A Conversation with Dr Kathleen Thompson
by Molah Media
Kathleen Thompson worked for many years as a paediatrician before moving into pharmaceutical medicine. In 2011, she was diagnosed with breast cancer and in 2015, wrote a book to use her story to inspire and educate others with breast cancer. She writes regularly for The Huffington Post and for Frost e-magazine.
You were diagnosed with breast cancer in 2011. What was your life like at that time?
When the diagnosis came, things were really going well in my life. I’d cut down on the number of hours I was working. I was getting fit – you know, I was really getting my life sorted. The kids were grown up and I was really enjoying my ‘me’ time. So the diagnosis was a bolt out of the blue to be honest.
What symptoms did you have?
Well this is the strange thing because I didn’t actually feel a lump. One day as I got out of the shower I noticed a funny red mark on my breast. A couple of days later it was still there and the doctor in me knew it looked odd. I rationalised it left, right and centre, telling myself it was just the hot water on my skin. On top of that, I had already felt my breast and there were no lumps.
But a couple of weeks later, I decided to have a bra-fitting. I had never done this, but it was in keeping with the ‘new me’ that I was discovering at the time. I went into London for this and the fitter said quite vaguely that she was really struggling with my right breast. She couldn’t get the breast to ‘sit’ properly. However, that vague comment with the red mark made me realise that I just had to get to the GP.
At my appointment, my GP couldn’t feel a lump either. He did say though that as per standard practice, when someone comes in with a breast problem, I had to be referred urgently to the breast clinic. He wasn’t concerned in any way.
What was the interval between you finding that red mark on your breast and going to your GP?
It was probably 3 weeks. It’s not what I would advise my patients to do but I was just getting my head round that fact that this was something I had to get checked out.
As a doctor did you find that you were trying to find other reasons to explain the change?
Yes there were 2 people in my head – the woman and the doctor. I would switch from a rational, straightforward process of thinking to being very panicky and convinced that it was serious, and back again to telling myself nothing was wrong. It was as if I had a split personality.
Can you talk through what happened from the time you saw your GP to getting the diagnosis of cancer?
I got my appointment within 2 weeks. As I was parking my car, I was talking the whole situation down telling myself that at least as a doctor I will know what’s going on. I also thought that the clinic staff would get annoyed with me for wasting their time as nothing was wrong with me at all. I was really in denial.
I went in and the receptionist told me to go straight for a mammogram. That threw me as I thought that I would see the consultant first; in my day that’s what would happen – you’d see the doctor first then have tests. As I was waiting to see the doctor after the mammogram, I overheard a lady next to me being told that if anything was abnormal on a mammogram, an ultrasound would be done. That was ringing in my ear when my name was called out and I was taken into a little room and the first thing I saw was…an ultrasound machine.
The doctor’s voice in my head said, ‘oh that’s an ultrasound machine, so they must have found something.’ But the woman’s voice was saying, ‘no there can’t be anything wrong because I only came for a check-up!’
Were you told the results of those tests on the day?
Well before the radiologist – a really lovely man – did the ultrasound, he explained that I was having it because there was an abnormality on the mammogram. He then did the ultrasound and explained what he could see and from the way he spoke I knew that I had cancer. He was very clever because he didn’t directly say it was, but he was gently preparing me for what was to come. Then he did a biopsy.
So within half an hour of being at the hospital, I had had all these tests and in my mind I had moved from being a normal patient to a cancer patient.
When did you get the results of the biopsy?
The thing was that as this was around Easter time, every other week was a bank holiday, so I couldn’t get into a Monday clinic appointment. In the end that 2nd appointment for results was 2 weeks after the 1st.
However, nothing was straightforward. At that 2nd appointment, my consultant was away and the doctor in his place wasn’t experienced so couldn’t tell me anything. Then at the 3rd appointment when I was actually told it was a cancer, the consultant there examined me. She felt that there was a bigger lump than on the ultrasound and another in the left breast. So I needed an MRI scan.
The MRI suggested that I had pre-cancerous changes called DCIS. Then the consultant wanted to know how much of the area was DCIS and how much was cancer. To get that information, a serial biopsy was needed; this meant that with x-ray guidance, I had to have several biopsies taken over different parts of the cancer. When I came back for those results I was told that a lot of the area was actually DCIS though there was still a cancer. In the end it was 5 weeks since my first hospital appointment that the consultant then confirmed that I needed surgery.
I was given a date for surgery that was 2 months away and I was devastated. Even though I knew that there wouldn’t be much growth in that time, knowing that I had this cancer meant I just wanted it out. The thought of waiting 2 months was really frightening.
What was going through your mind in those 5 weeks?
I immediately assumed I was going to die. That was despite me knowing that there are very good and effective treatments for breast cancer. I also went through the bereavement process. I got angry at little old ladies asking why they got to live so long and I didn’t. I got angry with people’s responses. I was horrified that I would be leaving my kids.
There was also this odd effect. I was very aware of colours and scents and sights. I was acutely aware of nature and little details. It was if I was taking more notice of the world because I would not be around to see it all.
Did you have any other treatment after surgery?
After surgery, I had radiotherapy then tamoxifen and letrozole which are hormone treatments.
There a range of treatment combinations for breast cancer. Why did you have that combination of treatment?
I don’t think I was given an explanation as I remember the first surgeon wasn’t really a good communicator. But perhaps I may have forgotten. I do remember being told that the cancer was not very big. Most was DCIS and the lymph (glands) nodes were not affected. The best treatment was to remove the lump and because the lymph glands were clear, chemotherapy wasn’t needed. The radiotherapy would reduce the chances of it coming back in the breast and as the cancer was hormone sensitive, the anti-hormone treatment was needed, again to reduce the chances of a recurrence.
Did you have your treatment on the NHS or privately?
I had it on the NHS and I think that cancer care through the NHS, on the whole, is of a very high quality.
How are you now?
Good. Touch wood everything is fine. I am past the 5 years of follow-up now so I don’t have any more set appointments now.
Did being a doctor help or hinder you as a patient?
Overall it definitely helped. From the beginning, I understood how hospitals worked and knew the jobs of the different people that looked after me. Knowing how to communicate, the right words to use, how things worked, what I needed to do to make things easier – all that removed the extra layer of complexity and fear.
Any advice for someone who has had little exposure to the hospital system?
Always try and take someone with you. I had a friend who came with me and made notes of what was being said at my appointments. When we walked out and I looked at the notes I was surprised at how much I had missed. So that 2nd person is a real advantage to have.
In addition, ask all questions – no question is too silly.
Were you treated differently as a doctor?
I didn’t get preferential treatment. I didn’t go out of my way to tell anyone that I was a doctor, though some continued to address me as ‘Dr.’ I think cancer is so serious that everyone is treated equally and with close care.
Who were your biggest sources of support?
I had a really good friend and my family to provide that. There were also some great sources of help at the hospital. My first breast cancer nurse was remarkable. She treated every patient as if they were the only patient, making us all feel very special.
What 3 things did you learn about the NHS that you didn’t know already?
I didn’t realise that if your GP was suspicious of a cancer diagnosis, you had to get an appointment with the specialist within 2 weeks and I was impressed with that.
I also was impressed with just how amazing and committed NHS staff can be.
Generally cancer care is excellent and of a high standard. However, when I changed hospitals part way through my treatment, I realised that some specialist treatments are only available in the bigger hospitals. However, although we don’t get access to every new drug like people do in the US, at least unlike the US, we all get access to treatment.
You have written a book about your experience with cancer, ‘From Both Ends of the Stethoscope.’ When did you decide to do this?
The realisation came quite early on, even at that first appointment. I got a strong feeling that I had been given this cancer for a reason and my experience just seemed to be calling for a book.
Your book is as well an account of your experience as it is educational. Was that intentional?
My main drive was to guide other people going through breast cancer; at times I struggled as a doctor and so I wanted to help those without a medical background. Whilst I could have just written about myself, I didn’t think that’s interesting unless you are famous and everyone knows you.
What I did was to use bits of my story as a teaching experience. I thought that would get information to the reader in a digestible way. Each chapter combines bits of my story with factual sections and that means you can read each chapter individually. Often, especially in the early days after a diagnosis of cancer, it is difficult to take in a lot of information, so breaking it up in chunks helps.
How is the book doing?
Since it was published in 2015, the book has won 2 awards. In April 2016, it was the winner of the Words for the Wounded Book Award. Words for the Wounded is a charity of authors who raise funds for ex-soldiers wounded in wars. The book is also a 2017 Jayney Loves Platinum Award winner; these awards recognise books and products that contribute to health and well-being.
What are you doing now?
Because of this book I work closely with events that raise awareness of breast cancer. I recently spoke about the subject at the Houses of Parliament. I also write for the Huffington Post and Frost e magazine.
Kathleen Thompson’s book, ‘From Both Ends of the Stethoscope’ is available from Amazon here: