October 15, 2026
#AD - This episode is sponsored by AstraZeneca
Dr Tonya Leonard was a GP when she found a lump she was sure was a cyst. By half past nine that morning, she was being told it was breast cancer and asked to decide by the following week whether she had finished her family. Her twin boys were just 18 months old.
Sixteen years, a second primary cancer and a diagnosis of advanced breast cancer later, Tonya joins Laura alongside Helen Forristal, Director of Nursing Services at the Marie Keating Foundation, for an honest conversation about living with advanced breast cancer.
They discuss metastatic or secondary breast cancer, breast cancer recurrence and the signs and symptoms women should be aware of, alongside treatment, scans, scanxiety, cancer fatigue and the difficulty of planning life beyond the next result.
Helen explains why advanced breast cancer remains largely invisible in Ireland, with no official count of how many women are living with it, and discusses the importance of specialist cancer support. Tonya shares the reality of living life in three-month segments, navigating mental health after diagnosis and learning that palliative care does not only mean end-of-life care.
The conversation is part of Living Loudly, Dying to be Heard, a campaign by AstraZeneca and supported by the Marie Keating Foundation, highlighting the experiences of people living with advanced breast cancer.
🔑 Key Points
Advanced breast cancer means it has spread
The cancer has moved from the breast to another organ; in Tonya's case, to lesions on her lung and under her arm.
Life in three-month segments
With a scan every three months, Tonya finds it hard to plan past the next result, the anxiety Laura calls scanxiety.
Fatigue is not the same as tiredness
Tonya describes cancer fatigue as like an injection of horse tranquilliser: once she feels it rising, she has minutes to lie down.
Women are living longer with it
Helen calls it the long middle, moving through lines of treatment; one woman in her group has lived with advanced breast cancer for 21 years.
Nobody is counting
Recurrences aren't recorded the way first diagnoses are; Helen's estimate is around 30% of women with primary breast cancer, and a University of Limerick project has started counting.
Know the signs of a recurrence
Symptoms depend on where it spreads, from a cough and breathlessness to weight change or bone pain; if something hasn't settled in three weeks, ask your doctor, "Could this be cancer?"
Mental health support needs to be specialist
Tonya waited eight weeks to see a psychologist; psycho-oncology services now run in Ireland's eight cancer centres.
Palliative care is not only for the end of life
Palliative teams help manage symptoms and support families, and the CLIMB programme supports children aged 5 to 12 who have a parent with cancer.
📚 Resources
Living Loudly. Dying to be Heard
A campaign by AstraZeneca and supported by the Marie Keating Foundation
The Marie Keating Foundation's support programme for people with advanced cancer
The HSE programme for children aged 5 to 12 affected by a parent's cancer
⏱️ Timestamps
00:00 — Welcome
01:52 — Helen Forristal and the Marie Keating Foundation
02:51 — Dr Tonya Leonard’s breast cancer diagnosis
06:21 — Advanced cancer support and Positive Living
09:28 — Scanxiety and living between results
12:08 — Living longer with advanced breast cancer
17:14 — Cancer fatigue
22:58 — Fertility and “Have you finished your family?”
29:17 — How many women are living with advanced breast cancer?
30:41 — Signs and symptoms of recurrence
37:57 — Mental health and psycho-oncology
46:45 — What palliative care really means
51:40 — Family, milestones and living with uncertainty
56:28 — Advice for young people
Thanks for listening! You can watch the full episode on YouTube here. Don’t forget to follow The Laura Dowling Experience podcast on Instagram @lauradowlingexperience for updates and more information. You can also follow our host, Laura Dowling, @fabulouspharmacist for more insights and tips. If you enjoyed this episode, please subscribe and leave a review—it really helps us out! Stay tuned for more great conversations.
