Dr Philippa: My 3 children had been the identical age as Kate’s once I bought most cancers

Like many of you, I watched the video released by Kensington Palace yesterday, happy that Kate Middleton‘s chemotherapy was over. 

And by the end, I was in tears. 

It was particularly poignant for me because, five years a go, I was in almost exactly the same position as our Princess of Wales.

I was 39 years old when I was diagnosed with bowel cancer in 2019. Like Kate, 42, I also have three children, who were 11, 7 and 4 at the time — roughly the same age as George, Charlotte and Louis.

Also like Kate, I was overwhelmed with relief and triumph when, at the end of 2020, after chemotherapy and multiple surgeries, I was declared cancer-free. 

In the clip, we saw a blissfully happy family, with three children who appeared to be like most youngsters; carefree and content. 

But I know the truth is that, over the past year, the young royals would have likely experienced situations we hope no child will ever have to consider.

For parents with cancer, managing childrens’ expectations, questions and comments is one of the biggest challenges of this devastating illness. 

And five years down the line, after several further procedures, I know the challenge doesn’t stop when the first lot of treatment ends.

As a GP, patient and parent I am often asked my advice for handling this situation. The truth is, there isn’t a ‘right’ way to manage cancer. There is only the best way for you, whether you’re Kate and William or any other family.

But there are a few lessons I’ve learned along the way. 

Firstly, on the whole, honesty is the best policy.  

Of course the young royals haven’t had much choice but to be open with their children, given the glaring media spotlight. But I think this is for the best. 

My husband and I vowed to be as honest as possible from the very beginning. When I was first diagnosed, my mum was with me at the hospital. 

I called my husband to tell him, and asked him not to say anything to the children yet — I wanted to tell them together.

I called my best friend — a child psychotherapist — from the hospital changing room to ask her what to do. 

I pleaded with her not to react as my friend in that moment, but offer me professional advice only. 

She advised me to tell the truth. 

The reality is that children will know something is going on; they are very intuitive and excellent at picking things up at home. 

The eldest two wanted to know if I was going to die. Even in that moment I told the truth; that the doctors and I were going to do everything that we could do to stop that happening. 

But I was also sure never to answer with a categorical ‘no’. 

You can change what you say exactly depending on your children’s ages, after all the questions asked by a four year old will be very different from an 11 year old.

For instance, for the two younger kids, I explained that the cancer was a ball of bad cells in my tummy which was hurting me and that the doctors were going to cut it out.

I told them that the surgery and chemotherapy meant I had to reserve all my energy for getting better, and therefore my brain and body may be slower than usual.

I always gave them hope; telling them doctors were going to destroy my cancer, and that they’d give powerful medicine to help me cope with feeling sick. 

There is a tendancy to think that, for those around you, the end of surgery and chemotherapy, and even being declared cancer-free, goes away with anxiety and panic.

The journey doesn’t end there, it is only the beginning of a new part of the story.

 

For me it meant — and still means — disabling ‘scanxiety’ every time I had a check-up, triggering the trauma of my initial diagnosis. 

I was grateful to be here and relieved to not be in treatment, but also felt as though I with what feels like a sword of Damocles hanging over my head. 

As for my children, I’ve witnessed illuminating changes in their behaviour. Perhaps it was simply kindness, but I worry that a lot of their newfound actions were driven by a sense of underlying anxiety. 

For instance, they ask often if I have a special disability key that opens public toilets — as they knew the impact of my surgery means I cannot wait.

They ask if I have my calorie supplement powders or snacks when we go out, and my bowels aren’t playing ball.

Still, they recognise when I am tired and try to send me to rest, even when I don’t want to. I try to see all these astonishingly empathetic traits as positives that my cancer has brought them. 

And then there’s the promises you do and don’t make. 

After my diagnosis, the children asked me to promise I would not die, or that I would come home from hospital after surgery. 

I chose my words carefully, assuring them that I was doing my best to get healthy — and stay that way.

But I stopped making promises. I no longer promise I will be at school pick up, or assembly as there was a time when a fever meant I had to go to hospital, or other medical situation. Instead I tell them I will do my best.

One question my kids have asked a lot is whether or not I am scared.    

I’ve always been open with my fears. Telling the truth meant they felt able to be honest about their own worries; they could tell me when they were scared too. 

I couldn’t fix it, as much as I wanted to, but I could simply be with them in it — and that felt like a powerful thing to do.

The same applies to anger. They were angry I was sick and, to be honest, I was too.  

I let my 11 year old say every swear word under the sun about the cancer, which triggered fits of giggles. 

They wrote their feelings about cancer on a stack of cheap plates and we smashed them to smithereens.

Feelings aren’t good or bad, they are just feelings and we need to express them and talk about them.

I hope I gave them what they needed.

Today, five years on from my diagnosis, I am pleased to say I am well — and currently cancer-free. 

Like the princess said, I too spend a lot of time these days feeling grateful for the ‘simple yet important things in life’. 

‘Of simply loving and being loved’.

I am not the person who I was before I had cancer. And neither are my family the same. 

They may well be more concerned about me. But they, and I, are also stronger, and recognise the joy in the time we spend together (in between the expected sibling squabbles). 

We are all different from how we were before — and always will be. And now I realise that is okay.