Kate Radcliffe gets annoyed by little things. Her heater breaks down or her dog plays up, and she becomes frustrated – agitated, even. But when the single mother-of-two’s oncologist tells her another treatment has failed to curb the growth of her metastatic breast cancer, she simply takes it in and moves on.
“I guess I don’t cope very well if things don’t go according to my plan,” she told Mamamia. “But my cancer is in my plan now; it’s all part of it.”
The 45-year-old’s primary diagnosis was Stage Three, confined then to her left breast and lymph nodes. But what began in May 2012 as an unusual-feeling patch of skin, as a clear ultrasound, has now taken hold in her bones and liver.
While Kate doesn’t deal in timelines and refuses to think further ahead than her next holiday, she has resigned herself to the inevitable.
“I know this is going to kill me. Everyone is going to die at some stage – I just happen to know how, most likely, that will happen. I mean, I say ‘most likely’, because I suppose I could still get hit by a bus, couldn’t I?” she laughed.
“I actually feel lucky in that I have time to spend building good memories with my family, with my friends, doing things I enjoy while I still can, while I’m still well.”
Metastatic breast cancer, also known as secondary or Stage Four breast cancer, occurs when the cancer cells have moved beyond the primary site of the breast to other areas of the body, most commonly to the bones, lungs and liver. While some women receive a metastatic diagnosis from the start, most cases occur several years later – even 10-15 years down the track.
For Kate, it was less than two-and-a-half years.
Five months of chemo, a double mastectomy, radiation to the site, and months of oral anti-breast cancer drug, Tamoxifen, failed to contain her tumour. She will now be on some form of treatment for the rest of her life, as doctors do what they can to give her as much quality time as possible with her loved ones.
Despite it all, she’s coping better this time around.
An element of the unknown is gone and, for her, that was the most daunting part.
“To tell you the truth, every time I went to a follow-up appointment I half expected it [to have spread]. It’s terrible to say that, but you just go with dread each time,” Kate said. “So when it turned out that I actually had metastatic breast cancer I went, ‘OK, that’s now something I have to deal with. And I won’t have to go to an appointment again wondering.'”
But there’s something else that’s made a big difference. Well, someone: Kerryn Ernst, Kate’s McGrath Foundation Breast Care Nurse. A woman who, since 2009, has supported more than 1000 Australian families through treatment.
“When I went through my initial cancer diagnosis I didn’t have a Breast Care Nurse dedicated to me like Kerryn is,” she said. “I had to go through six rounds of chemo, I had to have a port put in for the chemo and coordinate my surgery appointments and oncology appointments, and I had to do all that myself. It was the most overwhelming experience of my life.”
Kerryn, who is one of just seven McGrath Breast Care Nurses dedicated exclusively to patients with metastatic breast cancer, became a part of Kate’s life the moment she was diagnosed in February 2015. And she has remained so ever since, providing emotional and practical support, specialist advice on treatment and medications, and help interpreting the barrage of information given by doctors, all at no cost.
“I feel like she is a brand-new best friend,” Kate said. “She makes it all easy. I can talk to her about any concerns I may have, and she’s been to the majority of my appointments, so she’s like a second pair of ears as well… She’s just brilliant.”
Kerryn has been an nurse since 1999, mainly on oncology wards. But after her aunt, a woman who lived 600km from treatment and support, died from breast cancer, she was inspired to become a McGrath Foundation Breast Care Nurse. Nine years later, her patients at Canberra Hospital inspire her to continue.
"You like all of your patients, but there are some you just think, 'Gosh, we should have met at the yacht club having a glass of wine rather than here in the cancer centre,'" she told Mamamia. "You've just got so much in common sometimes, and you get along with them so well. That's the hardest thing, because you know it's going to be really tough when they die."
It's especially difficult when they have children, Kerryn said. A mother of two young ones herself, aged six and eight, she wonders how these women and their loved ones cope with it all. She supports them however she can; staying back late to arrange appointments or organise referrals, to advocate for them so they have the services and information they need precisely when they need it. Only once the job is done does Kerryn allow herself time to feel the weight of it all.
"I have my cries. If there's a sad song on the radio I'll bawl my eyes out. Crying in the shower is best for me, so my kids don't see me upset. But I think by the time honestly someone has lived with metastatic breast cancer for several years, you see the toll it takes on their body and you see the life they're not living," she said.
"They reach this limbo when they can't have anymore treatments, and they're in this holding pattern. So when they do pass away, you're sometimes relieved for them."
Kate is in a good place at the moment. Her cancer markers are low, and she feels relatively well. Between medical appointments, she even managed three overseas trips in 2017 (to England to see her son, France with friends, and New Zealand), and has spent the rest of her time doing the things she loved as a teenager: painting, drawing, reading, being with friends and family.
"I just want to live my life and fit as much into it while I can, while I'm healthy. And even when I'm not, it's about finding things I can to do. I've got a pile of books I'd like to get through, and I want to, finally, get through the last season of Game of Thrones," she laughed. "That would be great."
This weekend, Kate went on another one of her trips, this time with Kerryn by her side. The pair headed to the Sydney Cricket Ground for the Pink Test, a key McGrath Foundation fundraising event that this year is celebrating its tenth anniversary. Currently there are 119 McGrath Breast Care Nurses around rural and regional Australia, and through the awareness created via the internationally televised cricket match, the organisation hopes to attract at least $1.3 million to fund a further 10 for a year.
Kerryn attended last year and was thrilled about being there with Kate for the anniversary.
"It brings a tear to the eye, because it's that kind of public recognition that funds positions like this. And I know what that means on the ground; I know what it means to the families to have someone in this position," Kerryn said. "So it's just wonderful. I don't think words can really describe it."
Australia needs more incredible Breast Care Nurses like Kerryn Ernst. To help, please donate via the Pink Test website.