When single mother Lisa Evans was told she had no evidence of disease after brutal treatment for breast cancer, she was relieved.
But four years later, the 44-year-old has now undergone more surgery after doctors found pre-cancerous cells they said may have been caused by the common anti-cancer drug she was taking.
However, she wants people to look at the benefits of the drug, rather than what happened to her.
She was told the chances of it happening were very low.
“My friends say how do I feel? I say clearly I’m an overachiever,” she joked.
Evans, from Perth, had no symptoms or signs when she was diagnosed with breast cancer in 2017 aged 39.
It was only because her GP asked to check her breasts as part of a pap smear appointment it was even detected.
She told Evans she’d felt “thickening” in one of her breasts and sent her for tests.
”I wasn’t expecting it,” she said.
“It was just a little bit fuller – it would never have dawned on me there was something wrong.”
Evans was told she had a 6.5cm tumour in her left breast, which was classed as stage three cancer.
The government admin worker, who now runs therapeutic horse riding classes, had a mastectomy followed by chemotherapy.
She had a rare side effect of being allergic to the chemotherapy.
Evans lost part of her vision, coordination and suffered hallucinations.
She was so sick doctors even wanted to stop treatment, but she said she had to keep going for her two children, Ethan, 15, and Caitlyn, 13.
“I said I don’t have a choice – it doesn’t matter if it nearly kills me,” she said.
Following a breast reconstruction, Evans was finally told there was no cancer.
As is common with her type of breast cancer, she was put onto oestrogen-blocking drug tamoxifen to try to stop it returning.
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And though the side effects were harsh – she compared it to feeling like she constantly has flu – the research was clear in showing the benefits of keeping the cancer away.
But now, Evans has been told she had the early signs of endometrial cancer in her uterus.
Rather than planning her five-year “cancerversary” party, she’s recovering from a hysterectomy.
“You go on a drug to limit your chances of breast cancer again but then it gives you a higher risk of endometrial cancer,” she said.
“It’s very rare.”
However, she advised people to look at the benefits of the drug, rather than what happened to her.
Dr Mun Hui, medical oncologist at Chris O’Brien Lifehouse, said tamoxifen halves the risk of recurrent metastatic breast cancer.
“If the absolute risk is high due to higher stage disease, the absolute benefit is larger,” he said.
Hui said studies have not definitively shown tamoxifen increases the risk of endometrial cancer in premenopausal women like it has in those post menopause.
“The risk of endometrial cancer is low compared to the benefit against recurrent, incurable metastatic breast cancer,” Hui said.
“Additionally, most endometrial cancers are diagnosed in stage one.”
Government body Cancer Australia said it’s important to examine both the risks and benefits of tamoxifen too.
“It’s important to balance the risk of these rare side effects against the fact that anti-oestrogens lower the risk of breast cancer coming back and dying from breast cancer,” it said.
Now Evans is part of a charity calendar of breast cancer patients.
She took part in an “empowering” photoshoot in Darwin with six other women affected by breast cancer for the So Brave calendar, which is in its seventh year.
So Brave is Australia’s only breast cancer charity for women under 40.
Evans said it was a special day.
“We’ve all had reconstructions, and our bodies have changed due to the drugs. You’re in a pair of knickers but you feel safe,” she said.
