Courage, hope & dry mucous membranes
Annika Cripps became known to the Swedish public through her participation in the first dating TV show for seniors in Sweden, which became incredibly popular. She quickly became a favorite among viewers due to her warm and genuine personality as she shared her thoughts on romance, lust and the importance of nurturing a relationship, but what few people know is that Annika is a breast cancer survivor. Back in January 2016, Annika received an envelope in her mailbox with a return address from the mammogram she had just had. The envelope was thicker than it used to be, and she immediately realized that something was wrong. During this exclusive interview, Annika shares her personal reflections and experiences in a hopeful and inspiring way based on a desire to raise awareness about breast cancer.
HI ANNIKA, HOW ARE YOU TODAY?
I'm fine, thank you! I was actually just going through my calendar from 2016 because that's when I got breast cancer. I had to check the passage of time and it was actually a bit difficult because now I realized how crazy I actually was at that time (laughs), but otherwise I'm fine!
WHEN WERE YOU DIAGNOSED WITH BREAST CANCER?
I went for a mammogram in January 2016. Typically, you just get a simple letter saying that everything is fine, but this time I got a thicker envelope. So I immediately felt when I got the envelope that it contained more papers and then I realized that something was wrong. That was the first warning sign. I immediately had another visit to the hospital. I was of course a bit shocked, and I also talked a lot with my daughter, who is a doctor, and with a friend who had had breast cancer. There were also many people who told me that it could be a lump of fat and that it didn't have to be cancer. At my second visit when they were going to do a biopsy, it was not possible to insert the needle as the breast was so compact and I had to book another visit for an ultrasound instead. The ultrasound was when I really understood. I distinctly remember the doctor and nurse who did the ultrasound, and I immediately realized from their facial expressions that it was serious. It was noticeable throughout the room. But it was actually only after the operation, when the lump was surgically removed and analyzed, that I was told that it was actually breast cancer.
WHAT DO YOU REMEMBER MOST WHEN YOU GOT THE NEWS?
My oldest daughter, who is a doctor herself, was with me when I got the news. I remember the female doctor saying "Yes, 90% sure it's cancer and how does it feel Annika?". I remember thinking that it was a strange question to ask right away and instead reflected on the fact that the doctor had greasy hair. I sat there wondering why people go to work with greasy hair (laughs). But then I saw my daughter's eyes watering. Time stopped in those seconds. I was able to think through all of this at the same time. It's so crazy. My daughter is an extremely empathetic person, but she doesn't like to show emotion and when I saw that she was crying - I thought, this is serious. So everything kind of went through my head at once.
HAVE YOU HAD ANY SYMPTOMS BEFORE?
No, none at all! I did, however, have a risk factor with my breasts that I didn't know about. That was that I had "compact breasts", which are also called glandular breasts. That risk factor is pretty heavy. I had also been taking estrogen for 2 years before the cancer was discovered. I turned 60 the year I got the news about cancer and I was at the end of menopause. I got really bad urinary tract infections in 2014 that I couldn't get over and took long-acting penicillin for 3 months. My entire immune system was knocked out and then I thought that I had to start taking estrogen to avoid the urinary tract infections. It was absolutely fantastic to have estrogen - because I also felt so much better mentally, but unfortunately it was not a good time to take estrogen when I had this risk factor for "compact breasts".
HOW DO YOU KNOW IF YOU HAVE COMPACT BREASTS?
If you can feel your breasts, they should be soft, but if you can't squeeze them, then they are compact. Prior to breast cancer, I also had quite heavy breasts, and when I had a mammogram earlier, it was like trying to squeeze something that doesn't give. The term "compact breasts" or glandular breasts has come up in the debate in the last two years, with people starting to talk about this as a risk factor based on relatively new research. I had many positive health factors such as being healthy, normal weight and had breastfed my three children, which reduces the risk of breast cancer, but I didn't know that compact breasts could be a risk factor.
DID YOU PERFORM BREAST EXAMS ON A REGULAR BASIS?
Yes, but it didn't work. Before breast cancer, I had a big D-cup and sometimes an E-cup, and it wasn't possible to feel the inner part of the breast as they were so compact. So I did the best I could, but it was during the mammogram that the cancer was discovered. When I explained that glandular breasts can be a risk factor to my friends, they wanted their breasts examined instead - by me! The last time that happened we were in a pub (laughs)!
WHAT DO YOU REMEMBER FROM THE DAY OF YOUR BREAST CANCER SURGERY?
I had my surgery on March 29, 2016, and it's so interesting...in my calendar I had just written down a bunch of things about work and stuff. It doesn't say anything about an operation there. To find out what day I had surgery for this interview, I had to go to the app on my cell phone that shows how many steps I walk because I knew I didn't walk a single step on the day I had surgery. What was even weirder, in retrospect, was that I had booked a 50th birthday party for the Saturday of the week I had surgery - I was completely stupid. Then I went back to work just 10 days after the operation, and that was actually the hardest thing to read about in my calendar. It was also only after the operation that an armpit test showed that the cancer hadn't spread, which was really nice! However, in my case, there were also other things that already indicated that it hadn't spread. If the cancer lump has like a thick potato peel around it, then there is less risk that it has spread, which it seems to have on my MRI. I got good signals early on, but with the caveat that we all know it's a difficult disease. But after the surgery, I could sort of breathe. The cancer hadn't spread and that was great.
HOW DID YOU HANDLE THE NEWS WHILE YOU HAD TO WAIT FOR SURGERY?
I was very calm, I continued to work and went to the gym as usual. It sounds a bit superhuman, but I'm very pragmatic and see the big picture and everything also felt professionally handled by the health service. I actually slept well at night during this time. I also spoke to a friend who had gone through cancer treatment that was more difficult than mine when she received chemotherapy and she said this: "The only thought was that now I'm going to die, but I've had a really good life" and I learned something from that. Having that attitude helped me. I'm pretty tough considering that right now I live here and you don't know what tomorrow will bring, but I couldn't help but worry about it. A lot of people my age talk about everyone being sick.It goes without saying that you get sick when you are 60, 70, 80 years old, but not everything is a fatal disease.
HAVE YOU TOLD YOUR LOVED ONES ABOUT THE DIAGNOSIS?
I didn't post a status update on Facebook about my cancer diagnosis, but I told everyone except my mom and dad because I wanted to spare them the pain. My dad died in 2018 and in 2016 when I was diagnosed with breast cancer he was 92 years old and a bit dazed. I didn't want to worry him. My mom was fine, but me and my sister made the decision not to tell my parents. I told everyone at work and of course the reactions were a bit different. Some people who have been diagnosed with cancer find that people react badly when they tell people around them. I didn't care even if the reactions weren't always the best.
DO YOU HAVE ANY ADVICE FOR THOSE WHO HAVE A FRIEND OR COLLEAGUE WHO HAS ACTUALLY GOT CANCER?
Above all, it's best to listen and maybe instead of asking a lot of questions, say "If you want to talk about it, feel free to talk to me".
HOW DID YOUR FAMILY REACT TO THE NEWS?
My oldest daughter was with me in the hospital when I got the news and also when I had surgery. My sister, who lives in Ängelholm (in the south of Sweden, 6 hours away from Stockholm), also took the trouble to come up to Stockholm and was with me on the day of the operation. My two younger daughters were with me after the surgery when I would get the subsequent treatment plan, but they mostly stared at my mom's newly operated breasts (laughs). They are both very empathetic, but were perhaps not mature enough to have the same deep understanding that my eldest daughter, who is also a doctor, had. But all three of them were of course very concerned.
WHAT WAS THE SUBSEQUENT TREATMENT?
The breasts healed quickly and the operation was much less painful than I thought it would be. I've had foot surgery before and it was hell on earth but my breast surgery didn't even hurt. In my case, they removed a piece of cake, like a plum, on both breasts which took me from a D cup to a C cup, so in my case it was like a breast reduction operation. I never needed chemotherapy, but after the surgery I started treatment with Tamoxifen, which is an estrogen inhibitor. For three weeks I also had radiation every day of the week, but the radiation was very quick and only took a few minutes. I also got a contact nurse, which was quite new in 2016, who I could call at any time and ask questions about different things. The contact nurse was also there for the 5 years that I was enrolled. There were many doctor's visits that spring for them to set up the radiation correctly, but I felt that I got a very good treatment plan, which meant that I always felt safe, that everything was handled professionally and that I could trust the healthcare system. I had that feeling all spring. The only thing that was a small bonus with the breast cancer surgery was my fantastic surgeon. I was lucky enough to have one of Sweden's best cancer surgeons who was also a specialist in plastic surgery. After the operation, I got two perfect breasts and did not have to use a bra with a lot of support, which had previously given me pits in the shoulders, which was a relief and also became a small bonus in something that was otherwise very difficult.
HOW DID YOU REACT EMOTIONALLY DURING AND AFTER TREATMENT?
There were of course many thoughts about death during treatment, but after my breast cancer I appreciate life even more. I don't take anything for granted anymore. I have become so incredibly grateful for everything and I can't stand people who whine and complain too much, which I was more accepting of before my breast cancer. I have many girlfriends, but I have actually done a cleansing among friends after the cancer and removed all the energy burdens. In order to feel good, you have to get good energy and that applies to everything. I'm not paid to be a life coach. Life is too short. Before the operation, I also had such heavy breasts that I got pits in my shoulders after the bra. It may sound banal, but the breasts actually became more attractive after the operation, which was a positive thing.
DID YOU HAVE ANY SIDE EFFECTS?
I received very informative and clear information about the side effects of the treatment. The healthcare system does not make any "happiness calculations" but they informed me about everything. I was told that I could get burns from the radiation and I also got a gray area on my chest after the radiation, but it doesn't hurt to get radiation. I don't feel it at all! You can also get side effects from the anti-estrogen medication Tamoxifen. I was in menopause even before the breast cancer diagnosis with low levels of estrogen and on that I got estrogen inhibitors. I also stopped taking estrogen right away when I received that thick envelope from the mammogram. Estrogen-inhibiting medication is also much worse for younger women as they reach menopause earlier, but I was already in menopause. I don't think that the estrogen-inhibiting medication affected me so much in the beginning, but then again, my only focus was that I didn't want to die. Low levels of estrogen make you dry all over, but dry mucous membranes are not something you think about when going through breast cancer treatment. I've also always had slightly greasy hair, but suddenly my hair became super dry and brittle and my nails got worse. I was supposed to be on Tamoxifen for five years, but after four years I contacted my doctor because my urinary tract infections started coming back. When the mucous membranes become dry and fragile, they also become more susceptible to urinary tract infections and I did not want to end up where I was in 2014 when I had urinary tract infections all the time and then it was decided that I could stop taking Tamoxifen. I have also not had any urinary tract infections after the cancer treatment, which many people can get.
Image: Gray area on the chest after radiation
HOW DRY ARE MUCOUS MEMBRANES AFTER CANCER TREATMENT?
I didn't get so dry that I started bleeding during sex - my mucous membranes have never been that dry. During the time I was on Tamoxifen, I also met a man with whom I had a normal sex life and during this time I used local estrogen. I also use VagiVital AktivGel regularly and what I like about it is that it is mess-free. As an intimate wash I always use VagiVital V Cleanser and I will never use anything else. I recommend it to all my friends as it moisturizes so well and is really nice!
You can find VagiVital V Cleanser here
HOW WAS YOUR SEX LIFE AFFECTED AFTER CANCER TREATMENT?
That was also such a weird thing. During my cancer treatment in the spring of 2016, I was single and dating a guy I had sex with, and I still don't understand why I did it because he wasn't very serious. He was very interested at first, but when he found out I was 10 years older than him, then...yeah. I didn't always make good decisions during this period. For example, I didn't realize that I should rest and call in sick at work. The desire was there all the time during the four years of treatment. My libido was not impaired. I wanted to have sex. I can actually feel the lack of desire now, but then you have to struggle with it a bit on your own.
You can find VagiVital AktivGel for dry mucous membranes & pain during sex here
WAS YOUR BODY IMAGE AFFECTED AFTER BREAST CANCER?
No, I don't think so, but it's also so contradictory. I had a birthday dinner with my girlfriends when I turned 60, the same year as my cancer treatment. When I see pictures from that dinner, I look absolutely radiant. There's also a picture from a hike in Mallorca the same year, where I look really good, and I was also often praised in 2016 for not losing myself. Was it real or fake? I don't really know.
Image: Hiking trip in Mallorca one month after surgery
IS THERE ANYTHING YOU WISH YOU HAD DONE DIFFERENTLY?
My only regret is that I didn't call in sick. So in hindsight, it's a good tip to give up being a good girl! It was actually pretty crazy that I went back to work so soon. When I went for radiation I could have been on 25% sick leave, but in order not to miss work I was at the hospital for radiation at 06:30 every day so I could work after that. Absolutely insane! The colleagues I was responsible for were the greatest people in the world and often said to me, "Annika, aren't you going for treatment? What are you doing here?". They were incredibly supportive and smarter than me. Everyone around me said I should call in sick, but I was like that at the time - I've reconsidered. I would change it. Stupid. Life has different phases and now I had cancer. I actually thought about it when I saw the politician Lena Hallengren on the news, as she had significantly tougher cancer treatment than me. I felt like saying "go with the government now, Lena!" and almost wanted to send her an email. You also always say "Yes, but I feel good working" but there must be something in between, right? That I couldn't take time off and was on sick leave for four weeks - it's just ridiculous!
HAS YOUR ATTITUDE TO HEALTH CHANGED IN ANY WAY?
I've always liked wine and a bit too much sugar. After my divorce in 2008, it's been a lot of partying with late nights and a lot of dating, but that has changed after breast cancer. I take better care of myself after cancer. I'm more careful now. I never drink so much that I get a hangover and only drink 1 or max 2 glasses of wine and only with food and never on an empty stomach. I've always exercised and still do, but now I think more about taking care of myself. I stress less. I also sleep well and take care of my sleep, which has almost become a science, where it's important for me to get enough sleep and I have a weighted blanket, a nail mat and a pillow between my legs (laughs) so as not to disturb my hip. I can now become a bit of a hypochondriac sometimes. I got a wax plug in my ear, which made me lose my balance and I immediately thought it was brain cancer. It hasn't happened that many times, but cancer comes with one. It becomes a bit of a hypochondriacal light. After a prolonged cold that never ended, I thought that now it's cancer again. That can happen sometimes. Today, I have been declared healthy since 2021 and now participate in the regular mammography program, but I am and will always remain a cancer survivor.
DO YOU HAVE ANY ADVICE FOR WOMEN WHO HAVE JUST BEEN DIAGNOSED WITH BREAST CANCER?
If you are now affected by cancer, you need to be aware that breast cancer is probably one of the best forms, as the breasts protrude and are not close to any vital organs. Today, most people survive a breast cancer diagnosis. The tip is to actually believe in the healthcare system. I often sat in the waiting room and heard people being dissatisfied with this and that - and of course you can be deceived, but I think first and foremost you have to trust the breast cancer treatment. It's a super professional system with a whole team of people with enormous knowledge. Don't look for mistakes, but look at the big picture. Also, listen to yourself. Call in sick and stop being a good girl! My wise doctor told me to call in sick, but I didn't want to listen to her. It also came out really well based on my breast cancer. I have a new way of looking at life, where I value myself, my time and my health in a better way. I have developed a much closer relationship with my sister, where we are now very close and I have in many ways reassessed the meaning of life, which has been very positive!
By: Fanny Falkman Grindal