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From thyroid cancer at 25 to motherhood

From the outside, 34-year-old Katrina Mae is an accomplished young woman who has managed to strike a perfect balance between work and family. She is a Special Counsel at a top commercial Australian law firm and has a healthy 6-month-old daughter, Amelia. Katrina is also a survivor of papillary thyroid carcinoma, the most common form of thyroid cancer and one that primarily affects younger people. We interviewed Katrina about her head and neck cancer survival journey and how it is has changed her. Can you tell me about the circumstances surrounding your initial diagnosis? I received my diagnosis in 2012 when I was 25. I had just gotten engaged, was planning my wedding and my fiancé was away overseas so you can imagine that it was rather dramatic timing. My symptoms began as a sore throat with a little lump. I told my mum and sister who said it’s probably nothing serious but that I should still get it checked out. So I went to the local doctor who said it’s probably just a nodule on the thyroid. They did a biopsy which came as a surprise to me; I thought it would be a swab or something less invasive, but they were sticking needles into my neck while I was awake. If it came back benign, I would have just needed some thyroid medication. My father had had some thyroid issues previously so I assumed it just ran in the family. My doctor then told to see the specialist ENT surgeon Professor Jonathon Clark. When I arrived, he told me that I had papillary thyroid carcinoma (thyroid cancer) and that it may be in my lymph nodes and neck as well. He said he would need to do more biopsies to work out the scope but that I would definitely need surgery. As a young woman, any type of cancer is not something that one necessarily has on their radar. How did this diagnosis impact you on a personal level? It was a terrible shock. I went to my appointment with Professor Clark thinking that I’d only be getting some medication. My parents had actually offered to come with me to the appointment because my fiancé was away, and I had said there was no need and that I could go by myself. When I got out, I was overwhelmed and distraught. I immediately rang my parents and told them what had happened. I had actually planned to go out for dinner with some friends afterward as I was so confident I would be fine. I went to that dinner and told my friends that while I have cancer and I’m worried about whether I’m going to live, everything is fine. It was a bit of a denial for a while. It wasn’t until I actually spoke to my fiancé later that night when he rang me from East Timor that it hit home. His reaction prompted my reaction, and I finally recognised that it was very serious and poor timing with my other half out of the country. I’m lucky that I have a good family around who looked after me. I think the medical team that subsequently took me through my surgery and treatment was also phenomenal so I can’t complain. What did your treatment involve? I had a radical neck dissection where they removed my thyroid and 159 of my lymph nodes, and I was then treated with radioactive iodine. They also had to remove a small part of my thyroarytenoid muscles which is the muscle that sits next to the voice box, as the cancer was growing into that. I had all my surgery out of St George Private Hospital but then about 8 weeks after I’d had the surgery, I went into St George Public Hospital to their oncology unit for the radioactive iodine which involved swallowing a pill that kills cancerous cells while leaving other body cells relatively unharmed. Part of the thyroid's job in the body is to absorb iodine so it essentially tricks any cancerous thyroid tissue that is left in the body after surgery into sucking up the radiation. They had already removed most of the cancer but if there was anything else floating around my body, they were then able to kill that off with the radioactive iodine treatment. At the end of the treatment, they scanned me to check how much radiation I was emitting which was still only a low frequency. The fact that there was nothing or not much showing up was indicative of the fact that there hadn’t been much left behind by the surgery which gave me quite a bit of reassurance. Did your treatment affect your voice production? I saw a speech therapist at St George Public Hospital for a handful of sessions. With the nature of my work as a lawyer, I do a lot of speaking and my voice was getting tired very quickly which affected my projection. I actually didn’t realise it would be a possible side effect before the surgery. The doctors came in while I was in ICU afterwards, asked if I could talk, and then inspected my voice box and throat. I was very lucky that it didn’t affect me severely. After a couple of speech pathology sessions, all I needed to do was put into action the things that they taught me in those sessions. Did you have access to any peer support services during your recovery? I haven’t connected with anyone else who’s had head and neck cancer at all. On a few occasions, I’ve been interested to meet either colleagues, clients, and friends down the track who had other types of cancer when they were quite young. We bonded over those experiences to a degree. I actually haven’t even met anybody else who’s had head and neck cancer at all, let alone in my age group. I feel like it’s something that is rarely talked about. Did you want more patient support during your treatment and subsequent recovery? I had the support I needed but I was very lucky in that my surgery and treatment were effective the first time around. It was a fairly rough three months, but it was only a three to four-month period that I was having surgery, recovering, and undergoing treatment. This is a relatively short period as compared to people who might have another form of head and neck cancer and need multiple surgeries or multiple rounds of treatment. That said, I can imagine it would be very helpful to speak to other people who have already recovered. That way, you can gauge what are you in for and see a light at the end of the tunnel. I always think that makes you feel better knowing that people feel better with time Did having thyroid cancer mean certain milestones were delayed for you? I had to wait at least 12 months to become pregnant after the initial treatment. About three years in, when I went back for some more radioactive iodine for scanning purposes, I again had to wait a further year to conceive. So all up I had to wait four years after the surgery. The other factor is that iodine is quite important for the development of a baby so they have to monitor your medication quite closely before you decide to have a baby, once you’ve had your thyroid removed. Given that I’ve now got my healthy little baby Amelia with me, it all seems worth it. How do you feel changed by your experience of thyroid cancer? I grew up being a very gentle, timid kind of person and I was always terrified by medical procedures. I really had to toughen up. It does build resilience. As my mum said to me subsequently, I think about the things that I have gotten through in life and if I can get through that, I can get through anything. The silver lining was that it showed me that I was made of a bit more than I thought in terms of my personal strength. I am now nine years since my initial diagnosis and remain cancer-free. It was such a scary time, so I would love to do anything to help others facing the prospect of a head and neck cancer diagnosis. Beyond this, I want to support research to find targeted ways to remove all types of cancers that don’t injure the host as much as traditional chemo or radiotherapy.

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