Anj was diagnosed with triple positive breast cancer in March 2022 (Image: Michael Leckie/PA Real Life)
A mother-of-two who was diagnosed with triple positive breast cancer at 37 has said the medically-induced early menopause she experienced has been « harder » than chemotherapy. Physiotherapist Anj Periyasamy, now 41, explained her particular form of breast cancer is « fed by hormones » so she essentially needs to keep her ovaries « asleep », meaning she cannot use HRT to alleviate her extensive list of symptoms, which includes night sweats, hot flushes, mood swings, low libido, hair thinning, muscle aches and tendon pain.
« Menopause sucks, » Anj said. « It sucks big time. There are so many facets to it that nobody talks about.
« I cried in front of my oncologist and I was just like, ‘This is unbearable and I just can’t do this. I’m drenched (in sweat from hot flushes) half the time. My tendons are painful. It’s affecting my mood. I don’t know if it’s a post-chemo fallout and I don’t know if it’s post-menopause fallout’. And he assured me it was probably menopause. I knew chemotherapy would be temporary, but menopause psychologically gets to you, as well as physically. »
Reflecting on her initial diagnosis in March 2022, Anj explained that the sole symptom she experienced before discovering a lump beneath her breast was feeling « knackered », which she « put down to motherhood » while caring for her daughters, Jasmin and Maya, then aged five and two. Anj said she assumed it was « probably nothing », but « something just didn’t sit right », prompting her to arrange a virtual GP appointment where she was urged to attend an in-person examination.
At a clinic in central London, Anj said she underwent a consultation where the breast surgeon concurred it was « probably nothing » and that she was « too young » for breast cancer, yet still recommended she undergo a mammogram, ultrasound and biopsy as a precautionary measure. Within seven days, Anj was instructed to attend for an MRI, where she recalled looking at the specialist « square in the eye » and demanding: « Is this sinister or not? Just tell me straight. »
Anj was diagnosed with breast cancer at 37 (Image: PA Real Life)
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Following the breast surgeon’s confirmation of her fears that it might be cancer, Anj remembered responding: « But it can’t be. What about my children? I have to be around for my kids. They’re so little. »
Throughout the following six months, Anj underwent 16 rounds of chemotherapy, followed by a double mastectomy and breast reconstruction, 15 rounds of radiotherapy, alongside 14 rounds of IV Herceptin (a targeted antibody therapy to inhibit tumour growth) and six rounds of IV bisphosphonates (a medication to strengthen bones). She also received monthly injections of Zoladex and Letrozole to reduce her hormone levels and maintain her in medical menopause, before transitioning to Tamoxifen after two years owing to « horrid » side effects.
Beyond losing her hair, eyelashes and eyebrows near the conclusion of her chemotherapy treatment, Anj said her fingernails turned black, and she suffered from exhaustion and « chemo fog » that meant her body was « almost relearning everything again ». However, Anj said the side effects from menopause proved even « harder ».
« I had tendon pain so I couldn’t even go to the gym and exercise properly because my feet hurt, » Anj said. « If I sat for 20 minutes, I’d get up off the sofa and I would look like a penguin… It’s horrible, honestly.
« The other thing is sexual dysfunction and vaginal atrophy are massive. It’s really demoralising when you can’t have intimacy with your partner. The thought of osteoporosis really scares me too because (I’m encouraged) to do weight-bearing exercise and strength work, but then my tendons hurt.
Anj had 16 rounds of chemotherapy (Image: PA Real Life)
« And finally, I’m the most placid, chilled person, but the menopause rage – the pure rage – was like, ‘What is wrong with me? Why am I so angry?’. I used to get so angry about the girls bickering and I’d just go from zero to 100 really quickly. Sometimes I’d say to my husband, Damesh, that you need to take them. Just deal with them.
« Unfortunately, because my breast cancer was hormone-fed, I can’t use HRT to dampen the symptoms. I can’t even use certain herbal supplements. No one talks about this. »
Anj revealed her daughters picked up on some of her symptoms, which led her to attempt an age-appropriate discussion with them about what she was experiencing. She contacted the charity Breast Cancer Now, who provided her with a children’s book called Mummy’s Lump, which Anj said she read alone first and « had a cry », before spending « a whole week » mentally preparing to share it with her children.
« My two-year-old Maya was just not fussed, » Anj said. « I then read it to the older one, Jasmin, and she was like, ‘Ok can I go and watch Barbie now?' »
Anj said she’s since had discussions with her children, reflecting on her « short hair era » and occasions where they noticed she was missing from their family home so that she could receive hospital treatments. She continued: « Jasmin has asked ‘Are you better now, mum?’. That’s always a really hard question to answer because I hope to God I am, but they also want to make sure their mum is around. I never talked about death, but it wasn’t easy for them to see me sick. »
Following her diagnosis, Anj discovered the charity Trekstock Cancer Support through social media. Initially, she was going to collaborate with them professionally as a physiotherapist, helping to « draw up exercise pathways » for the cancer survivors they assist.
However, Anj revealed that the charity invited her to participate in their new photography exhibition, titled « Are You Better Yet? ».
She said: « It was really fun to be there. I did find it was nice because you get to go back over your story and get to (remember) the good and the bad, what you did it for, and why are you telling your story. »
She added: « I think (the exhibition) is a much-needed type of platform to raise awareness. »
Four years after her diagnosis, Anj shared that her eyebrows haven’t fully regrown and her skin has changed due to the menopause, but she’s living well.
Anj and her husband Damesh (Image: PA Real Life)
She explained that she’s sharing her story now because she wants to represent South Asian women: « There’s not enough education out there, there’s not enough awareness, and there’s not enough people that look like me – young brown women. »
Regarding what she hopes her daughters will learn from her journey, Anj expressed her wish that they would one day say: « I’m proud of you, mummy – you did it. »
She added: « But I also want them to read (about my story) and not be scared. It’s about being empowered and knowing how to get through a life crisis, then survive and thrive afterwards. »
Trekstock Cancer Support’s Are You Better Yet? exhibition is on display until March 29 at the FUJIFILM House of Photography in London. Anj can be followed on TikTok.
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