy will follow at the end of this year, and then she’ll undergo radiotherapy and be prescribed Herceptin.
“Once you’re in the machine at the Western you feel like you’re in safe hands. They’re amazing,” she says. “I’m just getting on with it. Through my job I’m used to dealing with problems and finding the best way to fix them. Of course, this is different. It’s been a bit like a bereavement, but once you get used to the idea, you are where you are, and I’m just hoping for the best.”
She makes dealing with cancer sound matter of fact. But there are telltale signs that it’s not so easy. She admits telling people is hard.
Her eyes fill with tears. “People are so lovely,” she says, her voice cracking. “It’s almost like when I got married . . . people say the nicest things. They are so concerned, and I find that upsetting. I don’t really know how to deal with that.”
Then there’s been the hair loss. “That wasn’t so bad, but the whole wig business is appalling,” she says, the light of an idea shining in her eyes. “It has to change. NHS wigs are all for elderly women and don’t fit. I was lucky to get a real one through the charity BosomBuds, but even that is not great. Something has to change in this area.”
Clare Smith could be just the woman to change it.
THERE’S DETERMINATION TO FIGHT
Gina Davidson gives her account of her friend’s struggle.
THE day had begun with the funeral of the mother of one of my closest friends.
She had finally succumbed to her long battle with bowel cancer and the service to celebrate her life was, as the best send-offs tend to be, one of grief suffused with laughter and joyful memories.
The day ended with my boss, the husband of another of my closest friends telling me that she had been diagnosed with breast cancer.
It wasn’t a good day.
Last Monday, when I finally caught up with Clare to talk about what was happening to her, was a better day. There had been texts and calls of support, especially around her first chemotherapy session, but we hadn’t managed to meet.
So, when I saw her, I admit I was shocked. She looked so healthy – her Kos tan being topped up by the Edinburgh sun – but she was no longer a blonde. In fact, she no longer had hair.
The chemo had started its wicked destruction of her hair follicles, so she’d just had the whole lot shaved off.
She laughed as she talked of her husband Frank’s reaction. But it was a typical Clare approach to a problem – find a practical way to control it.
She’s never been the sort to sit around and let things happen to her, she goes out and grabs them.
We first met on a hockey pitch at a time when I had little space for new friends. I was working hard and my mum was dying from breast cancer. Then her mum died, too. From shared grief a friendship was formed.
So now we’ve been friends for more than 15 years and in that time I’ve seen her transform from a rather scatty marketing graduate to become a wholly committed, fully-focused career woman who mingles with Scotland’s great and good.
She loves her job, her husband, her cat, her sport, her friends . . . her life. Like every woman with cancer.
And like every woman with cancer she’s determined to fight it. And I – and the rest of Team Clare – will be with her every step of the way. Even if she doesn’t feel she needs us.