Welcome back to the radiotherapy room

Take heart, writes Betty Jarman, the prospect of treatment for breast cancer is no longer the terrible ordeal that it was 20 years ago Twenty years ago, when the children were young, I had a lump removed from my left breast in our local suburban hospital. I had seen the lump when I was having a bath, and was rushed into hospital virtually the next day. I went into the theatre knowing that if it was found to be malignant, I would wake up minus a breast. When I came to, I was intact. This summer I was back in the same hospital, now due for closure.

I had noticed a slight darkening on the left breast. My doctor, as uncertain about it as I was, sent me to the breast surgery clinic. This was certainly an improvement on the first experience. After a mammogram, the consultant examined me. I heard him say something about "needle treatment'' and watched as he stabbed me with one. "Why am I not screaming the place down?'' I asked. "Because the needle is so sharp,'' he replied.

I had had a needle biopsy - the modern equivalent of surgery 20 years ago. It had been completely painless. Analysis of the fluid revealed a small tumour. I was told I would need a lumpectomy followed by radiotherapy.

The night before the operation I sorted through the numerous leaflets pressed on me by kindly staff: on post-op care, avoiding lifting and heavy shopping, when to return to work, and what exercises to do. The operation itself was painless: the following day I was walking in the hospital garden. Back home, a Macmillan nurse was available for practical advice and emotional assistance if needed.

After a few weeks, I went to the radiotherapy centre for "measuring and marking''. I felt like a paper pattern as sweeping red and blue lines were drawn on my breast. The leaflets had said that these should not be washed off, but this information proved out-of-date: the area of treatment was marked with a permanent, virtually invisible "tattoo" the size of a pinhead.

Old wives' tales, friends' sympathy and the prospect of 25 sessions daily over five weeks all aroused forebodings. The first session was the most intimidating. The setting was formidably space age, with a massive floor- to-ceiling wall "clock'' that rotates the radiation machine, a bulbous piece of equipment which loomed over me. The actual treatment only took three minutes and, again, was painless.

I was advised not to wash or use perfume on the treated area and soon mastered the contortions needed for a shallow bath or shower. Wearing synthetic fibres was not allowed as they created a feverish heat in my breast. At the suggestion of the friendlyradiographers, I bought capacious all-cotton vests from Marks and Spencer's men's department, adding cotton collarless shirts, which I wore with leggings. These were highly practical for stripping to the waist, either for treatment or applying cooling baby powder.

I anticipated a patronising comment when I asked what radiation dosage I was getting at the weekly doctor's clinic. Instead, I was readily given the exact figures. One doctor told me cheerfully that my skin might turn red, brown even black, and that thiscould last weeks, months, even years. I emerged, however, with a light tan and little discomfort.

Women waiting for radiotherapy formed an informal support club. We laughed together over our frequent visits to the loo when aspiring to "flush through" the radiographers' target of five pints of liquid daily, and bade warm farewells to those completing their "sentence''.

The radiotherapy centre is not that far from my home, but is impractical to reach by public transport and on a route bedevilled by traffic jams. I was collected and delivered daily, through fog and floods, by our local hospital's transport section, volunteers driving their own cars - part of a valuable countrywide service.

By the third week, I stopped waiting for side-effects and started working again. I now have three-monthly checks and an annual mammogram, take an anti-cancer drug, and feel perfectly well.

Recently there have been frightening allegations about breast cancer treatment: the quality and success of treatment varies according to where a woman lives; women have died or been harmed by incorrect radiation dosage, while some have been given stronger and fewer doses of radiation to cut costs.

Last week, we learnt that the national breast cancer-screening programme is to take X-rays of two views of each breast because research has shown this is a better way to spot early cancer. Issues about breast cancer are rarely out of the news, pressing on the anxieties of women.

But there is another side to the story. It is more than two decades since I first went into hospital. There have been significant advances in the treatment and understanding of breast cancer in that time. Women who from one day to the next are forced to move into the unfamiliar world of hospitals, surgery and radiotherapy can surely take comfort from my experience.