Betsy Duncan Smith says she can still hear the consultant’s words: ‘You are going to need a mastectomy.’
‘I was stunned, I was reeling. I found it incredibly difficult. Some people say they are relieved when they are told they need a mastectomy because they see it as a way of getting rid of the disease. It wasn’t like that for me.
‘The thought of having part of me removed was difficult to comprehend. I don’t even have my ears pierced. The fact was that my right breast had to come off. I was traumatised and would have done absolutely anything to prevent it.’
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Betsy, the former first lady of the Conservative Party, whose husband Iain was party leader from 2001 to 2003, still finds the diagnosis in 2009 difficult to talk about.
She is only now publicly discussing her mastectomy for the first time to promote the charity Medical Detection Dogs, which is engaged in two pioneering trials with NHS trusts to detect cancer using dogs it has trained to sniff out the disease from breath or urine samples.
Betsy, 57, was told she needed the mastectomy after almost six months of gruelling chemotherapy and then radiotherapy. Her doctors feared the cancer, which had been growing for at least 12 to 18 months before it was diagnosed, might spread to her lymph glands.
The diagnosis was bleak enough, but Betsy says the mastectomy was devastating.
‘I was in shock. I just couldn’t seem to come to terms with it. But I knew I had to get on with it. There was no choice.’
Well-bred, immaculately dressed, fiercely loyal to her husband, and a devoted mother of four, Betsy fits the classic mould of a Tory wife.
She is equally at home at a fundraising event with hedge fund billionaires as she is at a ‘rubber-chicken’ dinner to raise funds for the local Tory association. Betsy and Iain, who was Work and Pensions Secretary for six years until his dramatic resignation from the Cabinet days after the last Budget, have one of the strongest marriages in politics (they married in 1982).
Home is a 16th-century scuffed, but charming, Tudor farmhouse in three acres complete with tennis court with an alarmingly sagging net, in a picturesque Buckinghamshire village (the land is part of the ancestral estate of her father the 5th Baron Cottesloe of Swanbourne and Harwick).
It is an idyllic setting and Betsy has turned the garden into a thriving cottage industry — there are bees that produce prize-winning honey under the label Betsy’s Best.
The orchards, which are groaning with apples and sloes, are responsible for the Swanbourne Estate range of flavoured gins, which are stocked at the oak-timbered village pub, named after one of her ancestors. The pub takes all the vegetables Betsygrows. She also keeps cows, sheep, ducks, and chickens.
After two uncomfortable years in the spotlight as wife of the Tory leader — her husband was deposed in a bloody coup in 2003 — Betsy had relaxed into a life of relative domestic rural bliss.
The calm wasn’t to last. In the spring of 2009 she took one of her sons to the doctor with a sore shoulder. ‘I stayed behind almost casually saying to the doctor: “Could you also take a look at my breast. I’m not sure things are looking as theyshould.” ’
For the preceding month Betsy’s nipple had been retracting. ‘I kept thinking I wonder if I should do something about it, but I never did,’ she says. ‘There was always so much to do with the house.
‘The doctor told me straight away: “There’s a lump. You have to see a cancer specialist.” ’ An appointment was made that day.
The biopsy was deeply unpleasant. ‘The needle was so huge,’ she says. ‘I think they knew it was cancer even before the test. They said I would need chemotherapy straight after they did thebiopsy.’
The tumour was ‘quite large’, 61mm x 51mm. ‘It was soft and spongy, which is why I didn’t feel any lump. I was in a blur when they told me and remember thinking it can’t be happening to me.’
Betsy telephoned her husband at work at the House of Commons. Heput the phone down and from that day moved his office to their home.
‘It was a very emotional time,’ she says. ‘He was deeply shocked.’
After that he was with her at every consultation and chemotherapy session and there when she was told she had to have a mastectomy. He broke the news to their children, meeting their younger daughter Rosie, then 16, at the airport after she returned from a holiday. She was about to begin her A-levels at the time
‘I was so lucky I had Iain. He is a wonderful husband and a wonderful father.’
As well as Rosie, now 23, the couple have two sons, Edward, 29 and Harry, 25, and another daughter Alicia, 27 — ‘all relatively grown-up’ at the time of her diagnosis, says Betsy, adding: ‘I don’t know how I could have coped if they had been little ones.
‘They were a great support to me. It must be grim for women trying to get through this cancer treatment when they have to manage the demands of a young family, especially if they are on their own.’
The diagnosis of grade 2 cancer — a measure of a cancer’s aggressiveness, with grade 4 the most aggressive — came shortly after Betsy had celebrated her 50th birthday: just the age that her Uncle Pete, her mother’s brother and a father of three boys, had died of skin cancer.
Her cancer is more confirmation, if any is needed, of the random waythe disease can strike — Betsy has never smoked, is only an occasional drinker, and doesn’t look an ounce overweight. She eats healthily and spends much of her day working in the garden.
After her diagnosis, she was immediately started on chemotherapy to try to shrink the cancer, followed by radiotherapy.
‘The doctors were always very straight with me. They told me the prospects were good. Only 15 per cent die. I had drawn a short straw, but I never thought I was going to die.’ The chemotherapy was tough. ‘I didn’t realise it would flatten me so completely and wasn’t prepared to be so incapacitated.
‘After my first session, Iain had to rush me back into hospital because I was growing weaker and my energy levels were falling away.
‘By the time we got there I couldn’t move at all. I was still conscious, and could hear what was going on around me, but I didn’t have the energy to answer the nurses’ questions, or even give a thumbs up to signify “yes”.
‘When I came home I was incredibly weak and from that time onwards Iain had to do everything for me. There were days I just lay in bed. When Iain brought me meals, he would have to prop me up on the pillows and coax the food down me. I never knew it was possible to feel so bad.’
She lost her hair. ‘I didn’t care about that. It was just a bit colder and I wore a turban. I didn’t want a wig.’ After six months she underwent a six-week course of radiotherapy and then her mastectomy.
A year later Betsy had breast reconstruction surgery — ‘I had to wait because I wasn’t strong enough to undergo an operation,’ she says. Some days she recalls she was so weak she stayed in bed. Or she might venture down to watch daytime television.
Betsy is now free of the cancer, although she will continue to take Tamoxifen, which is used to prevent breast cancer recurring, for another three years. (The drug is given to people with oestrogen-positive breast cancer, cancer that is stimulated by the hormone — patients usually take it for five years.)
A couple of years after her life reverted to its normal pattern she went to an open day of the Medical Detection Dogs, which is housed in a field near Milton Keynes.
The charity has no government funding and raises all its own money. A three-year research project costs £345,000. Initially, Betsy wasn’t keen on going — the last thing she wanted was to think or talk about was cancer.
But putting aside her misgivings, she went along to watch the dogs detecting the disease from samples. It takes them only seconds. ‘I was blown away by what I heard and saw,’ she says.
The charity has now trained 20 dogs to sniff out evidence of breast, prostate and bladder cancer and their data shows that at least one has a success rate of 93per cent, while none of the dogs has a false-positive rate (ie wrongly identify cancer) of more than five per cent.The charity is now running proper trials.
The dogs do a day’s work at the centre and then go home to lead a normal life.
Impressed by the charity’s work, Betsy has since become a trustee — and the Duncan Smiths foster one of the MDD dogs, Jobi, a ‘wonderful’, lively black cocker spaniel which lives with the family.
Betsy has forged a close friendship and working relationship with Dr Claire Guest, a psychologist and animal behaviourist, who runs thecharity.
Claire was one of the team who published a paper in the British Medical Journal in 2004 which first suggested cancer had an odour that could be detected by dogs in samples ofurine.
A year after the Medical Detection Dogs charity was set up in 2008, Claire was taking her three dogs for their evening walk when her usually placid labrador Daisy refused to leave the back of her car and repeatedly nuzzled her in the chest.
Curious, she went for tests that confirmed she had a deep-seated growth, which could have been fatal had it not been detected early.‘I’d never have known it,’ saysClaire.
Betsy, who has always had dogs, suspects in hindsight her own pets may have tried to warn her something wasn’t right.
Back then she had a collie, a greyhound and a spaniel, ‘But I was always rushing round and if they had jumped up, I would have pushed them away,’ she says.
Betsy is unashamedly evangelical about Medical Detection Dogs. ‘Having been through cancer, and having had my breast removed, I am passionate about the early detection work our dogs are doing.
‘I believe they are much cheaper,more accurate, more reliable, quicker and less intrusive than machines.’
‘The science has been around since Man took dogs into the cave. We are now trying to make it work for the NHS because with early diagnosis it could save so many lives and so much heartbreak, not to mention making huge savings for the health service.’
Daily Mail