My ABC of living with metastatic breast cancer

Ray Cassiem has being living with metastatic breast cancer (MBC) for 11 years. She says her ABC has gotten her through it: attitude, belief and choice.

Ray Cassiem (61) lives in Cape Town with her husband. They have four sons and nine grandchildren.


I was diagnosed with Stage 3 oestrogen positive breast cancer in August 2005. My treatment consisted of a lumpectomy, chemotherapy, radiation and a selective oestrogen receptor modulator.

Four years later, in June 2009, I had my usual six-month check-up where a mammogram, X-rays, scans and blood tests were done. All were fine except my blood tumour marker; it had increased from 13 to 29 and my oncologist found it unusual. She sent me for a bone scan and a cancer lesion was discovered on my breast bone. The breast cancer had metastasised to my bones. I now had metastatic breast cancer.

I was put on an aromatase inhibitor and taken off the selective oestrogen receptor modulator. For the next two years, every month, I got an infusion of bisphosphonate to strengthen my bones. It was cut down to quarterly infusions for the following two years, then every six months and so on. I stopped the infusions last year as it was causing too much damage to my teeth and gums. I still take the aromatase inhibitor.

My ABC of metastatic breast cancer

It was a huge shock when I was told I’m metastatic and was challenging in the beginning. Now, I’ve accepted and embraced my condition. I have a good appetite, thankfully no pain, and I’m living an active life. 

I believe you need the ABC: the right attitude – surround yourself with people who add value to your life. You must believe you can beat cancer. Cancer chose me. However, I have the choice not to own it.  The three Ps are also something I live by: prayer (or good thoughts), perseverance and patience.

Obviously, I was anxious at first but with my faith and active life it became better over the years. I feared death before. Then, I was taught, at a support group meeting, that death is part of life. I accept that now. I now preach that we don’t get to choose when and how to die. But we do get to choose how we live. 

Becoming active 

Before my diagnoses, I just existed. After my initial treatment, I started living. I hiked the beautiful trails on Table Mountain. I joined a running club, first running 10km then half marathons. Becoming active has made a big difference in my life. 

I also joined the AmaBele Belles BCS Dragon Boat team. This sport reduces swelling of the arm after a mastectomy or lumpectomy. 

I changed my lifestyle by eating balanced meals in moderation and I believe in taking omega 3, zinc, vitamin B compound, vitamin C and D. 

Sharing and caring 

Last year, I retired. Now, I do lots of voluntary work for Cancer Buddies and I’m part of the Cancervive team. Sharing and caring is healing to my soul. 

Before lockdown, I gave motivational talks to educate, inspire and give hope; made pamper packs for newly diagnosed breast cancer patients; and organised support group meetings.

Financial cost of metastatic breast cancer

My medical aid doesn’t cover 100% of my medical bills as it only covers generic medication. I have had no option but to make payment arrangements to settle the accounts. 

The impact of COVID-19

All my appointments were moved to a later date. I queued at a private hospital; that has never happened before! 

Moving my appointments was nerve-wracking as I was off bone treatment and wasn’t sure if the cancer was spreading. My scans became more challenging as I didn’t know what to expect. I will be going for a scan soon and I’m positive all will be fine. 

Photo by Marike Herselman Photography |