Mother's Medically-Induced Menopause Proved Harder Than 16 Rounds of Chemotherapy
A mother-of-two who battled triple positive breast cancer has disclosed that the medically-induced early menopause she endured presented a greater challenge than her gruelling 16 rounds of chemotherapy. Physiotherapist Anj Periyasamy, now 41, received her diagnosis at age 37 and has since navigated an arduous treatment pathway, only to find the hormonal fallout profoundly debilitating.
A Diagnosis That Defied Expectations
Reflecting on her initial diagnosis in March 2022, Anj recalled the sole warning sign she experienced was feeling "knackered", which she initially attributed to the demands of motherhood while caring for her daughters, Jasmin and Maya, then aged five and two respectively. Despite assuming it was "probably nothing", a persistent unease prompted her to arrange a virtual GP appointment, leading to an urgent in-person examination.
At a central London clinic, a breast surgeon echoed that it was likely benign and remarked she was "too young" for breast cancer. Nevertheless, precautionary measures were advised, including a mammogram, ultrasound, and biopsy. Within a week, Anj underwent an MRI, where she confronted the specialist directly, asking: "Is this sinister or not? Just tell me straight." Her fears were confirmed when the surgeon indicated it could be cancer, to which Anj responded with disbelief, exclaiming: "But it can't be. What about my children? I have to be around for my kids. They're so little."
An Intensive Treatment Regimen
Over the subsequent six months, Anj embarked on an intensive treatment journey, comprising:
- 16 rounds of chemotherapy
- A double mastectomy with breast reconstruction
- 15 rounds of radiotherapy
- 14 rounds of IV Herceptin, a targeted antibody therapy to inhibit tumour growth
- Six rounds of IV bisphosphonates to strengthen bones
Additionally, she received monthly injections of Zoladex and Letrozole to reduce hormone levels and maintain medical menopause, later switching to Tamoxifen after two years due to severe side effects. The chemotherapy led to hair loss, including eyelashes and eyebrows, blackened fingernails, fatigue, and "chemo fog" that necessitated her body "almost relearning everything again".
The Unrelenting Menopause Symptoms
However, Anj described the menopause side effects as even "harder" to cope with than the chemotherapy. Her triple positive breast cancer is "fed by hormones", requiring her ovaries to remain "asleep", which precludes the use of Hormone Replacement Therapy (HRT) to alleviate symptoms. This has left her grappling with an extensive list of issues, including:
- Night sweats and hot flushes
- Mood swings and "menopause rage"
- Low libido and sexual dysfunction
- Hair thinning and muscle aches
- Tendon pain and vaginal atrophy
"Menopause sucks," Anj stated emphatically. "It sucks big time. There are so many facets to it that nobody talks about. I cried in front of my oncologist and I was just like, 'This is unbearable and I just can't do this. I'm drenched half the time. My tendons are painful. It's affecting my mood.' I knew chemotherapy would be temporary, but menopause psychologically gets to you, as well as physically."
She elaborated on the physical limitations, noting: "I had tendon pain so I couldn't even go to the gym and exercise properly because my feet hurt. If I sat for 20 minutes, I'd get up off the sofa and I would look like a penguin... It's horrible, honestly." The emotional toll was equally significant, with Anj explaining: "I'm the most placid, chilled person, but the menopause rage – the pure rage – was like, 'What is wrong with me? Why am I so angry?'. I used to get so angry about the girls bickering and I'd just go from zero to 100 really quickly."
Navigating Family Dynamics and Awareness
Anj revealed her daughters noticed some of her symptoms, prompting her to initiate age-appropriate discussions about her experience. She contacted the charity Breast Cancer Now, which provided a children's book titled Mummy's Lump. Anj admitted reading it alone first and "had a cry", then spent "a whole week" mentally preparing to share it with her children. While her younger daughter, Maya, was unfazed, her older daughter, Jasmin, responded casually before returning to her activities.
Subsequent conversations touched on Anj's "short hair era" and hospital absences. "Jasmin has asked 'Are you better now, mum?'" Anj shared. "That's always a really hard question to answer because I hope to God I am, but they also want to make sure their mum is around. I never talked about death, but it wasn't easy for them to see me sick."
Advocacy and Empowerment
Following her diagnosis, Anj connected with Trekstock Cancer Support through social media. Initially planning to collaborate professionally as a physiotherapist to develop exercise pathways for cancer survivors, she was later invited to participate in their photography exhibition, "Are You Better Yet?". "It was really fun to be there," Anj remarked. "I did find it was nice because you get to go back over your story and get to remember the good and the bad, what you did it for, and why are you telling your story. I think it's a much-needed type of platform to raise awareness."
Four years post-diagnosis, Anj noted her eyebrows have not fully regrown, and her skin remains affected by menopause, though she is living well. She is sharing her experience to increase visibility as a South Asian woman, emphasising: "There's not enough education out there, there's not enough awareness, and there's not enough people that look like me – young brown women."
Regarding her daughters, Anj expressed hope they will one day say: "I'm proud of you, mummy – you did it." She added: "But I also want them to read about my story and not be scared. It's about being empowered and knowing how to get through a life crisis, then survive and thrive afterwards."
Trekstock Cancer Support's Are You Better Yet? exhibition is on display until March 29 at the FUJIFILM House of Photography in London.
