I had already been through breast cancer once.

At 46 I was diagnosed with primary breast cancer. My treatment was substantial: a lumpectomy, full axillary lymph-node clearance, chemotherapy and radiotherapy, followed later by removal of my ovaries and approximately four years of tamoxifen.

I believed I had done everything I was supposed to do. I moved forward with my life.

When my cancer returned in 2023, medically it was extraordinarily advanced. Yet physically I had experienced virtually no warning. I actually felt as though I was at the peak of my fitness.

I did not spend months visibly deteriorating before somebody found advanced cancer. I went from feeling exceptionally well and functioning normally, to an extraordinary metastatic disease burden.

In August 2023, aged 50, I was diagnosed with exceptionally advanced Stage 4 metastatic breast cancer. At diagnosis there was approximately 85% liver involvement with metastases, a lung metastasis, and extensive bone metastases involving areas including my spine, hips and pelvis.

My prognosis was exceptionally poor and measured in weeks. Within a short period, the NHS reached the point of discussing hospice and end-of-life care with me.

I did receive conventional cancer treatment. I was given palliative paclitaxel, but I developed neutropenic sepsis and was considered unable to tolerate further intravenous chemotherapy at that point. My story subsequently included other systemic treatment, and I remain on endocrine treatment today.

I did not reject conventional medicine, and I am not anti-NHS. I developed neutropenic sepsis on three occasions and NHS emergency treatment saved my life each time. I have a very good relationship with my current oncologist and my chemotherapy nurse, and I am grateful for that care.

My point is a narrower one. There are cancer treatments and approaches available internationally that are simply not available to patients here. Reaching the end of what is being offered locally does not necessarily mean every possible option has been explored.

Through my own research and the cancer network I had built, I found Univ.-Prof. Dr. Dr. Thomas J. Vogl, a highly experienced interventional radiologist at University Hospital Frankfurt.

I travelled to Frankfurt because the type and extent of interventional treatment he was prepared to consider, for my particular metastatic disease burden, was not available to me in the UK.

Over the following period I underwent 11 TACE treatments — transarterial chemoembolisation, which delivers chemotherapy directly into the arteries feeding liver tumours while restricting their blood supply — followed by one microwave ablation, which uses heat to destroy targeted tumour tissue.

That year was extraordinarily difficult. I developed life-threatening sepsis three times and came extremely close to losing my life. My weight fell to five and a half stone. I developed severe ascites — a large accumulation of fluid in the abdomen — and required a permanent abdominal drain. I was repeatedly hospitalised and needed numerous blood and platelet transfusions as my body struggled through treatment.

And during that period, my metastatic disease disappeared on imaging.

I have now been in complete clinical remission — no evidence of disease — for two years. I continue to travel to Frankfurt for surveillance.

I remain on letrozole, prescribed by the NHS, as my ongoing systemic treatment. Letrozole is an aromatase inhibitor used in hormone-receptor-positive breast cancer. It is endocrine or hormone treatment — it is not chemotherapy.

Given the extent of my metastatic disease at diagnosis, my outcome has been extraordinary. I am careful about how I describe it, because it is my outcome and it is not a promise to anybody else.

Scans showing no evidence of disease did not mean I simply returned to my previous health. I continue to live with significant health problems and treatment consequences, including hypothyroidism, insomnia, substantial fatigue, and substantially reduced liver and kidney function.

I am not currently well enough to return to conventional employment. I funded significant elements of my own healthcare and treatment journey privately, including accessing money from my pension and life insurance. Over roughly the last year I have also navigated an extremely difficult divorce.

I mention this not for sympathy, but because the story is not: terminal cancer, then remission, then everything became easy. I am still learning how to live with illness, treatment consequences, exhaustion and major personal upheaval, while rebuilding a life.