This podcast contains the personal stories, opinions and experiences of its speakers, rather than those of Breast Cancer Now. Today we're talking to Dr. Hajra, a doctor who was diagnosed with breast cancer. I think that when a doctor is diagnosed with breast cancer, they automatically know everything about it, everything that's going to happen, how it's going to be. They'll just look at it completely practically from a medical point of view. And in actual fact, what was really interesting and surprising about Dr. Hajra's story is that as soon as she was diagnosed, she became a patient, she became a normal person. She said that that surprised her as well, how big the separation was between doctor and patient and how vulnerable she then became because she's very recently been diagnosed with breast cancer and it is still going through the treatment. Let's let Dr. Hajra tell her story. Let's have a listen. Today's guest is Dr. Hajra Siraj, an NHS GP and private aesthetics doctor who was diagnosed with breast cancer earlier in 2025. Dr. Hajra has been sharing her experience openly in a series of online videos. She shared topics such as fertility preservation and egg freezing and discovering she has the BRCA gene mutation, aka the Angelina Jolie gene. We'll be discussing these things as well as what it's like to be diagnosed with breast cancer when you work as a doctor. Dr. Hajra, welcome to the podcast.

Thank you very much.

So I'd like to start by just acknowledging that I know you've only recently been diagnosed with breast cancer and you're still very much going through it. You haven't had your surgery yet. So thank you for joining us. And please, of course, let us know at any point if anything is a bit too much or you need a break. So you're a GP or general practitioner in the NHS and you also do private work in aesthetics. Can you tell us a bit about each of those jobs and what you do?

So I've been a GP, I've been a doctor for 14 years now and I've been a GP I think since 2016. Before becoming a GP, I actually worked in oncology and palliative care. So I've had a lot of experience in dealing with people with cancer and treating people with cancer. And yeah, I really love my job. I am a workaholic and despite the diagnosis, I've continued working because actually work is one of my favourite hobbies as well. I love helping people and I find that a lot of the time you can sometimes, it's very shocking news and you can sometimes dwell on what you've been told and how you feel. But when I am at work and helping other people, it's the only time that I forget that I'm ill and I have total focus on the patients that I'm speaking to. So with my NHS job, I work in central London and I see a variety of patients and I love the process of diagnosing, problem solving, and also providing the emotional support as well that patients need. And now I'm on the other side. So I've got to say it's very unusual. In my other job, I have my own aesthetics clinic and I help people with hair loss, skin changes. I do skin boosters, micro-needling and all those sorts of things. And I think going through this journey of having cancer and seeing my hair, my skin, my body change so much since the diagnosis has highlighted to me even more the importance of that role, because sometimes someone might think, oh, it's quite shallow or something like that, but it absolutely isn't because the way you look has such and plays such a vital role in the way you feel. And it's a cycle as well. The way you feel affects the way you look. I, yeah, I like, I enjoy making people feel and look the best versions of themselves. And I enjoy the two jobs together. Actually, they're quite different, but they're also linked.

Absolutely. Well, I'll ask you about those changes and the kind of approach to the aesthetic side of it in a little while. But how did you end up starting your private practice through working with the NHS?

Yeah. So actually it was my sister who encouraged me. My sister's always been very interested in skin and aesthetics and she's also an NHS GP, works in A&E. And I went through a really stressful episode myself a few years ago and I broke out in a really bad case of acne and I realised how much it had affected me. So it was affecting my work. I was trying to avoid eye contact with people. I was avoiding going out, so was affecting my social life as well. And I didn't really realise how bad you could feel because prior to that I had no concerns about my appearance. Like I just didn't really think about it very much. And then when something went wrong, I started thinking about it and I went for aesthetic treatments, which really helped and made me feel like myself again. And prior to that, because we don't learn about aesthetic things in the NHS or at medical school, we learn about the standard things that you learn about which are the NHS work. So didn't learn about it. And I thought it was all a load of quackery. I actually didn't think these treatments worked. And then when I had them and then I started studying the science of them and there's so much to it and it's really amazing the advances in aesthetics. So me and my sister started a clinic together and we worked together for about one year and now we have separate clinics. And yeah, that's how I got into it and I really, yeah, I really love it. And it's not something that I thought that I would do in the past. It's something that came to me with life experiences. And I think again, with this new life experience that I'm having, I know there's going to be new things that are going to come out of it, which are going to be positive things.

For sure. Yeah. can absolutely imagine that being the case. And as a GP, you must have known a little bit about breast cancer. You must have had people come to you with signs and symptoms over the years. Were you in the habit of checking yourself?

No, I wasn't in the habit of checking myself. I... always told patients you should examine your breasts and I showed them how to do it and I explained and even when you're a doctor and you know things it doesn't mean you necessarily do those things yourself. So I knew it was very important but for some reason I didn't do it myself and I found the breast lump just by chance. Actually it wasn't a breast lump, I found a lump in my armpit and it was just by chance in the shower when I was washing. I wasn't proactively searching for it. And I think that if I had followed my own advice that I give to patients, potentially I would have found it earlier because I would have been looking and noticed a change potentially. Honestly, it doesn't make any sense because why wouldn't it happen to me? It has happened to me. So it's shown me that it can happen to anyone. Maybe I thought I was too young, also the other thing I was thinking is my chest is not very large. So I thought if there's something there, would be quite obvious to me. I don't need to go around searching for it, but that's absolutely not, not the case at all. So I can't explain why. And I imagine a lot of, as a patient, a lot of patients, a lot of people probably think the same, like it's not going to happen to me. So I don't need to check. And now I understand that as a doctor. But now as a patient, I can say definitely everyone should be checking and it makes such a big difference. If you find a cancer early, the treatment options, there's so much more available and the outcomes can be very different too when you find a cancer later. So mine is quite advanced now.

I think that that reflects what happens with a lot of people in the way we think. We think, oh, I know I should be checking my body. But I'll do it tomorrow or I'll do it next week or whatever. Whereas actually sometimes if you build it up, I think it can feel like more of a task, but actually all it is is potentially when you're in the shower, just having a 30 seconds of just having a little feel around your armpit and your breast and that's it. And that's, you don't have to think about anything else. You're not looking for cancer. You're just sort of feeling what you normally feel like.

Just like brushing your teeth. It's not a hassle when you, when you get into the habit. And it's not scary as well, like you said, when you get into the habit.

Of course, because it's just your body.

Exactly.

So how did you come to then be diagnosed after you found this lump in your armpit?

So I found the lump in my armpit and I know that's not normal, but I really thought it was something benign because it felt very smooth and it kind of shocked me as a doctor as well because it didn't feel like one would expect from a typical cancer, which you might expect to be irregular and craggy and hard. So the lump in my armpit felt very smooth, very round, very regular, kind of like a cherry or a grape. And it was mobile. It wasn't fixed and hard, but I still knew that this wasn't right. So I sent a message to my GP. So it was an electronic message and said, this is what I found. I don't think it's anything to worry about, maybe you can refer me for an ultrasound. And they contacted me the same day and said, come in for an examination. And I went and the GP examined me and she thought it was probably also nothing to worry about. And then she was saying, oh, maybe we should check again in a month's time. And then she said, oh, actually, let's just refer you now. Let's just refer you today. And she referred me to the hospital for suspected cancer. So that's called a two week wait appointment where you're seen by the surgeon within two weeks. And I wasn't really worried in the interim period. I was relaxed and I thought it's all going to be fine because I do loads of these referrals. Like every day I do these suspected cancer referrals, not because I really think the patient's got cancer, but I just want to make sure it isn't cancer. And so I was very relaxed in those two weeks. I didn't have anxiety or worry. And I went to the appointment and I saw the surgeon and he examined me and also didn't think it was cancer. And he said, just have an ultrasound anyway for reassurance. And the waiting time was an hour and a half. And I thought, oh, maybe I should just go because there's nothing to worry about. And then I thought, actually, I'm working every single other day. So there's not another day I can come back. So might as well just have it done. And it was during the ultrasound that the radiologist told me that it looked suspicious, and she found multiple lymph nodes. So the lump in my underarm was actually a lymph node that was affected with cancer, which has spread from the breast. And she found multiple lymph nodes and multiple lesions in the breast. But upon further investigation, probably only one of those lumps in the breast is the breast cancer, but there are a few other ones that looked irregular, but were actually benign.

So did the radiologist say the word suspicious to you during that appointment?

Yes, it was very clear during the appointment that I had cancer.

And did they know that you were a doctor and talk to you in a sort of a more direct way, I think, because of that?

The staff were quite distressed because I'm a doctor at that hospital where I was seen. So I'm not sure if they were more direct because I was a doctor. I think it was because it was so obvious that it was cancer.

I don't know that many people who have sort of known that it's almost definitely cancer in that appointment as opposed to waiting for then a results appointment where the doctor tells you what they found. So I wonder if maybe you were just sort of more natural at reading them and therefore it kind of came out then there and then.

They made it quite clear that it was most likely cancer. The radiologist did and then after, so she did... the scan and then took multiple biopsies and put like metal clips into the suspicious lesions. And then I had a mammogram afterwards. And then I saw the surgeon who explained the findings and said it would take about two weeks to get the biopsy results. And the staff were really nice. All of the other patients had gone and I was the last one there and everyone was really empathetic. And I don't know if that made it harder in some ways because when I left the appointment, I was sure that I was going to die very imminently because the nurse was, I think she was crying and the surgeon was almost crying as well.

Was that because they knew you through the hospital?

They didn't know me through the hospital, but I think they recognised, like they saw me as themselves, like it could be themselves because I was a staff member at the same hospital. Maybe that's why. And also I think because they weren't expecting it as well.

Yeah. It's obviously really upsetting and it's also so raw and also so recent.

It was recent. Yeah. So when I left that appointment, because everyone was so sad and maybe they couldn't give me all the information in the perfect way, because I was a colleague, perhaps I had a lot of... flashbacks from all the patients I've looked after. So at the time when I was looking after them, I didn't realise that I was traumatised because I was helping them. I was doing my job and I loved looking after people. I loved my job in oncology. I loved my job in palliative care. Obviously I was touched and moved and sad about patients, but I didn't feel really distressed when I went home. I felt happy that I was able to help people. When I got my diagnosis, I was seeing the faces of the people that I'd looked after, the people that had died. I felt like I was with them again. And I even remembered when I was a medical student, I had to follow a lady with breast cancer, follow her to her appointments. I remember her, so this was 20 years ago, and I remember her very vividly. like she was with me and she had lovely perfume and she was really glamorous and she had breast cancer and she showed me that it would spread up into her clavicle. And I remember being sad for her at the time, but then I'd forgotten about her and then the memory came back so vividly when I was diagnosed because it was in the same hospital, it was in the same place that I was going with her. And then all of the patients that I've seen just flashed back to me like, and there's so many of them. And I remembered them in so much detail. Like I remember their faces, their family members, their clothes, their smell. So I think it's a trauma that I didn't realise was a trauma triggered by my trauma. But then since I've started treatment and since I've got more knowledge about my own illness that that's not happening anymore. It was literally in that two week period. So I would say out of the whole, the whole time, the chemo and everything I'm up to now, that was the hardest period from the, between the biopsy and finally getting the results.

So that two week period before you got your biopsy results, you're obviously very, very scared and, you know, thinking about what might happen. What actually happened when you then got those results?

What did they say to you? So I saw the surgeon after two weeks and we were expecting my results, which is what normally happens. And my sister came with me and she's a doctor and my friend came with me and she's a doctor as well. And I hadn't really done any research or anything. I just wanted to be a normal patient, but they had done lots of research and they'd be reading on PubMed. And my friend had a big document with all of these notes that she'd been stayed up all night writing notes. So they came with me and they asked the surgeon, a different surgeon, the consultant lots of questions. And it turned out that my biopsy results hadn't actually come back. So we'd built ourselves up and yeah, I didn't get the results on that day. And so my sister and my friend were really upset because... they were expecting to get the results. And somehow I felt relief. And I met my consultant and I was really happy with the way he communicated with me. And I felt like I totally trusted him. So that's what changed. I met my consultant and then all my stress alleviated.

Wow. That's great that you felt you had a really good consultant. So when did those results actually come through?

Probably about a week or so later, maybe half a week. I can't quite remember because it's a blur and it kind of came gradually as well because I also had some scans and things and things are sort of drip fed to me over that time period.

So by that point, you already knew that it was cancer. You said it was quite advanced that it had spread to your lymph nodes. What kind of cancer was it?

So I've been diagnosed with triple negative breast cancer, which has spread to lymph nodes, but not to distant body parts. But at the time that initially I thought it had spread to distant body parts and I had a CT scan showing that I had a lesion in my liver, which was further investigated and that lesion was benign and unrelated to the cancer.

That's good news. That must've been a real relief.

So I think everything was a relief. Everything became a relief because initially I had anticipated the worst. So I thought I was going to die very imminently. And so when I did finally get the formal diagnosis, I was actually happy, which is probably not what most people feel when they're diagnosed with cancer. But I felt happy that it wasn't quite what I thought it was at that time.

What did your consultant then say to you in terms of what was going to be the course of treatment for you?

So my consultant was very clear and very optimistic from the beginning. And he explained that first of all, the treatment would be chemotherapy for 6 months. So for the first 12 weeks, every week, and then for the next 12 weeks, every 3 weeks. So that's the point I'm at now. I've just started, I've had one session of the three weekly chemotherapy. And then he explained that in about 65% of people, the chemotherapy will get rid of the cancer totally. And then I will have an operation. And then after the operation, I will have radiotherapy. And at the time we thought it was most likely the operation would be a lumpectomy, remove the area where the breast cancer is or was, plus the lymph nodes. But he did arrange genetic testing on the first day I think I saw him and I got the results of those later.

Was your reaction to treat yourself like you would treat one of your patients or do you think you approach it completely differently when it happens to you?

So for me, I like to be, I'm very different as a patient and as a doctor. So as a doctor, I'm a professional and I always tell people to do the best thing possible. But as a patient, I'm just a human being and I want to be more relaxed because in my workplace, I'm a perfectionist and I don't really want to be like that when I'm trying to be a patient. So I haven't done, I haven't read up on all the studies and the facts and the figures. I've left that to my friends and colleagues and my family members who are mostly doctors as well. I've left that to them to do. And I've just been just listening to what my doctor tells me and doing what they say basically.

Sounds very wise.

I can imagine you can get too involved and I thought I think that would cause anxiety. So I don't feel anxious about my medical care because somebody else is worrying about that.

Okay. And had you had any history of breast cancer in your family?

No history of breast cancer, no history of ovarian cancer. I have a very large family. I'm the youngest of my siblings. I have many aunties and uncles and I think 30 cousins on one side. My mum was one of seven and my dad was one of seven and only one person in my family had cancer and that was my auntie. But it wasn't breast or ovarian and no one else in this huge family has had cancer.

Really makes sense as to why you would never suspect that it would happen to you as well. And how are you feeling physically in these early stages?

I don't feel as bad as I thought, but it varies from day to day. So I feel better than I thought. I'm obviously feeling very different to my normal self. So I used to run regularly. I used to do military bootcamp sessions. I was very active. I didn't like to take the lift, thought who would be so lazy to take a lift? I was always taking stairs and, rushing around and, things like that. So now I'm mainly sedentary. And if I tried to exert myself, I see that physically I'm very weak compared to my normal. Um, but my mind is very active and energetic and it's not, it's, it's totally as energetic or maybe more energetic because I'm also on steroids, potentially more energetic. But yeah, my mind is still very active. My body's not the same.

Yeah. You can of course do light exercise now during chemo. If you can manage it, I know that lots of doctors really advise that you do keep active.

My doctor has advised actually. Like I said, as a doctor, I would definitely advise people do exercise and so on, my doctor advised it and I joined the gym and then a week later I cancelled the membership. But I do need to do some exercise.

You mentioned that you had the genetic testing. Could you tell us what happened with that?

So I had a blood test and the results came back 8 weeks later. And this was another thing which I thought would be nothing to worry about. And the results actually came back showing that I have a BRCA gene mutation. So the BRCA gene is a tumour suppressor gene. So if it's faulty, it means that you're at increased risk of getting cancer and specifically breast and ovarian cancer. So I've been diagnosed as having that gene mutation and it was a total shock. I was really, really, really upset when I found out and I was sort of, I was crying loads when I found out because I wasn't expecting it. And in some ways at the time, it almost felt worse than having the cancer, which is inexplicable now, because now I've come to terms with it. And I understand it's not as bad as I thought. But yeah, I was really, really upset when I found out because I felt like I've got this defective gene, felt like I was a defective person. That's how I felt.

Why do you say that it's not as bad as you thought?

So actually it's a good thing to have knowledge. So having knowledge of this gene mutation means that I can manage it so I know what to do to reduce the risk. So I'm going to have a double mastectomy. And that's going to reduce my risk of getting another breast cancer, a new breast cancer by 90% or so. And my surgeon said, if I keep the nipple, then there's a slightly increased risk, or if I remove it, there's another 5% risk. And actually that reduces my risk of getting a new breast cancer. It reduces it to less than the average population. And also I can have my ovaries removed as well and fallopian tubes to reduce the risk. So it's a good thing that I know because I can do those things. And the other thing is that there'll be many mutations that other mutations, but the BRCA gene mutation is one that's been very well studied, I think since the 1990s or so. And there's a lot of information about it and there's a protocol for it, now I know lots of people have it and it's much better to have it and I know what the plan is. It's not uncertain. So when I was diagnosed with the cancer, my surgeon wasn't uncertain. This was the plan of action. It's a protocol that you follow and it's the same with the BRCA gene mutation. You have choices, but there is advice and a kind of best way that the doctors think is for managing it.

That makes total sense. It's a known thing. And you know, you've, probably known about, mean, we'd mentioned Angelina Jolie in the intro, lots of us kind of learnt about the BRCA gene mutation in, I think it was 2012, 13, because it was around my diagnosis time. And that's why I remember that date. Um, but yeah, lots of people know about it because of that. And as you say, There's so much information about it and so many studies and things that it helps to know what you're dealing with, doesn't it?

And were you diagnosed with the gene mutation as well?

No, I have the PALB2 gene mutation. So when I was diagnosed with breast cancer in 2012, I was tested for BRCA and got the negative result. But then, but then they said it's fairly likely that you do have a gene mutation because my grandmother had had breast cancer. And then 10 years later, when I got secondary diagnosis, then, they then retested the same, the same DNA sample that they had from 10 years earlier. And they now were able to test for PALB2, which is very, very similar to BRCA in terms of its implications in, you know, risk of breast cancer, although there's less of an ovarian cancer risk with PALB2. But yeah, similar to you. I mean, I guess I had it the same way around to you in the had cancer and then discovered a gene mutation. So in some ways, I think it would be scarier to know you have a gene mutation and be worried about getting cancer in future.

And it's interesting. It's interesting because it shows how much science advanced in the time that you were diagnosed.

Yeah. And I'm sure in another 10 years time, we'll be talking about other gene mutations that we don't know about now.

Yeah. And maybe repairing genes, never know. Wouldn't that be great?

Yeah. And how has that, the BRCA mutation, changed the plan and your treatment? You've obviously said you're going to have a double mastectomy. Does it change anything else in terms of what you do from now on?

So I think the first thing was coming to terms with it. So the first thing that I felt was that I was a defective human. And then I kept looking back at thinking about myself when I was younger thinking, oh, imagine if I knew then that I was defective and that's what I was thinking. So I was really, really upset because I think I mentioned that I'm a perfectionist and then I felt I'm not perfect anymore, even though I didn't feel that with the cancer. I felt that when I got the gene mutation. And then what I did was the first thing I did is I called one of my colleagues and friends. And she's Jewish. And I know that a lot of Jewish people have that gene because that's what I've studied at university. And she told me that she knows loads of people with this genetic mutation and that they're living good lives. And she was quite optimistic. And I think hearing other people's stories is really important. hearing other people's stories is very different from hearing statistics. And I think also seeing Angelina Jolie really helped me a lot because actually she's not a defective person. She looks great, she's a great actress and living a really good life. So I think it's important to hear other real people's and also tell your story as well so you can help other people.

Absolutely, yeah. And I'm sure you don't need me to say it, having a gene mutation definitely doesn't make you a defective human.

Exactly.

I'm no doctor, but I'm fairly sure doesn't.

Everyone have some kind of gene mutation. Like there are gene mutations that cause just tiny little things. Gene mutations are happening all the time. But I didn't see it from a doctor's perspective. I saw it from like, definitely I would never think a patient was defective, but as a person, that's how I suddenly felt. And I don't feel that anymore at all.

Yeah, I can very much understand that feeling of thinking about or talking to yourself in a way that you talk to your patients or talk to your friends or whatever.

But yeah, since then I don't feel like that anymore. I've met lots of people with this mutation as well and there's a plan of action and actually, yeah, I don't feel that way anymore and I feel I've come to terms with it and it's not so bad and it's good in some ways that I know. And the other way that I think that it's quite good is because I found that when I got my diagnosis, a lot of people were trying to tell me what to do. So what to eat. I should eat chia seeds. I should drink this green tea. I should drink other concoctions of things. And it was getting a bit annoying because people are sort of trying to find a reason why you have cancer and trying to find maybe something that you haven't done right or something that you've done wrong. And then when I was found out that I had the genetic mutation, it's like, well, actually, this is nothing, not my fault at all. And, and really, even if you don't have a genetic mutation, it's still not your fault. But it was just helpful to me in that when people are saying, oh, maybe, maybe you didn't eat enough chia seeds. It's like, oh, maybe it's because of the genetic mutation. In some ways, it was beneficial. And yeah, I've definitely come to terms with it and I don't feel that way anymore.

Yeah, I totally get that as well. I also was always searching for a reason for my cancer and it's absolutely never anyone's fault. And I never thought it was my fault, but I did think were the things that I could have done differently, like drinking less alcohol when I was in, you know, in my late teens, early twenties and things like that. Actually finding out then that I was born with this gene mutation that I always had this likelihood of getting breast cancer at some point in my lifetime was real. Like it was a light bulb moment for me that just made me understand it. And I hope we get to a point someday where everyone understands why they get cancer. And there must be a reason for it, but we just don't know it yet. Like in your case, you didn't know it at the time you found out later.

Absolutely. Yeah.

So you were diagnosed in your late mid to late thirties and I was heartened to hear on your, I think on your Instagram, that when you were diagnosed, you were immediately spoken to about fertility preservation. And the reason that I was heartened about that was because it didn't really seem like it was a priority of the doctors when I was diagnosed. And it seems like it's been an afterthought for quite a lot of people. So it's really good to hear that doctors are, you know, talking to you about that straight away.

Yep. So the day that I had the ultrasound where they told me that I probably have breast cancer, the surgeon then asked me if I had any children. And he said that he was going to discuss my case and make it known that I didn't have any children. But I didn't understand why he was asking me that. I thought he meant that I was going to die. And do I have children that might be orphans? That's what I was thinking, maybe he's thinking. But actually he was thinking about fertility treatment. I guess. And then when I went to see my consultant, which was 2 weeks later, he referred me immediately. So there was no question about it. He said, I'm referring you to for fertility preservation before you start your chemotherapy. So it wasn't like something that I asked for. It was what he said he was doing. And that was, I had my appointment very quickly within days. And I thought I was going to be speaking to a fertility doctor and then thinking about the options, but that wasn't what happened. I just started the treatment that day, they gave me the injections. I did speak to the doctor, but I didn't realise I would start the treatment that day, it was, there was no, no, no delays.

That was what you, you wanted to, you wanted to go ahead with egg freezing?

Yeah, I wanted to go ahead. So I guess I hadn't thought about it in that much detail because it all happened so quickly. But what they did was give me a series of injections of hormones, which stimulated my ovaries to make more eggs. And I had an ultrasound scan every few days to check how many eggs I was getting and how they were progressing. And then I had a procedure where I was under sedation and they removed the eggs. And it was all a very positive experience because I know it can be a negative experience. You have to have injections and you feel bloated and moody. I was having mood swings and then all sorts of different things, but the way the whole thing was framed was very positive and happy. And I was referred to a different hospital for that. And that was another hospital where I trained when I was a medical student. And it was another hospital where I had worked and then I was sort of saying, oh, that's where I used to eat my lunch and that's where I used to do this and that's where I used to do that, it brought back happy memories and the whole thing was very positive.

What was it like going through that in the sense that you'd just been diagnosed with breast cancer and then suddenly almost straight away, you're doing IVF basically, you're doing the early part of IVF treatment? Emotionally did that have a big effect on you?

I felt that I was really lucky because a lot of my friends have to pay thousands of pounds for this. And then the doctor was explaining these eggs are frozen in time, whenever you want to use them, the DNA is of a 37 year old. And I was like, Oh, that's great. Like I felt the whole thing was very positive. And I was very excited about the future because I also felt that haven't given up on me. They're actually talking about the future. And it was very hopeful.

How do you feel about the possibility of becoming a parent someday in the future?

Now I'm not sure because after the BRCA finding about the BRCA gene mutation, I now feel that I need to have some genetic testing and maybe another round. So now I'm a little bit in a state of uncertainty and I'm waiting for another appointment and I'm not really sure exactly what the future holds now. But I think whenever I get that appointment and have a clear plan, I will feel more comfortable about that.

Yeah. Yeah. It's really difficult one in terms of having children when you have a genetic mutation that you know about. Obviously lots of people have genetic mutations and they have children and they don't know about the genetic mutation. So you're not thinking about it, you know.

But there's also a lot of hope that in 10 years time or 20 years time, there will be treatments that will allow us to hopefully fix those genetic mutations and treat breast cancer way more effectively than we do today and things like that. So there's so many like ethical things to think about and looking forwards as well. And science changes so much. Partly, I think I don't want to miss out because of fear. And then find out actually, I've actually missed out unnecessarily as well. So I think that I'm probably going to, so far I've gone for every, I guess I say opportunity, like the treatments are opportunities for me, because I'm lucky that I get off of the treatments. So I've gone for all the opportunities and I'll probably continue to do that and hope that science advances, which it will, of course it will.

Brilliant. Very wise to take, take it all one day at a time as well, especially whilst you're still going through your treatment at the moment. So let's move on to the beauty side. You work in aesthetics and you obviously deal with hair and eyebrows and skin and all of those things. You mentioned, I know you've only just really started chemotherapy, but you mentioned you've had changes already in your appearance.

Yeah. So when, before I started chemo, I knew that my appearance would change, but I didn't feel too anxious because one, I thought, well, I've got all the equipment and products at home to rectify it. And my sister made a plan for me already about what treatment she's going to do for me when I finish treatment, finish my chemotherapy. So part of me knew that changes in the appearance of rectifiable. that was reassuring to me in advance. Um, but now I'm actually going through the changes. It's very different than the theory of it. So my hair falling out, I knew that that was going to probably happen. And then when it happens, it's really scary, even though you know it's going to happen. And I've seen it in patients. I've seen it on in films and things, but when you actually see it to yourself, it can be quite scary. Even if you're expecting it. But I do know that the hair grows back. So, and I've had colleagues with cancer as well and they say their hair has grown back much thicker and nicer. So I'm looking forward to my hair growing back thicker and nicer. And then my eyelashes are falling out and my eyebrows are falling out, but then I know they'll grow back as well. And then my nails have gone a funny colour and I thought, oh my God, now I've got a melanoma. I thought, now I've got a skin cancer, what are the chances I get a breast cancer and a skin cancer at the same time? And I showed my oncologist and she said, oh no, that's just chemo nails. So the nails have gone brown. And then, so I've just put shellac nail polish on top. I don't know if that's medically the best thing to do, but just now my nails look very nice. I've managed that. And I think, I hope that's a reversible thing as well. And then I'm getting patches of hyperpigmentation. So I had, well, this one's gone now, but my skin on my elbow went brown. And then at the moment around my mouth, I've got this sort of dermatitis and inflamed skin. And so when you go through it, you kind of get a shock, even though you know, these things can happen. And, and I think the main thing that has been different for my appearance is my weight. So I've gained 15 kilos in a very short space of time. And it's because I've been probably too sedentary and I've been taking, I've been on steroids. I've been eating a lot of food because it's boosted my appetite. And I've loved eating all the food. I'm eating healthily. I'm eating unhealthily. I'm just eating everything. And I've enjoyed cooking and eating. And that's one of the things that's changed. And I do look very different and my clothes don't fit me anymore. But I think this is also something reversible after treatment. So I have to give myself a break and, just be optimistic and positive.

I know what I was always told by my oncologist was just eat all the food that you fancy eating because you need the energy and you know, you can obviously get infections when you have chemo and you're really going to need the energy if that happens. So just keep eating, also steroids make you so hungry.

Yeah, they do. Yeah. And also I want to feel happy as well. And I think if I restrict myself, there's so many things going on, having chemo, and if I'm restricting myself in, I shouldn't be eating that because I've gained so much weight, it's just adding an extra thing onto myself, an extra pressure onto myself. So I think I've been quite relaxed about my eating, but I have been trying to eat healthy foods as well as I've probably been, I've just been eating too much. But I think, it's when I look in the mirror, I don't, I really look different and I do get a shock. Um, but I just tell myself that this is reversible and we'll be okay when I finished my treatment.

I mean, I would have absolutely no idea to look at you that you were going through chemo. I mean, all of the things that you've just told me about, I can't see any of them. So you are obviously extremely skilled in makeup and hair and everything else, if you've managed to hide all of those things.

Yeah, people haven't realised that I'm on having chemo at all. Lots of people have been shocked because I haven't been keeping it a secret. And I'm not mixing with big crowds of people, obviously, because I don't want to catch infections, but throughout the summer where there've been events, which are like in the garden parties and things like that and spacious ones. I've been attending and people have been shocked. So I've got this thing on my arm, this bandage to cover my PICC line. And someone said to me, when I said that I've got cancer and this is my PICC line, they thought that I'd had a tattoo and that I was, they said, oh, I thought you were so cool and you had a tattoo and you've got a bandage covering your tattoo. I'd never guess that you're on chemo. And I think that it's a good thing in some ways, but it's also a bad thing in some ways.

So you've got expert insider knowledge in things like eyebrows and hair. Did you make a personal aesthetics plan? You said your sister was kind of making the plan with you.

Yes. After I finished my chemo, I'm planning on having skin boosters and things to get the glow back into my skin and to help my skin repair. But actually, with regards to my hair, I was planning to do hair loss treatments, like I do micro-needling with exosomes and things like that. But then I realised my hair is going to grow back anyway. So I might just leave my eyebrows, eyelashes and hair just to come back in the natural way and see how that goes. And then if I think it needs a bit of help, then I'll use aesthetic treatments. But I think these things are good to use when you need them, or when they're beneficial for you or to give a boost, but there's no reason to do it unnecessarily. So if my hair is going to grow back nicer anyway, I'll just let that happen in the natural way.

Yeah, here's hoping. I don't know what, I know what microblading is as in the eyebrows, but what's micro-needling?

So micro-needling. So for example, you can use a device like skin pen and it's a pen with lots of tiny, very tiny needles inside and you run it over the surface of the skin. and it creates controlled punctures to the skin and then your body, so it's damaged to the skin, but it's in a controlled way, then your body recognises that there's something there that needs healing. So it sends increased blood growth factors, everything that you need for healing and it heals those punctures. And in that process, it stimulates your skin to become healthier because it's actually healing the area. So that's how it works and it's been around for decades actually and there's lots of evidence behind it and it's actually very beneficial for the skin.

And I'm guessing you can't have that during chemo because of any infection risk?

Yeah, so during chemo I'm not having any treatments. I think it's better that unnecessary needles don't go into the skin because you get poor wound healing when you're on chemo. As you said, risk of infections and I think yeah, I think there's plenty of time after the treatments over to feel back to your normal self. But this time is just for mainly getting rid of the cancer and resting and recuperating, I think.

So you've still got quite a lot of your treatments come, including your surgery, your double mastectomy. How are you feeling with all of that ahead of you?

So I was feeling quite calm. Other than the worst times are when I was given the diagnosis at the two week rate appointment and then when I found out about the BRCA gene and then otherwise I've been quite calm. So I thought, okay, I've got an operation coming up and it's a double mastectomy, but that's fine. I thought it's better than having one mastectomy. You can have both. Then I thought everything was all calm and relaxed in my mind. But last week I went to a patient group meeting at my local hospital, actually turns out it's actually the regional centre, which I didn't know. It's just by coincidence that I live by there. And it was for patients and they came from all over and we had to attend a lecture and it was compulsory before you have a double mastectomy. And then we met patients afterwards. So I'm very used to going to lectures. I love going to lectures and this is a hospital that I work in. So I thought I'll sit right at the front during the lecture. And when the consultant, the surgeon, the plastic surgeon was talking about the operation, I started to feel quite squeamish, which is unusual because I'm a doctor and I didn't think that I was squeamish. And then I started to feel quite ill. So I told my sister who was with me, I don't feel very well. And then I ended up actually having a panic attack and fainting and then I was on the floor and my sister had to put my legs up but then she was trying to hide my underwear which were like Bridget Jones underwear and because I was at the front of the lecture and she was trying to protect my modesty and then everyone was crowding around me and I had fainted from getting so scared about hearing about it and then the staff put me in a hospital bed. My observations were fine, everything was fine, I was just scared. So I was quite shocked that I had reacted like that and nobody else fainted. So I don't know why I fainted. It was the day after I started a new chemo, but I don't think that's the reason. I think it was because I was so scared because all the other times I've been thinking about it, like maybe from a doctor's perspective, but then hearing about it from the patient's perspective made me feel very ill. And then afterwards we met women who have had the operation before. And we got to speak to them and then look at the outcomes and feel, and then I felt much more relaxed and then I felt fine.

That sounds like a lot.

Yeah I wasn't expecting that to be honest. So I guess even though I think that I'm coping with everything fine, there will be times when I'm not or I realise that I'm not and, but I didn't really realise that I would faint in a panic attack, but it was a very Bridget Jones moment.

And having had that happen to you, do you have any approach now to dealing with your mental health and anxiety going forward?

Everyone who has a double mastectomy at the hospital that I'm at is allocated with a psychologist. So I emailed her and told her what happened. And then I have an appointment with her I think in like two weeks or it's very soon. I'll see what she suggests because I don't want that happening again.

Yeah.

I think I've learned things about other people as well. Like my friends and colleagues have been so kind and they've been coming and dropping off food and helping me and checking in on me and how important it is to have supportive people around you. And the nurses in the chemo suite were telling me that like, every week or usually I go in with someone, usually it's my sister and they were saying how a lot of the people don't have anyone that goes in with them or anyone to help them. And I think it's very important to have your family and friends supporting you. Maybe you shouldn't have to be resilient, but when you get a difficult diagnosis, you have to be resilient. And I think a lot of good can come from negative situations. And I try to always think about the positives and I always try to visualise the most positive things. Last week I started a new chemo called... the nurses, they call it the Red Devil. And then I was feeling sad, like, there's a devil inside me. I can feel it making me weak and making me feel sick and all of this. And I thought this isn't helping me, this vision of a devil around me. And so I decided a few days ago, I'm going to call it the Red Angel. And it's totally changed the way I feel about the same thing. So I'm thinking, the nurse inject this Red Angel into me. And now it's getting rid of my cancer. It's fighting the cancer. And, and I'm visualising something much more positive and it's made me feel very different about the same situation. So I think positive thinking is really important and I would encourage anyone going through difficult situations. It's very easy. You imagine your funeral, you imagine all these horrible things, but just have the time to think about that, but try, try your best to think positively as well.

Yeah. I think that's a brilliant approach. And are you still working? Are you still able to work?

Yeah, I'm still working full time. And I love working. So as I said, it's... I feel normal when I'm working and I feel very distracted, forget that I'm ill, and I love helping people. So I'm working for my NHS job. I'm working remotely because I'm on chemo to reduce the risk of infection. So I'm doing my GP job remotely. The aesthetics job, I see people face to face, but I just make sure that they don't have any infections or any infections in their household. And I also work for a university, work for Imperial University and research. And so I'm continuing that job as well.

Wow, sounds very, very busy.

Oh, yes, it's very busy. I think what I'm doing is distracting myself. And in some ways that's good, it's not, distraction isn't recovery. But I think I've heard, I know other people when they finish their treatment, there's like a feeling of things can feel worse after they finish their treatment because everyone thinks that they're fine. And then I guess that's when it kind of dawns on you. Cause at the moment I have a lot of appointments, have lots of things to do. And I know that I will have to properly face what I've gone through and process it properly at some point. But I think at the moment I need that adrenaline and that to keep going.

Yeah, I totally get that. And you've been sharing lots of videos online on Instagram about your experience with breast cancer and as a doctor with breast cancer. Why was it important to you to be open with what's happening to you?

It's about helping other people. So educating other people. I was shocked to get the diagnosis and there are a lot of people my age and younger who have breast cancer and when you're a doctor, you see it from one perspective. When you're a patient, you see it from another perspective. And now I'm a doctor and a patient, and I have an idea of how I want to be spoken to as a patient, how I want to be given information, how I want to be treated, and also what makes a good impact on me as well. So I think I have the capacity to help people and I've always been like that. So I think... I think it just came naturally to me. It would be weird for me to not try and use it for a benefit of others.

Yeah. It's also another thing for you to do and keep yourself occupied whilst you're going through all this.

It's keeping me occupied while I'm going through it as well. And also the other thing I'm doing is I'm making videos for, hopefully it will be throughout London, but it's about mammogram screening. So I know a lot of people, women are scared of going for a mammogram or they think that they don't need it. And I'm making a video for the NHS to send out to people just to show that anyone can get it and the importance of examining yourself, going for the tests and things like that.

I'd like to finish with the question we're asking everyone on this podcast, which is Breast Cancer Now's vision is that by 2050, everyone diagnosed with breast cancer will not only live, but be supported to live well. What does it mean to you to live well?

I've got to say in terms of my treatment, I feel like I am already living well. So I've worked in, I am a GP in London, but I've worked in a lot of different countries with refugees from all over the world and asylum seekers. And I've seen that the access to healthcare is terrible. So I've seen things which are quite obviously cancer, but there's no treatment that they can have, or even if they are going to die, there's not gonna be morphine for them. So I've seen really, really horrible situations and really poor access to healthcare. So I'm very grateful that I have the access to healthcare that I have. So in my opinion, with my diagnosis, I feel that I'm already living well with it.

That's a great answer. Yeah, I think we do have to acknowledge everything that we have that is wonderful and how fortunate we are in this country to have access to the wonderful NHS and doctors like you, of course.

Thank you very much.

And where can people find out more about you and follow you and see those videos that you've mentioned? So people can follow me on Instagram. My name's @dr.hajra.aesthetics and that's where I'm putting my videos about living with cancer, aesthetic treatments as well, and the treatments, the chemo and everything that I've been having. I've just been trying to be as open and honest as possible.

Fantastic. And we'll put the links in the show notes as well. Thank you so much for all that you've shared with us today, especially when it's all so new and so raw to you as well. I'm sure it will help lots of people. And you know, there's so much stuff that you've shared here that will be really, really beneficial to people. So Dr. Hajra, thank you so much for joining us.

Okay, thank you so much. It's been lovely to meet you as well.

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