What Advanced Breast Cancer Really Looks Like with Helen Forristal & Dr Tonya Leonard #191

#AD - This episode is sponsored by AstraZeneca

Dr Tonya Leonard was a GP when she found a lump she was sure was a cyst. By half past nine that morning, she was being told it was breast cancer and asked to decide by the following week whether she had finished her family. Her twin boys were just 18 months old.

Sixteen years, a second primary cancer and a diagnosis of advanced breast cancer later, Tonya joins Laura alongside Helen Forristal, Director of Nursing Services at the Marie Keating Foundation, for an honest conversation about living with advanced breast cancer.

They discuss metastatic or secondary breast cancer, breast cancer recurrence and the signs and symptoms women should be aware of, alongside treatment, scans, scanxiety, cancer fatigue and the difficulty of planning life beyond the next result.

Helen explains why advanced breast cancer remains largely invisible in Ireland, with no official count of how many women are living with it, and discusses the importance of specialist cancer support. Tonya shares the reality of living life in three-month segments, navigating mental health after diagnosis and learning that palliative care does not only mean end-of-life care.

The conversation is part of Living Loudly, Dying to be Heard, a campaign by AstraZeneca and supported by the Marie Keating Foundation, highlighting the experiences of people living with advanced breast cancer.

🔑 Key Points

Advanced breast cancer means it has spread

The cancer has moved from the breast to another organ; in Tonya's case, to lesions on her lung and under her arm.

Life in three-month segments

With a scan every three months, Tonya finds it hard to plan past the next result, the anxiety Laura calls scanxiety.

Fatigue is not the same as tiredness

Tonya describes cancer fatigue as like an injection of horse tranquilliser: once she feels it rising, she has minutes to lie down.

Women are living longer with it

Helen calls it the long middle, moving through lines of treatment; one woman in her group has lived with advanced breast cancer for 21 years.

Nobody is counting

Recurrences aren't recorded the way first diagnoses are; Helen's estimate is around 30% of women with primary breast cancer, and a University of Limerick project has started counting.

Know the signs of a recurrence

Symptoms depend on where it spreads, from a cough and breathlessness to weight change or bone pain; if something hasn't settled in three weeks, ask your doctor, "Could this be cancer?"

Mental health support needs to be specialist

Tonya waited eight weeks to see a psychologist; psycho-oncology services now run in Ireland's eight cancer centres.

Palliative care is not only for the end of life

Palliative teams help manage symptoms and support families, and the CLIMB programme supports children aged 5 to 12 who have a parent with cancer.

📚 Resources

Living Loudly. Dying to be Heard

A campaign by AstraZeneca and supported by the Marie Keating Foundation

Positive Living

The Marie Keating Foundation's support programme for people with advanced cancer

CLIMB

The HSE programme for children aged 5 to 12 affected by a parent's cancer

⏱️ Timestamps

00:00 — Welcome

01:52 — Helen Forristal and the Marie Keating Foundation

02:51 — Dr Tonya Leonard’s breast cancer diagnosis

06:21 — Advanced cancer support and Positive Living

09:28 — Scanxiety and living between results

12:08 — Living longer with advanced breast cancer

17:14 — Cancer fatigue

22:58 — Fertility and “Have you finished your family?”

29:17 — How many women are living with advanced breast cancer?

30:41 — Signs and symptoms of recurrence

37:57 — Mental health and psycho-oncology

46:45 — What palliative care really means

51:40 — Family, milestones and living with uncertainty

56:28 — Advice for young people

Thanks for listening! You can watch the full episode on YouTube here. Don’t forget to follow The Laura Dowling Experience podcast on Instagram @lauradowlingexperience for updates and more information. You can also follow our host, Laura Dowling, @fabulouspharmacist for more insights and tips. If you enjoyed this episode, please subscribe and leave a review—it really helps us out! Stay tuned for more great conversations.

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