A former Marks and Spencer chief has revealed the series of heartwrenching activities undertaken by his family before his wife's death — which made the end of her life 'beautiful'.

Robert Swannell CBE, who was Chair of M&S between 2011 and 2017, lost his wife Patricia to advanced breast cancer last year, aged 71. 

The family learned that the disease which she'd overcome over a decade previously had returned in 2021. It had spread to her bones, liver and abdomen, and was terminal.

Now, on the year anniversary of her death, Mr Swannell has revealed that his wife's unusually practical approach to her mortality helped the family to cope. 

Facing the bleak eventuality head-on meant Ms Swannell, an artist and former investment banker, could organise important activities, like recording her final conversations between her children. 

The couple's daughter, Alicia, 38, made a long list of questions to ask her mother about her life — including whether or not she'd ever broken law and what she's most proud of. 

'She and her brother recorded many of these conversations on their phones as they talked,' Swannell told The Telegraph. 

‘It allowed us to talk endlessly about our lives, her hopes and dreams for the children.'

The family's preparedness meant they there was no 'unfinished business' with 'every tiny resentment or jagged moment in her life was explored and forgiven’.

It also meant she got to witness her eldest child, Will, 40, get married.

‘It made such a profound difference for Patricia to see her son married,' said Swannell. 'At the wedding the choir sang the old song, Button up your Overcoat, which Patricia used to sing to Will when he was very young, and everyone was just blubbing all over the place.’

Patricia Swannell accepted that she was 'going to be terminal' very early on and 'immediately went into death planning mode'.

'This approach wouldn’t suit everybody, but it suited her to acknowledge death, not to sort of rage about it, but to accept it,' said Mr Swannell.

‘There was no self-pity, although there was a sense of injustice at how women who had survived primary breast cancer were handled by the health system. She led all the difficult conversations with the family, and her sense of injustice shaped what she wanted to do with the months she had left.’ 

He describes the death as ‘truly beautiful'. 

'She was utterly at peace, at home, surrounded by love, with me and our children, and their partners, holding her hand.

‘As she died, we promised her we would look after each other as she had looked after us. If we were to be parted, it was a truly beautiful death. I can’t describe what a blessing that was in our grief and it still is, a year later.’ 

Although planning helped them in the final years of Patricia’s life, Swannell said there were moments where the family struggled.

‘I remember the oncologist coming in. He looked at her, and said, "I need to tell you that it’s quite likely that next week you’ll come off treatment. You’re very likely going to the hospice from there. And the end will be quick," he said.

‘We were devastated. But her cancer nurse was utterly brilliant and sort of scooped us up and wiped our tears.

‘It isn’t all easy at all. And actually, some of it is really awful. In particularly bleak moments you sometimes have thoughts that you wish you hadn’t had, like "would it be better for her and us if this just ended now?"

'Those thoughts pass but you do feel guilty and it’s very helpful to discuss them openly.'

Mrs Swannell previously told of her struggle to get a diagnosis for her secondary tumours, which were spotted nine years after she was given the all-clear from the disease. 

 It took four years of repeated trips to doctors, who at one point put her symptoms down to an autoimmune condition, before advanced cancer was detected. 

Highly articulate, Patricia was determined to use her own experience to expose deep flaws in the way secondary breast cancer is diagnosed and treated, somehow managing to bring grace to her own situation while also advocating for other women.

With the help of her husband of 42 years, she raised more than £1 million in less than a year and led a campaign with the charity Breast Cancer Now to make sure women and clinicians understand the risks of secondary (also known as metastatic) breast cancer.

This is not the same as cancer recurring where it first started, but when it recurs elsewhere in the body.

Patricia had assumed that when she saw a doctor at any point after her original diagnosis, they would automatically see her medical history and be alert to any sign, however apparently trivial, that the breast cancer might have returned, either in the breast or elsewhere.

She found, to her great cost, this isn't always the case.

By the time the true cause of her tiredness and searing hip pain was identified, she had large secondary tumours in her abdomen and bones.

A 2019 study by charity Breast Cancer Now revealed that Patricia Swannell is far from the only patient to have this experience. 

A survey of 2,000 patients with secondary breast cancer found that one in four visited their GP three or more times before being diagnosed. 

Speaking of the findings, Baroness Delyth Morgan, chief executive of the charity, said: 'While secondary cancer isn't curable, it is treatable, and early diagnoses can mean many more years of life.' 

Breast cancer is one of the most common cancers in the world and affects more than two MILLION women a year

Breast cancer is one of the most common cancers in the world. Each year in the UK there are more than 55,000 new cases, and the disease claims the lives of 11,500 women. In the US, it strikes 266,000 each year and kills 40,000. But what causes it and how can it be treated?

What is breast cancer?

It comes from a cancerous cell which develops in the lining of a duct or lobule in one of the breasts.

When the breast cancer has spread into surrounding tissue it is called 'invasive'. Some people are diagnosed with 'carcinoma in situ', where no cancer cells have grown beyond the duct or lobule.

Most cases develop in those over the age of 50 but younger women are sometimes affected. Breast cancer can develop in men, though this is rare.

Staging indicates how big the cancer is and whether it has spread. Stage 1 is the earliest stage and stage 4 means the cancer has spread to another part of the body.

The cancerous cells are graded from low, which means a slow growth, to high, which is fast-growing. High-grade cancers are more likely to come back after they have first been treated.

What causes breast cancer?

A cancerous tumour starts from one abnormal cell. The exact reason why a cell becomes cancerous is unclear. It is thought that something damages or alters certain genes in the cell. This makes the cell abnormal and multiply 'out of control'.

Although breast cancer can develop for no apparent reason, there are some risk factors that can increase the chance, such as genetics.

What are the symptoms of breast cancer?

The usual first symptom is a painless lump in the breast, although most are not cancerous and are fluid filled cysts, which are benign. 

The first place that breast cancer usually spreads to is the lymph nodes in the armpit. If this occurs you will develop a swelling or lump in an armpit.

How is breast cancer diagnosed?

• Initial assessment: A doctor examines the breasts and armpits. They may do tests such as a mammography, a special x-ray of the breast tissue which can indicate the possibility of tumours.
• Biopsy: A biopsy is when a small sample of tissue is removed from a part of the body. The sample is then examined under a microscope to look for abnormal cells. The sample can confirm or rule out cancer.

If you are confirmed to have breast cancer, further tests may be needed to assess if it has spread. For example, blood tests, an ultrasound scan of the liver or a chest X-ray.

How is breast cancer treated?

Treatment options which may be considered include surgery, chemotherapy, radiotherapy and hormone treatment. Often a combination of two or more of these treatments are used.

• Surgery: Breast-conserving surgery or the removal of the affected breast depending on the size of the tumour.
• Radiotherapy: A treatment which uses high energy beams of radiation focused on cancerous tissue. This kills cancer cells, or stops them from multiplying. It is mainly used in addition to surgery.
• Chemotherapy: A treatment of cancer by using anti-cancer drugs which kill cancer cells, or stop them from multiplying.
• Hormone treatments: Some types of breast cancer are affected by the 'female' hormone oestrogen, which can stimulate the cancer cells to divide and multiply. Treatments which reduce the level of these hormones, or prevent them from working, are commonly used in people with breast cancer.

How successful is treatment?

The outlook is best in those who are diagnosed when the cancer is still small, and has not spread. Surgical removal of a tumour in an early stage may then give a good chance of cure.

The routine mammography offered to women between the ages of 50 and 71 means more breast cancers are being diagnosed and treated at an early stage.

For more information visit breastcancernow.org or call its free helpline on 0808 800 6000