EMW23 (Nancy)

Name: Nancy
Age at interview: 50
Diagnosis: Medically-induced early menopause (following breast cancer treatment and a risk-reducing oophorectomy)
Age at diagnosis: 41

Background: Nancy is a housewife who lives in a metropolitan city with her husband and adult daughter. She is from a Chinese background.

About Nancy: A second bout of oestrogen negative breast cancer in her early 40s prompted Nancy to have genetic testing. After learning that she carried the BRCA1 gene mutation, she had an oophorectomy. As a result of surgical menopause, Nancy experienced hot flushes, headaches, forgetfulness and mood swings. Antidepressant medication helps reduce her hot flushes, and Nancy also takes a vitamin D and calcium supplement and exercises daily to help her bone and heart health.

More about Nancy: Nancy experienced three bouts of breast cancer, the first in her late 30s and the last in her mid-40s. After the second cancer diagnosis at age 41, she had genetic testing and learned that she carried the BRCA1 gene mutation, putting her at increased risk of breast and ovarian cancers. On her doctor’s advice, she decided to have an oophorectomy. Later, after her third breast cancer recurrence, she had a double mastectomy.

After her oophorectomy, Nancy described ‘not feeling good,’ and experiencing symptoms such as night sweats, stomach pains, headaches, mood swings, and forgetfulness. As she had experienced breast cancer, she was not able to have Hormone Replacement Therapy. Instead, she took antidepressant medication (venlafaxine) which she has found helpful for her hot flushes and mood. To help protect her bone and heart heath, Nancy also takes Vitamin D and a calcium supplement, eats nuts, and works in her vegetable garden every day.

Nancy had most of her cancer treatment in the private sector, which she found a positive experience, describing her treating health professionals as ‘very kind.’ She initially faced a language barrier with her oncologist and had to bring her husband or a friend to appointments. Eventually, her GP referred her to a Chinese-speaking breast surgeon, whom she found ‘easy’ to communicate with.

For information about early menopause and breast cancer, Nancy relied on information and resources from her doctors, as well as information on Chinese language websites, and a local NGO she volunteers with which provides social support and information for Chinese-speaking cancer patients. However, she wished she had been given more information about social welfare benefits for people in her situation.

Before her cancer diagnosis, Nancy worked as a teacher for ten years. Being unable to work after her diagnosis has been ‘very disappointing,’ and has also had financial implications for her family. Loss of fertility, however, has not been a concern because she and her husband had not planned on having more children.

Nancy reflected that while her family have been understanding of her early menopause-related mood swings, friends she has met through the NGO she volunteers with are her main source of emotional support. Sharing her experiences of early menopause with older friends who have gone through menopause has been helpful.

Nancy emphasised the importance of emotional wellbeing for recovery and encouraged other women experiencing cancer-related surgical menopause to talk to others in similar situations for support and encouragement.