Ordinary Love (2019): A Self-Found Lump

Tom and Joan are a long-married Belfast couple. Their life is built from small routines: the nightly walk, the running commentary, the shared jokes. It is also shaped around the absence of their daughter, who died.

Spoilers throughout. Joan's treatment is the plot, so this page walks through all of it.

In the shower, Joan finds a lump in her breast. What follows is the ordinary machinery of a cancer pathway. She sees her GP. She is sent to a breast clinic for a mammogram and a biopsy. Then comes the waiting, and the appointment where the word is finally said.

Joan has surgery, and lymph nodes are taken out at the same time. She is referred for chemotherapy, which Tom questions, since the tumor is already gone. The film sits inside the treatment: nausea, exhaustion, hair loss. It also sits inside the friction between a wife who wants to be looked at plainly and a husband who copes by fussing.

Joan goes on to a mastectomy and later reconstruction. In waiting rooms the couple befriend Peter, a former teacher of their daughter. Peter dies. The film ends with Joan through treatment and the couple resuming their walk.

The film follows the usual order of breast cancer care rather than cutting to the outcome.

1. Joan finds the lump herself and goes to her GP.
2. She is referred to a breast clinic, where imaging and a biopsy are done.
3. She has surgery, including removal of lymph nodes to see whether cancer has reached them.
4. She is given chemotherapy after surgery.

Each of those steps answers a different question, and the answers accumulate. Imaging asks whether there is something there. The biopsy asks what it is. The nodes ask how far it has been. Only then can anyone say what treatment is for.

Fatigue, nausea, hair loss and the tedium of infusion suites are all shown.

The film is also unusually honest that cancer happens to a marriage and not only to a body. It shows the carer's helplessness, the irritability, the arguments about nothing, and the loneliness on both sides of the bed.

Tom's objection is the one most families have, and the film answers it exactly as oncologists do.

Surgery and radiation are local treatments aimed at the area with cancer. Chemotherapy is a systemic treatment: the drugs reach cancer cells throughout the body. "Adjuvant" means treatment added after the main one, here surgery.

NCI says treatment choices depend on tumor stage and grade, hormone receptor status, HER2 status, and menopausal status. Some tumors also get a gene test that helps estimate recurrence risk. It is fair to ask your own team: what is the benefit of chemotherapy for someone with my results?

Timelines are compressed. In reality the waits between referral, biopsy, results, surgery and chemotherapy stretch over months, and much of the ordeal is waiting.

The film shows little radiotherapy, and no endocrine therapy — the hormone-blocking treatment that, for hormone receptor-positive cancer, NCI says typically lasts five years or longer. It can be a long part of treatment, and it is easy to miss on screen.

Lasting effects are glossed over too. Lymphoedema, the swelling caused by damage to the lymph system, can follow surgery or radiation, and NCI notes that menopausal symptoms need careful management. The fear of recurrence, which does not end when the appointments do.

Joan's reconstruction proceeds smoothly. In real life, ask your surgeon about possible complications and further operations before you decide.

The CDC lists these warning signs of breast cancer:

• A new lump in the breast or underarm.
• Thickening or swelling of part of the breast.
• Irritation or dimpling of the breast skin.
• Redness or flaky skin in the nipple area or the breast.
• The nipple pulling in, or pain in the nipple area.
• Nipple discharge other than breast milk, including blood.
• Any change in the size or shape of the breast.
• Pain in any area of the breast.

The CDC also notes that these can happen with conditions that are not cancer. It says to see your doctor right away if you have any of them.

Do not wait to see whether a lump becomes painful. A change in your breast is a reason to be checked. Men can develop breast cancer too and should report a lump the same way.

For people at average risk, the US Preventive Services Task Force recommends screening mammography every two years for women aged 40 to 74. That is a grade B recommendation from 2024.

The film is set in Northern Ireland, where national screening rules differ. This page covers only the US recommendation.

Screening does not replace reporting a symptom. Joan's cancer was found because she noticed it, not because a letter arrived, and a new lump should be checked right away, whatever your screening schedule. If you have a strong family history or a known BRCA variant, ask your team about a plan made for you.

• CDC: Breast cancer symptoms
• USPSTF: Breast cancer screening (2024)
• NCI: Breast cancer treatment (PDQ)

Cancer Explained is free and ad-free. Nothing is sold on this page. No sponsor sits behind it.

Did this page help you understand something about Ordinary Love, or nudge you toward a question you had been avoiding? Reader support is what keeps this page on Ordinary Love free, along with every other page here. Support our work.

The final image is the same walk they took at the start, which is the film's real argument: what treatment protects is the ordinary life, not some better one. Take the pathway seriously. Take the timeline with a pinch of salt, and expect the aftermath to last longer than the film suggests. Ordinary Love cannot tell you what to watch for, but screening and possible warning signs can.

This page discusses Ordinary Love for education. It is not medical advice, and nothing here is a judgement of anyone's real medical care. Spotted an error? Please email corrections@cancerexplained.org.