Helen King was 37 when she found a lump in her breast. She was diagnosed with a fast growing, aggressive cancer treated by mastectomy, chemotherapy and radiation. She is one of 3300 New Zealand women diagnosed with breast cancer every year. Unable to find candid stories about treatment, King decided to tell her own. Hannah Martin and Lawrence Smith documented a year of her life.

Hannah Martin byline
Lawrence Smith byline pic

There it was, all of a sudden. Easy to find, smooth, painless. As Helen King stood in the shower, warm water pooling near her feet, a brunch meeting beckoning on a lazy Sunday morning, her fingers brushed against the outlines of the small, hard lump on the top of her right breast.

Women are taught to fear lumps but breasts constantly change: during puberty, menstruation, when taking the pill, while pregnant or going through menopause. Most are harmless - cysts or collections of fatty tissue - but we’re saturated with media spelling out that lumps almost always equal cancer.

And it was with the former in mind that King told herself the small mass she grazed her fingers over was nothing. Having gone through an “appalling” few years - divorce, depression, leaving a career she once loved - getting cancer seemed unlikely. Cruel.

Living in her native Auckland, with “fur child” Bebe in Mount Albert, King’s friends know her as raucous, a rebel. Kind-hearted and ferociously smart. Warm. She recently took a step back from a long established career in the media, and outside work she’s just as busy. She loves cycling: so much so she started Nutters Ride Together, a monthly bike ride for people who experience mental distress. She volunteers as a board member for the Asylum Seekers Support Trust.

Due to start a new job as a communications advisor the next day, and consumed by first-day jitters, Helen put the “weirdness” of finding the lump aside and set about organising her outfit for Monday morning. A navy blue and white dress, a ruby red cardigan and barely broken-in black leather ankle boots were laid out while King mapped the quickest bus route to get to her new office.

There was no way she could have cancer. There was no way.

Five days later she was so uncomfortable she couldn’t wear a bra.

Within weeks she would lose her breast.

Red, and warm. The next day, the breast has changed again. King wasn’t concerned, but feeling run down and with an inkling she may have an infection, she visited an after-hours clinic.

Almost immediately the triage nurse suspected non-lactational mastitis, an infection in the fatty tissue. The nurse said: “It won’t be anything too bad, you’re too young.”

A second opinion was required, however, and for 30 minutes King sat and stared at details posted on the walls, flicking between apps on her phone, becoming impatient.

Finally a doctor ushered her into a room, instructing King to de-shirt.

King’s legs dangled off the bedside while the young British doctor checked both breasts and announced she was “quite confident” the redness was non-lactational mastitis. But the doctor puzzled over the lump and recommended an ultrasound to rule out an abscess.

Less than 10 minutes later King was cycling home with a prescription for a week’s worth of Augmentin, an antibiotic. The doctor wasn’t concerned, so neither was King.

Over the next week, unable to find time for an ultrasound and armed with antibiotics and self-assurance, King waited and watched. But days passed, and the antibiotics made no difference. The breast was changing, fast.

By the weekend the breast was rope-like and tough; heavier and visibly fuller. King typically responded to antibiotics within days; before long the seed of doubt was sown. “It was just too strange it hadn’t gone away.”

King visited a different clinic, where the doctor, confused the antibiotics had no effect, repeated earlier advice: You need to get an ultrasound.

A little under a fortnight into her new job, King left work on a Friday afternoon and walked the kilometre from her office to a radiology clinic in the CBD for the ultrasound. Anxiety had crept in and King was so flustered she couldn’t find the clinic, and was late.

King lay topless on the clinic bed, modestly covered with a robe, and watched as a sea of dark swirling shapes filled the screen. The sonographer moved the transducer wand across her chest; apologised every so often as she increased the pressure as she pushed the wand onto King’s sensitive breast.

King’s eyes flitted between the screen and the stranger. She started to get teary. She told the woman she’d had a rough couple of years. “I’ll be really angry if this is cancer.”

A black shadow appeared on the screen.

Then another, and another.

I just knew from her demeanour that it was something serious. I don’t know if she meant to, but she gave herself away. I knew then that there was something very wrong.

The sonographer called a radiologist for advice on the spot, telling King she would likely need a mammogram. In New Zealand, free breast screening (a mammogram every two years) starts at 45. At just 37, King had never needed one.

“I sat up that night and cried and cried. I knew my life had changed.”

Last August, leading Australian oncologist Professor John Zalcberg visited New Zealand to highlight our “appalling” cancer rates and “substandard” outcomes for particular cancer patients. Cancer is our deadliest disease – our cancer rates are 62 per cent higher than the world average.

Zalcberg said though New Zealand isn’t a poor country, when it comes to cancer, it’s lagging well behind. The “incredible delay” to world-class modern cancer treatment is impacting people’s outcomes, he said. It’s a battle we’re losing. The UK takes 143 days on average to fund a modern medicine after its registration. Australia takes 352 days. Here, patients wait 599 days on average for Pharmac funding, with no set time frame for decisions.

In the next 15 years, the number of New Zealanders affected by cancer is expected to double, but our survival rates are not improving at the same rate as other parts of the world. Māori and Pacific people have higher rates of preventable cancers, worse survival and higher death rates than other New Zealanders.

Monday morning brought news. King’s GP practice phoned saying it had the ultrasound results, just hours before King was due for the mammogram. King needed to come into the clinic after the mammogram, the nurse said, “and you need to bring support”.

King is dry-eyed and calm recalling that fortnight. She’s matter-of-fact, but her usual loud vibrato becomes quiet, punctuated with pauses as she relays June 11, 2018.

With the phone call replaying in her mind, King left work and Ubered to an Epsom clinic for the mammogram about midday. Mum Jean met her there.

While the difference in the breasts was obvious, the mammographer couldn’t confirm what was going on either. They would have to wait for the biopsy.  

The hours until her next appointment with the GP are a blur, but King clearly recalls the doctor’s office in Green Bay, West Auckland. “It’s highly likely you have cancer,” the doctor told King and her parents.

The next morning, a biopsy. King’s partner Ross dropped her off to Auckland’s private Mercy Breast Clinic where she was again met by her supportive parents.

A radiologist numbed the skin and punched through the tissue using what sounded like “an old-school ear piercing gun”.

For days, as she cycled through more tests and scans, doctors danced around what King already instinctively knew. Then, two and a half weeks after she’d found the lump in the shower and two days after the biopsy was taken, it was confirmed. Helen had stage two breast cancer.

Scans revealed three tumours. The largest two measured 4.5cm. The size of plums.

The cancer was HER2-positive. Aggressive, fast growing and more likely to recur after chemotherapy than other breast cancers. The prognosis for women with this kind of breast cancer is worse than those whose cancer was not HER-2 positive.

More than 400 women are diagnosed with HER2-positive breast cancer each year in New Zealand, accounting for approximately 20 per cent of breast cancers. Formally known as human epidermal growth factor receptor 2 (HER2) the cells have higher than normal levels of protein, causing the cancer to grow and spread rapidly.

King’s chance of cure is about 75 per cent.

Quickly, King’s surgeon, Isaac Cranshaw, threw around words like “mastectomy” and “reconstruction”. They discussed the first step in a series of procedures to rid the cancer: a full mastectomy and lymph node biopsy.

Days later she met a new face, confronted another demon. Flipping through a glossy “menu” of breasts, King and plastic surgeon Julian Loft looked at what she might look like after surgery.

Immediate reconstruction wasn’t recommended. A silicone implant wouldn’t work because of her breast size - it would be difficult to create symmetry - and surgeons needed muscle from her stomach or back to build a breast, but that operation would be years away. King’s BMI was too high, and to perform the mastectomy and reconstruction in one go was deemed too high risk.

It was surreal, King says now, struggling to describe how to reconcile shopping for new boobs. She went home and Googled post-mastectomy women to try and understand what it might look like. It was confronting. “It looks like someone has just erased that breast.” Though her own diseased breast was changing - becoming discoloured and getting heavier - she couldn’t imagine not having it.

Nothing prepared her for her appointment with Cranshaw just two days later, when he told her the mastectomy could be performed the following week. “I freaked out,” she says. “I didn’t expect it to be that quick.”

Over the next week King mentally prepared for surgery as best as she could, spending periods looking at her breast, Googling, searching images of women with breast cancer.

Being told you have cancer is earth-shattering, and the break-neck speed in which King had to come to terms with hers made it tougher. Broaching the conversation with her family and friends was like picking at a scab, exposing the hurt over and over. No-one knew how to react. King became adept at consoling others’ hurt, grief, and shock.

Days before the operation King had a “complete meltdown”. “I just panicked.” Initially pragmatic, when faced with the reality of the looming surgery, and only having days to accept it, she was filled with terror and anger. She was completely overwhelmed.

Her changing breast aside, she felt fine. Not sick, not sore; nothing requiring dramatic surgery. “It’s not like, say, your appendix — it’s causing you problems so you understand, it needs to go. I feel sick, and getting rid of my appendix will make me feel better.”

It wasn’t about a loss of femininity, she says. Losing her breast made it real. She had cancer. And once you’re on that train, there’s no getting off.

There’s a moment, a series of moments, in the lead up to surgery where you are completely alone. Even in the busy, bustling heartbeat of a hospital there are pockets where a patient is completely by themselves. After being dropped off by her parents, King signed in at reception and sat in the waiting room to be called by the surgeon.

Doctors and nurses cycled in and out of the room, and ran through the same checklist. Is this your middle name? What is your date of birth? Do you have any allergies? Once, twice, three times, until, alone in the perioperative suite, dressed in an airy linen gown and limb-hugging compression socks, it hit her: “Holy s.... This is it.”

A theatre nurse collected her, and they walked side-by-side into the operating suite. King pulled herself up onto the table. Unlike the movies, where you’re wheeled in on a stretcher as your family line the hallway like a 21-gun salute, familiar faces were few. She reminded herself to catch her breath, and exhaled as the nurse told her there were a lot of people in the room, and they were all there for her.

King is tough. Two years ago she entered a corporate fight after years of intensive sparring training, and every time she was hit, she hit back. She suffers few fools. But surgery winded her.

At first, King couldn’t bear to look at where her breast once was. When a nurse came into her room asking if she wanted to shower for the first time, King asked for her to be there with her. Unravelling the gauze dressings, King cried. “(It) was quite horrifying.”

The wound wasn’t “gory”, but it rattled King to see two plastic tubes stitched into her skin. “In that moment, standing in the shower, I was so vulnerable. I just cried. It was really full on seeing it like that.” Every day King had “a little look”.

King is numb across the front of her chest, down the right side of her torso and under and down the back of her arm. Describing this, she runs her nails along the skin on her chest. She knows she’s doing it but can’t feel it. The feeling may never come back. Her mastectomy scar runs along her chest and under her arm - where they cleared 21 lymph nodes - forming two peaks the doctors refer to as ‘dog’s ears’. It reminds King of a pig’s trotter.

Discharged to her parents’ home in Karekare, a small coastal settlement along the west coast of Auckland, for a week her mum meticulously emptied the drains stitched into King’s skin under her arm, monitoring how much fluid was exuding, and ferrying her on the hour’s drive back and forth to the hospital.

Two weeks after surgery, King had her first appointment with her oncologist. It was at this appointment she learned exactly what she was facing, and how it would be treated.

Though her parents had been to every doctor’s visit and scan, King went to this one alone. She wanted to protect them from whatever she was about to hear. During the three-hour appointment the doctor peeked, poked and prodded into every nook and cranny of King’s life: how many times a day she went to the toilet, how often she would get nauseous, whether she suffered carsickness.

In return he gave her the truth of the battle: the cancer was fast growing, and aggressive. It was in three lymph nodes, meaning it could have travelled further. “When you’re hearing those words, it’s like f...ing hell.”

Three treatment options were presented as rudimentary scrawls on an A3 piece of paper which King keeps in her ‘cancer box’. They chose option one: Four rounds of AC chemotherapy, four rounds of docetaxel with pertuzumab, 13 rounds of Herceptin and three weeks of radiation. But before it could start, King was confronted with another major life decision – whether she wanted children.

Just six months into their relationship, King and Ross were having conversations some couples would leave for further down the track. Her oncologist wanted to start chemotherapy urgently, but King was in the right stage of her cycle to go through a round of fertility treatment. Chemotherapy - particularly the kind King would have - can cause early menopause, and temporary or permanent infertility.

Fertility treatment was given the green light. Every day for four weeks King injected herself with hormones to stimulate egg production, undergoing blood tests and pelvic ultrasounds. “It’s like you have PMS but a million times worse.” Her eggs were harvested and frozen.

Remarkably, King returned to work. First from the office, then reducing her hours and working from home. But chemotherapy changed that.

Her first round was on August 14, two months after diagnosis. King barely remembers the orientation, as she grappled with the side effects of being in the thick of hormone shots and egg retrieval.

The clinic was quiet, fluorescently lit. Laying on a hospital bed in a private room, she underwent an electro-cardiogram to check her heart was working normally.

A nurse hooked her up to an IV through a plastic port in her chest, just below her collarbone. King has “finicky” veins, so a portacath was inserted after fertility treatment to ready her for chemotherapy. Some chemotherapy drugs can cause serious damage if a vein collapses during treatment; a port can prevent that. They also improve ease of access: most IV treatments can be done through them. A small incision is made in the chest, a catheter is fed from the port into a major vein and the port (where the needle enters) sits on the chest wall.

Doxorubicin is a bright, brilliant red. Infamously known as the “red devil”, it is a powerful drug for treating breast cancer – so powerful that if it were to leak from a vein through the body it could cause tissue to blister, burn and die. It’s also one of the drugs King takes on the very first chemo day, simultaneously with cyclophosphamide.

Doxorubicin is not prejudiced in its destruction; though it kills cancer cells it can also cause heart damage in large doses. The sight of it was jarring, and King was wary of what hell the devil would unleash. She’d read all the handouts from her oncologist and researched the possible side effects. Nausea, vomiting, diarrhoea. After about an hour and a half she went home and waited “for the fun to start”.

King describes her first chemotherapy session, in August 2018. Helen diligently documented her experiences on social media for the past year.

At first she felt woozy - the first and second days brought a foggy brain and a “weird” feeling. Day three and four were “f...ing hideous”. Day three to day seven: “[Like] a really bad hangover and a virus at the same time.”

She would be hot, nauseous, tired, aching. The fog would start to clear. She would feel like “s...”. Have a two-day respite. Things settled. She felt “normal”. Then be right back into it. Each cycle - initially three-weekly, then once a fortnight - followed a similar pattern; worse each time.

In the days before a cycle, when physically she was starting to feel like herself again, anxiety would set in, bringing sleepless nights. Among the myriad side effects, AC chemotherapy can cause hair loss, extreme fatigue, diarrhoea, constipation, cognitive impairment, changes to taste - food and drink becomes metallic, bitter or salty - a sore mouth, bladder irritation and pink or red urine. It can change the skin and nails.

Each month, King was given an injection to essentially shut down her ovaries, protecting them from the effects of chemotherapy. They left her languishing in menopause.

King later documented the sore stomach, the gastro issue and nose bleeds. Her sore mouth, insomnia, and skin issues. “My whole body feels affected now,” she wrote. “I noticed the other day I have about six eyelashes left on each side, I hadn’t even noticed they’d fallen out. I’ve been a big woman for a long time but I was fit and strong, my body feels weak now and I’m no longer toned like I was. It’s so disheartening.”  

Days passed where the most she could do was slowly inch from her bed to the bathroom and back again. Despite feeling like every cell in her body was yearning for sleep, King suffered insomnia, spending long stretches staring at the ceiling. Her constant companion and “fur child”, cat Bebe, was never far from her side. The steroids made her hungry, but she could seldom eat. And when she could, what she could stomach would change every day.

King with “fur child” Bebe, pictured after chemotherapy. Photo: Facebook.

King with “fur child” Bebe, pictured after chemotherapy.

King with “fur child” Bebe, pictured after chemotherapy.

It’s relentless. It’s really, really hard because you know what’s coming and what’s going to happen again. You know you’ve got to have this [treatment], I want the best chance to beat this cancer, but it’s mentally and physically so gruelling. It’s really tough.

King recounts these few months to Stuff from her Mount Albert flat, a small unit nestled in the garden of her landlord’s villa. A dark red pixie-cut wig hangs off a wooden doorknob in the lounge. At first she was self conscious about being bald, and got a wig after seeing how good they could look at a Look Good, Feel Better event. For the most part, it’s been left untouched - Helen was “paranoid” people could tell it was a wig.

Losing her hair was one of the few things she could control, and knowing chemo would take it, boyfriend Ross took on the role of backyard barber one day in September; a blue plastic poncho rested on King’s shoulders while Ross meticulously shaved her hair down to a zero.

King’s partner Ross has supported her throughout her cancer battle, including playing amateur barber. Photo: Facebook.

King’s partner Ross has supported her throughout her cancer battle, including playing amateur barber.

King’s partner Ross has supported her throughout her cancer battle, including playing amateur barber.

Even by then it was as though the life had already been sucked from her dark hair. It became brittle and thinning, chunks fell or pulled from her scalp. It hurt. After a few rounds of chemo all it took was running her hands over her head in the shower for the remaining stubble to fall out. Her eyelashes were sparse. Her eyebrows would otherwise be “overgrown”, but tweezers were no longer necessary.

On this day we’re going for coffee. Standing in the doorway of her bedroom, she reaches for a light silk scarf from the dresser - she folds it in half lengthwise and puts it over the top of her head. She deftly moves her hands, folding this there, and tucking that there, until her scalp is barely peeking out from behind a green leafed print. A small wrought-iron set of shelves is a rainbow of plastic bottles: painkillers, steroids, medicines for nausea and depression, pills for stopping constipation, pills to constipate. Take once daily. Take twice daily. Take as needed. Take with food.

King is about halfway through chemo. Tomorrow, she starts docetaxel and Herceptin - with the promise of bone pain and diarrhoea. She’ll receive Perjeta (pertuzamab) too, a newly funded chemotherapy drug which, when used with Herceptin, significantly improves outcomes for women with advanced HER-2 positive cancer. But King’s cancer is not advanced - so she has to foot the bill. Her parents dipped into their savings to pay the $20,000 it costs for four doses.

By the end of the driveway, King is struggling for breath. It doesn’t take much to become tired. In the days immediately following chemotherapy something as simple as a shower required her to lie down again afterward.

King pictured during radiation earlier in 2019. The line at the bottom of her neck is where the port-a-cath was inserted. She wrote: “It’s hard with the heat we’re having in Auckland. I’m ready for it to start cooling down. Source: Instagram.

King pictured during radiation earlier in 2019. The line at the bottom of her neck is where the port-a-cath was inserted. She wrote in an Instagram post: “It’s hard with the heat we’re having in Auckland. I’m ready for it to start cooling down."

King pictured during radiation earlier in 2019. The line at the bottom of her neck is where the port-a-cath was inserted. She wrote in an Instagram post: “It’s hard with the heat we’re having in Auckland. I’m ready for it to start cooling down."

It’s around 400 metres to her local cafe, where the owners welcome her with a smile and ask how she’s feeling. Their brownie is among the best she’s ever tasted, though she’s not always able to stomach one. Today is not the day. Tucked in her handbag under the table is her Work and Income application for funding her next three counselling sessions.

When she was first diagnosed, King, a former Stuff journalist, struggled to find stories about cancer in the media that she could relate to. Women with cancer were older, they had children - stories were light and fluffy and ‘pink’ - totally at odds with what she was going through. For that reason, King wanted to share her story – to show just how tough the fight can be.

The physical and mental slog isn’t the only battle Helen finds herself embroiled in. Much of her depleted energy source is spent battling Work and Income just to stay afloat. Living alone in Auckland, with rent and bills, and time off work, left King with only one option: going on a benefit.

After applying and wading through a number of appointments, King was approved for a Jobseeker Support benefit (deferred) - once known as the sickness and invalid benefit - which entitled her to about $300 a week. Her rent was $270, bills $40 a week, leaving nothing for food, doctors appointments, prescriptions, petrol.

While a standard prescription costs $5, a private oncologist prescription costs $15.

One trip to the pharmacy left King $45 out of pocket. When she spiked a fever and had to Uber to the hospital in the middle of the night, that cost $15.

It took writing a letter to her local MP’s office - Prime Minister Jacinda Ardern - to discover her benefit had been miscalculated.

But even then, supplementary assistance she was entitled to is asset and income tested and because she had more than $1000 in savings, she wasn’t entitled to more support. To counteract that King spent her savings paying out her health and car insurance for 12 months. It was two less payments to have to worry about meeting, and the depletion of her bank account earned her an additional $27 a week on the benefit. The total: $371.64.

“Nobody at WINZ could explain how I could survive on that.”

King cancelled her gym membership and put her student loan repayments on hold. She downgraded her phone plan - it cost more to break it. Access to the internet and a phone are not luxuries when you have cancer, they are necessities. A lifeline.

King felt “so guilty” for needing the help but she’s stroppy - in her own words - and able to advocate for herself. Having worked as a journalist and for a major health insurer, she knew how the health system worked and what the treatment process might look like. She’s resourceful and resilient, she knew to join groups to support her, and where to ask for help. She also knows it’s not that way for the vast majority of New Zealanders who get sick.

It’s such a punitive process. You feel like you go in there begging for money, and you have to show how sick you are… I have cancer. I didn’t ask for this, I didn’t cause this, all I’m asking for is, as someone who has worked their entire adult life and a taxpayer, to get what I’m entitled to…. But I felt like a criminal.

Between 2013 and 2018, MSD paid out more than $1.4m to New Zealanders with cancer.

Last year, 948 people with cancer received $323.28 per week on average from Work and Income.

Minister for Social Development Carmel Sepuloni was not available for an interview. In a statement, she said a review was underway to check the “adequacy” of welfare income.

The review follows the formation of the Welfare Expert Advisory Group, launched by the Government last May.

“I expect that as part of our response to WEAG and the Government’s overhaul of the welfare system that this issue will be included as part of a broader programme of work,” Sepuloni said.

King’s parents and sisters rallied to help. They started an online support group - organising who would take her to what appointment, tracking what she had in the cupboard, who would drop off meals, when. It was both a life-raft and a constant reminder that she couldn’t look after herself alone.

“I’ve always paid my own way, I don’t like taking from people. But in this situation, you have to learn how to say yes. ‘Can I do this for you?’ Yes. ‘Do you need me to do that?’ Yes. That’s hard when you’ve been someone who doesn’t want to be a burden on anyone, who wants to provide for themselves and stand on their own two feet.”

Independence was just “one more thing cancer took from me”.

Ministry of Health data shows of the 31,383 deaths in 2016, 30 per cent (9516) were caused by cancer. Our melanoma and colorectal cancer rates are among the highest in the world and, despite robust nationwide screening, about 600 women develop terminal breast cancer each year.

Dr Chris Jackson, oncologist and Cancer Society medical director, says there are things New Zealand does really well: We have a national breast cancer screening programme, “world class” surgeons and access to reconstruction surgery, good radiation machines,“fantastic” psychological care and“extraordinarily” good pathology services.

We “perform” alongside other high-income countries, but we’re in the bottom-band, Jackson says. We generally come in behind countries with similar publicly-funded health care systems, such as Australia and Canada.

When people say we do well comparatively - I think to myself, what do you mean? Comparatively to Uganda? What are you comparing us to? To me, that smacks of a really mediocre attitude.

Even for someone like King - Pākehā, middle class, educated, living in Auckland, with access to health insurance in a first-world country “with a good healthcare system and good oncologists” - “it still really sucks”. Pharmac restrictions, lengthy waiting lists for diagnostic MRI tests and a lack of government targets with a focus on early diagnosis all make it “feel a little bit like you’re trying to do your job with one hand tied behind your back”.

In 2011, Pharmac, the government’s drug buying agency, assumed responsibility for managing the funding of all cancer medicines. Prior to that, it managed the funding of cancer medicines dispensed in the community, but hospital cancer treatments were funded by DHB hospitals up to an agreed amount.

Pharmac has listed 12 new cancer medicines since 2011, and enabled wider access for 12 others, by funding them for more types of cancer. In the year to June 2017, 17 per cent of its $849.6m spend on medicines was for cancer treatments ($203m). More than a quarter of that was spent on trastuzumab (Herceptin) and pembrolizumab (Keytruda) alone.

While the world is moving incredibly quickly in terms of cancer research, if new research came out today, it could take Pharmac at least three years to look at it.

“If a judge makes a decision that impacts someone’s life you can go to an appeal - if Pharmac makes a decision that impacts someone’s life, there is no appeal. There is no ability for us to hold them to account for anything,” Jackson says.

Pharmac says it relies on the expertise of clinicians to make funding decisions. It says it can “move quite quickly” to fund drugs where there is clear “robust” evidence and “commercial arrangements” have been successful. 

In a way, King considers herself lucky. If she was diagnosed 10 years ago both Perjeta and Herceptin would have been out of reach, financially. Pharmac funded Herceptin in 2008, and Perjeta in 2016. She has comprehensive health insurance which allowed her to claim $60,000 worth of Pharmac funded drugs per year: the majority of which was chewed up by the Herceptin.

It also allowed her to seek out an ultrasound and mastectomy much sooner than would have been feasible through the public system.

“At stage two it had already spread to three lymph nodes – if I had to wait six months it could’ve been a very, very different story.”

King's insurance doesn’t stretch far enough though. According to Pharmac, the average cost of Herceptin, per patient, per year is $66,977.66. King will enter the public health system for nine of the 13 Herceptin infusions. It’s expensive: The first cycle cost $9900, then $7444 per infusion, compared with $192 per infusion for docetaxel – but it could be what saves her life.

One afternoon late last year, in the throes of treatment, King went to her sister’s house to do her washing and to pick up nephew Lucien from after-school care. Nearing the school, she was struck with a wave of nausea. Saliva pooled in her mouth and she found herself crouched over and spitting into a planter box as kids ambled out from their classes. She didn’t want to throw up and “embarrass” him. “I’m already his bald aunt going to collect him from school.” He was in a mood that day, she remembers. At home, she motioned for him to come and have a cuddle and a chat. It’s moments like that King worries about missing.

“[That’s] where I think ‘f…, if this kills me I don’t get to have anything to do with his life. This child could lose an aunt.’”

When you’re alone, people don’t see you go through the terror, or the anger, or the childlike thing of, ‘I don’t want to do this; I don’t want to have cancer, I don’t want to have to go to chemo’.

The biggest battle is mental, King says, one she’ll be fighting long after treatment has ended.

The underlying, niggling fear that treatment hasn’t worked or the cancer will come back is “paralysing”. The fear makes it hard to see a future, it makes it hard to “continually put on a brave face”. Because life will never be the same. Her body will always bear the scars of her cancer. Even now, weeks after finishing radiation treatment, she sports a red, raw radiation burn across her chest.

With cancer, life becomes a numbers game - your life expectancy and outcomes become percentages, statistics. She wants to live, to “have children, a pedestrian life with a house and a family” but is torn between wanting those things and the worry that sets in if she thinks about getting sick again.

“It leaves a big question mark over you; over your life.”

It’s staring death straight in the eye. King says it’s hard to talk about cancer without thinking about death as they’re knitted together so tightly in our psyche. Cancer is always there, in the back of your mind. “You’re always scared you’re not going to make it.”

It also picks your identity to pieces. Losing a breast changed the clothes she could wear. She’d always had a penchant for pin-up style vintage dresses, florals and bold patterns, but found herself buying clothes after surgery she wouldn’t have bought otherwise. Finding a bra that fit her prosthesis or ‘knitted knocker’ was nigh impossible. She had to resort to wearing two breastfeeding singlets at once. Looking through old photos - smiling, healthy with long hair - is difficult. Cancer has aged her, she says.

From 2016 (top left) to 2019 (bottom right) King wrote, “I find it hard looking at old pictures because it’s hard not to focus on the loss….but here I am. Bigger, balder and down a breast. Sometimes you just have to put one foot in front of the other.” Source: Instagram.

From 2016 (top left) to 2019 (bottom right) King wrote in an Instagram post: “I find it hard looking at old pictures because it’s hard not to focus on the loss….but here I am. Bigger, balder and down a breast. Sometimes you just have to put one foot in front of the other.”

From 2016 (top left) to 2019 (bottom right) King wrote in an Instagram post: “I find it hard looking at old pictures because it’s hard not to focus on the loss….but here I am. Bigger, balder and down a breast. Sometimes you just have to put one foot in front of the other.”

After months of intense treatment, of “holding her breath”, on April Fool’s Day 2019, King went back to work. She went back to the same office on the same bus, down a breast. Patches of new growing hair haloing her head in soft fuzz. She started part-time, slowly increasing her hours, and revelled in the normalcy of routine and being around other people. It was like “someone hit the pause button and I’ve started where I left.”

But of course, it’s different. Life is different.

There’s still a small lump protruding from her chest where the port sits. She will continue to have three-weekly Herceptin infusions until September and will be monitored “closely” for five years with yearly mammograms.

No-one has said in so many words whether the cancer is gone. A CT scan before treatment found no trace of cancer elsewhere. For now, King has to hope and hold on tight to what her surgeon told her at the very beginning:

“We plan on you getting through this, we plan on you surviving.”

Thanks to Helen for her participation in this project

WORDS Hannah Martin

VISUALS Lawrence Smith

DESIGN Kathryn George

EDITORS Kelly Dennett and John Hartevelt