Leandra Medine: In this round table conversation, I’d like to break down the larger conversation surrounding breast cancer, analyze why we feel so much shame talking about it and discuss the ways in which we can encourage people to feel more comfortable sharing their perspectives on the disease. Actor and model Elizabeth Hurley, a Global Ambassador for The Estée Lauder Companies’ Breast Cancer Awareness Campaign, joins us along with stylist and consultant Ann Caruso, a two-time breast cancer survivor. Estée Lauder asked me on behalf of Man Repeller to be a spokesperson for this year’s Breast Cancer Awareness Campaign, and I feel extremely grateful to be involved.
So, let’s start with Elizabeth. How did you get involved in the campaign?
Elizabeth Hurley, actress and model, Global Ambassador for The Estée Lauder Companies’ Breast Cancer Awareness Campaign. I joined the Estée Lauder campaign 22 years ago. Evelyn Lauder came to me when it was just beginning and asked if I would help her out. I said, “Absolutely, of course. What can I do?”
She said, “Women all over the world are dying of breast cancer and no one is talking about it and I want to change that.” You have to remember that this [time] was incredibly different from today. She had just co-invented the pink ribbon, and no one knew about it. There was no Breast Cancer Awareness Month, no magazine covers about breast cancer, no one on breakfast TV talking about breast cancer, no one sitting around a table talking about breast cancer.
It literally wasn’t talked about. No one spoke about it. My grandmother died of breast cancer and she, too, never spoke about it. She found a lump in her breast and was embarrassed about it, embarrassed and scared. She didn’t go to a doctor. She said everything was fine. She felt it getting bigger and bigger until, finally, she was in so much pain that she told her doctor and got medical treatment. It was too late; it was way too big. And she died from it.
Nobody talked about breast cancer at that stage. Everyone would just go about and whisper, “She’s got cancer.” She was one of twelve children and a couple of her sisters had died of cancer — maybe lung cancer, no one of breast cancer. But nobody really spoke about that, either!
Cut to today: We were just on the jumbotron in Times Square talking about breast cancer! We’ve been on every magazine cover talking about it. We talk about it now. People are much more inclined to talk about it now than twenty years ago, though it’s still incredibly painful and emotional.
Leandra: Ann, you’re a two-time survivor. Did you ever feel afraid to talk about it?
Ann Caruso: Yes. When I first was diagnosed nine and a half years ago, I was nervous to even tell some of my friends. You don’t know how people are going to react, and you want people to be very supportive because you need them to be there for you. You want them to be kind. And you’re afraid that if you do tell someone, they might not respond the way you need them to.
I’m a contributing editor at Harper’s Bazaar. The editor-in-chief, Glenda Bailey, had asked me to share my story with the magazine and I was frightened. I hadn’t spoken with all of my friends and I knew everyone was going to see it. But I said, “You know what, I don’t care about what certain people are going to say, like, ‘Oh my God I can’t believe she’s sharing all of her private things!’ and ‘How can she share that to the world!?'” It really is such a service to women. And to men. Both sexes need to know what is going on with a women’s body and how difficult it is to address the changes that you go through.
Elizabeth: The emotional trauma isn’t limited to those suffering from breast cancer. [It’s also] devastating for the people in their lives: kids, husbands, boyfriends, partners, parents. We’ve done quite a lot of work with family and the things people have said have been really illuminating.
We watched a beautiful film where kids whose moms were going through treatment spoke. I think many mothers feel the need to shield kids from anything that will upset them. [The kids] all unanimously said that the worst thing was when they knew that there was something going on and they weren’t being told. It made them really uncomfortable when their mothers said, “I’m feeling absolutely fine! It’s nothing!”
Leandra: Why do you think women feel so much shame around their breast cancer? I have a hunch, particularly because I consider myself a member of Generation Overshare. It’s much more difficult for me to retain private information about myself than it is to share it. And I know that’s not true of prior generations; I know that’s not true of my parent’s generation. My dad had colon cancer three years ago and he didn’t want us to tell anyone. He “felt like a loser,” and that’s an exact quote.
Ann: I know that when I was going through it, you want people to think that you’re healthy and vibrant. That you can work. You don’t want people to think that you’re sick. That was one of my challenges. I’ve had so many surgeries and in between, I needed to work. I’m a single woman and I need to make sure that money is coming in. Even though maybe there were times when I wasn’t working, I had to make it look like I was okay. When you’re sick, health is wealth. And when you’re not healthy and you don’t feel good and you don’t feel like you can go and do your thing, you kind of feel like…
Leandra: You don’t have anything.
Ann: Yeah, you don’t have anything. That’s why your health is so important. It’s challenging to live life to its fullest. For women with breast cancer, it’s also a body part that symbolizes femininity and sexuality. It’s so much a part of being a woman. It’s quite traumatic.
Leandra: I carry the BRCA1 gene. I discovered that when I was twenty five, two years ago. My mother carries the gene and had her ovaries removed preventatively when she was forty. My grandmother died of breast cancer. When my doctor asked if I wanted to be tested, I said “Sure.” I will up my check ups from once a year to four times a year, and I will have ovarian sonograms and that’s going to be what I do.
About a year later, I decided to also endure a round of IVF — partially because I was having difficulty getting pregnant, but also because all of those frozen embryos now serve as insurance in the event that something goes wrong before I’m finished having children. When people ask why I wanted to know if I wasn’t going to remove my ovaries immediately, my response is always because knowledge is power. Because now I know to go to the doctor four times a year. Something that my gynecologist, who actually delivered me, said right when I discovered I carried the gene has really stuck with me. I repeat it all the time. It’s that if you play by the rules, you don’t die from breast cancer. Meaning, get checked, get tested if you need to, know your family history and talk about it. If these conversations aren’t happening, people don’t know that there are so many resources. There is so much access to incredible technology and medicine.
Ann: Right. It’s so true. When people come to me and ask, “You know, my friend has breast cancer, do you think you could talk to her?,” I always suggest that they reach out to me or another person who has had breast cancer as well as go to several doctors for opinions. The more knowledge you have, the more you’ll know and learn.
Elizabeth: That was a big part of the campaign, particularly a few years ago. I think one of the biggest reasons people don’t want to talk about it is that primal fear that you’re going to die. If you have a lump and it’s detected early, you have more than a 90% chance of survival. But if you don’t talk about it, like my grandmother didn’t, if you don’t tell anyone because you think, “Oh it might go away, it might not be anything,” then you have a much worse chance. It’s NOT a death sentence to be diagnosed with breast cancer. You HAVE to understand that. You have to come forward and you have to talk about it because if you can say, “I survived it because I had a mammogram every year after forty; because I started checking my own breasts the minute I hit puberty; because my mother taught me to; because my friends bullied me into having mammograms,” that’s how you can take away the fear of saying, “I found something on my breast.” But you have to pass that knowledge on.
People are scared! I’m scared to have a mammogram. I have one every year. Scared I’m going to die, that I may not be there for my son.
Leandra: Of course. Specifically with breast sonograms and check ups and mammograms, we’re all immortal until proven otherwise, or it seems that way, right? To be confronted with your mortality when you feel like you have endless time left on earth is very, very scary. Especially when you’re still quite young.
What has kept you tethered to the campaign for this long?
Elizabeth: People often say, “Oh, October’s looming again. Are you nervous that you’ve been doing it for so long, that people are kind of bored of the message?” The reason they’re not [bored] is because everyone we speak to has had an experience with breast cancer in the proceeding year.
We did a beautiful lunch last week at Bloomingdale’s in White Plains and this great guy who is the general manager of the store stood up and did all the introductions. Then, just before I spoke, he suddenly got incredibly emotional. It turns out his wife has breast cancer. They’ve been doing breast cancer fundraisers for years and suddenly now, to him, it’s unbelievably personal because of what’s happened.
There’s no way you’re going to walk away from it now. Until the final frontier. Until they find a cure. There have been so many improvements [when it comes to] diagnosis and treatment since I’ve been on the scene. I remember when I first talked to two scientists at The Royal Marsden Hospital in London who have [done] BCRF research in my name. They said that twenty years ago, they saw a lot of really big tumors and that now, it’s very rare to see a big tumor because everyone’s been told about early detection. The machines are better, they detect it earlier, people are checking, they’re going for their mammograms. It’s been great progress.
Ann: Yeah, huge.
Leandra: When was your most recent diagnosis?
Ann: Almost three years ago.
Leandra: Is it something that’s still on your mind every day?
Ann: Yeah. Every day. Because I’m always at the doctor.
Elizabeth: How long did you take medication for?
Ann: I’m taking medication for the rest of my life. Every day.
Leandra: I know you mentioned part of the reason you were afraid to tell people is because you need a lot of nurturing and you want people to respond the right way. I’ve never really thought of it that way, but I can completely understand how someone who doesn’t quite know how to react to the prospect of mortality might throw you off guard when all you need is very sincere and direct empathy.
Leandra: Have you found that the illness has helped your relationships? Sort of weaned out bad ones? And can you share a little bit about the recovery process?
Ann: Yeah. Absolutely. You know, it definitely changes your life. At least, it’s changed mine. I’ve had so many surgeries. I’ve had complications, I’ve had infections, and then I’ve had to go back into the hospital and recover. I’ve had three expanders in one breast, which is very unusual.
Leandra: What does that mean?
Ann: An expander is what a woman has when she has a mastectomy. It stretches your skin in order to hold the implant. It’s quite traumatic to the body. You go through all of these things and it takes time to recover. I was happy with my body, you know? But you have to change. I had to learn how to dress for a different body. It was like getting used to a different person.
Leandra: People often think that’s such a trivial piece of the puzzle. When I was going through IVF, your body totally expands when you’re on all those medications — you’re like three sizes larger than usual — and it made me feel really shitty. I use fashion and my clothing as a form of identity-metabolizing, so I very much understand where you’re coming from. I think that’s a conversation in and of itself.
Ann: Yes. That was very difficult for me because I had to change the way I dressed. I had bigger breasts, which I never really wanted, and then they’re not the same, because I’ve had one breast removed. It’s constantly up and down with the sizes. Then, my second time having cancer, I went through Lupron —
Leandra: Oh my god. Devil liquid.
Ann: I know! Along with the other surgeries for my breasts and radiation, I went through ovary removal — oophorectomy — and I just gained weight. I’m healthy, and I feel very grateful. Along with all of that, I’ve learned what is really important in my life. When you go through so many different stages of recovering and not feeling the same about yourself, those down phases of recovering with your body and your mind — mentally, spiritually, physically — you lose your mojo. I have to get my mojo back. You fake it ’til you make it, and then finally get it back.
When you’re a cancer survivor, you have to learn when to say no and when to say yes, and people have to understand that. I try to keep my life at a certain place where I can stay grateful. That’s the most important part for me. Because walking outside and seeing the sun and being grateful — even when it’s raining, just that there’s this day happening and that I’m present in it — is the most amazing gift.
Leandra: And you still feel it three years later.
Ann: Oh yeah. More so now. I was so sick before. It’s getting better because I’m starting to feel better.
Leandra: How did you find the first diagnosis?
Ann: I felt the first one when I was in the shower, so I always encourage people to really touch themselves and make sure that they do their own self-exam. Actually, my boyfriend at the time felt it first, and then I felt it in the shower. And it kept getting bigger and it started to hurt.
Elizabeth: How long was it from when you felt it to when you went to the doctor?
Ann: Probably a month and a half. I did go to a gynecologist, who told me to get tested. She sent me to a place where I couldn’t get an exam for three or four months. I called her office back and asked for another place and she said no, I want you go to this place. So that was September, and I couldn’t get in until January.
Elizabeth: That sounds outrageous!
Ann: I know. I know. So, I called back again and I said, “I have a lump! You told me that I have a lump so you need to send me somewhere else!” And she said, “Nope, that’s what the doctor said.” And I was like “You’ve got to be kidding me.” So I called another gynecologist. I had to go to a brand-new one, so I had to wait another month to get an appointment with them and I found a new place to go, and they found the lump and it was cancerous.
Elizabeth: With a mammogram?
Ann: No, not with a mammogram, with an ultrasound. Then when I went to get an MRI, I had four lumps all over my breast. The first gynecologist I saw was horrible.
Leandra: Do you remember how you felt when you found out that it was cancer?
Ann: Oh God. I remember going back into the dressing room and I started crying. I had to go back for another biopsy. The next day, I remember going to a Bazaar party and Stevie Wonder was performing. I was out there dancing and my breast was killing me because they had put these huge needles in to take everything out. But I was like, you know what? That was yesterday, today’s today.
That’s important — every minute by minute, hour by hour, day by day. That’s how you have to process it.
Leandra: Do you feel like there’s anything you wished you had received, from a social support perspective, that you did not while you were fighting?
Ann: It’s really important for people to check in after the surgeries. Like, “How are you doing?” If you’re on Tamoxifen, you’re constantly being checked [to see] if you have other kinds of cancers. There’s always stuff. Constant pain if you’ve had a lot of operations, and you’re living in fear.
It’s really important just to check in. I’m tearing up! I try to do that with friends. Sorry…
Leandra: No! I’m sorry.
Ann: It’s just very tough. Sometimes people think that it just stops, but it doesn’t.
Elizabeth: Stops when the treatment stops.
Ann: Yeah. And some women will have a lumpectomy and you’re out in a day. It depends on your treatment. It can keep going and going. Some people’s surgeries are easy. And then other people, they’re just not that lucky.
Elizabeth: Well you’ve had particularly bad luck with your repeat surgeries and complications. It’s been tough.
Ann: Yeah. Yeah. But you know what? Sharing stories and talking to people is just so helpful. I follow so many women who I don’t know. I learn so much from other women. It’s one of the most important things. Because you get inspired.
Elizabeth: One in eight of us women get diagnosed with breast cancer by the time we’re seventy.
Ann: I’m petrified every time I go for a mammogram or sono or MRI. I have to bring someone. The one thing that really astonishes me is when people come up and say, “Thank you for sharing your story,” or — and I’m sure that you’ll get it a lot — or when they say, “You know my daughter has it and she had it fifteen years ago and she’s still so depressed about it and she still won’t talk about it.”
Leandra: What else do you think we can be doing? I think about that all the time because at a certain point — and I know we’re seeing it with social activism on the Internet — at a certain point, saying, saying, saying isn’t enough.
Elizabeth: Well, that’s the message of our campaign this year, isn’t it? “Take action together to defeat breast cancer.” This campaign is trying to get everyone to DO something. Speaking about it is vital, but DO something, too. It could be something like, “I’m going to take care of myself,” or, “I’m going to eat food that will nurture my body and be nutritious,” or, “I’m going to exercise,” or, “I’m going to do all the things that the doctors tell us: I’m not going to smoke, I’m going to drink less alcohol or no alcohol.” All of those things to look after the self, and then make our pledges of action: “My friend who’s going through chemotherapy — I’m going to take her kids to the park to give her a break. I’m going to do her grocery shopping. I’m going to call, to check in” — like you said, Ann, that is so important. Equally important is fundraising, which is really at the crux of the matter. We have to be part of the fundraising process, and encourage people who have something to spare to give. It is vital that we keep encouraging donations and fundraising efforts to the Breast Cancer Research Foundation. Because they will find a cure! They’re very confident.
Ann: At my last doctor appointment, my oncologist told me my next step, and one of the things I have to do (because the medication I take decreases my bone mass) — researchers came up with a shot I’ll be taking that will help to keep my bones from deteriorating. It also helps to prevent my breast cancer from moving into my bones. The things that are happening because of the research are just stunning.
Leandra: I assume that I’m going to get breast cancer at some point. I can’t imagine my life’s narrative unfolding without it happening. But I never think that it’s going to be the end of me.
Ann: Well, will you have the surgery?
Leandra: Yeah, I’m going to remove my ovaries when I’m finished with having children.
Ann: And what about your breasts?
Leandra: I’m going to start with a hysterectomy because I know that it stops a lot of the hormones that travel to the breasts. And then if I have to have my breasts removed, I’ll do that.
Elizabeth: We met a very inspiring woman about two years ago in the campaign. She was from a family who carried that gene; it was from her father, and he had lost several of the women in his family to breast cancer. Her sister had sadly passed away shortly after she was diagnosed – two daughters with breast cancer at the same time. She had just gotten married and did exactly what you did: had eggs removed, fertilized, embryos frozen. She had breast cancer. She completed her treatment and shortly after we met her, found out she was pregnant. And she had twins!
Leandra: Oh that’s so special! I’m sure you’ve come across such incredible stories over the last twenty two years. Do you feel so closely connected to the cause because of your grandmother?
Elizabeth: Yes, and I think it’s because of the way she dealt with it. She was a product of her generation and of the way we were, but I am so filled with regret that I didn’t think about it myself then, either. In retrospect, had we known what we know now — we were just like, “Oh, poor granny is very sick!” But we didn’t know to try. We were probably hopeless as supporters as well. It makes me very sad that she was part of that era where there was no help and support.
I have another close friend who has had breast cancer for more than five years and she will not talk about it. Everything’s fine.
Leandra: What do you do in that case? Do you feel like you have to respect it?
Elizabeth: Yeah. I just say to her, “You know I have a lot of contacts, so anytime you want anything, there are a lot of people who can help.”
Leandra: How can we help those who have breast cancer or who have had breast cancer, are suffering, but don’t want to talk about it?
Ann: Everyone’s situation is totally different. Some people just are really emotional and tired. There was this celebrity on TV and she was on several months after her surgeries and she said to the person who was interviewing her, “I’m tired. I’m really tired.” And I was like yes! Someone’s really telling the truth! This takes a lot out of your body. No one really talks about that stuff. They go on, they’re like, “Yes it was hard.” Shannen Doherty has been very vocal about how much pain she’s in, too.
Leandra: What are some final thoughts you’d like to leave our readers with?
Elizabeth: Young women checking their breasts is something that really has to be encouraged. Mrs. Lauder always told me that as soon as girls hit puberty, they should be taught to check their breasts, but what’s very important is that they be taught to do it at the same time of the month. Because your breasts fluctuate with your periods. It doesn’t matter what day you pick, but always do it on the same one. Mark it on the calendar. Become very familiar with your breasts so you’ll notice a change.
Leandra: That’s really good advice.
Elizabeth: And do the yearly exam from your doctor, too. This goes for older readers as well.
Ann: Definitely check yourself. Definitely reach out to your friends if they are going through something, [whether it’s] cancer or a hard time. Focus on healthy living, whether it’s spiritually, mentally or physically. Like you said, Elizabeth, it’s also important to raise money for research.
Leandra: And talk about it. If you have questions, if a friend is going through something and you’re afraid to broach the topic with them, just do it; they will let you know if they want to talk about it or not. If you’re going through something yourself and you’re feeling especially vulnerable but you don’t want to broadcast it, write it down so that you have a written record of how you were feeling when you were your most honest self. Maybe you’ll develop the courage to share that later on. And just show up. Be present, right?
Ann: Yes. So important.
Photographed by Krista Anna Lewis.