I was diagnosed with breast cancer in 2006. One day, when I came home from work, I found a letter from my family doctor in the mailbox. It said that he had tried to call me because the photos from my breast screening had shown dark, suspicious spots. I was extremely shocked because there was a high chance that I had cancer too.
What is breast cancer?
It is a malignant tumor in the breast that can grow slowly or quickly. Sometimes, the tumor can spread to other parts of the body. One in seven women will develop breast cancer. For example, in 2024, 15,394 women were diagnosed with breast cancer. It mostly occurs in women between the ages of 45 and 74. On average, 80 out of 100 women are still alive 10 years after diagnosis.
What is breast cancer screening?
In the Netherlands, breast cancer screening is carried out to detect breast cancer as early as possible. If it is caught early, there is a greater chance of a cure, and treatment is often less severe. The screening is offered to women aged 50–75 free of charge. Screening takes place every two to three years.
The diagnosis
I went to the polyclinic at the hospital for further examination, where they took X-rays again. Right after that, they performed a biopsy. Then I had to wait for the results, which confirmed that I had breast cancer. I did not yet know what stage I was at. The stage indicates how advanced the disease is. For example, it tells you how large the tumor is and whether it has grown into other organs or tissues. It also indicates whether there are metastases. In any case, it was clear that I needed surgery. I had a week to decide whether to have breast-conserving surgery or not. I did not need a week to think about it and indicated that I would choose breast-conserving surgery.
Was there any metastasis?
After the surgery, the tumor was examined. A lymph node was also removed and examined for metastases. Fortunately, this was not the case.
The tumor was found to be stage 2. This meant that the tumor was larger than 5 cm, but there were no metastases in the lymph nodes or other organs. In that respect, I was lucky.
Type of cancer
The cancer I had was hormone-sensitive breast cancer. This type of cancer grows due to the hormones estrogen (ER) and/or progesterone (PR). The tumor has receptors to which the hormones can attach. Around 80 out of 100 women with breast cancer have hormone-sensitive breast cancer. Cancer cells in hormone-sensitive breast cancer grow more slowly than those in other types of breast cancer.
Treatment for hormone-sensitive breast cancer
As mentioned above, I underwent breast-conserving surgery. This was followed by 33 radiation therapy sessions. These were intended to destroy any remaining cancer cells and reduce the likelihood of recurrence.Following surgery and radiotherapy, I underwent anti-hormonal therapy, which involved taking medication for five years to reduce estrogen (ER) and/or progesterone (PR) production, thereby minimizing their impact on cancer cells. The goal was to prevent the breast cancer from returning.
Light-hearted? Clinical?
The process I describe above sounds somewhat light-hearted and clinical. It was not like that at all. It was a drastic and intense process, affecting not only me, but also my family and friends. In addition, I had a full-time job, and the daily travel time alone was three hours. As can be seen from my blog Labor unions, my employer was an union that was just going through a reorganization.
I was dealing with an ineffective supervisor who was soon replaced by a female interim manager. However, she had absolutely no understanding of the Union world or mentality (or did she, and did I have the wrong idea?).
In any case, her only goal was to streamline everything as efficiently as possible, paying no attention to or empathy for a sick employee. This meant that, for fear of losing my job, I was forced to continue going to the office between chemotherapy treatments and do my work there as best I could. I was also the breadwinner and could not afford to lose my job.
I had five rounds of chemotherapy, with each round being administered on one day, followed by a three-week rest period to allow my body to recover somewhat. However, as I mentioned above, I did not have a rest period at all. I was in an unsafe work situation and was forced to keep working. The interim manager showed no understanding during my treatment and simply followed ‘the rules’ without any leniency or compassion.
For example, instead of paying my travel expenses monthly through my pay cheque, this interim manager demanded that I submit my train tickets for each day I worked. This meant that as soon as I stayed home for a day, it saved my employer money. The fact that this was ‘heartless’ towards me turned out to be totally unimportant! When I underwent 33 radiation treatments (five days a week for seven weeks), I was completely unable to work. However, I resumed full duties afterwards.
The impact of treatment
The treatments made me very tired and nauseous. I was constipated and my sense of smell and taste changed. On top of that, I lost my hair.
It may sound light-hearted as I write it, but everything was drastic: the chemotherapy made me feel sick after only one hour; with the radiotherapy, a different nurse touched me every day; and the whole process seemed very routine to me.
After each chemotherapy session, I had to visit the attending physician, who would determine whether I could undergo the next session based on the results of the blood tests taken prior to the session. This doctor made it seem easy, and she was more concerned with studying the numbers than with my well-being.
Support along the way
The young doctor who told me I had breast cancer was very nice. He also operated on me and did a very good job.
The doctor I talked to about how much radiation I had to undergo was also nice. Throughout this ordeal, I had become accustomed to giving ‘desired answers’ and being treated more like a statistic than a person. This doctor, however, appeared genuinely interested in how I was doing, and I remember being deeply affected by that.
Before my hair started falling out, I had a wig made. I went to a wigmaker who showed a lot of care and attention, and the result was beautiful.
After completing all my treatments, I remained under observation for a few more years. The doctor who had operated on me had left the hospital, but his replacement was wonderful. She was a woman who, as soon as I arrived at the hospital, would tell me that the examination results were ‘good’, and then listen to me. She was interested in how I felt, my life, my worries and my fears.
The cab driver who took me to and from my radiation treatments at another hospital 33 times was also very involved and compassionate. On the last day of my radiation treatment, when he picked me up and took me home, he had bought me flowers. How thoughtful.
The unseen heroes: family and friends
Here are just a few of the people who helped me along the way:
Peter, who accompanied me to the hospital to receive my diagnosis. Connie, who took time off work to attend every chemotherapy session with me. Kees, who shaved my hair and sat with me during the early days of treatment. Frans, who made sure I ate something on my second day of chemotherapy. Martin, who prepared soup for me and helped me heal with singing bowls after each session. Duco, who took me out for short outings to keep me from feeling isolated. Marlies, who expressed her empathy through art. Victor, who cooked meals to help me regain my strength. I could not have made it through this experience without the unwavering support of my loved ones.
However, I would particularly like to mention my son, Raoul. He had only just begun his study as a documentary photographer at the Royal Academy of Art in The Hague when I was diagnosed with cancer. For that reason, I didn’t want to burden him too much with the heaviness of my experience. Nevertheless, Raoul was there when I had surgery, when I lost my hair, and throughout the subsequent process.
He photographed everything, and he also entered the photo contest organized by the Pink Ribbon Foundation, a fundraising organization that finances projects and research into the treatment, aftercare, and long-term effects of breast cancer. The theme of the contest was to depict femininity during breast cancer, emphasizing ‘power’ (strength, resilience, overcoming). Raoul’s photo of me, with one half of my bald head covered by my wig, didn’t win the contest, but the accompanying text moved me deeply. The text read:
Inner strength
‘This is my mother. On 15 June 2006, she was diagnosed with an aggressive form of breast cancer. She underwent surgery on 26 June 2006 and is currently undergoing chemotherapy. She does not wear a wig at home, but she does outside.
She is a strong woman who does not let the outside world know how vulnerable she feels as a result of being diagnosed with breast cancer, having surgery and undergoing chemotherapy.
Ideally, she would just carry on as if nothing were wrong. She is open and vulnerable with family and friends, but averse to feigned interest and pity. In her view, strength and vulnerability coexist.’ Raoul’s words captured me perfectly.
Conclusion
This journey was long and difficult, but it was also filled with moments of strength, love, and resilience. Through the ups and downs, I’ve learned that it’s okay to be vulnerable, and that real strength comes from knowing you’re not alone. I’m proud of what I’ve overcome, and I carry the support of my loved ones with me every day.
Johanna, 3 June 2025
