In 2018, Kate, a 36 year old female living in Los Angeles, California, started falling asleep whilst at work as a consultant.
“I’m a pretty high-energy person and I was getting into my office and falling asleep at my desk at like 10 o'clock in the morning.”
She also started experiencing severe nausea and hot flushes, which doctors thought may be early menopause. Around 6 months later she felt a lump in her breast.
“As soon as I felt it, I knew. So I went and got a biopsy, and yep, cancer.”
She began her breast cancer treatment journey and was sent into medical menopause straight away to stop her hormones, which were accelerating the cancer’s growth.
“I had chemotherapy for a year, and they put me in medical menopause straight away through two years of IV treatment. I had a partial mastectomy in 2019, then continued my IV treatment. In 2020, I had a double mastectomy and DIEP flap reconstruction, which basically means I haven't used implants or anything, they used my stomach and my abdomen and made my boobs out of my own body. Unfortunately, I had a major infection afterwards…I ended up having a stomach pump in my abdomen for like six months, which was rotten…”
A major difference between natural and medical menopause is that medical menopause occurs overnight. Kate explained the emotional turbulence menopause caused for her, and the ways in which her menopausal symptoms continue to impact her life.
“Prior to cancer I already had depression and major depressive disorder, and we've had to work really hard because without the hormones, I dropped even further…Depression, anxiety, and then just being able to control my emotions. I tend to really swing now… you know when little kids are crying one minute and then happy the next, like they can't control their emotions? It was like that. I felt like a child…One time when I first started [medication], I was in the kitchen and was fine, like I had cancer or whatever but I was fine, I was cooking and then just out of nowhere I was beside myself, hysterically crying. And my partner was here and I was kind of laughing because I didn't know what was wrong with me. So it's those really sudden shifts in your emotions…I’m more sensitive to things now [like] television programs.”
Another major symptom she described is hot flushes.
“All of a sudden it kind of comes from your stomach, like a fire is burning through a building, and it just gradually goes up to your head and the heat escapes. And it happens randomly, I probably get about 15 a day. It could be when I'm in a line at the grocery store and all of a sudden I start sweating. It's not sexy.”
She continued, “and then the brain fog, I forget things. I was a list person already, but I have to be really specific with my lists…chemo gives you “chemo fog” too, so it’s a combination.”
“I was a workaholic. But even that now is just totally inconceivable to me…I used to be able to multitask a lot more and now I have to be very focused on one thing…otherwise I'm like all over the place.” Kate reflected.
She explained how chemotherapy has aged her body, causing joint pain and increased risk of injury.
“Sore joints are a real big one because obviously with all of your hormones, less things work as well as they used to. Especially in the morning, after getting out of bed, it takes a while to warm up the joints. I couldn't just jump out of bed like I used to and go for a run. I have to do a whole lot of exercise to warm up and a light walk and stuff.”
Menopause has also hugely affected her sleep quality, mainly due to excessive sweating.
“Sometimes I wake up and it's like I'm swimming in the ocean. The easiest way to explain it is like I got into the shower in my pyjamas and then got back into bed. It's pretty hectic.” She explained.
“I've had to change all my bedding and things like that..it [has to be] light and breathable fabrics. I struggle to sleep with anyone in the bed other than my dog. My partner and I don't live together, but when he comes over, he'll start in bed and I'll end up out on the couch just because I'm either hot and sweaty or I can’t sleep as deeply…I also have insomnia, so I don't sleep anywhere near as much as I used to.”
Interestingly, Kate still experiences bleeding a couple times a year. Prior to medical menopause, she didn’t endure any difficult symptoms during menstruation. However, she explains that despite bleeds happening very occasionally, they are extremely challenging to deal with.
“It's just super heavy and awful. I feel faint… it [lasts around] two days and it's super heavy…I can't go out when I'm like that just because no matter what I put in, whether I put in my menstrual cup or whatever, I bleed through.”
Today, Kate has been cancer free for three and a half years, and her experiences continually drive her to advocate for open discussion regarding the realities of treatment. Working with ‘The Breasties”, a support organisation for those impacted by breast and gynaecological cancers, she has made profound and beautiful connections through unideal circumstances.
“It's one of those businesses you don't want to grow because you don't want more people, but every month when we have our LA meetup, there's a handful of new people. And like we say, ‘it's the worst club but the best members’…the friendships and the community I've formed through this is second to none.”
Prior to undertaking chemotherapy, Kate received very little information about medical menopause. She emphasises the importance of finding support groups as most of the advice she has received to manage her symptoms has been from other patients.
“I'm really passionate about opening up these conversations and talking about them because from our work in the cancer community, it helps people feel seen, heard, and to hear other examples of things that we do to manage symptoms. Everything that I've learned to help me with menopause has been from the community. It hasn't been from doctors. And obviously, if it's anything crazy, I discuss it with my doctors. But the little things, like these little portable fans, [or] frozen things that you can put around your neck… it's things like that the community really helps with.”
She implores cancer patients to advocate for their own health, as it will improve wider health outcomes and remind those affected that there is support available.
“We need wider discussions within the community, to then extend out to society…Talk about the reality so people don't feel alone, because it can be really isolating…Let’s make it less of a taboo.”
She felt really excited to learn that Phenxx is creating products with a focus on healthy, cooling sleep for women going through menopause - whether naturally over years or the overnight variety like so many other cancer patients like herself.