Nine years ago, at the age of 56, Jane Wiles from Bathurst in the Eastern Cape was diagnosed with stage three breast cancer. The disease was advanced; it had spread to the lymph nodes of the structures surrounding her breasts.
A decade earlier, Wiles’s husband had died of lung cancer.
Doctors told her that if she underwent chemotherapy, she would have six years to live.
Wiles said that since then she has been “living in and out of a suitcase on my way to death”. But, she said, she has come to realise that she has a “chronic” rather than a “terminal” illness.
Before her diagnosis, Wiles said, she had experienced only one warning sign — pain in an armpit. She subsequently had a mammogram — her first. The procedure showed cancer “all over” one of her breasts, “scattered in small pieces”. As it wasn’t in lumps, it couldn’t be detected externally through touch.
During a sonar on Wiles’s breasts, she recalled the radiographer exclaiming loudly: “Oh my God! It’s everywhere!”
Wiles said: “The day you’re diagnosed, you find yourself on the other side of the river. People no longer see you as normal and you sort of never get out of that situation.”
Initially, she was treated with chemotherapy. But after a few years of that, Wiles’s oncologist recommended a double mastectomy — the removal of both her breasts.
Once her “very large” natural breasts had been removed, Wiles didn’t opt for reconstructive surgery. “My sexuality has never resided in my body and my identity does not lie in my breasts. I was ironically actually quite relieved to be rid of them,” she said.
Wiles did, however, feel “humbled” by the “drastic” effects of chemotherapy. “I remember standing in front of the mirror one day, looking at myself. I had no hair on my head, no eyebrows, no eyelashes and no pubic hair as the chemo made it all fall out. I had teeth missing. I couldn’t wear my teeth plates due to a swollen mouth because of the chemo. I was thin and my skin was yellow. I thought: ‘It’s over with this little body.’ I felt like nothing.”
Chemotherapy has also permanently numbed her hands and feet. Her body produces too much oestrogen — a process closely associated with breast cancer. Pills that prevent this have resulted in her developing high cholesterol and arthritis.
Four years ago, Wiles’s cancer advanced to stage four — terminal. The disease had spread to other organs. But subsequent radiation and chemotherapy worked well. It has allowed her to live a much longer and relatively pain-free life.
She said: “I’ve actually become a little bored with the idea of death. I’m not scared of what happens after death, I’m frightened rather by the painful process before that — so petrified that I’ve been hoarding left-over morphine given to my mother before she died a few years ago.”
At her age, Jane doesn’t consider cancer a “tragedy”. She said: “Many people of 65 become ill anyway.” Instead, she uses her illness to create “meaning” in life.
Surgery and reconstruction
Breast reconstruction after a mastectomy (the removal of breasts) is a prescribed minimum benefit for most medical schemes and is therefore usually covered.
Breast reconstruction can now be accessed in the public sphere without medical aid, for example, at the Helen Joseph Breast Clinic in Johannesburg or Tygerberg Hospital’s Breast Clinic in Cape Town.