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Robert B - Interview 10

Age at interview: 70
Age at diagnosis: 70
Brief Outline: Robert was diagnosed with breast cancer in 2008. His treatment included mastectomy, radiotherapy and tamoxifen. His treatment went smoothly although his radiotherapy caused some skin redness and has hot flushes and lethargy taking tamoxifen.
Background: Robert is a retired bank manager. He is married and has 2 adult children. Ethnic background' White British (Scottish).

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 When Robert found a small growth on his breast he was unsure what to do about it. For several months he monitored it before eventually showing it to his wife. She encouraged him to seek help and he showed it to his practice nurse when he was there for a routine visit. He was referred on to his GP who did a thorough examination and he was referred quickly to the hospital.

 
He knew that men could develop breast cancer, but was shocked when he was told he had breast cancer. He was unprepared for his diagnosis and his wife was not with him. He told her immediately but waited until his daughters were visiting a few days later so that they were not alarmed and could see he was looking well despite his diagnosis.
 
He was overwhelmed with information, and felt he was given too much. He did not enjoy being given treatment choices and wanted the specialists to tell him what he should do. His wife read the information and searched the website for information and told him what he needed to know.
 
At the time of his diagnosis and treatment, he told family and friends his diagnosis. However he felt quite embarrassed about it particularly when he has to explain that he is the patient when he is collecting his tamoxifen prescription. Since his radiotherapy finished he considers his illness to be behind him and treats it as an interruption in his life. He does not keep it a secret, but neither does he openly tell people that do not know already.
 
He has a strong Christian faith that has given him comfort and strength throughout his breast cancer experience. He does not fear death but he lives his life day by day. He feels fortunate to have reached the age of 70 in good health and wants to enjoy his retirement to the full. 
 
 

Robert was concerned about a small mole-like lump but was unsure about seeing a doctor. He showed...

Robert was concerned about a small mole-like lump but was unsure about seeing a doctor. He showed...

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Well, you know, I’m actually quite health conscious, you know? I do a lot of walking and so on, and I decided I’d volunteer to get my cholesterol checked right, and it was a wee bit high and I was sort of back and forth – and I noticed I had just a wee sort of growth under my nipple. Just a small one. When I was at the nurse for my cholesterol. I said to her, “You know do you think I should see the GP about that?” And she sort of had a wee bit of, “I think you should,” she says. So I went to the GP, and he looked at it and he said, “I’m not worried about that at all, but,” he says, “I think your breast’s a wee bit swollen,” he says. “I think I’ll send you to the breast clinic.” I went, “what?” you know really? And to make matters worse, I’m very friendly with [name of friend] in the [hospital]– he’s just retired from the breast clinic. I said, “[name of friend], I have to go to your breast clinic you know.” “Why?,” he says. I said, “Well, the GP said I’ve got a wee swelling.” “Aye,” he says, “I’m sure you’ve nothing to worry about. There’s not many, you know, male breast cancers about,” you know? But he couldn’t have been more wrong you know. So full marks to the GP. And full marks to the health service – they were very good to me. I went from the time I went to the GP and got referred, and my consultation in the outpatient was only about two weeks, and they tested it there and then. And the other thing was, too, it was a Saturday morning I went for this test, and the doctor that was running the test, I knew him as well, you know? And he says, “What are you here for?” And I told him.” Oh, I’m sure you’ve nothing to worry about.” But he actually ran the test, you know? So I’d too many friends at court, I think – so the consultant told me there and then that I had breast cancer.
 
So I was very, very fortunate. If I hadn’t been that I was getting my cholesterol checked, I probably wouldn’t have gone you know to the doctor for it – until it became really, you know, evident you know. So I was really fortunate that way, that they got it very quickly you know.
 
Was it a spot, or was it a lump?
 
It was a wee sort of growth – almost like a wee wart, that sort of thing.
 
On the skin?
 
Yes, just under the nipple, below the nipple, just on the skin.
 
Right.
 
It had been there for a wee while, and I thought, I wonder if I should go and see about that, you know? And the fact, I probably wouldn’t have gone just for that, but the fact I was going for something else gave me the opportunity, you know?
 
Yeah, to go along.
 
So the GP, good on him for spotting it, you know?
 
It was actually a good few months I’d been looking at this, you know, and I’m saying, “I wonder if I should be asking about it.” I was just a wee bit concerned about that, and then the fact that I was getting my cholesterol checked, I thought, “Ah, this is a good,” and I said to [my wife] – “Do you think I should let the nurse see that?” And she said, “Yeah”, and she had a look at it and I said, “Do you think I should get the GP to look at that?” And she said, “Yeah, I think so.”
 
Yeah – so did you mention that you had this to your wife previous?
 
No.
 

Robert had been feeling fine and thought his GP was overreacting when he referred him. It helped...

Robert had been feeling fine and thought his GP was overreacting when he referred him. It helped...

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When you went to the GP and he said he was referring you on, did you have any suspicions then? Coz obviously, he, or did you feel like you were ..?
 
I didn’t think there was anything wrong with me, no – I didn’t really. Coz I felt fine. I never… I thought, is he overreacting a bit – but I didn’t really think there was anything to worry about. [My friend was] telling me, “You’ve nothing to worry about,” I mean, that definitely – so it came as a real shock, it really did. That took a wee while to cope with, to come to terms with. That was probably the worst time – coming to terms with it, you know?
 
Right. What was difficult about that?
 
Just the, you know, the fact that I had cancer. Although I never sort of, I didn’t think I was going to die because they were very, the consultant was very positive when I went, you know, at the beginning and you know, they said there was a very, you know, high cure – that’s not the right word.
 
 
 

Robert was offered cosmetic surgery. He said he wasn’t bothered about having another scar at his...

Robert was offered cosmetic surgery. He said he wasn’t bothered about having another scar at his...

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 So when you came out of surgery and you’d had the mastectomy…

 
Had the surgery, oh aye, that’s right, of course.
 
(overtalk) had the mastectomy, I mean, how do you think it looks? Have they done a good job with the scar?
 
Yeah, it’s fine – I mean, ok, my nipple’s away and everything, and the consultant said, you know, “you can have cosmetic surgery,” and I went, “at my age? Forget that,” you know?
 
So you were offered that?
 
Yeah, I was offered that.
 
At the time, just before they were going to do the…
 
Before… When I went initially, you know, they were discussing the surgery and said, you know, “you can have cosmetic surgery.” I says, “…don’t need cosmetic surgery at my age,” you know? If I was a young guy or something, uh uh, but I didn’t worry too much about that. But anyway, they made a very neat job of it.
 
And how do you feel about your body now?
 
Well it’s, I mean, I’ve got enough scars as well, you know? But the fact that the age I am, it doesn’t bother me at all. The thing is I feel ok – that’s the main thing, you know?
 

Robert describes what it was like to have the treatment and fit things around his daily...

Robert describes what it was like to have the treatment and fit things around his daily...

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 Did you take precautions like, did you rest and just be quite sensible round that time, or did you not change much in your normal routine?

 
Well, I had to change my routine because I was going every day, you know, and I found that a bit of a discipline, you know, coz I’m quite busy. Aye, and I found that a bit of a discipline, and I didn’t change my routine any more than I had to, quite frankly, you know?
 
Was it the same time of day you went every time?
 
No it wasn’t, actually – it was a bit of a nuisance. Sometimes they had to change it, and then one day they phoned up in the morning and say their machine had broken down and I couldn’t come that day – and then they phoned up at lunch time and said, “Oh, you can come in the afternoon, they’ve fixed it.” Then there was another time that I wanted a day off to go to a funeral. Oh no they were quite, “Oh, I see. Oh alright then.” But they were quite, you know? I said we would add on the other end, you know, but they were a wee bit kinda iffy about that, you know?
 
So it wasn’t very flexible, then?
 
No. You’ve got your twenty treatments and that’s it, you know? They’re quite, you’ve got to go every day. And then you met the same people coz they were going too.
 
Was there people with all different types of cancer?
 
Yes, aye.
 
Did you feel any sort of camaraderie with them?
 
Yes I did. And also the radiologists or the girls that did the machine, they were good as well. It’s very precise – you probably know it’s very precise – they put it up in the computer and get you in the exact position and so on. The first time I was really surprised, you know, how short it was – of course, it’s so powerful. But you’re in it for such a short time. But I got used to it alright you know.
 
Had you to wait once you were there, or were you taken in…
 
Ah yes, but most of the time, not unduly. Not unduly – their appointments worked pretty well.
 

Robert had a few side effects from the tamoxifen but said they were ‘no big deal’. He took his...

Robert had a few side effects from the tamoxifen but said they were ‘no big deal’. He took his...

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 How do you find the tamoxifen?

 
Sometimes, I get quite hot with it, and other times I think it makes me sleepy. I always nod off after my lunch and after my tea, but I might have done that anyway – coz I was inclined to do that anyway. I think it makes me a wee bit sleepy, and sometimes I have hot flushes with it – but I have to persevere with that for five years, so I just get on with it. But it’s no big deal.
 
Right, ok. So you don’t get any major – some men have been complaining about pains in their joints and their legs and things like that?
 
No, nothing like that.
 
What about mood swings?
 
As far as the tamoxifen’s concerned? No, I don’t have that.
 
No? Some men have been complaining about getting quite angry with it.
 
No. I don’t think, no, I don’t think so, no. No, no. No. I never heard, is that so? I must tell my wife that one. If I get angry sometimes, I’ll say that it’s the tamoxifen. No, I haven’t found that at all.
 
No, that’s good. So you manage to take it without too many complaints?
 
Yeah, but I have to remember to take it, you know? The fact that it’s only one pill a day – and I take it in the morning, you know, and [name of wife] will say, “You haven’t taken your pill yet.” Coz I take it out when I’m having my breakfast to make sure I don’t forget – and sometimes I do. “You haven’t taken your pill,” you know? So I don’t know what I’d do if I was on a lot of medication. I have to say that I’m finding that my memory is bothering me a wee bit. I think that’s my age, as well – you know, sometimes my memory’s causing me problems. Physically, I’m fine, but mentally I’m not as sharp as I used to be. But that’s not the tamoxifen. But I need to remember to take it.
 

Robert B said patients are expected to make treatment choices now. He felt overwhelmed by...

Robert B said patients are expected to make treatment choices now. He felt overwhelmed by...

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 Were you given any choice in what treatment you had?

 
Well, the way they do things nowadays, in the health service, you know? They don’t tell you. They suggest, you know? And you’ve got to make the decision, you know, which I find a bit strange – but that’s the way things are done nowadays, you know? They said, “Well you know we recommend that you have radiotherapy, but you know, do you want it?” In fact, the chap, it was quite a young oncologist – he said, “If you take no treatment at all, you have a sixty four percent chance of living for ten years,” you know? “But if you have radiotherapy, then that’s increased greatly, you know?” So he told me that. But you know, I had to make the choice, you know? Yes or no, in other words.
 
Yeah – and how did you feel about that?
 
I felt as if he should be telling me, not just asking me, he should be telling me, you know? That’s just the way it is now, and I find that a wee bit of getting used to. That and the other, the way that they tell you, give you so much information now. That can be quite overwhelming, like when I went for my consultation to the [name of hospital], you know, they were hitting me with all sorts of information you know and trying to take it all in – that’s why they say that you should take someone with you, so that if you don’t pick it up, they will, you know?
 

Robert B felt he got too much information and that ‘they almost blind you with science’.

Robert B felt he got too much information and that ‘they almost blind you with science’.

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 At the time, what you were going for your regular appointments, you know, when you were given your diagnosis and afterwards for the follow up tests, did you give, did you feel that you were given enough information?

 
I actually think I felt I got too much information, you know? I would have preferred to have just got on with it and didn’t tell me quite so much, but you’ve got to know everything, you know? And my neighbour [name of neighbour], too, he’s the same – you know, they almost blind you with science. I think they tell you too much, quite frankly. Maybe that’s just coz I’m a male. I mean, I was quite happy to have my anaesthetic and just go into that theatre and not know anything about it until it was all over, you know? But no, they tell you everything and I would have been quite happy with less information, quite frankly – just get on with it, make me better, you know? That’s how I felt. That’s a male thing, maybe. It could be, you know? 
 

Robert said his faith has been a source of strength and that the church had played a big part in...

Robert said his faith has been a source of strength and that the church had played a big part in...

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 You sound as though you’re very well supported in your own community?

 
Yeah, that’s right. If I hadn’t had that, I might have wanted some support – but no, I was well supported. It was quite – it was actually almost overwhelmed by, you know, the care that I had from everybody. I really was. It was quite a sobering experience, really, you know? And as I say, it made me think of my mortality you know – but no, I was fine, and people were so good to me, so good to me. I like to think, myself, that I was positive about it, you know? I didn’t sort of, I never felt sorry for myself – no. But you know, it was certainly was a sobering experience, but people were very good to me they really were. The hospital and just my family and my friends in the church and everything – yeah, they were very good to me, and that helped tremendously – of course it did, of course it did.
 
Right – so your faith has been a major strength to you?
 
Oh yes, there’s no question about it – and the church that, you know, has been a big factor in caring for us as a family. Not just… Caring for [name of wife] too, they’ve been tremendous.
 
That’s good.
 
Uh huh. So I mean that has been the major thing, no question about it. Coz, you know, if you’re getting older, a bit, and you don’t have faith in the future, you know, then things aren’t quite so good, you know? If you’re just living for this life and you’re getting on a bit, you know, I wouldn’t like to be like that. No.
 

Robert didn’t want to make a big deal of his illness. He found that people were surprised when he...

Robert didn’t want to make a big deal of his illness. He found that people were surprised when he...

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 So how did you tell your wider family and friends?

 
Just when I met them – I didn’t make a big deal of it, you know?
 
And what was their reactions?
 
Probably quite, you know, the fact that it was – not the fact it was cancer, the fact it was breast cancer which surprised most of them, yeah. Again, coz it was a male – that surprised most, that surprised them all, probably.
 
So were they, how were they in their reactions when they were surprised – did you find them quite…
 
Quite quiet.
 
Quite quiet.
 
Not saying too much about it, you know?
 
Right – so they weren’t too inquisitive about it?
 
No.
 
Right.
 
Didn’t say too much about it.
 
Right – do you think that’s because they didn’t know what to say, or they just couldn’t get over the shock themselves?
 
I think probably weren’t quite sure what to say because it was breast cancer, you know? And men don’t get breast cancer. They probably didn’t know what to say. But that didn’t mean to say that they weren’t supportive – probably just didn’t know what to say.
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