Every year in the UK, 50,000 women are diagnosed with primary breast cancer. This kind of diagnosis can be devastating enough, but when you’re also living with an incurable and life-long illness, it can be crushing.
Such was the case for Janine McDonald who received the news she thought she’d never hear: in 2005, after living with multiple sclerosis (MS) and its debilitating symptoms for seven years, she was told she had breast cancer.
“I thought having MS made me immune to everything else, I didn’t think I would be so unlucky to have two illnesses,” the 49-year-old from London tells HuffPost UK.
The awful news came just one year after her mum died from secondary breast cancer. Janine discovered a lump in her breast just before Christmas and, within a matter of weeks, was told she had an aggressive form of cancer.
Balancing the two illnesses has been particularly hard for her, as she has had to navigate the new and terrifying symptoms that her MS throws up while praying they aren’t a sign of her breast cancer returning.
But despite all of this, her outlook on life is incredibly positive. “I don’t take anything for granted now, I try to enjoy myself and live it up,” she says. “My attitude has totally changed.”
MS is a lifelong and incurable condition which can affect the brain and the spinal cord. It’s estimated that 100,000 people live with it in the UK.
Janine was diagnosed in 1998 after the soles of her feet went numb. “I was cleaning a floor and thought I’d hurt my back,” she recalls. “After a few days I went to the GP who booked me in for an MRI scan.”
Janine had previously been diagnosed with what doctors suspected was Bell’s Palsy, where one side of the face droops, so they wanted to investigate her new symptoms further. In a matter of months she was told she had relapsing remitting MS with a progressive variant, where people have distinct attacks of symptoms which then fade away either partially or completely. Although Janine notes that in her case, she never fully recovers from relapses.
“By the time I was diagnosed, I wasn’t surprised as I’d done a lot of research,” she recalls. “I thought I’d rather know what it was than have a question mark hanging over it. I was shocked but also relieved because it explained everything.”
Symptoms of MS can include fatigue, difficulty walking, problems with vision, numbness or tingling in different parts of the body, and issues with balance and co-ordination. In some cases, it can cause serious disability.
It’s not unusual for Janine to lose her taste and smell. She’s also experienced horrendous vertigo to the point where she’s been hospitalised, and then there’s the all-encompassing ‘I-can’t-move’ fatigue.
Over time, Janine’s MS began to affect day-to-day life more severely. She was a single parent, trying to get her young son Sam to school, but eventually even the simplest tasks like driving or climbing the stairs to her flat became impossible. She also became unable to work.
To this day, Janine manages her condition with beta interferon, an injection which can reduce the inflammation that damages nerves in MS. However she’s still no stranger to discovering new and worrying symptoms.
“I have periods where it flares up, something goes numb or I go incredibly tired,” she explains. “Sometimes I’ll lose the use in my thumbs.
“I never fully recover from each flare up, it always leaves something behind. For example the side of my face is permanently numb now, one of my feet drops when I walk so I have to be careful not to trip up.
“Psychologically it’s really difficult. I could wake up tomorrow and not be able to use my legs.”
Because she had already lived with an incurable disease, Janine truly believed she wouldn’t be so unlucky to receive a second diagnosis. But in December 2004 all of that changed when she discovered a lump in her breast.
“I woke up in the night and had an itch in my breast,” she recalls. “Then I discovered a lump and something deep in my soul just knew.”
It was right before Christmas so Janine had to spend the festive break celebrating with her family and acting like everything was fine. But on the inside she was feeling fraught.
In early 2005, she was diagnosed with primary breast cancer.
“I broke down when the consultant told me,” she recalls. “How was I going to tell Sam?”
Almost immediately, the then 37-year-old knew she wanted to have a double mastectomy: “I thought, ‘what’s the point in having them [breasts] if they’re trying to kill me?’”
Due to the aggressive nature of the cancer, doctors wanted to operate straight away, however Janine wanted to wait until her son’s birthday had passed.
In February 2005, she had a double mastectomy, followed by chemotherapy and radiotherapy. In December 2005, she began a course of medication called Herceptin, which she had to take every three weeks for a year.
“I asked about reconstruction after the mastectomy, but the doctors couldn’t guarantee that it wouldn’t affect the MS,” she says. “It wasn’t a risk worth taking so I decided to be flat.”
There was a period of time during her treatment where Janine believed she might not survive. “I told my ex-husband there was a good chance I wouldn’t make it so we made plans for the future,” she recalls. “It was really difficult.”
She had to stop having her beta interferon injections while undergoing chemotherapy, however the one saving grace was that the treatment seemed to ease her MS symptoms.
“It was kind of like my body put MS on the back burner because I had to fight something else,” she explains.
Eluned Hughes, head of public health and information at Breast Cancer Now, reiterates how tough it can be for people with multiple conditions to strike the right balance between treatments.
“In some cases, certain cancer treatments might not be possible with a pre-existing condition or long term-medication may need to be altered during therapy,” she tells HuffPost UK. “It’s vital that women in this position, along with their support networks, are kept fully-informed of any potential obstacles, to ensure they feel in control of their treatment at all times.”
Since her mastectomy, Janine says life is definitely more complicated as there’s always an underlying possibility that her cancer could return. This is even more problematic when her MS causes new symptoms.
For example, a few months ago Janine experienced “a funny turn” where she couldn’t speak properly for 20 minutes. “I thought it was probably just the MS,” she explains. “And then on the Monday I questioned it and went to see the GP, who sent me to A&E because they thought I might have had a mini stroke. They were looking to see if the cancer had gone to my brain, or if it was the MS - it just complicates everything.
“I have to face everything again when a new symptom comes up, which seems to happen a lot. Nothing is ever simple. I worry about the cancer spreading.”
Janine was also diagnosed with type 2 diabetes in 2014, which prompted her to lose weight - she dropped from a UK size 22 to a 14.
“I found out everything I could about it, lost five stone and reversed it,” she says. “It’s helped me feel better with my MS too as I’m not so heavy, so I don’t feel like I’m going to fall all the time.”
Despite the fact her MS is progressive and incurable, and she’ll never be given the all-clear from her cancer, Janine has a very positive outlook on life.
“I missed out on a lot - there are things I wanted to do (I wanted to be a nurse or paramedic) which I haven’t been able to - and I can’t remember what it feels like to not be ill,” she explains.
“But you just have to take each day as it comes and enjoy it, if possible, and find out what you can do to help yourself.”
Her ultimate piece of advice for women living with multiple conditions is to stay positive.
“Always try to look on the bright side,” she says. “Obviously that’s not always possible, but a sense of humour certainly helps and has given me some great memories - like the times my dad and I would come out of a chemotherapy session and link arms and sing ‘always look on the bright side of life’.
“Life really is what you make it... I choose to have a laugh. Don’t get me wrong, it knocks me when I have a new set of symptoms to deal with but after a couple of days I’ll readjust to my ‘new normal’.
“I feel like I’m living proof that you can get through and cope with a lot more than you think you can - and come out of the other side a better person for it.”