The radiologist looked nervously at his notes.
“I’m sorry, I was wrong,” he said seriously. “It’s serious.”
Until then, even the specialists investigating 40-year-old Ella Cieslak’s persistent cough and fatigue had thought she was most likely suffering from a respiratory infection.
She had thought the same thing. After all, she was fit, active and had never smoked.
Most importantly, despite a string of strange symptoms over the past nine months and three separate visits to a nurse at her local GP, repeated blood tests had revealed nothing serious.
But the scans told a completely different story.
Ella had breast cancer – despite never feeling a lump or noticing any other change in her breasts.
And by the time it was diagnosed, the disease was in stage four, meaning the disease is incurable, although treatment can help keep the disease at bay.
Ella Cieslak, left, had a persistent cough and fatigue, and specialists thought she was suffering from a respiratory infection, but it was cancer
By the time Ella’s breast cancer was diagnosed, the disease was in stage four, meaning the disease is incurable
Cancer originating in her left breast had spread throughout her body, including to both lungs, her lymph nodes, liver, spine and brain, where doctors discovered multiple tumors.
However, when the specialist told Ella the news, her first reaction was disbelief.
‘None of the doctors I had seen before had thought I had anything to worry about,’ says Ella, assistant manager at a hotel and pub in Poole, Dorset.
‘Even the pulmonologist at Poole Hospital told me he thought it was just an infection. He told me that I just didn’t look like someone who would become so seriously ill.
“When they finally announced the news, I was in complete denial. I asked the specialist to show me every scan because I thought: it’s still not right.’
Ella even had an aggressive form of breast cancer.
The diagnosis ultimately cleared up the debilitating cough that left her struggling to breathe and talk to colleagues at work.
But it also came after months of other, seemingly unrelated health problems — including stomach and intestinal problems, itchy skin, extreme fatigue, pain on the left side of her body and unusually swollen veins.
Ella had first sought medical help in September 2025, when she was seen by a nurse at her local GP surgery after developing stomach pain, itchy skin and changes in her bowel habits.
Tests revealed the common stomach infection Helicobacter pylori, for which she was given antibiotics.
Blood tests – including checks of her liver function, iron, vitamin B12 and folic acid levels – were normal.
She returned to the operating room the following month after having problems with the medication. She saw a nurse again, but by early this year she had developed a new set of symptoms.
Ella struggled with fatigue and constant pain down the left side of her body, including her left arm and leg.
She also noticed that the veins in her limbs on the same side seemed unusually swollen and sent pictures of her hand and leg to the operating room in February.
In March she was seen again by a nurse and underwent another series of blood tests, including checks of her thyroid, liver and kidney function and vitamin levels.
Once again, everything went back to normal.
“I started to think something was wrong,” she says. “But then they checked my blood again and everything was fine.”
Then, in early May, Ella developed a brutal dry cough.
Within a few weeks, the complaints had become so severe that she could hardly sleep, walk or talk to colleagues at work.
‘I couldn’t sleep. “I couldn’t walk,” she says. “So I tried to make an appointment and it ended up being at the doctor’s office.”
She says the first available appointment was two weeks later, on May 21.
The GP initially suspected an infection, but was so concerned about the combination of symptoms that he ordered a chest x-ray.
Four days later the result was abnormal.
Ella was given antibiotics while specialists considered whether she might have tuberculosis or another lung infection.
But further research raised more serious concerns.
A CT scan was followed by an MRI of her brain and a PET scan to look for signs of disease elsewhere in her body.
When Ella returned to the hospital to discuss the results, the radiologist who had initially reassured her delivered the devastating news.
A subsequent biopsy revealed that she had HER2-positive breast cancer, an aggressive form of the disease that accounts for about 15 percent of breast cancer cases.
HER2 is a protein found on the surface of breast cells that helps control their growth. In HER2-positive cancers, tumor cells produce unusually large amounts of the protein, which allows them to grow and divide more quickly.
A lump is by far the most common warning sign of breast cancer, but in some cases changes cannot be felt or seen just by looking.
One big United Kingdom study of more than 2,300 breast cancer patients, about one in six women were found to have developed symptoms that initially occurred without a breast lump.
Instead, symptoms may include nipple changes, breast pain or skin changes – while, in rarer cases, the first signs may be caused by cancer that has already spread elsewhere in the body.
Just four days after receiving her diagnosis, Ella began chemotherapy with docetaxel, in addition to two such targeted drugs, trastuzumab and pertuzumab.
For Ella, there had been no warning sign in her chest at all.
HER2-positive breast cancer was once associated with a particularly poor outlook due to its tendency to grow and spread quickly.
However, the development of drugs that specifically target the HER2 protein has dramatically improved treatment.
Just four days after receiving her diagnosis, Ella began chemotherapy with docetaxel, in addition to two such targeted drugs, trastuzumab and pertuzumab.
But doctors were also faced with the pressing problem of the cancer that had spread to her brain, where scans had revealed 23 separate tumors.
Last month, Ella underwent Gamma Knife radiosurgery in Bristol – a highly targeted form of radiation that can destroy tumors in the brain while limiting damage to surrounding healthy tissue.
Despite the name, the treatment does not involve surgery or an incision. Instead, multiple beams of radiation are precisely aimed at the tumors.
Ella is now waiting for scans to determine how well it has worked.
Doctors have told her that because her cancer cannot be cured, treatment is instead aimed at controlling the disease for as long as possible – and Ella is determined this could take years.
“I’ve tried to stay positive,” she says. “That’s what’s keeping me alive right now.”
But almost overnight, the fiercely independent “workaholic,” who says she routinely walked 50,000 steps a day, found herself unable to work or even drive.
And just as she was accepting the diagnosis, Ella was dealt another devastating blow.
Her partner of three years told her he couldn’t cope with her illness – and ended their relationship.
“He told me he had suffered some childhood trauma after some of his family members were diagnosed with cancer and said he didn’t want to do it again,” she says.
‘I felt very angry. I just looked at him and said, ‘What are you talking about? I’m not going to give up now. I’m going to fight it.’
For Ella, who had always taken pride in taking care of her health, the diagnosis was particularly difficult to understand.
“I was very active and never really stopped,” she says. “I’ve always tried to be very healthy.”
Ella says she now wishes she had tried harder to find out what was causing her symptoms.
“I was angry, and I was angry with myself,” she says. ‘I trusted my doctors, but I should have been more pushy. Maybe they would have taken me more seriously.’
Her life now bears little resemblance to the life she had before her diagnosis.
She can no longer work or drive because of the tumors in her brain and has lost much of the independence she once took for granted.
Close friends have become her support network and have a GoFundMe page to help her through treatment.
And Ella refuses to give up her plans for the future. She hopes to see her favorite band, Imagine Dragons, when they next play in Britain.
And she has already set herself a significantly further goal. For her 50th birthday – in ten years – Ella plans to be in the Maldives.
