Courage, hope & dry mucous membranes - Annika Cripps on her breast cancer

Annika Cripps became known to the Swedish public through her participation in the first dating TV show for seniors in Sweden, which became extremely popular. With her warm and genuine personality, she quickly became a favorite among viewers as she shared her thoughts on romance, desire, and the importance of nurturing relationships, but what few know is that Annika survived breast cancer. In January 2016, Annika received an envelope in the mailbox from the mammography screening she had recently undergone. The envelope was thicker than usual, and she immediately understood that something was wrong. In this exclusive interview, Annika generously shares her personal reflections and lessons in a hopeful and inspiring way based on a desire to raise awareness about breast cancer.

HELLO ANNIKA, HOW ARE YOU TODAY?

I'm feeling great, thanks! I have actually just gone through my calendar from 2016 because that was when I was diagnosed with breast cancer. I had to review the timeline and it was a bit tough actually because I realized now how crazy I partly was back then (laughs), but otherwise I'm fine!

WHEN DID YOU GET THE BREAST CANCER DIAGNOSIS?

I had a mammogram in January 2016. You usually just get a simple letter saying everything is okay, but this time I got a thicker envelope. So I immediately felt when I got that envelope that it contained several papers, and then I understood that something was wrong. That was the first warning sign. I immediately got a follow-up appointment at SÖS. Of course, I was a bit shaken, and I also talked a lot with my daughter who is a doctor and with a friend who had had breast cancer. Many also told me that it could be a fatty lump and that it didn't have to be cancer. During the follow-up when they were going to take a biopsy, they couldn't get the needle in because the breast was so compact, and I had to book a new appointment for an ultrasound instead. It was during the ultrasound examination that I really understood. I remember so well the doctor and nurse who did the ultrasound. I immediately understood from their facial expressions that it was serious. It was felt throughout the room. But it was really not until after the operation, when the lump had been removed and analyzed, that I got the news that it was actually breast cancer.

WHAT DO YOU REMEMBER MOST CLEARLY FROM WHEN YOU GOT THE NEWS?

My eldest daughter, who is a doctor herself, was with me when I got the news. I remember the female doctor said, "Yes, 90% it's cancer, and how does that feel, Annika?" I remember thinking it was a strange question to ask right away like that and instead reflected on the fact that the doctor had greasy hair. I sat there thinking about why a person goes to work with greasy hair (laughs). But then I saw my daughter's eyes tear up. Time stopped those seconds. I managed to think all this at once. It's so crazy. My daughter is an incredibly empathetic person, but she doesn't like to show emotions, and when I saw that she was crying – then I thought now it's serious. So everything kind of rushed through my head at once.

DID YOU HAVE ANY SYMPTOMS BEFORE?

No, none at all! However, I had a risk factor with my breasts that I didn't know about. It was that I had "compact breasts," which is also called gland-dense breasts. That risk factor is quite significant. I had also taken estrogen for 2 years before the cancer was discovered. I turned 60 the year I got the cancer diagnosis and was at the end of menopause. In 2014, I had very troublesome urinary tract infections that I couldn't get rid of and took long-acting penicillin for 3 months. The whole immune system was knocked out, and then I thought I had to start taking estrogen to avoid the urinary tract infections. It was absolutely wonderful to get estrogen – because I also felt so much better mentally, but unfortunately, it probably wasn't suitable to take estrogen when I had this risk factor "compact breasts." Then you still don't really know what caused the cancer. It was maybe a combination of everything.

HOW DO YOU KNOW IF YOU HAVE COMPACT BREASTS?

If you feel the breasts, they should be soft, but if you can't really squeeze them together, they are compact. Before the breast cancer, I also had a fairly heavy bust, and when I previously had mammograms, it was like trying to press something together that doesn't go.  The term “compact breasts” or dense breasts has come up in the debate in the last two years as this has started to be discussed as a risk factor based on relatively new research. I had many health factors like being well-trained, normal weight, and having breastfed my three children, which reduces the risk of breast cancer, but I did not know that dense breasts could be a risk factor.

DID YOU YOURSELF REGULARLY CHECK YOUR BREASTS?

Well, it didn't work. Before the breast cancer, I had a large D sometimes E cup, and it was not possible to feel deep inside the breast because 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 dense breasts can be a risk factor to my girlfriends, they have wanted to have their breasts examined – by me! The last time that happened was when we were at the bar (laughs)!

WHAT DO YOU REMEMBER FROM THE DAY YOU HAD YOUR BREAST CANCER SURGERY?

I was operated on March 29, 2016, and this is so interesting... in my calendar, I had only written a bunch of work stuff. There is nothing about an operation. To find out which day I was operated on for this interview, I had to go into an app on my phone that shows how many steps I take, because I knew that the day I was operated on, I didn't take a single step. What was even stranger in hindsight was that I had booked a 50th birthday party on the Saturday the same week I was operated on – I was completely crazy. Then I went back to work only 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 it could be confirmed through a test in the armpit that the cancer had not spread, which was very relieving! In my case, there were also other signs beforehand indicating that it had not spread. If the cancer lump has a thick potato skin around it, then the risk that it has spread is lower, which was seen during my MRI. I got good signals at an early stage but with the caveat that we all know it is a tricky disease. But after the operation, I could in a way breathe out. The cancer had not spread, and that was really great.

HOW DID YOU HANDLE THE NEWS DURING THE TIME YOU HAD TO WAIT FOR THE OPERATION?

I was very calm, kept working and went to exercise as usual. It sounds a bit superhuman but I am very pragmatic and see the whole picture and everything also felt professionally handled by the healthcare. I actually slept well at night during this time.  I also talked with a friend who had undergone a cancer treatment that was tougher than mine as she had chemotherapy and she said this: "The only thought was that now I am going to die but I have had a very good life" and I learned that from her. To think like that. It helped me. I am quite pragmatic and think that now I live here and now and then you don't know what tomorrow has to offer but I can't keep worrying about that. Many people my age talk about everyone who is sick. It's obvious that you get sick when you are 60, 70, 80 years old but not everything is terminal illness.

DID YOU TELL YOUR SURROUNDINGS ABOUT THE DIAGNOSIS?

I didn't write any status update on Facebook about my cancer diagnosis but I told everyone except my mom and dad because I wanted to spare them. My dad died in 2018 and in 2016 when I got the breast cancer diagnosis he was 92 years old and a bit confused. I didn't want to worry him. My mom was completely clear but my sister and I 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 experience that people react wrongly when they tell their surroundings. I didn't care if the reactions weren't always the best.

DO YOU HAVE ANY TIPS FOR THOSE WHO HAVE A FRIEND OR COLLEAGUE WHO HAS JUST BEEN DIAGNOSED WITH CANCER?

It's mainly about listening and maybe instead of asking lots of questions saying "If you want to talk about it, you are welcome to talk to me."

HOW DID YOUR FAMILY REACT TO THE NEWS?

My eldest daughter was with me at the hospital when I received the news and also when I had the surgery. My sister who lives in Ängelholm also made the effort to come up to Stockholm and was with me on the day of the operation. My two younger daughters were with me after the operation when I was to receive the subsequent treatment plan but they mostly stared at mom's newly operated breast (laughs). They are both very empathetic but perhaps not mature enough to have the same deep understanding as my eldest daughter, who is also a doctor, had. But of course, all three of them were very worried.

WHAT DID THE FOLLOW-UP TREATMENT LOOK LIKE?

The breasts healed quickly, and the operation was much milder than I had thought. I have had foot surgery before, and that was hell on earth, but my breast operation didn't even hurt. In my case, they removed a wedge, about the size of a plum, from both breasts, which made me go 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 operation, treatment with Tamoxifen, which is an estrogen-inhibiting medicine, was started. For three weeks, I also had radiation every weekday, but the radiation went very fast and only took a few minutes. I also got a contact nurse, which was quite new in 2016, whom I could call anytime and ask questions about various things. The contact nurse was also there during the 5 years I was enrolled. There were many doctor visits that spring to adjust the radiation correctly, but I felt that I got a very good treatment plan, which made me feel safe all the time, that everything was handled professionally, and that I could trust the healthcare system. I had that feeling all spring. The only little bonus with the breast cancer operation was my fantastic surgeon. I was lucky to get one of Sweden's best cancer surgeons who was also a specialist in plastic surgery. After the operation, I got two perfect breasts and didn't have to wear a bra with a lot of support, which had previously given me dents in my shoulders, which was a relief and also became a little bonus in something that was otherwise really tough.

HOW DID YOU REACT EMOTIONALLY DURING AND AFTER THE TREATMENT?

Of course, there were many thoughts about death during the treatment, but after my breast cancer, I appreciate life even more. I no longer take anything for granted. I have become incredibly grateful for everything, and I also can't stand people who complain and whine too much anymore, which I was more accepting of before my breast cancer. I have many girlfriends, but I have actually done a cleanup among friends after the cancer and removed all energy drainers. To feel good, you have to bring in good energy, and that applies to everything. I am not paid to be a life coach. Life is too short. Before the operation, I also had such heavy breasts that I got dents in my shoulders from the bra. It may sound trivial, but the breasts actually became nicer after the operation, which was something positive.

DID YOU EXPERIENCE ANY SIDE EFFECTS?

I received very informative and clear information about the side effects of the treatment. The healthcare system doesn't do any “happy calculations” either; they informed about everything. I was told that I could get burns from the radiation, and I also got a gray area on my breast after the radiation, but it doesn't hurt to get radiation. It doesn't hurt at all! You can also get side effects from the estrogen-inhibiting medicine Tamoxifen. I was already in menopause before the breast cancer diagnosis with low estrogen levels, and on top of that, I got estrogen inhibition. I also stopped estrogen immediately when I got that thick envelope from the mammogram. Estrogen-inhibiting medicine is also much worse for younger women as they enter menopause earlier, but I was already in menopause. I don't think the estrogen-inhibiting medicine affected me that much in the beginning, but then again, my only focus was that I didn't want to die. Low estrogen levels cause dryness everywhere, but dry mucous membranes are not something you really think about when going through breast cancer treatment. I've also always had slightly oily hair, but suddenly my hair became super dry and frizzy, and my nails deteriorated in quality. I was supposed to take Tamoxifen for five years, but after four years, I contacted my doctor because my urinary tract infections started to come back. When the mucous membranes become dry and fragile, they also become more susceptible to urinary tract infections, and I didn't want to end up where I was in 2014 when I had urinary tract infections all the time, so it was decided that I could stop Tamoxifen. I also haven't had any urinary urgency after cancer treatment, which many can experience..

Caption: Gray area on the breast after radiationa

HOW DRY DO MUCUS MEMBRANES GET AFTER CANCER TREATMENT?

I didn't get such dry mucous membranes that I started bleeding when I had sex – my mucous membranes have never been that dry. While I was taking 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 non-sticky. For intimate washing, I always use VagiVital V Cleanser, and I actually will never use anything else. I recommend it to all my girlfriends because it moisturizes so well and feels really nice!

You can find VagiVital V Cleanser intimate wash here

HOW WAS YOUR SEX LIFE AFFECTED AFTER CANCER TREATMENT?

That was also such a strange thing. During the cancer treatment in spring 2016, I was single and dating a guy I had sex with and I still don't understand why I did, since he wasn't very serious. He was very interested at first but when he found out I was 10 years older than him, well... I didn't always make the best decisions during this period. For example, I didn't realize I needed to rest and take sick leave. The desire was still there throughout the four years of treatment. Libido was not reduced. I wanted to have sex. Lack of desire is something I can actually feel a bit now but then you have to struggle with it a little on your own.

You can find VagiVital AktivGel for dry mucous membranes & pain during intercourse here

DID YOUR BODY IMAGE CHANGE AFTER BREAST CANCER?

No, I don't think so but it's also so contradictory. I hosted a birthday dinner with my girlfriends the same year as the cancer treatment when I turned 60. When I look at pictures from that dinner, I look absolutely radiant. There is also a photo from a hike in Mallorca the same year where I look very healthy and I also often received praise during 2016 for not falling apart. Was it genuine or fake? I don't really know actually.

Caption: Hiking trip on Mallorca one month after the operation

IS THERE ANYTHING YOU WISH YOU HAD DONE DIFFERENTLY?

The only thing I regret is that I didn't take sick leave. So in hindsight, a good tip is to forget about being a good girl! It was actually completely crazy that I went back to work so quickly. When I was undergoing radiation, I could have had 25% sick leave but to not miss work, I was at the hospital to get radiation at 6:30 AM every day so that I could work afterwards. Totally insane! My colleagues, whom I was the manager of, were the best in the world and often said to me; "Annika, aren't you undergoing treatment? What are you doing here?" They were incredibly supportive and wiser than me. Everyone around me told me to take sick leave but I was like that then – I've re-evaluated that. I won't do that again. 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 a much tougher cancer treatment than me. I felt like saying "but forget the Government now Lena!" and almost wanted to email her. People also always say things like "Yes, but I feel good working" but there must be a middle ground? That I couldn't take time off and be on sick leave for four weeks – that's just ridiculous!

HAS YOUR RELATIONSHIP WITH HEALTH CHANGED IN ANY WAY?

I have always liked wine and a bit too much sugar. After my divorce in 2008, there was a lot of partying with late nights and lots of dating, but that has changed after breast cancer. I take better care of myself after cancer. I am more careful now. I never drink to the point of a hangover and I only drink 1 or at most 2 glasses of wine and only with food and never on an empty stomach. I have always exercised and still do, but now I think more about taking care of myself. I stress less. I sleep well too and am careful with sleep, which has almost become a science where it is important for me to get enough sleep, and I have both a weighted blanket, a spike mat, and a pillow between my legs (laughs) to avoid hip pain. I can now sometimes be a bit hypochondriac. I got some earwax plug in my ear that made me lose balance and I immediately thought it was brain cancer. It hasn't happened many times but cancer stays with you. It becomes a light hypochondria. After some long-lasting cold that never ended, I think now it's cancer again. That can happen sometimes. I have been declared healthy since 2021 and now go to 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 get cancer, you should be clear that breast cancer is probably one of the best forms since the breasts protrude and are not close to any vital organs. Today, most people survive a breast cancer diagnosis. The tip is actually to have faith in healthcare. I often sat in the waiting room and heard people complain about trivial things – and of course, you can run into idiots, but mainly I think you should trust breast cancer care. It is a super professional system with a whole team of people with enormous knowledge. Don't look for faults but see the whole picture. Also listen to yourself. Take sick leave and stop being a good girl! My wise doctor told me to take sick leave but I didn't want to listen to her. There was also a lot of good that came from my breast cancer. I got a new way of looking at life where I value myself, my time, and my health better. I have gotten a much closer relationship with my sister where we are now very tight, and in many ways, I have reevaluated the meaning of life, which has been very positive!

By: Fanny Falkman Grinndal