The Laura Dowling Experience

#AD - This episode is sponsored by AstraZeneca

Dr Tonya Leonard was a GP when she found a lump she was sure was a cyst. By half past nine that morning, she was being told it was breast cancer and asked to decide by the following week whether she had finished her family. Her twin boys were just 18 months old.

Sixteen years, a second primary cancer and a diagnosis of advanced breast cancer later, Tonya joins Laura alongside Helen Forristal, Director of Nursing Services at the Marie Keating Foundation, for an honest conversation about living with advanced breast cancer.

They discuss metastatic or secondary breast cancer, breast cancer recurrence and the signs and symptoms women should be aware of, alongside treatment, scans, scanxiety, cancer fatigue and the difficulty of planning life beyond the next result.

Helen explains why advanced breast cancer remains largely invisible in Ireland, with no official count of how many women are living with it, and discusses the importance of specialist cancer support. Tonya shares the reality of living life in three-month segments, navigating mental health after diagnosis and learning that palliative care does not only mean end-of-life care.

The conversation is part of Living Loudly, Dying to be Heard, a campaign by AstraZeneca and supported by the Marie Keating Foundation, highlighting the experiences of people living with advanced breast cancer.

🔑 Key Points

Advanced breast cancer means it has spread
The cancer has moved from the breast to another organ; in Tonya's case, to lesions on her lung and under her arm.

Life in three-month segments
With a scan every three months, Tonya finds it hard to plan past the next result, the anxiety Laura calls scanxiety.

Fatigue is not the same as tiredness
Tonya describes cancer fatigue as like an injection of horse tranquilliser: once she feels it rising, she has minutes to lie down.

Women are living longer with it
Helen calls it the long middle, moving through lines of treatment; one woman in her group has lived with advanced breast cancer for 21 years.

Nobody is counting
Recurrences aren't recorded the way first diagnoses are; Helen's estimate is around 30% of women with primary breast cancer, and a University of Limerick project has started counting.

Know the signs of a recurrence
Symptoms depend on where it spreads, from a cough and breathlessness to weight change or bone pain; if something hasn't settled in three weeks, ask your doctor, "Could this be cancer?"

Mental health support needs to be specialist
Tonya waited eight weeks to see a psychologist; psycho-oncology services now run in Ireland's eight cancer centres.

Palliative care is not only for the end of life
Palliative teams help manage symptoms and support families, and the CLIMB programme supports children aged 5 to 12 who have a parent with cancer.

📚 Resources

Living Loudly. Dying to be Heard
A campaign by AstraZeneca and supported by the Marie Keating Foundation

Positive Living
The Marie Keating Foundation's support programme for people with advanced cancer

CLIMB
The HSE programme for children aged 5 to 12 affected by a parent's cancer

⏱️ Timestamps

00:00 — Welcome
01:52 — Helen Forristal and the Marie Keating Foundation
02:51 — Dr Tonya Leonard’s breast cancer diagnosis
06:21 — Advanced cancer support and Positive Living
09:28 — Scanxiety and living between results
12:08 — Living longer with advanced breast cancer
17:14 — Cancer fatigue
22:58 — Fertility and “Have you finished your family?”
29:17 — How many women are living with advanced breast cancer?
30:41 — Signs and symptoms of recurrence
37:57 — Mental health and psycho-oncology
46:45 — What palliative care really means
51:40 — Family, milestones and living with uncertainty
56:28 — Advice for young people
Thanks for listening! You can watch the full episode on YouTube here. Don’t forget to follow The Laura Dowling Experience podcast on Instagram @lauradowlingexperience for updates and more information. You can also follow our host, Laura Dowling, @fabulouspharmacist for more insights and tips. If you enjoyed this episode, please subscribe and leave a review—it really helps us out! Stay tuned for more great conversations.
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In this bitesize moment pulled from the Laura Dowling Experience back catalogue, Dr Clodagh Campbell shares two client stories about reclaiming time for yourself, then walks through the Four Ds, a simple way to sort an overwhelming to-do list into what to delete, delegate, delay or do.

When your life feels too full, the answer isn't to try harder. It's working out what can give. Psychologist Dr Clodagh Campbell shares two client stories and a simple tool for figuring out what to drop.

🔑Key Points
• When life feels too full, the question isn't how to cope better, it's what can change and what can give
• Alice, a successful business owner, worked herself into the ground out of a deep fear of letting her parents down
• By the end of their work together, Alice had hired a manager, taken a three-month sabbatical and learned that rest could be as simple as walks on the beach
• Nikki, a mother of three, couldn't imagine one hour a week for herself, until a small boundary around one yoga class let her husband step up too

🎧 Listen to the full episode here.
Thanks for listening! You can watch the full episode on YouTube here. Don’t forget to follow The Laura Dowling Experience podcast on Instagram @lauradowlingexperience for updates and more information. You can also follow our host, Laura Dowling, @fabulouspharmacist for more insights and tips. If you enjoyed this episode, please subscribe and leave a review—it really helps us out! Stay tuned for more great conversations.
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Dr Dan McCartney, dietitian, lecturer in Human Nutrition and Dietetics and Programme Director of the Human Nutrition and Dietetics programme at TU Dublin and Trinity College Dublin, joins Laura to discuss the vitamins and minerals many of us simply aren’t getting enough of — and why that matters for our health.

Drawing on Ireland’s national food intake data, Dan reveals striking levels of inadequate intake across essential nutrients including vitamin B6, folate, vitamin C, vitamin A, zinc, magnesium and selenium. At least half of the Irish population have inadequate intakes of magnesium and selenium, while more than 40% have inadequate vitamin C intakes.

Laura and Dan also discuss the European Food Safety Authority (EFSA) and proposals to lower or restrict the levels of certain vitamins and minerals available through supplements. Dan questions the rationale for reducing these levels when nutrient intakes are already low, discussing proposed levels for vitamin D, as well as restrictions affecting magnesium and the importance of vitamin C. He explains why he believes a restrictive, one-size-fits-all European approach may not meet the nutritional needs of the Irish population.

They also explore whether some recommended daily amounts are focused more on preventing severe deficiency than achieving optimal health, including vitamin C recommendations based around preventing scurvy and vitamin D recommendations historically centred on bone health rather than immune function.

The conversation returns to Dan’s early research into vitamin D and COVID-19, before moving into nutrition and immunity, healthy ageing, dementia, pregnancy and epigenetics — and why the nutritional choices we make today can influence our health decades into the future.

🔑 Key Points

Half the population are falling short on key nutrients
Dan discusses inadequate intakes of magnesium, selenium, vitamin B6, folate, vitamin C, vitamin A and zinc in Ireland.

Why are nutrient intakes so low?
Poor diet quality, low fruit and vegetable intake, low wholegrain consumption and highly refined diets.

EFSA and proposed supplement restrictions
Laura and Dan discuss EFSA and proposed European changes affecting vitamin and mineral supplements, including vitamin D and magnesium, and why Dan is concerned about further restrictions.

Are recommended intakes actually optimal?
Dan questions whether some guidelines focus on preventing severe deficiency rather than supporting optimal health.

Vitamin D, immunity and COVID-19
Dan revisits the research that led him and Dr Declan Byrne to propose a link between vitamin D deficiency and severe COVID-19 in 2020.

Nutrition across a lifetime
From pregnancy and epigenetics to ageing and cognitive health, Dan explains why nutrition today can affect health decades later.

📚 Resources

Optimisation of Vitamin D Status for Enhanced Immuno-protection Against Covid-19
Dan and Declan Byrne, Irish Medical Journal, 2020

Vitamin D Deficiency and ARDS after SARS-CoV-2 Infection
Faul et al., Irish Medical Journal, 2020

Autocrine vitamin D signaling switches off pro-inflammatory programs of TH1 cells
Chauss et al., Nature Immunology, 2022

Nutrition, immunity and COVID-19
Philip Calder, BMJ Nutrition, Prevention & Health, 2020

European vitamin D supplementation trials, meta-analysis
Rupprecht et al., Nutrients, 2023

⏱️ Timestamps

00:00 — Cold open
02:07 — Meet Dr Dan McCartney
04:03 — Vitamin D and COVID-19
06:10 — The 2020 research
13:49 — Why vitamin D levels run low
19:08 — Vitamin D and immunity
32:00 — Ireland’s nutrient inadequacies
34:02 — Poor diet quality
35:09 — Zinc, magnesium and selenium
37:24 — Are nutrient guidelines out of date?
38:03 — Scurvy vs optimal health
45:48 — EFSA and proposed supplement restrictions
46:24 — Vitamin D supplement levels
50:11 — Magnesium restrictions
51:03 — Nutrition guidelines for Ireland
54:35 — Primates and vitamin D
55:51 — Ageing and dementia
57:39 — Pregnancy and epigenetics
1:02:43 — Why good habits compound
Thanks for listening! You can watch the full episode on YouTube here. Don’t forget to follow The Laura Dowling Experience podcast on Instagram @lauradowlingexperience for updates and more information. You can also follow our host, Laura Dowling, @fabulouspharmacist for more insights and tips. If you enjoyed this episode, please subscribe and leave a review—it really helps us out! Stay tuned for more great conversations.
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In this bitesize moment pulled from the Laura Dowling Experience back catalogue, Dr Denis O'Driscoll, pharmacist working in the HSE addiction services gives a straight, compassionate answer on how hard it is to come off drugs and stay off, and why staying stable on treatment counts as success too.

Is staying on treatment for life a failure, or is that thinking part of the problem? Dr Denis O'Driscoll gives an honest answer.

🔑Key Points
• Coming off drugs and staying off is never easy, and that is worth saying out loud
• Recovery is not one straight line; staying stable on treatment is a positive outcome, not something to be ashamed of
• Coming off completely is wonderful when it happens, but it is very challenging, and it is not the only measure of success
• Relapse is part of recovery, not a failure, and the priority afterwards is getting people back into support quickly

💛 If you or someone you love needs support, the HSE Drugs and Alcohol Helpline is there on 1800 459 459.

🎧 Listen to the full episode here.
Thanks for listening! You can watch the full episode on YouTube here. Don’t forget to follow The Laura Dowling Experience podcast on Instagram @lauradowlingexperience for updates and more information. You can also follow our host, Laura Dowling, @fabulouspharmacist for more insights and tips. If you enjoyed this episode, please subscribe and leave a review—it really helps us out! Stay tuned for more great conversations.
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Kenneth Keavey has a PhD in chemistry and spent his early career in pharma and biotech. He now grows organic vegetables on twenty-five acres outside Galway, and he's the first to point out the irony: he was an organic chemist, and now he's an organic farmer.
In this episode he takes Laura through what's actually on the food we eat, and how little of it we're told. Around 95% of conventional fruit and veg has had some treatment or another. Citrus is dipped or sprayed after harvest in waxes containing quite toxic, in some cases carcinogenic, chemicals to stop fungus growing on the skin. Most of it is legal, disclosed somewhere, and almost never read.
Then comes the detail that stops the conversation. In the EU you're allowed 10mg of glyphosate per kilogram of wheat and 20mg per kilogram of oats — twice as much of a probable carcinogen in your porridge as in your toast. Kenneth and Darina Allen went to the Department of Agriculture to ask why. They were told that people eat less porridge than they do toast.
It isn't all alarm. Kenneth refuses to scaremonger and is as clear about what isn't known as what is. He's also quietly hopeful: his own land is full of insects and birdsong, and he has watched how fast nature comes back when you let it.

🔑 Key Points

He was an organic chemist before he was an organic farmer
His PhD is in chemistry and his first career was in pharma and biotech, which is where the caution comes from.

Around 95% of conventional fruit and veg has had some treatment
Post-harvest waxes on citrus contain toxic and in some cases carcinogenic chemicals, and some produce carries up to fifteen applications.

You're allowed twice as much glyphosate in porridge as in bread
The EU limit is 10mg per kilogram of wheat and 20mg per kilogram of oats. Kenneth and Darina Allen asked the Department of Agriculture why, and were told people eat less porridge than they do toast.

The safety data usually comes from the manufacturers
Unlike medicines, pesticide safety data is largely supplied by the companies selling the chemicals, and permitted limits have risen since the 1990s as application increased.

80% of the world's insect biomass is gone
A test anyone can run from memory: a windscreen after a night drive used to be covered in insects, and now there's virtually nothing on it.

Ireland has gone from 600 vegetable growers to about 60
The sector has hollowed out in twenty years, we import 85% of our fresh fruit and veg, and vegetables are the one thing that hasn't risen in price — which is why a 39c bag of carrots is a problem, not a bargain.

Nature comes back faster than you'd think
His farm is full of insects and birds, with nine native Irish honeybee hives that out-produce every other apiary his beekeeper runs.

📚 Resources

Green Earth Organics
Kenneth's organic farm and nationwide home delivery service in Co Galway

Silent Spring
Rachel Carson's book on the effects of blanket pesticide use, discussed in the episode

IARC (World Health Organization)
The classification of glyphosate as probably carcinogenic to humans

⏱️ Timestamps

01:26 — Twenty years of Green Earth Organics
02:35 — From a PhD in chemistry to organic farming
03:57 — Around 95% of conventional fruit and veg has had some treatment
06:34 — Glyphosate, the most applied chemical in history
06:59 — Twice as much allowed in your porridge as in your toast
07:17 — What the Department of Agriculture said when they asked why
10:39 — Silent Spring, and the year the birdsong stopped
12:25 — 80% of the world's insect biomass is gone
22:15 — From 600 vegetable growers to about 60
50:06 — Five summers of farm work, three sheep, and the leap
Thanks for listening! You can watch the full episode on YouTube here. Don’t forget to follow The Laura Dowling Experience podcast on Instagram @lauradowlingexperience for updates and more information. You can also follow our host, Laura Dowling, @fabulouspharmacist for more insights and tips. If you enjoyed this episode, please subscribe and leave a review—it really helps us out! Stay tuned for more great conversations.
Hosted on Acast. See acast.com/privacy for more information.