Diagnosed with breast cancer exactly 20 years after her last bout of it, Anne Nolan is both devastated and scared.
Her sister Bernie — famous, like Anne, for singing in The Nolans, and later appearing in The Bill — died in 2013 aged only 52 after her breast cancer spread.
Another sister, 61-year-old Linda, is now undergoing chemotherapy at the same time as Anne.
After being successfully treated for breast cancer in 2006, Linda has liver cancer.
Once famous as members of the joyful and wholesome singing group, a darker fame is stalking the Nolan clan.
Anne, now 69, has been having chemotherapy after a lump — which she found in April — turned out to be malignant. She faces surgery and possibly radiotherapy, too, as her cancer was detected at stage three.
She says: ‘I’m not brave. I haven’t been brave at all — I’ve been crying and probably stressing my sisters and my daughters.
‘I just haven’t got any choice. Either I do it, take chemo, or face the consequences.’
It’s the news she has long dreaded and she has been having panic attacks and receiving therapy for anxiety.
She told me: ‘You fear that just one single cell is out there, somewhere, wherever in your body, and that it has escaped the treatment and will turn into a cancer that will kill you, even though you may have been in remission for years,’ she says.
Anne has had problems with lumps in her breasts for almost her whole adult life. ‘The first time was when I was maybe 25 and I had a benign lump out with 12 stitches,’ she says.
‘It was only when the doctor said that the lump had been tested and was benign that I realised that it could have been cancerous.
‘After that, I would have lumps aspirated with a needle [to take a biopsy] probably once or twice a year. I did say to the doctor: ‘Must I really keep on doing this?’ and she told me: ‘Yes, because the one time you ignore a lump, then it will be cancer.’
In 2000, that prediction came true. ‘They had taken out two cysts — which were benign — and the doctor examined me and she found the cancer, which I had missed’ recalls Anne.
‘I had a lumpectomy, chemotherapy and radiotherapy. I did get quite ill, which was my own fault because I was doing a summer season in Blackpool at the time and I got a bit tired. I ended up in hospital for a week on antibiotics.’
Anne recalls that it was hard telling her daughters, Amy and Alex, who were then aged 19 and 13.
‘Apparently I told one of them when we were walking in the park and the other when she was in the bath,’ she recalls.
‘I think I broke it pretty abruptly. They knew I was having tests and they asked me how it had gone and I just said: ‘I have cancer.’
‘One of my daughters burst out laughing when I told her because she thought I was joking, and I had to say, ‘No, I’m serious’, and in that instant she was crying.’
She continues: ‘I do remember that I had moments of pure despair with the cancer. I remember we would go out for a meal and everyone would be really happy sitting around the table, and then I would think, ‘I have cancer’, and it would be like a black cloud coming over you. I would just feel so scared.
‘You feel really alone, even if there are lots of people with you who want to help.’
She adds: ‘I was watching Comic Relief and there was someone on the show who had lost three children. I don’t think that there can be a greater pain. There is always someone worse off than you and it doesn’t hurt to remind yourself of it.
‘We have been through a bit. But there are families who have been through even more. You must not think about people who have been through nothing because then you aren’t able to cope.
‘People say, ‘You are being brave’, but you don’t have a choice.’
Her new diagnosis came after she and Linda returned from filming the TV series The Nolans Go Cruising, along with sisters Maureen and Coleen.
As Linda told the Sun newspaper recently: ‘On May 7, our sister Maureen called me at 10am to say that Anne’s breast cancer had been confirmed.
‘Then, half an hour later, my oncologist’s secretary phoned me to say: ‘We need you to have an MRI scan because we’ve seen something on your liver.’
‘I couldn’t tell anyone then because they were so obviously devastated about Anne.’
Anne and Linda started chemotherapy at the Royal Victoria Hospital in Blackpool on the same day, June 5. Linda joked: ‘Forget the Chemical Brothers, we’ve become the Chemo Sisters.’
Maureen has moved in with Anne, who is divorced, to look after her, and Linda has gone to stay with their other sister, Denise. Anne remains hopeful of a full cure after a mastectomy or lumpectomy.
The mother of two (Amy is now 39, and Alex, 32) and grandmother of three (to Amy’s son Ryder, eight, and Alex’s children Vinny, ten, and Nevaeh, five) says: ‘I don’t want to die. I love my life so much.
‘I love my daughters, my grandchildren, my friends, all my family. I want to live for as long as I possibly can.
‘I am scared of dying, as well. Even though I believe in God, I’m still scared.’
Linda was diagnosed with breast cancer in 2007 and secondary cancer on her pelvis in 2017. She now has incurable liver cancer.
Linda hopes that the disease responds well to treatment and has been told she may live for another 15 or 20 years if it does.
She says: ‘I’ll be 75 in 15 years time, and I would’ve had a great life. So that’s why I’m again, for the third time, going to give it everything I’ve got.’
The sisters are pulling together now, but there was a nuclear falling-out after four of the sisters — Coleen, Maureen, Linda and Bernie — took part in a 30th anniversary comeback tour, which excluded Anne and Denise.
Anne furiously accused the siblings of ‘stabbing her in the back’, and said that they were ‘dead’ to her.
However, within a year she had written to them all to make up, for the sake of the extended family, and she was reconciled with Bernie, Maureen and Denise long before Bernie became ill.
She made up with Coleen just before Bernie died. The night before she passed away, all five sisters sang her favourite song, Have Yourself A Merry Little Christmas, to her.
Today, they are bonded as never before. Now mature women with children and grandchildren, Anne will not hear any suggestion of rifts or rivalries in the Nolans.
She says: ‘We are all very close, all very supportive. All of us. It is fantastic. Nothing will ever, ever come between us again, especially not something in showbusiness. I will never fall out with my sisters again, ever.’ The fact that cancer has struck more than one sister has led to tests to see if there is a genetic link that’s left them predisposed to the disease.
Some years ago, Bernie and Linda were tested to see if they have mutations of the BRCA1 or BRCA2 genes, which are strongly linked to breast and ovarian cancer — but they did not.
Instead, they have been told that a ‘rogue’ gene was responsible.
This gene, called CHEK2, usually repairs damage in the breast. However, a study published in The Lancet in 2002 suggested that a mutation in CHEK2 may account for some familial breast cancer susceptibility not caused by BRCA1 or BRCA2 mutations (see panel, right).
Anne says: ‘It’s horrible when it is breast cancer in a family of women. I have daughters and granddaughters, so it is a very real worry. They will take medical advice now.
‘I have talked to my daughters about it and it is a big decision to take to have your breasts removed. And one of the possibilities of genetic testing is that you have your breasts removed and then you get cancer somewhere else.’
She says having had cancer before, she always feared its return. ‘I think that only people who have had cancer can probably realise what a grip the experience has on you.
‘Every time anything is wrong with me, or is different, anything, no matter how small, I think: ‘That’s it, the cancer is back.’
Anne adds: ‘I’ve also started having anxiety attacks. That’s got something to do with the pandemic. They say that when you’re having chemotherapy, you can pick up any kind of infection — it can be fatal. So I think that’s been playing on my mind as well.
‘This has broken me down a bit, to be honest.
‘I think part of it is because I’ve not been able to see my daughters and grandchildren. I’ve not touched them, I’ve not been able to hug them or kiss them.’
The tragic death of Bernie, who died three years after her diagnosis, leaving a daughter and husband, has been troubling both women.
Linda — who, like Anne, has lost her hair due to chemotherapy — says: ‘I look in the mirror now and I see Bernie, because I think we’re so alike anyway and it just brings back all of her trauma and how sick she was.’
Anne says: ‘People talk about fighting cancer, but I think that is wrong, because it implies that people who have died didn’t fight it.
‘Well, Bernie fought and fought and fought until her last breath.
‘We will never know the answers about why this has happened. Some people have a belief that there is fate, or a reason, or that things are meant to be.
‘I think that must be a comfort when bad things happen.
‘My own belief is that you can’t sit around thinking: ‘Why me?’ or ‘Why us?’
‘The question is: ‘Why not me? Why shouldn’t it happen to us?’
By Thea Jourdan for the Daily Mail
The Nolans’ story highlights the frightening way breast cancer can run in families.
If your sister has breast cancer, you have a nearly 6.5 times higher-than-average risk of developing the disease between the ages of 20 and 40, and double the average risk after the age of 50, according to a major trial published in 2008.
Most ‘family’ cases of breast cancer are linked to inherited mutations in the BRCA1 and BRCA2 genes — they account for around 2,250 (5 per cent) of the 55,000 new diagnoses in the UK each year.
‘For women who have a faulty BRCA1 gene, the lifetime risk is a 60 per cent to 90 per cent chance of developing the disease,’ says Louise Grimsdell, clinical nurse specialist at the charity Breast Cancer Now.
Without this mutation, the lifetime risk is just over 14 per cent.
But in the case of the Nolan sisters, it is a different faulty gene that is involved. As Anne reveals in these pages (see main story), Linda has a mutation of CHEK2, a tumour suppressor gene, just as Bernie did.
‘Most women with familial breast cancer do have faulty BRCA1 or BRCA2 genes, but a small proportion of women have other genetic mutations that we now know can also raise the risk,’ says Charles Coombes, a professor of medical oncology at Imperial College London.
It is thought that around 4 per cent of genetic breast cancer cases are linked to a faulty CHEK2 gene.
The lifetime risk of a woman with a CHEK2 mutation developing breast cancer is up to 37 per cent, and they have a 50 per cent risk of passing the defective gene on to their daughters and sons.
Men with a CHEK2 mutation may be at increased risk for breast and prostate cancers.
In recent years, women have been screened for other known mutations, too, usually if they have a strong family history of breast cancer but test negative for BRCA1 and BRCA2.
What isn’t clear is what proportion of cases are linked to as-yet-unidentified ‘family’ genes, although the vast majority of breast cancer cases are not inherited.
So far, scientists have found that mutations of the PALB2, CHEK2 and ATM genes all increase the risk of breast cancer, as well as BRCA1 and BRCA2, ‘but there could well be more,’ says Professor Coombes.
Any mutation can pass on through families.
CHEK2 mutations can lead to a higher risk of breast cancer, but also colorectal cancer and possibly others.
Meanwhile, a review of the ATM gene, published in the journal Current Oncology in 2018, found that around 1 per cent to 2 per cent of adults in the U.S. had one mutation of this gene, which aids tissue repair, and women who carried this mutation had a 25 per cent greater risk of developing breast cancer.
PALB2 mutations are also linked to increased risk of breast cancer.
‘These genes are another part of the tissue repair machinery and can go awry,’ says Professor Coombes. He hopes more women will be able to be tested for a wider range of mutations in the UK, not least because this could assist with treatment options.
‘There is no gene therapy yet for breast cancer, but we do know certain drugs are more active in patients who have BRCA gene mutations,’ he says.
But inherited genes are only part of the picture. And it’s not certain that women with these genes will develop breast cancer, says Jayant Vaidya, a professor of surgery and oncology at University College London.
‘Even with the faulty BRCA genes, between 20 per cent and 30 per cent of women do not develop the disease; and women with CHEK2 mutations have a lower risk than that, somewhere below 50 per cent,’ he says.
Indeed, increasing age and being female are the two biggest risk factors for developing breast cancer, and there are lifestyle factors that can make a difference, too.
Professor Vaidya adds: ‘Hopefully in the future we will be able to combine multiple factors, including lifestyle and environmental, and determine a woman’s actual risk.’