Two photos five years apart, almost exactly to the day. Both are from the same woman. Each one tells a strikingly different story. And when I look at them both side by side, I still find it hard to believe that I am that woman.
I only see fear in one. I look fragile. I am afraid of the future. It was taken in November 2015, five months after I was diagnosed with stage three breast cancer. In the other picture I took last month, I’m alive and strong – I’m no longer scared. Maybe tired. But also defiant. They have been shared thousands of times on social media over the past week and the response has been overwhelming.
But why did I decide to make something so intensely personal in public? Because it’s important that we face the nasty truth about cancer that affects one in two British people.
Thanks to medical advances, it’s not always a death sentence today. There are 2.5 million people in the UK who have been diagnosed with cancer. That number is projected to rise to four million over the next ten years. But survival isn’t the whole picture. For the vast majority, cancer will change their body – and life – forever. It’s not just about ringing a bell and then being happy.
At the time of the first photo, I was a 40-year-old breast surgeon consultant who worked at Ipswich Hospital. At first I thought the lump I discovered in my left breast was just another harmless cyst. The last thing I thought about was it was cancer. And yet it was so. All of a sudden I had the treatments I prescribed for my patients.
As a doctor, it was difficult to know what was coming – chemotherapy first, then surgery and radiation therapy, and the possibility that I might not be cured. And it was hard to lose control of my body. My hair fell out. My gums started bleeding. I felt sick all the time and my bowels stopped working. Everything hurt. Night sweats – caused by medical menopause, which is a side effect of some breast cancer drugs – made me think I was getting the bed wet.
Breast surgeon consultant Liz O’Riordan in 2015, pictured left, and on the comeback path in 2020, pictured right
How hedgehogs calm my mind
Restoring my sanity after breast cancer wasn’t just about exercise.
Since hanging up my surgical gown, I’ve also thrown myself into charity work.
It all started when I found a tiny hedgehog in my garden.
I knew they shouldn’t be outside during the day and after a quick Google search I found that there was a hedgehog rescue center, Poppy’s Creche, in nearby Stowmarket.
Dr. Liz O’Riordan with a rescued hedgehog
The center is run by an amazing couple in their 70s who care for more than 100 orphaned and poor hedgehogs.
It’s a full time job. Baby hedgehogs have to be fed every two hours day and night and have no day or night off.
I asked if I could help and they said yes.
I now spend a few hours every Tuesday morning cleaning up hedgehog houses and building nests with old newspapers.
I have a couple of hedgehog houses and an infrared camera in my garden. I leave dry kitten food and water outside for the migrating pigs.
Like I said, Dermot and I had only just married when I was diagnosed with breast cancer.
Having a child has always been our plan, but my treatment has taken that option away.
I still mourn the family I will never have – and caring for animals is arguably one of the ways I can still look after and care for.
My once agile mind struggled to remember what the TV remote was called.
I had six chemotherapy sessions every three weeks so I could recover between cycles. In the beginning, I did everything to stay active. I rode my bike to the oncology clinic and did park runs in my good weeks. I even went to my local gym. But over the months I got weaker. I had to stop and catch my breath when I went upstairs.
I was only married to my husband Dermot, 56, who is a fellow surgeon, for a few years when I was diagnosed. One morning he asked me if I wanted to do a photo shoot commemorating chemotherapy.
He had read in the local paper about a photographer, Alex Kilbee, from Pakenham, not far from where we lived in Suffolk, and suggested that I take my picture. I told him he was crazy. But I thought about it and the idea slowly grew on me. I hadn’t worn a wig and I really liked my bald head. Maybe it would be fun to have my picture taken.
On the day of filming in Alex’s home studio, I felt immediately at ease. I started posing in different sweaters and dresses, but the pictures didn’t really mean anything. I suggested taking off my top.
I was – and am – a private, shy person. But I also knew that in a few weeks my left breast would be cut off. I would never look like this again.
Alex’s mother had breast cancer too, and he understood. At first he suggested we photograph Dermot holding me – so that I would be covered up to some extent.
And suddenly, as he did, every sense of denial that I had held onto seemed to dissolve: this was really happening. I had cancer. I was just about to have my breast cut off. I couldn’t live in five years. I was close to tears and turned to Alex. He captured everything I felt in that moment on camera. It was like therapy. There are days when it is still too painful to look at this photo.
For the next six months, I had the mastectomy and reconstruction with an implant, followed by three weeks of radiation therapy.
It took another six months before I was physically and mentally ready to return to work part-time. It was very difficult to see breast cancer patients and to know the harm the life-saving treatments I recommended would do.
Unfortunately, my cancer reappeared in May 2018 as a repeat of the scar tissue that had been my left breast. That meant having my implant removed – I’m “flat” now.
After surgery and more radiation therapy, I had to take another type of hormone-blocking drug because the first one, tamoxifen, hadn’t worked. For the new drug to work properly, I had to stop my own production of the female sex hormone, estrogen, which is produced by the ovaries. That’s why I had mine removed a few months later.
Shortly thereafter, a book was published that I had written with Oxford University Professor Trisha Greenhalgh, who also had breast cancer. The Complete Guide to Breast Cancer included everything I learned and what got me through treatment and beyond.
I had also started giving lectures on my experiences as a patient doctor. But I also increasingly suffered from a pain syndrome after a mastectomy – pain in the chest wall, tension in the scars under my arms and stiffness in my shoulders.
Ultimately, this forced me to retire as a breast surgeon at the age of 44 in February 2019. If I couldn’t move my arm properly, I couldn’t operate safely.
Liz O’Riordan was robbed of the career she’d built for two decades in just over three years
Did you know already?
The left breast is five to ten percent more likely to develop cancer than the right breast. Nobody is sure exactly why that is.
In just over three years, the disease I’d treated for 20 years had robbed me of my career. I had no income but a tiny pension.
But beyond that, I had no purpose in life. My father was a doctor and my mother was a nurse. I always wanted to be a surgeon and never do anything else. Now I had to figure out who I was and how to fill my days. I was lost
A year after my treatment ended, I was discharged from my hospital team, as usual. I was fine
But fear still haunted me. Every little symptom, pain or pain made my mind race. Was it just a cough … or a recurrence of cancer in my lungs?
I would spend hours in the middle of the night running my hands over my body looking for lumps. How on earth have other people dealt with this uncertainty without knowing if tomorrow would be the day their cancer returned?
I had to learn to focus my energy on more productive things, and part of what kept me healthy is exercise.
In recent years, numerous studies have been conducted to prove that exercise should be the “fourth” treatment for cancer – after surgery, chemotherapy and other drugs, and radiation therapy. In fact, the latest cancer guidelines recommend that every cancer patient have five sessions per week (three aerobic exercises such as running or cycling and two muscle building).
Staying fit reduces the side effects of any treatment, reduces complications from surgery and chemotherapy, and also helps with depression and anxiety.
It improves bone strength and reduces the risk of osteoporosis, which is increased due to breast cancer treatment as a result of early menopause. And most compellingly, it can reduce the risk of some cancers recurring by 50 percent. It’s huge.
I wasn’t exactly out of shape before cancer. I had just started doing triathlons. I kept cycling after cancer, but as time passed and the treatments put strain on my body, my pain got worse.
I started to lose motivation. Life became a round of constant physical therapy appointments and pain medication. It was hard to go on even though I knew I should. And of course life stands in my way, no matter how much I promised myself that I will come back to it tomorrow.
In February I looked in the mirror and I didn’t like what I saw.
It had nothing to do with my scarred, ugly chest. I looked weak. I had put on more than one stone since I was diagnosed. I couldn’t think of any more excuses. But could I get my body back?
Liz O’Riordan says she was in good shape before chemotherapy
Did you know already?
Men have breast tissue – but because of hormonal and other cellular differences, they are less likely to develop breast cancer than women.
I followed a trainer, Clara Swedlund, on Instagram. I got in touch. Clara had won a bikini bodybuilding competition the previous year and graduated with a degree in sports psychology. When we talked, I found that we were a perfect match. And then another crazy idea came up that quickly occurred to me: How about if I took part in a bodybuilding competition too? I knew I had no chance of winning, but it didn’t matter.
I wanted to show other women that as a “uniboober” with short hair and glasses you can stand on stage and look powerful, beautiful and strong.
During the lockdown, I bought some weights and resistance bands. Clara told me what to do four times a week. I filmed myself doing sports so she could check my technique. I changed my diet: bodybuilders are scientific about food and I would weigh and track everything I ate to make sure I had the right nutritional balance.
Since most of the shows were canceled thanks to Covid, Clara suggested the goal of another photo shoot instead.
When the gyms reopened, Dermot came with me. But for the photo, the last thing I wanted to see was in a tiny bikini and the mandatory fake tan.
I knew right away that Alex Kilbee should be the one taking the picture.
This time it was a completely different experience. Instead of being nervous and shy, I was proud of my body and wanted to show it off. I was ready to face the camera, a completely different woman.
When I first saw the pictures, I didn’t recognize myself. Was that really me?
I hate the fighting terminology associated with cancer. But I saw a warrior staring at me. I think she was always inside of me. I just didn’t know.
Of course, most patients will not go as far as I do after breast cancer. But do what you can. You don’t need a gym. Everything can be done at home, and you can split it up here and there in five minutes.
When you go to the bathroom, you squat up and down 10 to 20 times. When the kettle boils, do push-ups against the kitchen counter. Do calf raises on the lower step before going to bed.
I am so excited about promoting the benefits of exercise for cancer patients of all ages and stages that I started a charity called CancerFit with four other amazing women – doctors, cancer patients, and exercise coaches.
It’s still in its infancy, but we have a lot of blogs from patients who stayed active during treatment to inspire people to get off the couch. Please visit our website cancerfit.me for more information.
Cancer will always be a big part of my life, but it’s time for something else. I’m writing another book – about being a surgeon and later a patient.
The review was cathartic. It wasn’t easy being a female surgical trainee in a man’s world, but I loved it. It was sad to think about everything I could have achieved if I hadn’t had cancer. But then I think about what I’ve achieved. And I think bring you the next challenge.
- Liz and Alex Kilbee are searching for other breast cancer survivors to be photographed for an upcoming exhibition on worry, uncertainty, hope and strength. To participate, visit Alex’s website museportraits.co.uk. For post-cancer fitness information, visit cancerfit.me.