Published: 31.08.2020

Jaana, breast cancer survivor: At Docrates, it’s the quality of life that matters, not the statistics

We are meeting with Jaana Nurmi on a couch in Kaffila, a volunteer-run cafe in the community house Bokvillan on Arabianranta, in Helsinki. The sun lights up the room, which used to be the home library of Arabia factory’s plant manager. Jaana is an entrepreneur who was diagnosed with breast cancer in the summer of 2017. She tells us about her journey with breast cancer and, especially, about the significance of precise diagnostics in the planning and success of breast cancer treatment.

Cancer without warning

The breast cancer diagnosis was a total surprise for Jaana Nurmi, since there were no previous signs of cancer. Cancer was diagnosed by mammogram.

– I had no symptoms, and thought that this is just a routine check-up. However, the hospital called me afterwards and asked for old mammograms. Soon after this, they called me back to retake the mammograms and take an ultrasound scan. The doctor told me that two changes in the breast tissue were found, and they should be sampled. They couldn’t take both samples at the same time, so I was sampled twice, says Jaana.

– I still thought that there was nothing wrong with me. You often hear stories about changes in breasts, but usually they are harmless.

During the second sampling, Jaana was told about the results of the first biopsy.

– The doctor told me that cancer cells were found in the sample. I was told that I’ll be called in for a surgery planning session in the near future, says Jaana.

Jaana took the news rather calmly.

– After the doctor’s appointment, I walked to my car and called my husband. He asked whether I could drive after this news, but I was not in shock. I’m an organiser, and immediately started to ponder what should I take into account in terms of my work and how to organise everything else.

The doctor’s appointment was a shock

Three days after the biopsy results arrived, Jaana received a call from the hospital. A doctor’s appointment was scheduled for the following week.  However, the appointment didn’t go well.

– My husband came with me to the doctor’s appointment, but the visit was still a shock for me. I’m not used to being ill or having to visit many different doctors, so the clash of cultures between me and the doctor came as a huge surprise.

Right at the start of the appointment, the doctor asked Jaana to sit down and take her shirt off. The doctor wanted to show right away where the incision will be made during the surgery.

– I thought that this came too soon. I asked whether they should first diagnose my cancer more precisely in case there are cancer cells in the other breast or elsewhere in my body. The doctor told me that my breast will not be MRI scanned since I’m over 40 years old. If more tumor tissue was found later on, I would be operated on again and again, continues Jaana.

– I was thinking that this cancer would spoil my entire summer and if they have to operate on, for example, my other breast later on, it would be too much for me.

Fortunately, I had my breasts MRI scanned

Jaana was not satisfied with this decision and wanted a second opinion. She decided to call an experienced radiologist Matti Kestilä who specialises in breast cancer and happens to be Jaana’s family friend.

– The first thing Matti did was to ask me how I was doing. No other doctor or nurse had asked this question before. We talked about my situation and Matti said right away that I should naturally take a breast MRI. He recommended calling breast cancer surgeon Jari Viinikainen who works at a private cancer treatment facility, Docrates Cancer Center. I immediately booked an appointment with Jari, and Matti came with me to the appointment. Jari also asked how I was doing and spent a lot of time clarifying the situation and discussing it with me. We took our time to go through the situation and operation possibilities. I felt that I could trust him, says Jaana.

– It was fortunate that I took the MRI; otherwise they would have only operated on the tumors visible in the mammography and ultrasound scan although there was cancer in its early stages visible elsewhere. This was shown on the MRI scan, says Jaana with relief.

– After the breast MRI, we had long discussions on the alternatives for an operation with Jari Viinikainen. Matti Kestilä participated in these discussions, and they worked closely together.

Jaana is thankful for the way she was received at Docrates.

– At Docrates Cancer Center, things started moving immediately. Someone from Docrates was always available for me, and the doctors answered all my questions and responded to my concerns. As an entrepreneur, I appreciated that appointments and other scheduled meetings were arranged flexibly so that I was able to coordinate the appointments with my work. In this way, I could plan my work and other engagements.

“It was fortunate that I took the MRI; otherwise they would have only operated the tumors visible in the mammography and ultrasound scan although there was cancer in its early stages visible elsewhere as well. This was shown on the MRI scan.”

Jaana’s medical expenses insurance covered her treatment in the private sector.

– I knew that I would get high-quality treatment at Docrates. My friend had told me about Docrates and recommended the hospital in case I would need their services some day. My uncle also participated in a clinical drug trial at Docrates. He suffered from pancreatic cancer and, due to the investigational medicinal product, he got some extra time.

The breast cancer surgery took nine hours – a new breast was built using tissue from the abdomen

In addition to actual tumors, early stages of cancer were also found in Jaana’s breast. Therefore, her entire breast was removed.

– Jani Viinikainen is an extremely thorough breast cancer surgeon. When we were deciding what to do, it was easy to trust him and Matti.

Removing the entire breast is a big and challenging operation that usually takes the whole day. Jari often performs such extensive surgeries with another experienced surgeon, Sinikka Suominen.

– The surgery was performed at the premises of Docrates’ partner, Helsinki Hospital, and it took nine hours. The surgery took so long, since a new breast was built using tissue from my abdomen at the same time. We had gone through everything with Jari several times, but, nevertheless, I didn’t quite understand how big the surgery was. When I woke up, I was in shock. I felt cold and shaky. But, I was surrounded by a magnificent team in the Helsinki Hospital. I spent five days there, and received first-class care and treatment.

The surgeons managed to remove cancer tissue with clear margins and the pathologist’s results showed that Jaana’s cancer was non-aggressive. Therefore, Jaana did not need adjuvant therapy, i.e. radiotherapy or chemotherapy.

– When I was released from the hospital to continue my recovery process at home, they gave me post-surgical support bras and instructions for self-management. My stomach was cut open, but the wounds healed surprisingly fast. Then, I visited Docrates oncologist Timo Joensuu’s practice. Timo had familiarised himself thoroughly with my medical records in advance. He told everything about the treatment, recovery, follow-up and all the rest.

Hormonal therapy still ahead

– Since I’m an entrepreneur, I was pleased to hear that I would not need chemotherapy or radiotherapy, says Jaana with relief.

– When I was first diagnosed, I thought that this will take the entire year.  But everything went a lot quicker. I was operated on at the end of June, and 12 weeks after that I was back to work and my wounds were healed.

Jaana’s breast cancer will be treated with hormonal therapy for five more years. As a side effect of the hormonal therapy, Jaana’s menopause symptoms have returned.

– My menopause ended last summer, so it’s unfortunate that they are back at this age. However, hormonal therapy is crucial in avoiding the recurrence of breast cancer.

Scarred soul

When looking back at everything here on Kaffila’s couch, Jaana tells that in the midst of all this she didn’t have time to process the issues or stop and think about the disease.

– I’m the kind of person who takes care of her duties.  But when I returned to work, I realised that I was not OK. I felt that my soul was scarred. I’ve always been a positive person, but now I wasn’t myself. I felt that I was unable to feel grateful for anything. I read somewhere that the disease actually begins after the surgery for many women. This made sense to me in the condition I was in, says Jaana.

– Matti Kestilä recommended that I discuss with Docrates oncologist-psychotherapist Päivi Hietanen. That helped a lot. Such issues were raised which I hadn’t thought at all before this: for example, how breast cancer affects women’s feminine identity. Päivi is a professional and we dealt with quite deep issues, but I suppose that one has to go deep every now and then.

When I went to see Päivi, she understood my situation right away. She prescribed additional sick leave for me. I went to see Päivi a couple of times, until we agreed that there was no need for me to see her anymore. If you dig too deep, older issues may also surface, which may disturb mental healing.

Jaana says that she also received full support and protection from her husband Tapsa.

– I’m extremely grateful for that. I’m so happy that Tapsa was with me during all the doctor’s appointments and everything. Your mind is not working properly when you have just received a cancer diagnosis. Later on, we pondered together what the doctor had said. Tapsa has stood by me throughout the entire journey.

Lymph nodes under Jaana’s arm were drained during the surgery, which caused her hand to become sore and numb. Therefore, she booked an appointment with Docrates physiotherapist Reio Vilipuu.

– Reio was absolute wonderful and skillful. The treatment was somewhat painful, but helped relieve the pain.

One year after the breast cancer surgery

Jaana’s first annual follow-up was at the end of the summer of 2018. The news was good – everything was in order and weight was lifted off Jaana’s shoulders. It’s important to check the breast in the future as well and hormonal therapy will continue. Jaana receives lymphatic therapy and the new breast will be corrected with minor operations.

– I could have very well lived without this experience, but in my opinion all experiences enhance your mental growth. I’ve always loved life. I’ve always wanted to make my everyday life good. The only difference is that now I consider more carefully how I spend my time. I still haven’t returned to full strength. I want to spend my evenings doing the things I like. Previously, I had five different jobs that took all my time, says Jaana.

– I’ve learned that human beings don’t know their limits before they reach them.

– I spent last summer lying on my bed at home. I wasn’t used to that so it was a huge thing for me. Now I’m happy that we can again visit our summer cottage in Hanko. I take care of my vegetable garden, hike, read and naturally bath in a sauna. I can also easily work remotely from my summer cottage. I would like to live in Spain with Tapsa one day or at least spend longer periods there, says Jaana.

– When I fell sick, I started to write my own blog. Writing the blog is a way to process my issues. I write about breast cancer, treatments and the ways of the world. I wanted to offer an honest perspective on contracting breast cancer. Perhaps someone could benefit from my stories.

– At the moment, I’m extremely satisfied with my life. I enjoy every moment of the day. In the mornings, I walk with my dog and listen to Jari Sarasvuo’s Aamulenkki podcasts. Those podcasts have helped me cope.  I often laugh out loud when I listen to them.  Having a dog has forced me out of my bed.  I take my dog everywhere with me. When I was lying on the bed after the surgery, my dog was beside me. It’s my personal trainer, walking buddy and nurse, says Jaana with a smile.

Jaana also finds peer support activities empowering.

– I found about Siskot ry’s activities when I fell sick and now I’m participating in their operations. I like the open-minded atmosphere in Siskot ry meetings, and talking about things as they are. At Siskot ry, we also talk about those who didn’t survive. Our activities include peer support, knitting chemo caps and doing many other things together.

An entrepreneur appreciating rapid treatment and a human touch at Docrates

Jaana tells that she grew up in an entrepreneur family and learned to work since she was a little girl.

– I worked for 28 years in my parents’ company. When I grew up I left to study, first marketing and then bookkeeping. I also had my own well-being company. I wasn’t planning on starting to work in the financial sector, but my husband fell seriously sick and his advertising company needed help, so I ended up being a partner and bookkeeper there. The business has grown and we enjoy working together, says Jaana.

Jaana thinks that Docrates’ services fit well into her entrepreneurship.

– I appreciate quick access to treatments and flexible agreements on appointments and treatments. Elsewhere this could take the entire day. It’s so easy to always come to the same place, and find a parking space in the parking garage. The hospital is also very clean and stylish, says Jaana.

– The significance of the quality of life is emphasised here: they offer quality of life, instead of just focussing on the statistics. What is marvelous, is that all the employees pay attention to the patients. Even the cleaner greets you. Employees look in the eyes and smile, which is great, since we all need our spirits lifted up. They notice people.

– There have been no queues and appointments have taken place as planned. You can enjoy refreshments and snacks in the lobby. I have to admit that I often rewarded myself with a good cup of coffee and cookies, says Jaana.

– In addition, sometimes it felt overwhelming to take care of all the things, so it was a relief that Docrates took care of the practical issues, for example, contacting the insurance company and such. My special thanks to Helena, who was my personal nurse, says Jaana before she continues her journey from Kaffila’s yard accompanied by her dog Heksu.

An extract from Jaana’s blog, 19 May 2018:

“I think that “weird confusion” best describes my feelings during the past year. The question “What should I do” was also on my mind. I’ve been a thinker and organiser my whole life. Now, things haven’t been organised, but follow me just behind my back. …Is it really so that one has to suffer, to be weak – forced to be weak– before one can be strong again? How weak, vulnerable or unhappy must one be to be strong again? How strong can one be? Can one be weak without being forced? Can one grow strong without suffering? What does strong mean?

At this very moment, I love my life and thank for everything that I have been given. I’ve always been satisfied with my life, but now my life is somehow fuller.

Waking up in the morning, birds singing, lacing up my sneakers, morning coffee, dear people, heartbeat of life, a smile from a stranger, a sincere question from a friend close by: how are you feeling now? Desire to really hear the faltering answer. I love life, and I’m deeply thankful for it every day. I can’t understand why I’m so fortunate that I’ve been given an opportunity to continue this life of mine, the story of my life.

I wish you the same feelings, without breast cancer <3