Jo McNamara Rad Chat Host (00:00)
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Naman Julka-Anderson (00:04)
And me, Naman Julka-Anderson. Rad Chat is a forward-thinking global knowledge hub where healthcare professionals can advance their expertise in therapeutic radiography and oncology. Unlike traditional academic resources, we blend real-world experience, expert insights, best practice, and patient perspectives.

Jo McNamara Rad Chat Host (00:21)
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Naman Julka-Anderson (00:38)
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Jo McNamara (00:47)
So this is a bonus episode where we're going to be hearing from our guest, Professor Joanna Callaghan, sharing her experience of cancer and how she then went on to create goodbye breasts with an exclamation mark.

So Joanna, for anyone out there, tell us a little bit about yourself and maybe life before cancer.

Joanna Callaghan (01:05)
Yeah, okay. Well, I am a filmmaker and a professor of filmmaking at the University of Sussex. I make films usually about difficult subjects and try to make them accessible, really. So I'm really working communication, which is about bringing together sort of more, more perhaps difficult ideas and through film and my

my creative powers, transforming them into something that may be able to reach an audience before my cancer, I was finishing a series of films about philosophy, actually. So I was taking kind of ideas like Plato's ideas and actually using narrative and storytelling to communicate those. So I was finishing off a series of sort of four films that I'd made about philosophy.

And also another film about actually recording, which is something that I've done all my life is record my life and record my family's life. And I made a film in around 2018, which was about this desire to record. And it's a sort of archival film, which looks back at the archive I've made and tries to make sense of it.

Naman Julka-Anderson (02:16)
Joanna, what got you into filmmaking to begin with?

Joanna Callaghan (02:19)
⁓ well, I'd always loved films, watching films, and I liked photography a lot. And I was working in a different field actually, and I had done a degree in social sciences and was working in management consulting actually. And, but somehow the passion of sort of film and photography stayed with me. And I decided to go back to, you know, university and study film. And I suppose it's...

Again, it is about communication, it's about opening, trying to understand things myself. I think that's something that drives me is trying to make sense of the world and trying to make sense of, you know, my world. And so that's why I wanted to use and film. not sort of I could never draw, for example, I was kind of crafty, but I couldn't draw. So I didn't go into art making in that sort of traditional sense. But I liked photography and I liked

video and I liked film and so I just you know started you know teaching myself and going to school and learning and then I kind of quit that job and moved into moved into sort of film and television.

Jo McNamara (03:28)
Amazing, sounds so interesting. Joanna, you have had a cancer diagnosis, if you're happy to, will you just talk us through kind of how you became diagnosed and your treatment pathway?

Joanna Callaghan (03:39)
Yes, well yeah it's a bit of a story. My mother had breast cancer when she was 67 and then my sister, I have four sisters, one of my sisters at 47 developed breast cancer and you know she had a lumpectomy and had radiotherapy and was all fine and when I turned 47, because 47 is young,

we know that only 20% of breast cancers occur under 50 and 47 is young and I thought I want to get a mammogram. So I asked my GP and my GP agreed and I went to a mammogram and at that mammogram they found something. And fortunately it was small and they did a lumpectomy and I had radiotherapy and I went on to Tamoxifen. And then

A few years later, my sister was actually 10 years after her diagnosis. Her DNA became part of a study to test for a new gene that they had found, a new breast cancer gene called PALB2. And it came back that she carried that gene. And it sort of seemed pretty obvious to me that I probably had that gene as well. I got tested and yes, I did. And

so I began to learn about having a preventative mastectomy. PALB2 is around 40 to 60 percent, but of course the risk depends on your family history. So I was just about considering a preventative mastectomy and or risk reducing mastectomy when I found another lump. And so at that point I had a double mastectomy.

I had, I didn't have radiotherapy this time, but I had chemotherapy, Herceptin, I went on to ⁓ Letrozole and around seven or eight months later I had an oophorectomy had my ovaries removed also to reduce my risk. So that's kind of my two time diagnosis story.

Naman Julka-Anderson (05:37)
Did you know much about radiotherapy before you went for radiotherapy?

Joanna Callaghan (05:41)
I did know a little bit because my sister had been, so I had known a little bit about it. And there's a lot of information actually, you get a lot of information. So I knew something about it, but still of course all these things, it's never quite the same when you actually get there. I mean one of the things that kind of bothered me, which now in retrospect really seems kind of minor, but at the time

was this tattoo that I had to get and I was like, why do I have to get this tattoo? Can they not just mark it every time and do this? And then obviously I came to learn and understand why it was needed. so I remember that element of it. And I remember how exact the timings are, of course. You get this very specific time and again, was, why is it at like 5.03?

You know, now I understand, you know, ⁓ but that was sort of my, you know, what I had thought at the beginning of the radiotherapy. And I do remember, I do remember the feeling, I mean, if you would like me to talk to you about that, had, it was very mysterious. I really found it mysterious how this worked. And it took me quite a few days before I could actually ask, you know,

about what's, because you're a little bit, I was a little bit terrified, you know, I think you do come into these things and you know had to stay still and I was a bit worried if I moved what would happen, you know, and and things like that but I thought it was mysterious and I, I kind of began to understand that, you know, of how powerful it actually is, you know, and that's why you only have this very short bursts and therefore, you know, over this period I was actually only having around, I don't know, three or four minutes or something total over the whole days, I mean that's

I know if that's exactly right, but the point being is that it was a bit like a magic, a magic laser gun of some kind that was going to help me with my cancer. So it was strange, mysterious. It was scary at first, but then it was like, right. I'm kind of, I've been lasered or something. And my son at the time, he was very sweet. You know, he was, he was probably about seven or eight. So he was watching lots of, you know,

cartoons and things with people with laser guns. So we've joked that that's what I was kind of having this kind of special ray stuff that was going to give me extra power.

Jo McNamara (07:48)
It's definitely one way. I love looking at things through children's eyes because isn't it just marvellous to think of the things that they kind of assume or think that's happening. It can make it a bit more light-hearted than maybe what it is to go through.

You kind of talked a little bit about obviously that kind of preventative measure that you were going to take.

How difficult was that decision? You know, was that something that you really had to go over? And did your sisters also go through those kind of decision making processes knowing that you'd also had that gene as well?

Joanna Callaghan (08:30)
Well, I was in a sort of unusual position, I suppose, in that I had been considering the risk-reducing mastectomy. So I had a bit of knowledge and information already. And so I was kind of on my way, though it was kind of a difficult thing to consider. So when I had the second diagnosis, sort of, in a strange way, made it simpler, made the whole thing simpler

and and I was in this yeah I was in a unique position because I'd had a cancer diagnosis so I kind of knew what was coming in some way and but I was sort of having a having a mastectomy of the one breast that had the breast cancer and of course removing the one another one that didn't and that's why in fact I made this project is that I felt that I was in a kind of unique place and that therefore I needed to sort of talk about that. when I had my first

breast cancer diagnosis, I couldn't record anything did not, there is nothing, I have nothing from that time because I think I was too shocked and too, it was too difficult. But the second time I felt a bit more, a bit more able to do that. And that's, that's why I actually began picking up the camera and doing it. So it was, it was difficult, but at the same time, this act of recording, which is what I began to do is record this experience of the decision to have my, to have the, have the mastectomy.

And in doing that recording, I was able to take a bit of control back over what was happening to me.

Naman Julka-Anderson (09:49)
It's interesting around the control, there's lots of people on social media who use their voice to talk about their experiences, surgery, even things outside of oncology. Actually, I suppose the cancer community on social media is quite big, I would say now, especially across Instagram. I think a lot of people help each other out. I don't know if with the genetic counseling side of things, if you were guided towards any support groups for anybody else who's going through something similar.

Joanna Callaghan (10:13)
At the time I had the testing, no, but I've since discovered many actually. in fact, you know, some of those ⁓ are part of the film that I made, some of those groups. And I've made some really great friends through that experience. From like BRCA chat for example, that they were a group, even though they're BRCA,

they welcomed me because we don't have anything for PALB2 at the moment. So that support has definitely been important to me and it does exist out there.

Jo McNamara (10:47)
So talk us through Goodbye Breasts. Where did that idea even come from?

Joanna Callaghan (10:52)
Well, when I knew I was going to have this mastectomy, I decided to start documenting it. I wasn't sure what I was going to do with it at this point, but I just knew that it was important for me to do it for myself.

It was sort of like a kind of rehearsing in a way of what was happening to me. So I picked up the camera and I started doing video diaries and of the process of actually before, during and after the surgery and actually documented that process.

Also as part of the recovery period, I was trying to get back my body, trying to get it back to be something that I recognised and also in a way to say goodbye to what I had lost. Because I think when you remove your breasts and whether you like them or you didn't, whether you replace them or you don't, you lose a part of yourself and you lose a part of your history that you can never really get back.

I was kind of mourning my breast. I was mourning that and I wanted to somehow find a way to express it when you're going through this or any kind of treatment your body becomes kind of

like an object of medicine really. It's being rendered in images and scans and tests and doctors and nurses and clinicians are talking to you about parts of your body that you don't know, know, your milk ducts or your lobules or your the fat cells or your lymph nodes.

All of these things you start learning about and of course you see the diagrams and you start to look at the breast and you think, okay, that's what's inside of my breast and that's how it looks. But it's still quite foreign, you know? And so I wanted to find a way to make my breasts, you know, something that was part of me and how I saw myself and something that with my family too. And you talk about, you know, through children's eyes,

that we could together cope and learn and understand what was happening to me and to us as a family. So I had lots of daydreams about going inside of my breasts. If only I could go inside my breasts and take them back, know, a bit like my fantastic voyage, that sort of 1966 sci-fi film where scientists get injected into the body of a man with a virus and they travel through and they kind of...

fight the virus and stuff. So it was a bit like that. I wanted to sort of go inside my breast and sort of reclaim them. So I had this daydream about doing that. And then I spoke to about with my husband and he's a creative person too. And he said, well, why don't we do it? Why don't we make a bit of breast?

So we started drawing these drawings, these breasts and imagining, well, you know, what if you could actually go inside the breast and you could actually experience it? And, and that's where it started really. I mean, the rest of it, like how to make it, everything was another whole thing, but that was definitely the beginning, of like how to,

to open this experience to others too, to understand, could it be useful? Could it be useful for other people to see a breast from the inside, something that they have never done or never seen or never imagined? And that's what we did. We made a giant inflatable breast, which is nine meters wide by eight meters by five meters high. And you can go inside of it and inside of it, you can encounter breast anatomy and listen to stories

by people affected by the issues. That's part of the exhibition.

Naman Julka-Anderson (14:13)
Are there any other elements to the exhibition?

Joanna Callaghan (14:15)
Yeah, so I mean, meanwhile, the film is a story of the making of the breast, of course, this film is the story of the idea, how the idea took off and how we, you know, we made it really, and the discussions and conversations we had to do that. There's also the community that I met along the way. So that

you know, after my mastectomy and the sort of support communities that I met in person, mainly actually not online in fact, I wanted to sort of bring them their voices into the conversation as well because, you know, we would meet, we would talk and share and it's very intimate, you know, with people you don't know that well and people are so generous, you know, with their time and with themselves.

And I wanted to bring that in. So I worked with, or I brought in around six, seven women who we had a kind of workshop where we talked through our breasts, talked about our memories of our breasts, experiences, and then what we'd been through and what we missed. I did interviews with these women as well. So their voices appear in the film and they appear in the film as well. But I did that also in a sort of creative way. I used animation to sort of

bring those voices in as a sort of way to hear even better what people are saying, I suppose, and think about it. So it included the giant breast, it includes this community of women and the support that's out there. And it also includes dance, actually. So when I was recovering from the surgery, you have these post-operative exercises you have to do

and they're kind of a bit boring and you know again as part of trying to make it your own I started to experiment with them and and try to find other ways to work with them.

And then I actually developed it into a dance with the help of a choreographer. We make this boob boob dance, which is sort of the exercises that you need to do, but sort of slightly more groovy. And actually we wrote a song, I wrote a song with a musician and singer and we put it to music and we made a music video. So that's also part of the film. So it has all these different kind of a bit wacky elements, but

the point is it is a serious subject matter, but that doesn't mean we can't bring people into the conversation and provide entry points into it. And that was very much my intention with making The Big Breast and the film is provide a way for people to come into the conversation in perhaps a way that is accessible and maybe a little bit less scary or less threatening than usually the idea of sitting down and having a conversation about a mastectomy or a conversation about cancer.

Jo McNamara (16:53)
Love it Joanna and I have seen that dance music video with the exercises and I do, I love it. I was there kind of learning going, yeah, that's really good. And it was also very good because a lot of the exercises that physiotherapists give you don't necessarily get the abduction that we need for radiotherapy. So I was very pleased to see your choreographer doing a bit of that kind of abduction that I thought, yeah, that will help our radiotherapy patients. And for anyone listening, you need to do those exercises for life.

Joanna Callaghan (16:56)
I've...

Jo McNamara (17:21)
So not just preparing for radiotherapy, not just after surgery, that is for life. So you're gonna do that dance for life. So yeah, you'll definitely learn the moves, but by the end of your life, you'll have it down and nailed with all the choreography and music. So I love it. And you're going on tour with it, aren't you Joanna? And you've won loads of awards for the actual film itself. Congratulations.

Joanna Callaghan (17:45)
Thank you. Yeah, we premiered it here in Brighton at the Cinecity Film Festival and we won the Audience Award, which for anyone who doesn't know, that is the only award that really has any value, to be honest. It's the people's vote and yeah, the people voted for it. And that was very exciting and gratifying. And the result being that we got a tour with Picturehouse Cinemas and we're going out around the country on a Q &A tour starting in Brighton

and featuring guests or a host, usually a medical professional, but also others as well to explore, obviously from the film, anything that's been brought up, but really about how medicine, community and creativity come together in recovery.

Naman Julka-Anderson (18:30)
I suppose as part of the recovery, so looking at body confidence, obviously if you're showing something over time you're going to see almost like a rollercoaster, the peaks and the lows etc. How have you found that experience through the storytelling of what's obviously gone out on screen and everything else but maybe also in the people you've spoken to in the little community with their experience of it?

Joanna Callaghan (18:50)
I have had really positive feedback about that. Actually, in the Q&A's people mentioned that as being something they were found very powerful and also they were kind of grateful for. Because there's something about filming your own body. Okay, that's one thing obviously. And so filming your own body and showing your own

scars and things, which I did in a mirror. So it's sort of one shot. I don't cut it also. There's also something in the edit, right? So it's not being cut, but it's the sort of story of the surgery and how the body can heal over time. Of course, at the beginning, it looks, you know, the scars are a little bit shocking, but over time the body does heal. And I also really wanted to show how amazing the surgery is

that is done because I had a reconstruction. had a tug reconstruction which is taking the muscle from the inside of my thighs and ⁓ creating a flap and creating new breasts and it's extraordinary surgery. It's, I mean, it's long, it's like 10 hours on an operating table and not everybody can do it. I was able to do it. And

it is a life-saving surgery and it was something I wanted to show and that for me was was I suppose yeah liberating as well because it's just a body I know you know we all have that right and and showing what happens to that body I think it was important to me.

Jo McNamara (20:23)
Obviously going through a cancer diagnosis and treatment is traumatic at the best of times and so lots of people do seek emotional support. Did you find that making the film was a way of you kind of, know, some people might journal, but did you find that actually that process and the art that comes with filmmaking has helped you emotionally and psychologically deal with having a cancer diagnosis?

Joanna Callaghan (20:49)
For sure, absolutely. It has helped me. I've always picked up the camera as a way of understanding my life, but this was a little bit different. I haven't done so much video diary before and I think there was a need to express myself. I didn't know what I was going to do with it. So it was a bit different to sort of like just popping it out there, you know, on social media, but

in the doing, in the speaking of what was happening and acknowledging it, it was helping me, of course. And then, you know, as a family, I think the other thing to talk about is the role of family in this. something that, you know, have a son and a husband and we, you know, often have made things together. And so why wouldn't it be any different now?

I mean, obviously it's a much more personal situation, but it was something that we could do together. It was a way for us all to take back our lives and to sort of make it our own experience instead of being the subject or the object of an event and feeling out of control. We could take a bit of control back. And it brought us closer together, of course. I mean, sometimes it was difficult, right? It's difficult to work with your husband and your child.

But you know it brought us together, it gave us a focus, know, also things to do, you know, which I think is really important and it's something, you know, that when you when you're feeling down and feeling bad, I mean, you know, it's hard but I think actually taking action is important, whatever it is, as small or as big, you know, as you can. So it definitely helped me to sort of

process what has happened to me and to incorporate it. So that was something that I think is important. I don't think you can ever forget about something like this. It's not something that you know you might think, I just want to forget about it and get on with my life. I'm not sure that it's really possible. I think you incorporate it. I think it becomes part of you. It doesn't mean you have to think about it every day but for me I wanted to incorporate it into myself of how I see myself and making a film and making art was part of

that process.

Jo McNamara (23:00)
So Joanna, in terms of the tour, if anyone is interested about coming to see Goodbye Breasts, firstly, do you have to have had a breast cancer diagnosis or can anyone go and see it? And how do you get tickets?

Joanna Callaghan (23:12)
The film is a story of a two-time breast cancer diagnosis and my creative approach to recovery from it. But it's a film for everyone because actually it's about family, it's about community, it's about creativity. And it's actually quite a joyful story.

I think it brings people into the conversation and it makes it accessible through all the different elements it has. There are difficult moments, but there are also some lovely moments that you can laugh at. And that's important. I think laughter is a really powerful force for good, even in difficult times. It's something that can break the ice. It can bring us together. And so the film has funny moments and I think that makes it accessible to people.

It's not just for people who've had breast cancer. Obviously people who have had breast cancer will find things in it that they can relate to, but anybody who's been through any kind of illness will also recognise what it's like to go through something that's difficult and to come out the other side. And it's very much for, you know, the families and the communities around people who have had illness. I think that was always important to me is that it's, you know,

It could be your sister, your daughter. It's a film that I very much wanted to bring men into the conversation, actually. I didn't want it to be just a film only for women who've had breast cancer. I wanted to make a conversation to bring in men because men are fathers and brothers and sons and they are affected by this.

Men can also get breast cancer as we know. They're affected by caring for the people around them that have had breast cancer. So it's a film for everybody.

You can see it at, well can visit our website and there you'll see a list of all of the screenings, but I can tell you it's going to Brighton, London, Norwich, Cambridge, York, Nottingham, Oxford, back to London and Bath. And it's at Picturehouse Cinemas mainly, but it's also at Broadway in Nottingham and Phoenix in East Finchley.

Jo McNamara (25:18)
Okay Joanna so for anyone listening do you have any top tips that you'd like to leave listeners with?

Joanna Callaghan (25:25)
Yeah well my my top tips are for two different kinds of audiences I suppose, so those going through it and those who are supporting others going through it. So for those going through it, my top tip is find your way to process what is happening to you. It's yours so do what you feel and you think is is best for you

like I said before about sort of finding a way to incorporate what's happening to you rather than sort of pushing it away. And the other thing is to not to reach out to the community that's out there. There are a lot of support out there, know, you know, one on one or groups and there's also a lot of information. you know, information is power. So, you know, be your own advocate, reach out and get as much information about what is happening to you and the support from others that are

know that have been experiencing the same thing. My second tip is for people supporting women going through breast cancer or mastectomy and it's this is mastectomies are a difficult subject to talk about but that doesn't mean we shouldn't speak about them and I think it's very important to ask

you know ask about it, to ask very specifically about the mastectomy to not be afraid of it because in the asking you're acknowledging, you're acknowledging what a huge issue it is actually and even though it could be uncomfortable for you I think that other person will be will be grateful for you taking the the risk and the courage to ask a difficult question.

They can always say they don't want to speak about it, but I think I was surprised how nobody asked me. I was kind of surprised that people didn't ask about the mastectomy. They'll ask about the breast cancer, I guess, generally. But that was part of the big motivation about really saying, look, let's talk about breast and let's talk about a mastectomy. Because it's a huge life-changing operation. It's a life-saving operation. But let's talk about the specifics of it because

if we don't talk about it, we won't understand it. We can't help people going through it.

Jo McNamara (27:24)
Amazing. Joanna, we could carry on and talk about it all night, but we have to let you go. So a huge thank you to our guest Joanna Callaghan for sharing her experience of breast cancer and goodbye breast exclamation mark. Please do go and check out the show notes to learn more about the tour and the website and to check them out on social media. So thank you all for listening to Rad Chat. My name is Jo McNamara joined by fellow host Naman Julka-Anderson.

Jo McNamara Rad Chat Host (27:48)
So what do you do now? Well you can use this episode as part of our free continual professional development accredited content which offers flexible learning that fits your busy schedule. Just check out the show notes for the reflective questions, links to literature and resources and link to the completed form to receive your accredited certificate.

Naman Julka-Anderson (28:07)
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Naman Julka-Anderson (28:30)
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Jo McNamara Rad Chat Host (28:45)
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