Dermot Joyce from Cahir, Co Tipperary shares the story of his late wife Audrey Keating Joyce as they and their eight-year-old son Jack navigated their way through a breast cancer diagnosis and bereavement as a family
It all started when we were getting ready for a weekend away towards the end of March 2016 and Audrey found a lump on her breast that she was a bit concerned with, so we decided that we would call the doctor on the following Monday morning.
Audrey got an appointment for the Tuesday morning. Again the doctor was concerned and referred Audrey for a mammogram in the Bons Secours Hospital in Cork and she got her appointment for two weeks later. Audrey attended and had her mammogram, and they were concerned enough to carry out some biopsies and an ultrasound on the same day.
We met with the Consultant Surgeon that same day too and he told us that he was sure that Audrey had breast cancer and that he didn’t feel the need to wait for the full biopsy results. He was so sure that he went ahead and scheduled an appointment for the Consultant Oncologist for the following Wednesday.
We went to meet the Oncologist as planned and he informed us the earlier test results confirmed what we already knew. He already had a plan in place and went through it with us: that Audrey would need to go through eight cycles of chemotherapy, have a mastectomy and then a course of radiation. Within the space of four weeks of first attending her doctor Audrey was having her first chemo session so things moved pretty fast.
Audrey had her chemo sessions every two weeks and we quickly became aware of when her bad days and good days were going to be, so we tried to plan stuff for the good days (after all Jack was only three at the time). As with everything she did, Audrey took all this in her stride and got on with things, and completed her cycles of chemotherapy.
We then had a little short break form treatment before her mastectomy was scheduled for September. Audrey has her mastectomy and also some lymph nodes removed from under her arm and was given time to recover before her radiotherapy treatments started in November and December 2016. She had 15 radiotherapy sessions in all in CUH, which meant 15 trips to Cork over three weeks. All went well and we had a good Christmas despite the year we had.
Audrey attended her oncologist for a regular appointment in January 2017 and he said that she was cancer free-but she was an ideal candidate for a trial drug that would increase the chance of her remaining cancer free. The trial included monthly consultations with the oncologist and quarterly scans (all free of charge) so we decided that the benefits of the trial and the extra screening would be worth a monthly trip to the hospital.
The trial went well and at the end of Jan 2018 the trial was completed and Audrey was still cancer free. But then around November and December the following year Audrey was beginning to experience pains in different areas which she thought were muscular but didn’t go away with physio.
Following consultations with her doctor and oncologists bone scans and MRI’s were scheduled for early January 2020 following which on January 15th it was confirmed that Audrey’s cancer had returned and she now had several spots on her bones. The oncologist told us that the diagnosis was terminal, and all that could be done at this stage was to treat Audrey with a view to slowing down the spread of the cancer.
Another treatment plan was commenced and we had a pretty good few months but around September and October 2020 Audrey began to experience pains again and she progressed to needing radiotherapy on different parts of the body. In January 2021 her oncologist changed her medications and her hospital admissions became more frequent, and in April she had scans and lumbar punctures done and nothing of any significant consequence showed up, although the oncologist did say he was concerned.
After some days of severe pain Audrey was admitted again on May 19th and all the tests were redone. They found some new tumours and were confident it had spread. After two weeks in the Bons and another week of full head radiotherapy Audrey was transferred to Marymount Hospice, where she received wonderful care from the team there.
Audrey passed away, surrounded by her family on 19th of June 2021. She was laid to rest on the 22nd of June, the day before her 51st birthday.
Audrey is/was (I’m still not sure which word to use) an amazing lady. She always made time for everyone. She had an amazing strength of character and bore her illness with great dignity.
I can count on my fingers the amount of times over the last 5 years that she complained or cried to or with me, and most of these were because she wouldn’t be around to help others when the need will arise in the future; that’s just the way Audrey was.
Despite all she was going through personally and with Covid lockdowns she still made sure to meet her friends when she could. As I said, an amazing lady, wife and mother.
When Audrey was first diagnosed in 2016 we spoke to the nurse in the Daffodil Centre in the Bon Secours Hospital in Cork about what we should say to people, particularly Jack and the nieces and nephews who were all under 10 at the time. The advice we got was to be honest without going into too much detail, but not to make any promises that we couldn’t keep.
When the second (terminal) diagnosis came all the kids were that bit older and were more switched on. We just told them that Audrey’s cancer had returned (we had explained to them about cancer the first time around when Audrey shaved her head before her hair fell out from the chemo), and that this time around the cancer wouldn’t be going away but the doctors were going to give her medication to help her keep well.
Once Audrey got a date for an appointment we told it to Jack and wrote it up the calendar, and he wrote it on his own calendar. We explained whether they were day appointments or whether they were overnight appointments, who would be minding him and details like that.
When Audrey was moved to Marymount Hospice in Cork and it was apparent that she was going to pass on I sat down with Jack and his cousins, aunts and uncles and explained to him that his mam was very sick and wasn’t going to be coming home, and that she was going to die.
Audrey had a wide circle of friends who she kept up to date on her journey. When Audrey wasn’t able to keep the updates going we did it for her. Being open about your illness is not for everyone but it worked for us, and we have had a lot of positive feedback from Audrey’s friends about how happy they were about being kept informed.
Legal & financial practicalities
In terms of advice on financial and legal aspects of the journey from our experience, check your mortgage and life insurance policies - most institutions will pay out on a policy when a terminal diagnosis is given and where a person has less than six months to live.
Check any pension policies that you have and ensure there is a nominated person on the form in case of your death. Make or revise your will as necessary. Check your local credit union if you have an account that has what’s called a death grant that goes towards the cost of a funeral upon receipt of a copy of the invoice.
Make sure Next of Kin is filled out on any legal forms, and contact your local Department of Social Protection office to check what benefits you might be entitle to.
Ask for help
Ask for and accept help and assistance, be it childminding, school runs, house cleaning, cooking, baby sitting. Build a network around you that you can depend on at short notice, as things will happen at short notice.
It can be overwhelming at times both asking for and accepting help, and personally this is one of the things that I found particularly difficult. Make use of the Irish Cancer Society Daffodil Centres in hospitals, and use your local cancer support centre (there’s one in most big towns nowadays).
Importantly, if you are a husband/wife/son/daughter/carer of someone with cancer you need to look after you too: take your walks, have a coffee or pint with friends. Much as you would like to be with your loved one all the time it’s just not possible, and you need to look after yourself because if you’re crocked you’re no good to anyone.
Finally, I want to offer a simple heartfelt thank you to each and every person who crossed our paths on our journey over the last five years including family, friends, medical teams, carers, hospice teams - there are too many to mention individually.
To my son Jack: you are an amazing young man and you inherited your mother’s tremendous strength, I promise to look after you to the best of my ability
To my beloved Audrey: thanks for being part of my life, I will love you forever.
Learn more about breast health and about how you can support breast cancer patients this October.
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