The moment my worst nightmare came true
Eight months after her breast cancer diagnosis, Queensland MP Coralee O'Rourke has a renewed appreciation of the importance of health and family
Wedged between her Cabinet colleagues, O'Rourke, the State Minister for Communities, Disability Services and Seniors, was sitting in the chamber of Queensland's Parliament House. It was Tuesday, October 16, 2018, and the raucous squabbling of Question Time had just wrapped up.
Cabinet colleague and Health Minister Steven Miles was standing in front of O'Rourke, beginning what would be an intense two-day debate on abortion.
She glanced down at her phone suspecting the missed call was from her doctor at The Wesley Hospital.
"I was looking at my phone seeing the missed call as he (Miles) was talking about some of the reasons why women would be wanting to choose an abortion and (he referred to) some of those women who have recently found out they've got cancer or breast cancer," she says.
"And I'm sitting behind him, directly behind him, trying to hold it together. I walked out of there and rang them (the doctor's surgery) back."
There was no history of breast cancer in O'Rourke's family, but she was about to find out she was one of the many women battling this disease.
More than 18,000 Australian women were diagnosed with breast cancer in 2018. One in eight women will be diagnosed with it by the age of 85. At 47, O'Rourke hadn't expected to become one of these statistics.
It was a quiet Sunday night when the Labor Member for Mundingburra realised she might soon become one.
Speaking to Qweekend on the sprawling balcony of level seven at Parliament House - which has views over Brisbane's CBD - O'Rourke points at her office, tucked behind the historic Red Chamber. It was here, after flying down from her home in Townsville on October 7 last year, that she made the unnerving discovery.
"I was doing some work at my desk and I just kind of went, 'Hang on a minute, that doesn't feel right'," she recalls. "Periodically, I checked (for lumps). It wasn't sort of something I was probably as vigilant with as I should have been.''
Like many people who unexpectedly discover a lump on their body, O'Rourke began mulling over what it could be. She felt uneasy.
"When I got home (from Brisbane) I went to the breast screen clinic at Domain (a shopping centre in Townsville) and they said that because there was a symptom, the best course of action would be to have a diagnostic mammogram done and with that comes the ultrasound.
"To get an appointment up home it was going to take almost four weeks (in the public system)." Fortunately, O'Rourke was able to book into The Wesley Hospital's breast clinic in Brisbane on October 15. About 1pm that day, she had a mammogram, then an ultrasound. The doctor told her the result was consistent with cancer, so they did a core biopsy to get a test sample.
There is never an easy time for someone to be told they have cancer. For O'Rourke, hearing the gut-wrenching diagnosis while in the halls of Parliament, far away from her family and her home, was especially difficult.
"So I had a bit of a meltdown in my office," she recalls. "The Premier (Annastacia Palaszczuk) and the Deputy Premier (Jackie Trad) were the first two people I spoke to. They were really good, I was a mess but they were really good. The Premier said don't worry about anything, take whatever time you need. I didn't at the time realise but that was in the middle of Breast Cancer Awareness Month."
While her colleagues' warm gestures gave O'Rourke some reassurance, it was the comfort of her family that she longed for - her daughter Hannah Stewart, 22, son Riley, 19, and husband Lewis, 55, who were more than 1300km away at the family home.
O'Rourke lets out a large sigh before finding the words to describe the hours that followed her diagnosis, the experience still visibly raw as she chokes back tears.
"I don't know whether you'd classify it as the hardest (part), but facing your own mortality, and the fear for your family (is difficult)," she says.
"My family is very important to me and the possibility of not knowing what this cancer was, what the prognosis was going to be, was really hard. I think probably having the diagnostic testing and getting the diagnosis by myself, in hindsight, I wouldn't do again. Not having any of my family with me to hear that news was pretty hard."
TIME TO CHOOSE
Grade one hormone positive - those were the four words O'Rourke was told following her lumpectomy. The lump that she had found was called an invasive ductal carcinoma. It had begun in her breast's milk duct but had broken through its wall.
However, when doctors operated on October 25, they found a second lump in the same breast. A ductal carcinoma in situ was discovered - defined as abnormal changes affecting the cells in the milk ducts. It was recommended that O'Rourke undergo a mastectomy.
"Because it hadn't gone to my lymph nodes, the options were to have either the mastectomy or have radiation," she says. "If you have radiation then there's a five to 10-year window where you should be OK, you should be clear - but that would only take me to my mid-50s. I still want a long time to go."
Then O'Rourke started to consider whether she should have both of her breasts removed to provide peace of mind for the future.
"I had to start thinking about what that meant. How do I feel about that? Do you have reconstruction done at the same time?" she says. "There was a lot of thinking to do."
In the end, she says, it wasn't a hard decision. She decided to have both breasts removed. "Because of my age I wanted to take away any possible chance of reccurrence," she says. "I had a cancer I wanted to get rid of. I didn't want to put something else (chemotherapy) into my body that was potentially going to cause more (problems)."
The double mastectomy was scheduled for December 11, leaving O'Rourke to think about it for much of November.
"I tried everything to keep myself busy. A couple of weeks before (the surgery) … I went back to work because I was going a little bit crazy at home and I needed to keep myself occupied," she says. "I was worried ... it's a big surgery."
O'Rourke had the double mastectomy and reconstruction at Brisbane's Mater Hospital, through the public health system, on a Tuesday - more than two months after she found the first lump.
For the reconstruction, her surgeons removed some of her stomach fat in a procedure called DIEP flap reconstruction. "They effectively do hip to hip - take a piece out and that's how they reconstruct," she says. To put it simply, fat from O'Rourke's stomach has now formed her new breasts.
It took 12 hours but the operation was successful and, despite its invasiveness, O'Rourke was discharged the following Sunday. On December 23, she flew home.
A HELPING HAND
Over those trying months, a barrage of medical jargon was thrown at O'Rourke as she navigated hospital wards and check-ups. But it was during this time that she found support in a woman she'd never met.
Townsville Hospital breast care nurse Claire Smith's phone number was given to her while she was in Brisbane. Soon after returning home, O'Rourke rang her.
Smith recalls: "I hadn't met her, she was waiting for some surgical follow-up. I'd had a phone call from her and she was highly anxious, highly distressed and had just arrived back in Townsville."
Smith says it's her job to be a conduit between all facets of care; to provide a smile while helping patients navigate the sometimes overwhelming medical system. "For me it's very much around trying to support the patient and their family," Smith says. "Provide education in meaningful ways and try and deliver it in a way that's relevant to that particular patient."
Smith admits the 150 new cases of breast cancer that were seen at the Townsville Hospital last year were a huge workload. She says the job requires mental dexterity, "having to jump between someone … who might be really nervous about a new diagnosis, somebody who is stressed about the results they've just been given from the surgery or someone who's five years down the track getting their clearance and you're saying 'Bye, everything is good now'. It can be very emotionally taxing.
"The bonus in the job is that almost all of our breast cancer patients are just really delighted to have a breast care nurse involved. That compensates, it gives a real sense of job satisfaction because you're able to think that you've made a difference."
O'Rourke says she can't speak highly enough of the breast care nurses. "The doctors give you all the medical information that you need. The breast care nurses are that emotional support," she says. They also help to translate what all the medical jargon means.
A FAMILY AFFAIR
There was someone else O'Rourke needed to talk to about her diagnosis - her daughter. Hannah is only 22 and the odds are in her favour. About 79 per cent of new breast cancer cases diagnosed are women over the age of 50. With no family history of the disease, the young mother of a two-year-old boy, Noah, hadn't contemplated the possibility of what breast cancer could be like for her. It wasn't until her mother's diagnosis that Hannah started to think about it.
"We have had a bit of a chat about it," O'Rourke says. "I wanted to make sure that as a young woman she was doing her regular checks. Then, when she does eventually get to that age where she can have the mammograms, (after 40), to make sure she does that regularly because I don't want her to find herself in the same situation I found myself in."
With their mother initially confronting the diagnosis by herself and then undergoing her operation in Brisbane, Hannah and her brother Riley leant on each other in the months that followed. "Seeing her get better made everything feel a lot more positive," Hannah says. "It was a very daunting feeling at first. Obviously never having it in our family, it was a bit hard."
O'Rourke's cancer diagnosis also prompted her to talk to her son about it. "I've spoken to him more from the perspective of knowing what you're walking around with and making sure that you're looking after your health in every way possible," she says. "I've had a conversation with all of my family around the fact that we need to make sure that we're looking after ourselves."
The new awareness has given the family all the more reason to spend time together. "Every chance we get we are all together," Hannah says.
Seven months on, O'Rourke says she's becoming stronger. Now back at work, commuting between Townsville and Brisbane, the politician is feeling more like herself - albeit, hot under the collar.
As part of her recovery, O'Rourke has been prescribed Tamoxifen, a hormone blocker, which she must take for at least five years. It has effectively pushed her into an early, chemically induced menopause, which turned an already humid north Queensland summer into a flaming furnace.
"The biggest thing for me is the hot flushes," she says. "It's like someone has turned on a furnace in your entire body. The temperature goes up 10 degrees instantaneously."
But fortunately, the hot bursts are now settling down. "(Medication) probably messes with my emotions a little bit," she says. "And (I feel) tired, so tired. They tell me it's because my body is going through so much recovery so all your energy goes into healing."
Aside from juggling a demanding career with a new-found tiredness and a temperamental body temperature, O'Rourke says she's getting there. "It's possibly a little bit cliched when you say facing something like that gives you a new perspective on life, but it actually really does," she says.
"They're (her breasts) not natural-feeling but they don't have any cancer in them."