A cancer diagnosis can strike at any time and in any setting - including in prison.
Each year, an estimated 300 inmates in New South Wales will be diagnosed with the disease while in custody, adding complex layers of challenges to what is already a life-changing experience.
At a minimum-security prison on the outskirts of Sydney, Michael (not his real name) describes what it was like to receive such news.
“I was shocked," he says. “It was pretty much all through my body, in my spine, in my hips, in my head. It's a blood cancer but it seeped into the bones."
Midway through 2020, Michael, who is in his 40s, was diagnosed with multiple myeloma, a form of blood cancer that affects the immune system.
Michael was diagnosed with multiple myeloma in 2020. Source: SBS
"I was worried for my family, for myself, but mainly for my kids. My boys just lost their mother not long ago and I was worried for them that they were going to lose me.”
I was worried for my family, for myself, but mainly for my kids.
Leanne Foster, a cancer care specialist with Justice Health and Forensic Mental Health Network, says that's a common feeling among inmates when they are first delivered a diagnosis.
"I think with anybody that has a diagnosis of a terminal illness, it's quite shocking and then they go through denial; 'no I'm not going to die, I don't want to die in custody,'" she says.
Ms Foster explains how for many, it feels like a double sentence.
"Being diagnosed with cancer is quite a horrible thing but also being in custody, it's like a double whammy, so we try and reduce as much stress as possible.
For the past four years, Ms Foster has been supporting cancer patients in the NSW correctionalsystem, from diagnosis to remission, management and end of life care.
"The treatment is really no different to what there is in the community, except the access of family," she says.
Leanne Foster supports prisoners with cancer. Source: SBS
Ms Foster works to ensure all of her patients are treated with "dignity and respect".
"There is always a stigma with being in custody. We don't ask them why they are here and we don't treat them any different. We all need to be treated fairly and equally and not be judged because cancer does not discriminate."
Treatment in custody
Shortly after his diagnosis last year, Michael was transferred to hospital for a stem cell transplant, a process that removes cancer cells and replaces them with healthy ones.
"I was in a normal ward with everyone else, [but] they still had two officers there all night and all day," he says.
"I thought they treated me well. All the nurses were friendly, all the doctors were friendly. They gave me the same care as everyone else. It is important because it makes you feel good and motivates you to get better."
I was in a normal ward but they still had two officers there all night and all day.
But, he says, it was difficult to go through without the support of his family.
“[There was] lot of pressure. I can't go to my support, my family. It was hard too because of COVID. I couldn't get visits while I was in hospital so it was pretty hard going through it by myself.
"But you've just got to deal with it. It's part of being in jail."
Ms Foster says most health services are happy to take on her patients, but there are challenges at times.
"I've had some medical centres say no because I say where I am from, who I am, and I have a patient that needs help in the community."
Michael says it's important all cancer patients are treated equally.
"We've been punished, we're doing our time. We should still be treated like human beings. We've still got to get out in the community one day and we'd like to be treated like everyone else."
Cancer awareness in custody
Michael is now in remission.
"I am feeling real good. My legs are still a bit sore but they reckon it's going to take six to 12 months for my body to get back to normal. But there is no cancer. I am in remission and I'm very happy," he says/
He believes prison populations should be included in early cancer detection campaigns.
"Cancer is a silent killer. It'll sneak up on you and if you don't find out you've got it, it might be too late."
Ms Foster has been working to boost cancer awareness among those in custody, saying in some cases, inmates may have developed the disease before they are placed into a correctional facility.
Leanne Foster hopes to expand cancer awareness campaigns in correctional centres across NSW. Source: SBS
"We've had quite a few that have had quite advanced disease when they've come. So they didn't know about it in the community, it was picked up when they came into custody."
Last year, Ms Foster held breast cancer awareness days at two women's correctional centres.
"The women in Silverwater and Emu Plains really embraced it. It was a great day, lots of questions asked, the girls were really receptive of it."
She says the women were encouraged to undergo an examination and that resulted in two diagnoses.
"We had two women there that had breast cancer. One of them said later on if she was in the community she would not have gone and had it checked. So she's had a double mastectomy and the other one is still being treated.
"It's been quite an eye-opener for the other girls in the centre."
Ms Foster is hoping to expand the campaign into in 2021.
World Cancer Day is marked on 4 February. More information about cancer and a list of support organisations in Australia can be found at
