White Coat Black Art·First Person

Cancer taught me the hard truth about speaking up for myself

As a little girl, Jennifer Fotheringham was shushed for asking about cancer. As a grown woman, she was dismissed for asking about a mammogram. Now as a cancer survivor, she knows not to be silenced.

Hearing my diagnosis was hard. Not being heard by the health-care system is harder

Jennifer Fotheringham with her husband Geoff and son Max. (Submitted by Jennifer Fotheringham)

Originally published on April 23, 2022.

This First Person column is from Jennifer Fotheringham, who heard a radio program that spurred her to book a mammogram that she believes saved her life. For more information about CBC's First Person stories, please see the FAQ.

Nobody forgets the moment they learn they have cancer.

For me, it was early December as I drove from Montreal to Ottawa. Clear road, caffeine in hand, sing-along tunes blaring, the day couldn't get any better.

It didn't.

A call from my doctor's office interrupted my music, so I hit the button on the steering wheel to answer. The nurse got straight to the point: "So, Jennifer, I am just following up about your upcoming appointment at the cancer clinic." This was the first I'd heard of it. 

It wasn't the first time I'd wondered if the health-care system was listening to women like me.

What's cancer? I asked. Shhh, they said

The word cancer has gripped me from the time I was a Little. I remember visiting my great-grandmother and stopping short of kissing her cheek, which was covered in a yellow goo encased in crust.

Later, the Littles listened as the Bigs gossiped.

It's cancer, they whispered.

What's cancer, I asked.


After Great-Grammy died, cancer took shape in my developing mind as a murderous villain that eats you from within until you get lemon-meringue-face and die. From the Bigs, there was no reassurance forthcoming that cancer was something people could survive or manage or live with.

There really isn't a good time or place to receive cancer news but hurtling down a highway at 120 km/h is perhaps the worst.

Or perhaps it was meant to be. After all, it came almost exactly a year after another noteworthy car experience that had brought me to this point.

'She was 49.' So was I 

When I became a Big, I counselled women with cancer at The Ottawa Hospital. Their courage awed me but their losses hurt. Determined to improve my own mental health while assisting with theirs, I started a professional practice that allowed me to see clients in their homes. 

As another tool to help me cope with the stress of my work, I reprogrammed my car radio to music stations, deciding to embrace singing behind the wheel instead of listening to sad stories and negative news.

Until one very lucky day when I didn't.

The first thing I heard was a man's voice saying, "She was 49 when she found a lump." 

Forty-nine. That was my age.

The story on White Coat, Black Art was about Lucy van Oldenbarneveld, a longtime Ottawa CBC broadcaster, who survived breast cancer by finding it early, while devastated by the loss of her sister to the same disease.

From their story emerged another, about current Ontario breast screening guidelines and mounting evidence challenging their position that 50 is the best age to start screening.

Listen: Lucy van Oldenbarneveld and her sister got breast cancer in their 40s. Lucy survived, but her sister did not.

Featured VideoOne in five women who get breast cancer are in their 40s. Canada's current guidelines say women in that age group who are at low risk of breast cancer don't need regular mammograms or breast self-exams. But Lucy van Oldenbarneveld disagrees. She and her sister got breast cancer in their 40s. Lucy survived, but her sister did not.

Me at age 44: "I want to get a mammogram."

"Only your grandmother had breast cancer. And the guidelines say not until 50."

After the radio program ended, I called my husband and told him that I was getting a mammogram.

"Jen, did you find a lump?" 

"No. But I don't want to."

Initially, I assumed getting a mammogram would be easy. I was wrong. What I thought would be a couple of calls and a short doctor's visit ended up being a months-long endeavour.

Clinic: "The pandemic has made it difficult to get a screening now. You should wait."

I refuse.

And that made all the difference.

After my diagnosis, I learned about research pointing to the benefits of screening before age 50 and problems with research that suggested it was unnecessary — even harmful — to screen earlier.

After listening to a radio program about breast cancer in women in their 40s, Jennifer called her husband to say she was getting a mammogram. (Brian Goldman/CBC)

My cancer journey has been marked by many life-altering coincidences, including a connection to Dr. Jean Seely, professor of radiology at The Ottawa Hospital, head of breast imaging and co-author of a groundbreaking paper identifying significant flaws in the research that guides our current national screening guidelines — guidelines that recommend against screening women before 50.

Seely was responsible for the biopsy that confirmed my cancer. 

She was also one of the women featured on the radio program that prompted me to get a mammo in the first place.

My experience, which I'm sure is not unique, has been neither easy nor comfortable. But despite the difficulties, diagnosis and treatment, cancer has forced me to confront my fears, speak up for myself and accept that courage doesn't avoid discomfort. 

It relies on it.

Jennifer Fotheringham is a social worker with a private practice doing mental health and workplace wellness therapy. She lives in London, Ont., with her husband Geoff and son Max.

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