The C-Word (2015): Breast Cancer at Twenty-Eight

Spoilers throughout. This page discusses Lisa Lynch's illness and her death in 2013.

Lisa Lynch was a magazine editor in London, newly married, when a lump turned out to be breast cancer. She was diagnosed in 2008, at 28.

The film follows the machinery of treatment: mastectomy, chemotherapy, hair loss, radiotherapy. It also follows the writing. She could not find anything that sounded like her own life, so she started a blog called Alright Tit, in the voice she actually used. Sweary, funny and unsparing about bodies and indignity. It found an audience, became a book called The C-Word, and turned her into a spokesperson she never planned to be.

She was told she was clear, and life resumed awkwardly. Then in 2011 secondary cancer was found in her bones and later her brain. Lisa Lynch died on 11 March 2013, aged 33. The film does not soften that.

This is the fact the story turns on, and it is worth being exact about.

The US Preventive Services Task Force recommends a mammogram every two years for women aged 40 to 74. A 28-year-old falls below that range, so no routine screening test was aimed at her.

Under 40, there is no routine screening recommendation, so noticing a change and reporting it matters. That is not a comforting message, but it is the accurate one.

The most valuable thing in ninety minutes is a distinction that public conversation constantly blurs.

Primary breast cancer is cancer that is still in the breast where it began.

Secondary breast cancer, also called metastatic, has spread to another part of the body. The NCI says it most commonly develops in the bones, lungs, brain or liver. Treatment aims to control it by stopping or slowing its growth, and the NCI notes that some people live for years with well-controlled metastatic breast cancer.

The film draws the distinction clearly and repeats it.

Because Lisa's route in was a lump she found, the list matters here more than usual. The CDC names these warning signs:

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

The CDC says these changes can also come from conditions that are not cancer, and that some people have no symptoms at all. It also notes that some people have no symptoms at all.

Being young is not a reason to wait. Tell your care team what is new and ask to have it examined.

Routine screening starts at 40 in the United States. Some people are offered something different.

The Task Force's routine recommendation does not apply to people with a high-risk genetic marker such as a BRCA1 or BRCA2 variant. It has a separate recommendation on risk assessment, genetic counseling and genetic testing. Ask your care team whether that applies to you.

The Task Force also says the evidence is insufficient to judge the benefits and harms of extra ultrasound or MRI for women with dense breasts. If you have been told your breasts are dense, ask your care team what it means for you.

The film covers roughly five years in about ninety minutes. Treatment is compressed, so the pace should not be read as typical. Every person's course is different.

Nothing is sold here and no sponsor stands behind this page. If the primary and secondary distinction was new to you, you can help keep it free for someone else. Support our work.

The C-Word is a good adaptation of a real woman's writing, and it is unusually careful about the one thing that matters most: primary and secondary breast cancer are not the same disease.

Its second lesson is about age. Lisa Lynch was too young for any screening programme. Under 40, the only early-detection tool is a change that gets reported and taken seriously.

• Centers for Disease Control and Prevention — Breast Cancer Symptoms
• US Preventive Services Task Force — Breast Cancer: Screening
• National Cancer Institute — Metastatic Breast Cancer
• Penguin Books — The C-Word by Lisa Lynch, with author biography
• Shelf Awareness — Obituary Note: Lisa Lynch

This page discusses The C-Word 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.