How a positive outlook can transform cancer care

Funny side: Travel writer Ileana von Hirsch had breast cancer diagnosed in 2016

Cancer is not a laughing matter, of course. 

There is nothing funny about it when you look at the bigger picture — yet if you put it under the microscope and focus on those little wriggling, squirming moments, there is plenty of amusement to be found.

The idea for this journal developed when a well-meaning lady sent me a book by someone who had suffered a very aggressive cancer and survived, though she had a gruelling time of it.

There are lots of things that are not fun about cancer, most of them unavoidable, but at the top of my list is something that is luckily very avoidable: namely, 95 per cent of the books written by people who have had cancer, which all end up making you feel utterly depressed.

To quote the satirist Dorothy Parker, these are not books to be put aside lightly but should be thrown away with great force.

This particular book was so horrific that I felt the need to exorcise any traces of it in my memory by writing its absolute antithesis: an anti-misery memoir that is safe to give to cancer patients who want cheering up, as I did.

I am not a brave person — quite the opposite. I am afraid of crowds and daddy longlegs. If people shout, I feel faint. I keep my distance from large dogs and won’t swim in the sea when there are big waves.

In fact, I can only tolerate the absolute minimum amount of adrenaline needed to stay alive. I was therefore as surprised as the next person to realise that a huge number of funny things happen on the way to chemo, or indeed on the way to most places, and that once you get your eye in you completely forget to be scared.

My oncologist told me that if on the first appointment he can get someone to smile — and curiously enough, there is no correlation between the gravity of a diagnosis and the likelihood of someone smiling — they will have an easier time of it.

If a fundamentally cowardly person like me can find things to smile about, then there is hope for everyone.


Life seems to separate into two expanses, like the Red Sea before Moses — life before cancer and life after.

My Moses moment happened on holiday on the small Greek island of Ithaca, where my family come from.

When my breast turned a bit hard and red, the local doctor didn’t believe my self-diagnosis, at the age of 57, of mastitis (inflammation) — ‘At your age? Are you mad?’ — and promptly told me to get a scan.

The write stuff: Penning a journal made all the difference, she says - and it includes dog Cleo

The write stuff: Penning a journal made all the difference, she says – and it includes dog Cleo

The clinic was a pop-up affair: the scanning machine, together with a trigger-happy radiologist, came over from the neighbouring island once every two weeks, the machine held together with duct tape and Blu Tack, the doctor held together with nicotine patches.

By the time my turn came to be scanned, the radiologist was on his last nicotine patch and reaching for his cigarettes. He was visibly bored and scanned me with a weary look on his face, then suddenly sat bolt upright and said, ‘Holy Mother of God!’

One doesn’t really like providing excitement for doctors, so I asked what the matter was.

He looked at me with shining eyes and said: ‘It is either nothing, or a very rare cancer and you have two to five years to live. Please do let me know how you get on — I don’t often ask patients, but this is exciting!’

I told my children that I had an abscess and needed to go home to London to get it drained, then I booked the next available flight back.

A week later my new surgeon, Mr G, sat with a heap of reports of all the biopsies, etc.

A look of puzzlement crossed his face. ‘Why would you think you only had two to five years to live?’ So I told him.

He continued to look puzzled, and said: ‘I would say it is a perfectly normal, very treatable breast cancer. You have a 70-80 per cent chance of surviving, and I see this sort of thing every day. In fact, I see hundreds of people like you every month.’

Being told you have a boringly normal cancer after thinking you have only a few years to live is excellent news, so, whatever else Mr G said to me that day, I just remember the huge grin that kept spreading over my face, and nodding happily and saying, ‘That’s wonderful news, thank you!’ — and it was.


Early on, I overheard my husband call a family conference.

‘Right, everyone, we are no longer in cruise mode. We are now in crisis-control mode, so pay attention.’ Three adult children, three dogs, a sister or two and our lodger all looked at him expectantly. ‘This means,’ he announced, ‘that when you have finished eating, you each clear your own dishes, which means you don’t just leave them near the dishwasher, you put them in the dishwasher.’

I am at risk of becoming spoilt.


Losing your hair sounds awful but in fact it doesn’t have to be a big deal at all — and this is from someone who really dislikes baldness. I loathe shaved heads, buzz cuts, shiny pates, scalps… I told my husband when I married him that our marriage would last as long as he had hair — after that, I wasn’t promising anything.

He loses no opportunity to tell me, from his elevated position on the high moral ground, that (following my course of chemotherapy) I am the bald one now, and he isn’t leaving me.


As a cancer patient, your goal — and challenge — is to see how often you succeed in eating food that is 100 per cent good for you and bad for your cancer cells. Sadly, it seems that cancer cells and I share exactly the same taste. We love roast beef and buttered toast, we adore chocolate, we crave cookies at teatime.

What this means, though, is that you have to deprive them of their (and your) favourite foods and instead stuff yourself with broccoli and cabbage.

Cancer cells hate these, just like you do. Your new goal is to see how disgusting you can make anything, on the principle that if you hate it, so does your cancer.

Juices are a great place to start. You can get your daily dose of disgusting in one go. Buy one of those ninja machines that whizzes everything up, experiment every day with throwing in as many bitter green leaves as you can, and see just how foul you can make the drink on a scale of one to ten.

'Losing your hair sounds awful but in fact it doesn¿t have to be a big deal at all ¿ and this is from someone who really dislikes baldness,' says Ileana

‘Losing your hair sounds awful but in fact it doesn’t have to be a big deal at all — and this is from someone who really dislikes baldness,’ says Ileana

I usually get to nine — Swiss chard will boost the score, fast — then add sheep’s yoghurt and salt, which can push it up to ten. If you are going to do the sissies’ soft option with fruit juice, make sure to include the peel, core, worms, mushy bits, pips and stalks.

The funny thing is that I now find it all quite delicious and am thinking of writing a recipe book called Hard Core.

With bone broth, the principle is the same. How many unsavoury ingredients such as bones, knuckles, sinews, ligaments, kidneys, herbs, roots, onions, bugs and flies, etc, can you squash into your stockpot, and how long can you simmer it before the household rebels? After two days, your family will be ready to move out.


If I am being honest, my idea of domestic hygiene is having a quick look around to make sure no one is watching when I pick a piece of fallen food off the kitchen floor and put it back on the plate. The pre-wash cycle on the dishwasher is three dogs licking the plates.

So when my oncologist said (during my chemo), ‘You know, your immune system is now severely compromised, so you must always carry hand sanitiser with you, wear gloves when handling raw meat, wash your hands after touching your pets or picking things in the garden, and avoid germs and dirt in general’, I tried to keep a straight face. My immune system will just have to take its chances.

In fact, the whole time I had chemo, I never had so much as a sniffle. Chemo cleared up a chronic bladder condition, a fungal infection of my toenail that I seemed to have been born with and all sorts of other annoying little things that simply got nuked along with the cancer.


You have cancer, so the TV remote control is all yours. No matter what football game is showing, you have priority. Any channel you want: country music, repeats of Two and a Half Men, The X Factor, Welsh sheepdog trials — Welsh anything, in fact, especially if it is in Welsh and if, like me, you are neither Welsh nor speak the language.

Whatever you want, you get. You know it won’t last, so enjoy … (If you’re a man, then obviously you’ve always had control of the remote, so there is no new benefit to you.)

One awful time, the satellite dish broke and my husband undertook to get it fixed before my next chemo so I could follow the Welsh-language sheepdog trials. ‘Play the cancer card,’ I told my husband bossily. He called the repair man and was given an appointment to get it fixed in two weeks’ time.

I was distraught. Perhaps in those two weeks, for the first time ever, Huw Ap Llewellyn would not get his sheep and I would miss it.

I rang the repair company the next day and said in a breaking voice how I had cancer and the only thing that made the chemo bearable was watching Welshlanguage TV.

‘Oh,’ said the lady manager. ‘Why didn’t your husband say so? I had cancer five years ago and I know exactly what you mean. Leave it with me.’ Twenty-four hours later, my television was new and improved. Always play the cancer card.


After the operation your surgeon may well change his tune. Pre-surgery, Mr G’s upbeat view was: ‘The breast I will operate on will be smaller, firmer and higher. And then, if you want, we can make the other side match so you will have had, in effect, a top-notch breast lift.’

Post-surgery, he examines his handiwork with satisfaction and then says: ‘That looks great — and once the swelling goes down, gravity will have its way, it will droop and deflate just like the other side and be a perfect match, so I don’t see any need for further cosmetic work.’

Promises, promises.


A good husband is a wonderful source of strength and deserves the final word. At dinner with the children one evening, I asked mine if he thought my two 2cm of newly re-grown hair would look good if I dyed it platinum blonde.

He said yes, he was sure anything would look good. My eyes grew misty with love and emotion, and I turned to the children and said: ‘You see, children? That is love — when your wife looks like I do and you still think she is beautiful.’

The table fell silent to appreciate the poignancy of the moment; then my husband said, ‘I didn’t say you looked beautiful.’


As it turns out, a year of having cancer has given me an unexpected second chance at glimpsing the meaning of life.

I have finally understood so many crucial things I’d been oblivious to, or to which I had attached no importance: having a peaceful routine focused on health rather than acquiring things; cooking in an engaged and leisurely way, rather than juggling three pans of burning stuff while cradling the phone under my ear; giving quieter or shyer people the time and room to blossom in front of me; appreciating small things and just being kind.

POSTSCRIPT: False alarm, many apologies, I thought I had finished with the previous nicely judged final paragraph. It turns out that my cancer had metastasised bafflingly fast, has spread all over my liver and is now inoperable.

‘You cannot be serious,’ I say to my doctors. But they are serious. They avoid eye contact, they look away. I am back in Cancerland.

A mental adjustment must now be made — one no longer talks about a cure, one talks about management, with the aim of drawing out as many years of comfortable, high-quality life as possible. Every three weeks from now on, I am to have a ‘light maintenance programme’ (which you are not supposed to call chemo, as it upsets everyone who loves you).

My first few days after the diagnosis of metastasis were spent trying to stop the weeping and wailing from friends, family and colleagues. This is understandable; I make the same mistake even now when I hear someone has cancer. I think, ‘Poor thing, they are dead,’ even though I know from my own situation that this is completely wrong.

Your husband, until now your rock and anchor, suddenly develops full-blown hypochondria. A slight cough, a pain in the side that persisted for three weeks, and he tells me: ‘You will have to bury me. I can tell this is the end, I’m riddled with cancer.’

My first reaction was annoyance that I was going to have to stop thinking about myself and start thinking about others again. I am not proud of this but, as almost any wife and mother will know, putting oneself first is a novelty not to be relinquished without a fight.

A reassuring number of X-rays and scans were unanimous in agreement: it was nothing a little vigorous exercise wouldn’t fix.


For me, in summary, the prognosis is good, though the downside is that I might last long enough to get Alzheimer’s.

Cancerland is not where you chose to live, but it is where your job has relocated so you have to make the best of it.

I have been lucky enough to move almost immediately to the very desirable, leafy residential quarter called Remission, from where I can do my monthly runs down to town for treatment. And from that peaceful vantage point, the views are good; I can commute easily between it and Normal-land. My glass is always half full, and I raise it every day in silent gratitude for all my blessings.

n A Funny Thing Happened on the Way to Chemo: A Rather Unusual Memoir, by Ileana Von Hirsch, is published by Short Books, £8.99. To order a copy for £7.19 (20 per cent discount) visit or call 0844 571 0640, p&p free on orders over £15. Offer valid until 26/06/2018.



– ‘Did you catch it early?’

If the answer is ‘yes’ that’s fine, but the answer may be ‘no’, which could be a bit of a conversation stopper unless you are close to the cancer patient.

– ‘My aunt/sister/mother had the same thing and she’s fine.’

You mean well, but your relatives’ experience, in all likelihood, has nothing to do with your cancer patient’s experience. Talk about your aunt/mother/sister by all meaNS, but don’t draw any conclusions from that.

– ‘I always thought you were too old to have such long hair anyway.’

Really not a good thing to say, even if it is true.

– ‘Good afternoon, Sir, what can I get you to drink?’ 

Said to me by a male waiter with an enviably long and glossy ponytail, when, proudly sporting one inch of new hair, I ventured out for the first time without a turban. I nearly cried, but instead, told him I had cancer and that I would accept a complimentary coffee for having my feelings hurt.

– ‘What’s for dinner?’

How should the cancer patient know?


– (If you are a husband or partner) ‘Can I bring you a cup of tea in bed?’

– ‘Can I come and see you? I’ll only stay for an hour…’ — The only-stay-for-an-hour bit is important.

– ‘May I come and sit with you while you have chemo, or take you to radiotherapy?’

– ‘Would you like to come and stay with us in the Bahamas when this is all over?’

– ‘Gosh you are an inspiration!’

– ‘You have such a beautiful shaped head, you can get away with being bald.’

– ‘Dinner is ready!’