A solo mum-of-five is dying of breast cancer after multiple imaging tests failed to pick up the deadly disease.
Teresa McCarthy, 58, has declined further treatment - without which she will die. She has already lost several family members to breast cancer, putting her in a high-risk category for the disease.
She has seen first hand the severe impact treatment had on the quality of their remaining lives.
"It's terrifying. Those numbers about how often Māori die of cancer, they're not statistics to me. They are my whanau and now I'll be one of them," she said.
Waitematā District Health Board has apologised for not "fully catering to [her] cultural needs" after she complained of racial bias. But it has defended its clinical treatment, saying doctors acted in the woman's best interest to provide high-quality care.
McCarthy's story dates back to November last year when cancer was fully removed from her right breast and she was told by clinicians at North Shore Hospital the chance of her cancer returning was low.
By the end of June she started experiencing stabbing pains in her breast and by July she discovered multiple lumps, "which you didn't need to feel, you could see them sticking out", she said. She saw her GP who referred her to North Shore Hospital to see a specialist.
During the next two months, two ultrasounds and a mammogram failed to pick up the cancer and instead specialists said it was an infection from her November surgery. She was given antibiotics and sent home on two occasions.
It wasn't until September 14 when she had an appointment at Waitematā DHB that a specialist made an urgent inpatient referral to Auckland City Hospital for further testing. That's where a biopsy was done and her returned cancer diagnosed.
Waitematā DHB says it didn't do a biopsy earlier because multiple imaging tests had been unable to detect cancer.
"It is possible that the cancer recurrence was either too small or masked by the
concurrent infection at those initial scans," a DHB spokesman said.
The New Zealand Breast Cancer Foundation advises a "triple check", including a physical examination, imaging tests and a biopsy, which can be done on the same day. This, however, is not part of DHB guidelines.
Adele Gautier, from the foundation, said about 12 per cent of cancers aren't detected through a mammogram, in particular lobular breast cancers.
McCarthy told the Herald she felt like she was judged, whether it was unconscious or not, for being Māori and she believed this clouded clinicians' judgment for her treatment.
She also claimed a doctor told her she was partly to blame for her cancer due to being overweight, which is disputed by the DHB.
In November, she was offered chemotherapy and radiation as a precautionary measure after her surgery. But she declined, saying she did not want to go through the suffering that her two sisters, mum and two best friends did - all of whom died of breast cancer.
"I am also a single mum with two children still at home and the main financial burden is on my shoulders. I cannot afford to finish work and be on a sickness benefit due to my financial responsibilities to support and assist my children in completing their education."
She said it was her body and she felt doctors did not respect her decision to refuse treatment, which she believed had influenced their subsequent treatment of her.
"I am incredibly disappointed with the level of cultural competency the practitioners demonstrated, the lack of professionalism, my support people being excluded from the complaints process and the substandard care I received," she wrote in a complaint to the Health and Disability Commissioner, which is investigating.
McCarthy said she felt robbed because she wasn't listened to. She has now been referred to Hospice for end of life care and will find out how long she has left to live tomorrow.
A Waitematā DHB spokesperson said clinicians acted in her best interests and worked diligently to provide high-quality care. They later admitted her cultural needs were not fully catered for and apologised for that.
Her daughter Jedi described her mum as a "really humble person who'd had a really hard life but had always risen above".
The 23-year-old, who is studying a Bachelor of Law and Health Science, said it made her sad when she thought about how her mum had been treated.
"To finally get told it's cancer and it is what she thought it was after being told time and time again that it couldn't be, is really really hard to swallow."
About breast cancer in New Zealand
• Every day nine women are diagnosed with breast cancer in New Zealand; one will be Māori.
• Data from Counties Manukau DHB in 2011 showed Māori are about 56 per cent more likely to die from breast cancer than non-Māori. Pasifika women are also understood to have a much higher death rate from breast cancer than Pakehā women.
• In total, close to 3300 women are diagnosed with breast cancer each year in New Zealand, and more than 600 will die from the disease.
• Between the age of 45 and 69, women can get a free mammogram which picks up 88 per cent of cancer and is estimated to give a 92 per cent 10-year survival rate. You can sign up to a 2-yearly mammogram by clicking here.
• But 12 per cent of cancers can't be picked up through a mammogram and require further testing.
• Symptoms of breast cancer include a new lump in the breast or underarm, thickening or swelling of part of the breast, irritation or dimpling of breast skin, redness or flaky skin, pain or discharge other than milk in the nipple, including blood.