At 47, Klash Singh from Chadwell Heath in Essex had been the fittest she’d been in years, thanks to a combination of a fulfilling career as an Area Sales Manager, a busy family life and regular gym work outs.
During August 2008 on what seemed like an ordinary morning, Klash was getting dressed for work when she felt a small lump the size of a pea in her left breast. She stopped what she was doing and asked her partner Kevin, to see if he could feel anything.
Kevin agreed that he could feel something too, but Klash brushed it off because she’d had no other symptoms and the lump seemed so tiny.
“It was only small,” says Klash, “And I didn’t really think anything of it.”
People around her, however, were not so quick to dismiss the discovery of a lump. Despite Klash’s insistence that it was nothing, her boss made her go to her GP the following day, just to check it out. Her GP agreed that although the lump was small, it needed to be assessed by a specialist without delay. He referred her through her private medical insurance to Mr Steven Snooks at Spire Roding Hospital in Redbridge. Klash remembers the appointment well: “Things moved really quickly. In a matter of hours, I went from the GP’s surgery to Mr Snooks’ consulting room, discussing the lump and what would happen next.”
What did happen next is that Mr Snooks, a Consultant General and Breast Surgeon with over 30 years’ experience in both private practice and the NHS, examined the lump and requested a mammogram, MRI scan, ultrasound of the breast and a core biopsy (a common set of investigations for the diagnosis of a breast lump).
Klash was nervous about the investigations, especially the biopsy, but was reassured by the female radiologist at the hospital who performed it. “During the biopsy, the doctor was so kind and spent a lot of time talking to me about general things such as shoes and holidays to help steady my nerves.” None of the tests and investigations were conclusive, so Mr Snooks advised Klash that the lump would have to be removed.
The operation – a wide local excision - was carried out on 29 September 2008. Afterwards, the lump was sent off for analysis. The results came back with some shattering news – it was a multi-focal carcinoma and Klash would need further surgery to clear the cancerous cells from the lymph nodes that surrounded the lump.
Klash was devastated. “It was such a big shock to hear the word ‘cancer’. I couldn’t understand why it was happening to me. I was still young and had never been fitter. My daughter was with me that day, and we cried floods of tears.” Her mind started racing about all the things that are often associated with breast cancer…..losing a breast, chemotherapy, hair loss, and so on. Klash says, “I felt like I was on a big wheel of emotions, being told things I had no control over.”
Following this second operation, the hospital pathologist was still not happy with what he could see in the cells. The lump, which was originally estimated to be just 2cm, had turned out to be nearer 5cm. But because Klash did not want a mastectomy, the only option was further surgery to ensure a clear margin surrounding the lump.
After 3 operations in just 5 weeks, Klash was totally drained. Not just physically, but emotionally too – and the effects of so much surgery to her breast was obvious. ‘My breast looked deformed’, she says. As a salesperson who had always looked immaculate and who took great care over her appearance, this was incredibly hard to deal with.
“There were days when I couldn’t bear to look at myself in the mirror…sometimes I just wanted to lay down and never get up again.” When the time came to see Mr Snooks again, Klash and her partner dreaded going into the consulting room. Having heard bad news in the same room twice before, they were scared of what they might hear.
“This time, he just looked different,” says Klash, “Mr Snooks was waiting at the door and smiled at us and said, ‘we got it all.”
While Klash and her partner were obviously delighted to hear this, they were about to find out that the good news would be short lived. Now her surgery was over, she was passed into the care of Consultant Oncologist Dr Eliot Sims at Spire Roding Hospital, who specialises in treatment for cancer, using radiotherapy and chemotherapy, after surgery. “I was told I would need 5 or 6 weeks of radiotherapy, which I had expected. And because the lump had been oestrogen-positive, I’d need to take Tamoxifen for 5 years to reduce the chance of the cancer recurring. The first bit about the radiotherapy I could deal with. But I was gutted about the Tamoxifen... I’d heard it could bring on the menopause and I just didn’t feel ready for this... I thought it was the end of the world for me as a woman.”
Then Dr Sims dropped the bombshell that Klash had dreaded. Before having radiotherapy, she would need to have 6 sessions of chemotherapy. She simply hadn’t been prepared for this, but Dr Sims was insistent she needed it because the lump in her breast had been twice the size it was originally thought to be. His decision was also influenced by her age, as younger women generally benefit more from chemotherapy.
“I felt destroyed,” says Klash, “like I every time I struggled onto my feet, I was kicked back down again by this disease.”
At first, Klash was adamant that she didn’t want chemotherapy. “It sounds crazy, but all that went through my mind is that I was just too busy for all this. I had a family I adored, a career that I loved, and a life to be getting on with.” Also, chemotherapy meant that she might lose her hair and that was the thing Klash had dreaded from the start.
“I feel your hair is the first thing that people notice about you... it IS you. The thought of losing it was just devastating. But the Oncologist made things very plain to Klash, pointing out that her life was at risk if she didn’t go through with the treatment, as there was a higher chance that the cancer would reoccur.
Dr Sims’ plain and honest words made up Klash’s mind. She talked over her programme of chemotherapy with Dr Sims, and decided that best way she was going to get through it was by doing it on her terms. Klash had always been able to pick herself up when she most needed to. She had not had an easy life and there were still some huge challenges in her family life – but her strength of character was immense and she had always dealt with whatever life threw at her. Klash decided that she wanted treatment on a Thursday, so that she could deal with the side-effects over the weekend. This was also the best day to fit in with her job as she had no intention of stopping work while she was having treatment and letting her work friends and clients down.
She also decided that she did not want anti-sickness drugs, as they contained steroids. Klash had worked hard for several years to lose a lot of weight, and was proud of her success. She really didn’t want to lose control of her weight again.
Another decision Klash made was to try a ‘cold cap’ to give her the best chance of keeping her hair. Klash booked her first session of chemo at Spire Roding Hospital just before Christmas 2008. “The receptionist who booked me in had had a double mastectomy herself, so knew totally how I was feeling. We talked for a long time and she said there was most definitely life after breast cancer. Those were the words I needed to hear at that time.”
Klash reflects on her first session of chemotherapy at the private hospital. “The oncology nurse, Mary Casey, was amazing. She took as long as I needed to talk about the cold cap, dealing with sickness and all the other effects of treatment. We had a real connection; she just seemed to anticipate what I wanted. After I went home, I thought about everything she’d said and decided against the cold cap after all. Not thinking straight, I texted her at 4am in the morning to tell her about my decision... and she texted back!”
Spire Roding’s Senior Oncology Nurse Mary Casey says, “Making decisions about aspects of their treatment is often vital to patients because it allows them a modicum of control at a time when their lives have been turned upside down by their diagnosis.”
After just a couple of sessions of chemotherapy, Klash discovered just how challenging this latest stage of her cancer journey was going to be. “Soon after each session, I’d get a rash and blisters in my mouth and I couldn’t swallow. After just 10 days, my hair started falling out in handfuls.” She says “I felt as though the roots of my hair were on fire. Even though it was the thing I most dreaded, on Christmas Day 2008, I asked my son to shave my head. As he was doing it, I felt wetness on my head. I didn’t know what it was at the time, but now I know it was his tears. He knew how much my appearance meant to me.”
Once her hair had been shaved, Klash felt strangely relieved. She remembers, “Actually, I didn’t look bad! Everyone handles it differently. My way was to buy some expensive wigs and some amazing chokers, to make sure I still looked good. I decided early on that I didn’t want to wear a bandana, as it would look more obvious that I was having cancer treatment.”
But just as she was coming to terms with losing her hair, her eyelashes and brows fell out. “It was a massive shock,” says Klash, “but I learnt to do my make up differently and how to draw on eyebrows to give my face some balance again.”
In the first few weeks of 2009, Klash was at the half way stage of her treatment and found that the side effects became ever tougher to deal with. Her nausea increased, and her left arm felt numb and painful when she stretched it out.
At Spire Roding Hospital, Mary Casey and Jan Clark, another senior nurse, were a great source of comfort and camaraderie for Klash during her chemotherapy treatment, and certainly kept her spirits up.
Outside the hospital, Klash found that other people, too, were incredibly understanding and supportive. “I wanted to be open about things and told everyone what was happening to me. My customers were amazingly supportive.” Klash adds, “Between trips to the hospital to have treatment, I continued to work, go to meetings and go to the gym when I could. My routine had always been my sanity, and I had to make a new ‘normality’ for myself. When a bomb goes off in your life, you’d give anything to have your old routine back. Making a new routine out of your situation helps keep you sane.”
As her last chemo session came and went, Klash felt a great sense of achievement. “I stuck to my guns all the way through, and this made me feel incredibly proud.” Even though her treatment was at an end, the challenges just kept coming for Klash. Her ex-husband, son, daughter and sister were also suffering from health problems which all came to a head at this time. But with her own strength and the strength she had gained from those around her during her own life-changing journey, she continued to be ‘a rock’ for herself and her family.
Nearly 3 years have passed since her initial diagnosis, so how is life now for Klash….? As part of her follow-up care programme at Roding Hospital, Klash sees either Mr Snooks or Dr Sims once every 3 months. During the check-ups, they found two more lumps…..fortunately, one was merely scar tissue and the other was fatty tissue. “I’d never been so relieved to hear that I’d got fatty tissue in my body!” remarks Klash.
After 2 ½ years without hair, it finally started to grow back this year. She is adjusting to life on Tamoxifen, something she never thought she would do. “It’s easy to think about the negatives of the drug, such as the hot flushes and the fact that it can bring on the menopause. But now that I know more about it, I’m grateful for the things it does such as strengthen the bones against osteoporosis.”
Mary Casey adds, “When a patient has had oestrogen-receptor positive breast cancer like Klash, Tamoxifen is prescribed to lower the risk of the cancer returning. It blocks the receptors in the breast that accept the hormone oestrogen, which is responsible for some types of the disease. The drug causes the cells to divide less often and become more susceptible to being killed by the body’s immune system.”
Klash continues to work hard in her career, and has kept up her gym workouts. In fact, on 13 July, she was fit enough to complete the 10k Epping Race for Life. She raised over £3,000 for Cancer Research UK, which her company doubled to £7070 (To read more about Klash's fund raising, visit www.raceforlifesponsorme.org/klashsingh0805).
She has also embraced some new things in her life, such as becoming the proud owner of a ‘bearded dragon’ lizard! Looking after Zeus has been a great new focus for Klash and she loves caring for him and sharing him with her grandchildren. About her journey so far, Klash says,
“Living with breast cancer has been an incredibly hard journey, but in many ways, I’m glad I’ve made that journey because it’s made me a better person. It has truly made me appreciate everything and everyone in my life, especially my beautiful family and grand-children. When you are first diagnosed, it’s like a bomb going off in your life. You realize how you take your daily routine for granted, and how you would give anything to have that old routine back.”
“Now I’ve come through the other side, I’m just glad to be alive. Having breast cancer made me see things in ‘black and white’, what was important and what wasn’t.”
Klash has the following advice for anyone who is diagnosed with breast cancer: “Keep busy,” she says, “don’t stand still and try to keep as much of your routine going as possible, or make a new one like I did. It will give you some control over what’s going on in your life. Be kind to yourself... you will find support coming from places you never expected. If people see you’re a fighter, they want to help you in your battle. I’ve always known I was strong, but this has made me even stronger. Not just for myself, but for everyone else around me.”
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