The human condition: The fight of their lives

Breast cancer runs in Tracy Elkins's family but, at 34, only her own determination secured the early diagnosis which saved her life. Below, Tracy tells the story of the battle she, her family and staff at Addenbrookes Hospital fought to rid her of cancer

WHEN Tracy Elkins's mother died of breast cancer at the age of only 48, she warned her daughter that the disease could be hereditary. Tracy, now 36, had to fight to convince her GP to send her for a mammogram as she was considered too young to be at risk. Eventually, in August 1996, she was referred to the clinical genetics department at Addenbrookes Hospital in Cambridge, a programme financed by the Cancer Research Campaign, the charity that devotes the most resources to fighting breast cancer. When Dr James McKay at Addenbrookes discovered that she did indeed have cancer, she decided to have a double mastectomy. Tracy, a former pre-school teacher, is married to Tony, 45, a fireman. They have three sons, and live in Wickford, in Essex. This is Tracy's diary.

August 29, 1996. Today me and Tony went to Cambridge to meet Dr James McKay and his clinical nurse Emma at Addenbrookes Hospital clinical genetics department. I was expecting a simple blood test, but Dr McKay explained that to test for the cancer gene it is necessary to take a blood sample from someone who already has cancer. Because there have been so many deaths in my family from breast and ovarian cancer, I'm high risk, but they can't test for the gene because all the previous sufferers are dead. I was given a mammogram and they immediately noticed there could be a problem. I had a biopsy straightaway - a needle was used to take samples of tissue. Now we have to wait for the results. I have never been so frightened in all my life. On the way home all I could think about was Tony and the children - Chris is nine, Andrew is six, and Craig is only three. What if I die like my mother? What will Tony do, how will he cope? The thought of leaving him and the children breaks my heart.

August 30, 1996. I have spoken to my sisters, Denise and Michelle, and told them I had to have a biopsy. Haven't told Deana yet as she lives in the USA. I don't want to worry her till I know the results. Can't stop crying. I spoke to my Auntie Beryl and Uncle Jack and asked if the result is positive will they come and look after the children. They have been so supportive, I don't know what I would do without them.

September 5, 1996. The biopsy result is not good news. They have found a small area of cancer. I can't even feel a lump; thank God I had the mammogram. Dr McKay and Emma are being so nice; they say the treatment now is my choice and I want to have a double mastectomy. We have an appointment with Dr Salter, the consultant surgeon at Southend Hospital. Tony feels bad as he said everything would be okay but it's not.

September 6-9, 1996. Start to think about what insurance we have. Aunt Beryl and Uncle Jack will come down to look after the children when I am in hospital. I want things to carry on as normally as possible for them. Tony will have to keep working as we still have bills and a mortgage to pay, but he will take time off when I come out of hospital.

September 9-11, 1996. Tony's mum is so upset she can't talk to me. I spoke to my sister-in-law Michelle; she has a friend who went through the same thing. Called her and asked her, did she keep looking at her husband and kids and crying? What if it's in my lymph glands or bloodstream? Called Emma for reassurance. I keep asking her the same questions over and over. My care nurse Ann came today and went through all the reconstruction procedure with me. Sounds good. Called Emma again, don't know what I would do without her.

September 17-18, 1996. Went to see the man who will be making me some nipples. I was amazed when I saw the examples, they look really good. Craig not very well. I looked at him and thought, "What if I'm not here when he's ill? That's when he needs me most." From now on I am going to fight this, not just for myself but for my family.

September 19-22, 1996. We have spoken to the children. Told them I had an infection in my boobs and was going into hospital to have the infection removed. Went to see a woman called Chris, she had a double mastectomy and also reconstruction. I was amazed at how she looked, it really cheered me up. Denise is going to Cambridge to have a mammogram. Later: Denise called, everything is fine, thank God.

September 23-27, 1996. I look at Tony in bed when he is sleeping and thank God for the wonderful husband I have and I know we will get through this together. Starting to think about chemotherapy. Hope I don't have to have it. Getting all the jobs done I would normally do for Christmas so when I come home I won't have to worry about it. Went to see my GP. They are so shocked that I have got breast cancer.

October 1, 1996. Going into hospital tomorrow. In one way I feel relieved it's finally going to happen, in another I feel terrified. Been crying a lot. Tony gives me lots of hugs and kisses.

October 2, 1996. Said goodbye to the children and cried my eyes out. When we got to the hospital I had to wait until 2pm before my bed was ready. Had a blood test. Tony had to leave to pick up the children, he was not very happy as he wanted to see me settled. He came in later with some Kentucky Fried Chicken. Dr Salter came to see me. I have a lot of pen marks round my boobs. I have also got to have a chest X-ray to make sure everything is okay there. Said goodbye to Tony. Hope he will be all right tomorrow.

October 3, 1996. It's 6am and I have to have a shower. I can't have anything to eat or drink. My whole body is shaking, I feel so frightened. Went with my nurse to have an X-ray to make sure my chest is clear. Tony came and found me. He had got me the biggest bunch of flowers I'd ever seen, they really cheered me up. Surgery at 1pm [during which both the mastectomy and reconstructive surgery are performed]. Later: When I woke up all I remember is Tony being there. Have been in so much pain, and had a lot of nausea, they say the morphine is making me feel sick.

October 5, 1996. Mr Salter took off some of the padding he put round my chest, that eased the pain. Still feel nauseous. Tony asked the nurse to give me some toast, he made me eat it and said it would do me good, and guess what, it did.

October 6, 1996. I had to speak to the children, I needed to hear their voices, felt better then. Friends visited - a full house. When they left, the nurse took my dressing off. Tony was with me. I was shaking like a leaf and crying. He said, "We'll look together" but I couldn't at first. He said it was really neat and gave me a kiss and a hug. Then I looked and thought, "What a lot of stitches - they can only get better."

October 7, 1996. Feeling a bit sorry for myself. Hair needs a wash, I need a shower, but can't as I have drains leading from my armpits. They said they are going to take two of them out today; I hope so, I wake up in the night feeling so stiff. I do exercises to loosen myself up. Mr Mackay is coming to see me tomorrow. They removed two drains - it was really painful.

October 8, 1996. Tony came to the hospital to be with me when they remove the remaining three drains. It really hurt, but I was glad when they were removed. Mr Mackay and Emma came, and the first question I asked was whether he had the results of whether the lymph nodes are affected. They still don't know. A lot of visitors today.

October 9, 1996. Mr Salter and Ann came to see me, and I can't believe it. The cancer has gone. My lymph glands are all clear. I gave Mr Salter a big hug. Called Tony. I was in tears. I really frightened him - he thought it was bad news, but for the first time through all this it was tears of joy. I can't believe it, I have WON!

October 10-13, 1996. Came home. So tired, had the best sleep ever. I feel so drained. Beryl helped me shower, I didn't realise how it would take it out of me. I thought I was going to faint. Tony decided to sleep on the floor, he feels uncomfortable in bed in case he hurts me. Am starting to move my arms more each day. Had a glass of wine!

October 16, 1996. Today has been a really shit day. I feel really low and am having panic attacks and can't stop crying. They did say I would have days like this. I hope I don't have many of them. Still feel fed up and tired, hope it will be a better day tomorrow.

October 18, 1996. Beryl and Jack have gone, am really going to miss them, they have been so good. Tony said I have not to worry, he will try his best and things will all get done in the end. I had a few tears. Tony called on the hour to make sure I was okay. In the end he came home at 3pm. Chris and Andrew have gone to their nan's for the weekend. I feel really tired, so bed at 5pm.

October 21-23, 1996. Went to get the rest of my stitches out today. Did a little bit round the house. Really tired at 6pm, Tony says I have done too much. Called Ann today, really worried about pain in my right breast. She said to use pain killers and see how I get on. I can't move in the morning, it is really getting me down. Tony has been so good, he has been doing all the washing, seeing to me and the kids, and doing the housework, also going to work on nights. I get so frustrated not being able to help him more. I also know how lucky I am to have such a good husband, he still finds time to give me lots of kisses and cuddles.

October 25-27, 1996. Woke up this morning feeling like my chest and back are going to break, I feel that stiff. I was able to have a shower and wash my hair. Tony had a good sleep as Denise is here to take over things, it's a great help to be able to go to bed and not worry about the children. Clocks went back. Tony stayed an extra hour at work, came home totally knackered, then had to clean the house, see to the children, take Chris to football. Denise cooked dinner, then they went home with three extra kids in tow, I really feel like I need the break but it's hard letting the kids go. Called them at 7.30pm and they seem really happy, and that makes me feel good.

October 28-30, 1996. Went to the hospital today. I have still got an infection in my right breast. They have doubled my antibiotics. I hope it will clear up; if not I will have to have the prosthesis removed. Came home and we both had a nap. Got up and went for an Indian meal, really nice. We went to Lakeside to do a bit of Christmas shopping. We got home at 5pm, I was really tired so I went to sleep for a couple of hours. Spoke to the children, they are having a really good time. I have really enjoyed the break but now I'm ready for them to come back.

October 31-November 3, 1996. Went to Cambridge to see Dr McKay and Emma to see if I need any other treatment - chemotherapy or Tamoxifen. Thank God, they have reassured me that I don't, though I will still have to go back for a checkup. If they find the cancer gene in my blood samples, they will call me. My right breast still feels sore on the scar tissue. They have given me more antibiotics. The children are coming home, I can't wait to see them.

November 4-6, 1996. Went to see Mr Salter. The infection is making my scar tissue weak, so I have to go in for another operation to relocate the scar and clean me up. All I can think about is the kids, they have seen me getting better and now I have to tell them I am going in again. Andrew cried. I think this must be so hard for them to understand.

November 7-9, 1996. Surgery all seemed to go well, thought I was not going to be sick but I was, at 3am. The staff here are really nice. Feeling really dizzy, they say it is from the anaesthetic, but on the whole feeling much better than with my last operation. Tony got me some goodies from the supermarket.

November 10-11, 1996. I have had a really good night's sleep. Was hoping to go home today, but the doctor said no. Hoping it will be tomorrow, as Tony has to go to work on Monday night. Some stupid woman who said she is an auxiliary nurse came and asked me if I was worried about secondary cancer. She frightened the living daylights out of me. I told her she shouldn't go around asking people questions like that. Asked her to leave.

November 12-14, 1996. I can't get the thing in my head about secondary cancer to go away. Called Emma; she went through a few things and said she would get James Mackay to call me. Things going round in my head. Dr McKay called me and went through it all with me and put my mind at rest. At the end of the day, he saved my life. I can't thank him enough.

November 15-21, 1996. Feel a lot better. I want to try and get things back to normal, ie driving to school to get the children. Went to the hospital. Things went really well. Tony went with me, he always comes with me, there is not one time that he has not, even if he has been on nights.

December 3, 1996. Had a good night out with the girls yesterday, our Christmas meal. Tony picked out a nice dress for me. Got to bed at 1.30am! Tony got the children ready for school and I got up at 11am.

December 22, 1996. Haven't been able to write for a long time as I have been busy getting the children's Christmas stuff ready!

30-31 December, 1996. Went to see Mr Salter. Good news, I don't have to go back until the end of March. I'm really glad to see the end of '96 and hope '97 will be a good and healthy New Year. With all my family's love and support I have beaten this.

Tracy Elkins remains free of cancer and now works at a children's hospice. She is also a volunteer counsellor for the Cancer Research Campaign, which yesterday marked its 75th anniversary with National Cancer Day