Medically reviewed by Nieca Goldberg, M.D., FACC

October is Breast Cancer Awareness Month.

As told to Marnie Goodfriend

All I ever wanted to do was become a doctor. My dad was a surgeon, and my mom was a nurse. I received a PhD in the genetics of cancers and spent my 30s training to become a breast surgeon. I loved the human body, and I loved operating. It was my life. But I never checked my own breasts. I thought, “I’m a doctor. I’m not going to get breast cancer.” I was healthy, had no history of breast cancer in my family and felt invincible. I had recently gotten engaged and had just signed up for my first triathlon when I saw a lump. It ended up being just a cyst, and I still didn’t check my breasts.

Two and a half years later, a month after I had cycled up the Stelvio Pass, a major mountain pass in Italy, I found another lump. My mammogram was normal, but when I got my ultrasound scan, I looked at the screen and saw cancer. The surgeon was my friend and a mentor who had trained me. She saw what I saw and asked me, “Who do you want to treat you because I don’t think I can?”

I had a week of waiting for the formal results, but as a doctor, I knew too much. I told my parents, “In a week, I’ll be telling you I have breast cancer.” It’s like I dissociated from myself. The results were positive for stage 3b breast cancer, and I started chemotherapy to shrink it down. Suddenly, I was about to undergo every treatment that I gave my patients, realizing how little I knew, how scared I was and how huge the decisions are that women with breast cancer need to make in a very short period of time.

The chemotherapy drugs — every three weeks for five months — were horrible. You lose everything — your fertility, your dignity, your power, your hair, your nails, your sense of pride. I didn’t know how to navigate being intimate with my husband: Do you touch the breast or not? How do I function in the world? The chemo treatments brought on instant menopause, so I had brain fog, hot flashes, and night sweats so bad I thought I wet myself in bed. You’re dealing with these instant changes to your body and your life while being really ill.

(Photo/Liz O’Riordan)

The week before Christmas in December 2015, I had a mastectomy with an implant reconstruction, and they took a couple of my lymph nodes out. But sadly, there were 13 centimeters of cancer left in my breast, and it had spread to my lymph nodes. So, the following month, I had another surgery to remove all my lymph nodes, and in April 2016, I had radiotherapy (that’s what we call radiation in the UK) and was put on a drug to try and stop the cancer coming back. During this time, I couldn’t work, and it took about another eight months once treatment had finished to get my energy levels and immune system back up to be able to work again.

When I returned, I was shadowing another doctor to make sure I was safe to practice. As a cancer patient, it was extremely difficult to tell patients they had cancer. It felt like I was reliving my own diagnosis, and knowing how much they would hurt post-surgery was mentally challenging. Everyone was asking me how I felt after the cancer, but I just wanted to be Liz.

With cancer, your identity suddenly changes. People didn’t recognize me because I used to have long hair, and now it was short and gray. I went to a local hospital where I’d worked as a junior doctor and saw the woman who had trained me. The only way she could treat me was to stop being my friend to try to reduce the emotional toll of operating on someone you know. It was really hard to be operated on and treated by colleagues of mine and my husband who is also a surgeon.

(Photo/Liz O’Riordan)

I found myself at home alone, unable to have children. I lived in a small village and didn’t have many friends. I’d lost my job, my purpose, my identity and my financial security. I started blogging weekly about my experience and decided the day after I got my diagnosis, to “come out” on Twitter. I used to tweet about triathlons and baking. Now, I was flooded with information and support from people all over the world. They told me, a breast cancer surgeon, how to cope with chemotherapy, what toothpaste is best if your mouth is sore and recommended cookbooks. Overnight, I had an instant network of women supporting me. With my writing, I wanted to offer a sensible opinion that wasn’t reactionary — and doctors and nurses thanked me for doing so. I realized I could help people in a different way.

I began explaining breast cancer with videos, writing and posts on social media, using my dual experiences as a surgeon and patient to reach people around the world to help them navigate cancer. In some ways, it was more fulfilling than being a doctor. I could connect with patients on an intimate level and encourage healthcare providers to talk about sex, menopause and how to help people live after you’ve operated on them, not just be alive. The growing community also shared important resources like CoppaFeel!, a UK-based organization that teaches you how to examine yourself properly and sends a text reminder on the first of every month to check your breasts.

In the spring of 2018, I noticed a nodule on my chest underneath my left armpit. It was a recurrence on my chest wall, and that meant I had to have my implant taken out, and more surgery and radiotherapy. I had my ovaries removed in September 2018, and I was put on a different hormonal blocking tablet to stop the cancer from coming back. I received a lot of therapy and treatment for my left arm because I couldn’t lift it very high, and to perform reconstructions, you have to contort yourself into awkward positions. Psychologically, I was a mess. I was so fearful of the cancer returning that I couldn’t be around women who were having recurrences, so I ended up retiring at 43.

This led to a collaboration with another local doctor who’d been diagnosed with breast cancer around the same time as me. Between us, we had bought 20 books about being a breast cancer patient and read questions on the internet like, “Is it safe to have sex during chemo?” “Will my husband’s hair fall out, too?” “Should I be detoxing?” You want to connect and be hugged, but there are men out there who are sleeping in separate bedrooms because they’re scared they’re going to catch cancer. We wanted to tell younger women to start taking preventive measures now, and if you’re already getting mammograms, the importance of checking your breasts in between.

Liz receiving Humanitarian Award, 2024

To dispel misinformation online and support patients, we decided to write a common-sense book about breast cancer, answering every question patients have from diagnosis to death. I’m deeply concerned about the rise of false information and people pushing alternative therapies and scams to make money. People believe them, and women in their 30s and 40s are dying because they’re doing something on TikTok instead of believing healthcare providers. Our book covers sex, exercise and mental health. We now know that exercise can reduce the physical and mental side effects of cancer and the risk of recurrence. It also helps fight fatigue. Before cancer, I was all about the data, my heart rate and ideal heart rate zones. Now, I show up to local park runs and cycle with people because I’ve made lasting friendships, and it brings me joy. I’ve got into wild swimming as well, swimming in rivers in the wintertime.

In 2022, six months after my mother passed from metastatic cancer of her right arm, my breast cancer came back in the skin near my mastectomy scar. I had more surgery, and now I get monthly injections and take a low-dose form of chemo I’ll be taking for the rest of my life, but the fact that I could use this horrible experience for good changed me. Sharing my writing online paved the way to becoming a published author and being asked to give a TEDx talk to help and protect breast cancer patients and the people who love them. I talk about how I never thought I’d feel like a woman again — I just looked like an alien. Then, I remembered when I was operating, all I could see of people was their eyes, which made me realize I don’t need external attributes to define me. Having a different relationship with ourselves and our bodies starts from the inside.

Today, I speak at events and conferences around the world, have a robust following on social media, and in 2024, I received a Humanitarian Award presented to me by Elizabeth Hurley. My new book, The Cancer Roadmap, will be released this November, and I’m working on another book about food and going into season four of my podcasts. But, I also have to remind myself that I have breast cancer, which means taking more time for myself. More river swimming, more walking the dog, more peaceful moments in the garden.

Resources

The Brem Foundation

The Get in Touch Foundation

Susan G. Komen Foundation

Breast Cancer Research Foundation

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Our Real Women, Real Stories are the authentic experiences of real-life women. The views, opinions and experiences shared in these stories are not endorsed by HealthyWomen and do not necessarily reflect the official policy or position of HealthyWomen.

Exercise is an important component in the overall strategy for improving the health and strength of your bones. The optimal exercise regime for preventing osteoporosis has yet to be established, but these guidelines are based on our current state of knowledge. We do know that exercise works best when you have adequate levels of estrogen, calcium intake and vitamin D. The diet should be low in fat with emphasis on cereals ,fruits and vegetables.

We think of bones as solid, rocklike structures, instead they’re living tissue that is constantly changing. Peak bone mass usually occurs between age 20 and 30 and then slowly declines. Bone loss accelerates during the first several years following menopause. A Recent study indicated that a fat-laden diet could lead not only to obesity and heart disease but to the thinning, fragile bones of osteoporosis. The foods we eat, the amount of physical activity we perform and various environmental and genetic factors contribute to bone health. If you have been diagnosed with osteoporosis , check with your physician before starting any exercise program.

Effect of good/bad Posture:

How we work, play, sit and move can determine the chronic stress placed on our spine. Viewed from the side, the spine is shaped like an S-curve. It is ten times stronger when these natural curves are maintained. Good posture and body mechanics can alleviate/prevent back pain and protect your spine against fracture.

Posture:

• When standing, an imaginary vertical line should connect your ear, shoulder & hip.
• Don’t lock your knees. Stand with feet straight ahead or slightly turned out.
• Pull in your stomach muscles so as to prevent a sag.
• Maintain a normal (not flat or exaggerated) curve in your low back.

Sitting:

• Do NOT sit or stay in the same position for prolonged periods of time.
• Sit in a firm, straight-back chair with your buttocks all the way back.
• Use a lumbar roll to maintain the natural curve in your low back.
• Tuck your chin in and pull your head straight back.
• To get out of a chair, slide forward without slouching and then stand up.

Moving & Lifting:

• Keep an upright back.
• Use your legs instead of your back ,when you lift even the lightest object. Keep a wide base of support. Squat down, keeping your chest upright.
• Avoid forward bending. If you must lean forward, bend where your legs meet your trunk, NOT at your waist.
• When lifting, hold objects close to you. Keep the activity close to your body.
• Avoid twisting movements. Always point your feet in the direction you’re moving.
• It requires lots of practice before new ways of performing daily tasks become a habit. But the payoff is long-term back health. Observe how many times you bend over and how many hours you’re sitting during a typical day: ie. cleaning the bathtub, picking up a child, reaching for your workout bag or purse, gardening, commuting, watching t.v. or working on the computer. Start off with a few changes. Make a consistent effort to be aware of your movements and protect the normal curves of your spine.

Flexibility:

Much of our day is spent sitting or bending ,thanks to advancement of science. This can tighten some muscles and put a lot of stress on the spine. As part of an overall program of stretching, develop good flexibility in your spine, hamstrings (back thigh), hip flexors (front thigh) and pectoral (chest) muscles. Avoid forward bending exercises to prevent extra stress on the bones and discs of the spine. Stretch the muscles to a point of tension, not pain, and hold the stretch for 15-30 seconds at least 3 -5 times daily or as directed by your physical therapist.

Strength Training:

Strength training is probably one of the most important things you can do to build or maintain strong bones. During exercise muscles are challenged, to pull on their bony attachments stimulating bone formation. If you want to increase bone mass in a particular bone, the exercise must recruit muscles that attach to that bone. It has been observed that a certain strength training intensity stimulates bone growth. You must challenge a muscle to fatigue after about 8-10 repetitions, 2-3 times/week. It’s important to gradually increase resistance as your muscles become stronger, instead of cruising through a workout that has become easy. Use of free weights appears to stimulate bone growth in the hips (probably due to weight-bearing). To increase bone density in the spine, utilize either free weights or exercise machines. Have an exercise professional design a well-balanced strength program for you involving major muscle groups, particularly in the hips, wrists and spine (common osteoporosis fracture sites). Learn proper exercises for the upper/lower back and abdominals to give you strength for good posture.

Weight Bearing Exercise:

Each time we step, jump, run or balance on part of our body, the impact causes compressive force on the bone which in turn encourages bone building. That’s why it’s important to participate in regular weight-bearing exercise which is appropriate for your fitness level and current bone health. For example: very fast walking, uphill walking, stair-stepping, jump rope or jumping activities, high-impact aerobics, jogging, certain types of dancing, soccer, tennis, squash and basketball can be good exercise choices for bone-building. High impact forces and a variety of movement patterns cause a stronger bone response.

However, your strength, heart health and bone integrity must be adequate for safe exercise. Your doctor or physical therapist can tell you what’s safe and effective for you. Strength training exercises done standing (or when balancing your weight on a leg or hand) are also an important part of a weight-bearing exercise program.

Balance:

Good levels of strength and flexibility guarantee that you’ll keep your balance more easily. To help prevent falls, activities that require balance are also good to practice. Many forms of dance
can promote good balance.

A simple exercise: Practice standing on one foot for 30 seconds. Repeat with the other leg. When you can do this easily, try it with your eyes closed or while moving the “air leg” forward-and-back or out-and-in. There are all kinds of balance games and activities you can do. Remember to progress gradually and provide for something to grab if you need a balance check.

As an adolescent or young woman, exercise can boost your bone mass. After the mid-thirties, success means keeping the bone you have (or slowing the rate of bone loss). Whatever your age, exercise is good medicine for your body and your bones.

Disclaimer
The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Biosimilars are medicines used to treat many chronic diseases. And they’re close copies of biologics.

What are biologics?

Medicines made from living cells

Biologics are complex medicines made from living cells, like yeast or bacteria.

• Regular medicines (like aspirin or antibiotics) are small molecule drugs. They’re made with chemicals. They have a simple structure and can be copied exactly. These copies are called generics.
• Biologics are large, complex molecules. They target certain cells or processes in the body to help fight diseases. They can treat many chronic conditions, but they’re often very expensive.

What are biosimilars?

Close copies of biologics

Biologics are too complicated to copy perfectly. Instead, scientists make medicines that are very close to the original biologic. These are called biosimilars .

• Biosimilars deliver the same amount of the active ingredient into the body at the same rate as the biologic .
• They work the same way, are just as safe and usually cost less.

How do biosimilars work?

They block damaging cells and signals

Biosimilars help stop inflammation and damage.

• Many chronic diseases come from overactive immune responses that cause too much inflammation.
• For example, special proteins called cytokines send inflammation signals in the body.
• When cytokines overreact, they cause chronic inflammation.
• This inflammation makes symptoms worse and causes damage.
• Biosimilars target these cells and block the signals to reduce inflammation.

What do biosimilars treat?

Biosimilars can treat chronic conditions

Biosimilars block the inflammation signals that cause symptoms and damage in different chronic conditions.

• Crohn’s disease
• Stop the immune system from attacking the gut.
• Multiple sclerosis
• Keep certain immune cells from getting into the nervous system.
• Rheumatoid arthritis
• Block proteins that cause joint inflammation.
• Ulcerative colitis
• Stop immune cells that cause inflammation in the bowel.
• Psoriatic arthritis
• Block damaging signals that cause joint pain and swelling.

Why do biosimilars matter?

Biosimilars offer more access to effective treatments

Biologics take many years and a lot of money to develop. So they have a very high cost.

Biosimilars:

• Can be made at a lower cost.
• Are just as safe and effective as the original biologics.
• Give more people access to the best medicines.
• Help people with chronic conditions get needed treatment at a lower cost.

Are biosimilars right for you?

Like all medicines, biosimilars may have side effects. Always talk to your healthcare provider about the best options for you.

This educational resource was created with support from Sandoz.

If you or someone close to you has migraine disease, you may already know that it’s more than “just a headache.”

Many people think of migraine as a severe headache, but migraine is actually a neurological condition with many different symptoms. Yes, the most common symptom of a migraine attack is head pain, which can be severe or moderate and long-lasting. But there are many other symptoms as well.

Migraine symptoms can include:

• Sensitivity to light, sound and smells
• Eye pain
• Vision problems like tunnel vision, blurry vision or seeing flashing lights
• Nausea
• Dizziness, numbness and tingling
• Sweating
• Increased urination
• Fatigue
• Frequent yawning
• Constipation

And migraine may come with or without aura, which is a warning that a migraine headache is coming on.

There’s a wide variety of ways to experience migraine and a wide variety of treatments available as well.

Getting through cancer treatment is no easy feat. The intensive therapies, changes to your body and fears about recurrence are all common for women who’ve completed cervical cancer treatment. But recovery doesn’t end when treatment does. Survivors may deal with long-term physical, emotional and sexual changes.

Knowing what to expect after treatment can help you prepare and feel more at ease as you move forward.

Here are 8 things you should know if you’ve had or have cervical cancer.

Life after treatment can bring many challenges, but you don’t have to face them alone. If you notice any changes in your emotional, mental or physical health, please reach out to your HCP. They can help you make a personalized treatment plan. This plan will help manage symptoms, support recovery and maintain your quality of life.

This educational resource was created with support from Merck.