‘The body you inhabited has gone forever’: Breast cancer will change Sarah Ferguson’s life – it did mine

I watched Sarah Ferguson working the room at an awards ceremony a few years ago and was struck by her good humour and gumption. She’ll need both to handle her recent breast cancer diagnosis because – unless you are made of a tougher stuff than the rest of us – the horror and fear is overwhelming. You can’t hear the words “you have cancer” without thinking you might die.

I did.

So I am filled with enormous empathy for the Duchess of York and more than a little sadness. Having lived through the same diagnosis and having had a single mastectomy as she has, I know her life will never be the same again. It’s not just the physical impact but the emotional toll cancer takes, the damage to your sense of self and your place in the world.

The body you inhabited has gone forever, you’ve lost the breast with which you (perhaps) fed your children, or that jiggled when you ran to catch a bus. I remember wearing a one-shouldered silver jumpsuit to the National Television Awards shortly before I had surgery, my way of saying goodbye and thank you to the chest I’d always known.

It helped, but even when you have put the surgery, the chemotherapy (which I didn’t have to have as part of my treatment) your frailty and sense of loss behind you, you have to learn to live with the risk of reoccurrence. We all secretly feel invincible, don’t we? Cancer takes that from you too.

The duchess’s tumour was diagnosed in a routine mammogram. Mine wasn’t. A mammogram missed a 6cm tumour in my milk duct twice because I have dense, fibrous breasts which made it hard to see. Given this, you have to know your own breasts and check them every month, after learning how to do that properly. If you have any doubts, I’d urge you to listen to them: your instincts are stronger than you think.

It’s a controversial thing to say but women’s medical issues can still be written off as all in our heads, whether they’re to do with periods, ovaries, breasts or the menopause. Don’t let that be you. Your life might depend on it.

As we know, the earlier breast cancer is detected and treatment starts, the better the outcome, and I am delighted to hear the duchess’s was picked up in its early stages. So be vigilant, check, check and keep checking. Have your mammograms and push your doctor for an ultrasound if you have breasts like mine. Take your lumps and bumps seriously.

But it’s also important to remember that our fears about breast cancer date from a time when the duchess and I were still little girls. She is 63, I am 52, we grew up in the Sixties and Seventies when the disease was a taboo subject, our mothers and grandmothers scared into silence because it was a killer.

Today I’m glad to say outcomes are different. Some positive news emerged recently from researchers at Oxford Population Health who found that women diagnosed with early-stage breast cancer are now 66 per cent less likely to die from the disease within five years (of diagnosis) than they were 20 years ago.

I’m grateful to Sarah, with her public profile, for revealing her own diagnosis and her plans for a full recovery. She has done that, as I did, in the hope of helping other women.

What she will need to do next for herself is to learn about the lifestyle factors that can impact cancer and increase the likelihood of it coming back.

Obesity, stress, alcohol, lack of sleep – we know all these things harm our health. Breast Cancer UK estimates that 30 per cent of breast cancers in this country could be avoided with lifestyle changes. There’s only so long you can keep withdrawing from your lifetime bank of wellness.

The duchess has recognised this saying her illness is a wake-up call to get fit and lead a healthier life. “I’m taking this as a real gift to change my life to nurture myself, to stop trying to fix everything else. I can't make another excuse.” This was my response although I know others who have thrown caution to the wind and now live with a “I could be dead tomorrow” attitude.

I was diagnosed in July 2021 and had my mastectomy in October that year.

Since then I have radically overhauled my diet, my sleep patterns and my fitness. I am more or less teetotal, I don’t eat sugar or processed foods, I get my eight hours a night and take naps when I need them. I do breathwork every day while sitting in my open bathroom window bathing in the morning light to keep my circadian rhythms in synch. I protect my mental health, practice gratitude and find awe where I can.

I also chose to do a DNA test to see how my body functions and I would encourage the duchess – and everyone else – to do the same. (They are available on the NHS.) Mine identified my modifiable risk factors. If I had known them 20 years ago I could have made my own lifestyle changes but instead I cheerfully drank alcohol, ate a lot of chocolate, starch and refined sugars, and skated by on very little sleep. If I'd have the test earlier, I might not have had to have a mastectomy, I might have been able to have a lumpectomy instead, or taken alternative routes to preserve my health.

In my book about my transformation Walk Yourself Happy (to be published in September) I explore physical and mental health and how we can all improve our own using walking and nature. It’s backed up with compelling evidence from experts including Professor Tim Spector (nutrition), Professor Russell Foster (sleep) and psychiatrist Sue Stuart-Smith.

The title comes from the promise I made to myself after my mastectomy, that I would get outside every day for the rest of my life, to find recovery and healing in the natural world. “I love joy,” the duchess said as she reflected on the changes she wanted to make. That’s how I felt, and in between caring for my three children and making television programmes, I acknowledged the need to make more time for my lifelong love of walking in nature.

Sarah is talking about going to Wales and Scotland to climb mountains when she’s well enough. “I'm going to be super fit, super strong,” she says. “I’m going to really understand what caused this and look at it straight on.” Well, if you fancy a walking companion who knows exactly what you’ve been through then I’m your woman.

Walk Yourself Happy by Julia Bradbury will be published by Little, Brown on 14 September 2023. To raise funds for breast cancer research please go to pinkribbonfoundation.org.uk