Last week I had lunch with a girlfriend, the long, unhurried kind we keep promising each other and rarely manage. Somewhere between the bread and the coffee, she told me she had lost a friend to breast cancer. Our age. A mother. She had been fighting it without telling most of the people around her.
The same month, I found out that one of my childhood friends had been going through breast cancer without telling any of us. Two women, both carrying it on their own. That’s what I kept thinking about on the drive home.
It made me realise how much I’ve been putting off. October is Breast Cancer Awareness Month and Menopause Awareness Month, and I’d been scrolling past both, kicking them a little further down the road. If you’ve been doing the same, please stop.
Women our age are brilliant at keeping everyone else’s appointments. The children’s dentist, the boiler service, parents’ evening, the dog’s jabs. Our own check-up is the one that slides to next month, then after the holidays, then whenever things calm down. The problem is, things never calm down.
Book the mammogram
If you’re over forty, work out when you last had a mammogram. If you can’t remember, that’s your answer.
In Portugal, free screening now starts at 45, and in the UK the NHS invites women from 50. If you’re not yet called for screening, ask your doctor whether you should start sooner. If the letter never arrived, don’t wait for it. Ring your GP or health centre and ask.
Screening doesn’t catch everything, so get to know what’s normal for you. A lump or swelling in the breast, chest or armpit, a change in size, shape or feel, or pain that won’t go away should all be seen by a doctor, even if your last mammogram was clear. Most changes turn out not to be cancer, which is a reason to get them checked quickly, not a reason to wait.
Don’t wait for menopause to find you
Menopause was another thing I’d filed under “later”. I assumed it would arrive in my fifties and I’d deal with it then. A new study of over a million women has just shown that our hormones start changing in our late thirties and early forties, long before our periods stop.
The early signs are easy to blame on everything else: bad sleep, waking at 3am, losing your cool with the children, anxiety for no reason, or simply not feeling yourself. If anyone tells you you’re too young for that, they’re wrong.
The boring advice is the right advice
The good news is that what lowers your breast cancer risk and what helps you through menopause is largely the same list. It’s what we’ve supposedly been meant to do for years, and between raising children and keeping a hundred balls in the air, it’s the first thing to go. I’m afraid a few more balls are needed in the juggle.
I believe nutrition is key, both for lowering your risk and for staying strong if you ever need treatment. Cancer cells use sugar for fuel, which is one more reason I keep it to a minimum, and too much of it adds weight, one of the clearest risk factors we know of. I also keep bacon, sausages, ham and other processed meats as an occasional treat rather than a weekly habit, since they’re firmly linked to cancer. Eat well, but don’t let anyone tell you a green juice is a substitute for a mammogram.
The Mrs H Method
- Book your mammogram this week if you’re due. If a friend is due too, take her with you.
- Check your breasts once a month. Pick the same point each month, ideally a week after your period when breasts are least tender, or the same date if your periods have stopped. Look and feel for anything new, and if you find something, see a doctor rather than searching online.
- Lift weights twice a week. Ten minutes at home is enough, and yes, the dumbbells you bought in January count. Strong muscles protect your bones, and bone is one of the first things to suffer at menopause. A brisk walk on the other days helps too.
- Drink less. Breast cancer risk rises with every glass, which is the one none of us wants to hear on a warm evening on the terrace. Pick your alcohol-free nights and keep them.
- Eat for your weight and your energy. Protein at breakfast, more vegetables, beans and wholegrains, fewer sugary drinks and processed foods.
- Get a blood test while you feel well. Ask for cholesterol, liver function and vitamin D, so you have a starting point to compare with later.
- Keep a simple diary of your periods, sleep and mood, in a notebook or on a tracking app. It makes a conversation with your doctor much easier.
- Ask about HRT early, before you’re struggling. Women on HRT showed fewer menopause-related changes in the study, although it’s too soon to say the HRT was the reason. Your doctor can talk you through the benefits and the risks, including for breast cancer, so you can decide what’s right for you.
Put your own oxygen mask on first
By taking care of yourself, you’re taking care of your family. They need you well, and in good humour, for a very long time. None of us has to do this alone, or suffer in silence, either. The more we talk about our check-ups, our blood tests and our 3am wake-ups, the more we find that our friends are going through exactly the same thing. So mention your mammogram over lunch. Ask a girlfriend when she last had her bloods done. Let’s look after ourselves, and each other.
A Note from Mrs H
I never met her, and I’m still taking in what my own friend went through without us knowing. I keep thinking about how ordinary their weeks must have looked from the outside. If this piece moves even one of you to pick up the phone, it’s done its job.
When did you last have a check-up, and what’s the one thing that keeps pushing it down the list?
— Mrs H