Woman's Hour - Breast implant rare cancer risk, Gemma Arterton, Nonna’s cookbook

Episode Date: September 4, 2024

We hear about the thousands of women suing the breast implant manufacturer Allergan over alleged links with a rare cancer. We have an exclusive interview with a woman who has received a payout from the company after falling sick. Susan Axelby tells our reporter Melanie Abbott that she ended up being diagnosed with cancer after having an operation which was supposed to prevent it. Plus, Nuala McGovern is joined by lawyer Sarah Moore to go over details of the case and reveal whether more women in the UK are likely to take action. And Professor Suzanne Turner from Cambridge University will discuss her research into this cancer and give advice to women who have implants, including the fact that the numbers diagnosed are small and it is treatable.Actor and producer Gemma Arterton returns to our screens this week for the second season of Funny Woman, which tells the story of Sophie, a comedian trying to forge a path for women’s voices in the male-dominated world of 1960s comedy. Gemma joins Nuala to tell her about the series and her own passion for getting women’s voices heard.Giuseppe and his Nonna, Marianna, have been making social media content together since 2021, sharing videos of them making food inspired by Nonna’s Italian home cooking, but vegan. Giuseppe and Marianna join Nuala to discuss their relationship, how Nonna found social media fame in her 80s, and their first cookbook Cooking with Nonna. Presenter: Nuala McGovern Producer: Maryam Maruf Editor: Deiniol Buxton Studio Manager: Gayl Gordon

This BBC podcast is supported by ads outside the UK. I'm Natalia Melman-Petrozzella, and from the BBC, this is Extreme Peak Danger. The most beautiful mountain in the world. If you die on the mountain, you stay on the mountain. This is the story of what happened when 11 climbers died on one of the world's deadliest mountains, K2. And of the risks we'll take to feel truly alive. If I tell all the details, you won't believe it anymore. Extreme. Peak danger. Listen wherever you get your podcasts.

BBC Sounds. Music, radio, podcasts. Hello, this is Nuala McGovern and you're listening to the Woman's Hour podcast. Hello and welcome to Woman's Hour. Well, today, the first broadcast interview with Susan Axelby, who developed a rare type of cancer allegedly linked to her breast implants. She warns that others with similar implants could be, and I quote, walking around like time bombs. Our investigation in a moment

with our reporter, Melanie Abbott. Also today, the actor Gemma Arterton. Gemma stars in a new season of the TV series, Funny Woman. And in our conversation, Gemma spoke about words, feminist and also feminism. And she believes they can have

negative connotations for some. And she asks whether it's time for new words that represent balance, equality and inclusivity. Stay with us for her full thoughts on that. And let me know your thoughts. Agree? Disagree? Or maybe you even have a new word or words in mind. You can text the programme. The number is 84844.

Also, fans of Italian cooking or cucina, stay with us for the Italian nonna. That's 85-year-old Mariana with her grandson, Giuseppe Federici. You might know them from their Instagram fame of cooking together. They have so many followers. So they bring a little bit of Sicilian sunshine to our airwaves today. And I have tried one of their recipes. That's torta della nonna, or grandmother's cake.

And yes, it stands the test of time, as do many of our grandmother's recipes. So maybe you have a recipe from your gran that you go back to again and again. Let us know. Also with the memory that it conjures up. You can text the programme 84844, as I mentioned, or WhatsApp message 03700100444 on social media.

We're at BBC Women's Hour. Or you can email us through our website. But let us begin with a special investigation by this programme that has discovered more and more women are suing the breast implant manufacturer Allergan, claiming their implants have given them a rare form of cancer. The textured implants that are sold under the brand BioCell were recalled in 2019. This followed more than 100 reports

of what is called breast implant-associated anaplastic large cell lymphoma, or BIA-ALCL. It is a cancer of the immune system and develops in scar tissue around the implants. It happened to Susan Axelby. She's from Sheffield and she's now received £57,000 in an out-of-court settlement from Allergan.

We will hear exclusively her first broadcast interview shortly. But first, let us speak to our reporter, Melanie Abbott, who's been following the fallout from breast implants since 2010. Melanie, welcome and give us a bit more about what we know about BIA-ALCL. Yes, well, the first report made by Allegan about it was in 2007.

It documented cases then. And we know this because of documents that Allergan provided to the French health regulator eight years ago, back in 2016. And that showed that by then, there had been 104 complaints of this breast implant associated lymphoma. Yet the recall of these products didn't happen until three years later, three years after those documents had been handed over. And has Allergan explained about that? I did ask Allergan, but they haven't responded. But when Susan got her implants, there had already been cases.

That's right, yes. She got her implants back in 2011. By then, according to Allergan, in those documents I mentioned, there'd been 19 complaints of this type of cancer. But those figures weren't revealed until five years after Susan got those implants. Now, we can't say when Allegan might have begun collating those figures, but we certainly know that someone was logging the data as early as 2007. And there had been some reports before then too. Now, Susan has received this out of court settlement, £57,000 from Allegan, without them admitting liability.

Susan's story begins when she had a preventative mastectomy 25 years ago. Her family has a history of breast cancer. She was given the implants then, but she told me that she was never happy with that outcome. They weren't formed properly. One was higher than the other one. All the skin was puckered. The nipples were in the right place. Scars. Well, I didn't even think I would have any scars. And then I got

necrosis and they said it was because there wasn't any oxygen getting to the nerve ends. The smell was horrendous. It was like dead meat, but worse. Because necrosis is when your skin is dying, isn't it? Yes, that's right. So I had to go through all these injections and put this powder put on to see if they could make it grow. And it did, but it was all starred and it did never look right. What did you do? Did you just try to live with it?

Well, I did try to live with it, but it was always on my mind. And to be quite honest, I had a bit of a mental breakdown. I was housebound for two years. I turned to alcohol. I was drinking every day, early in the morning till, you know, I collapsed at night. Gosh, did you eventually try to get something done about them then? I've got a daughter and we tried to get her the genetic testing. So she went to see a breast cancer nurse and I went with her. And Alicia mentioned how bad my breasts were. And she said, do you mind if I have a look?

And she actually took a step back and went, you know, sharp intake of breath. And then I was referred to a surgeon and she put new implants in and tried to like even my breasts up, which she did and didn't look too bad. Although I didn't look like a page three model. So that's when you got the Allergan implants? That is when they got the Allergan, yeah. Then a few years after that, I got some swelling in my left breast and it felt hot to the touch. So I went back to the hospital and they drained 500 millilitres of fluid out of it. Then I went back home and it swelled up again. So I went back again and they drained the same amount off again. Within a month, that was.

And then it started to swell up again. And they found out I've got this very rare cancer. What was your reaction when you were told that? Well, I didn't believe it. I was in denial. I'd had my breast stuffed. It stopped me getting cancer. And now I've got cancer.

I thought, how can that be? And it wouldn wouldn't go in and I even said to the nurse I said I got cancer and she wouldn't tell me then my husband came and I said I'm sorry my husband came and sorry to bring it all back you see not only have they hurt me they hurt my husband they hurt children are you ok yeah it has ramifications for everyone around you of course

yes I'm sorry about that no don't worry so then of course. Yes, I'm sorry about that. No, don't worry. So then, of course, he said, you know, we're going to have to take it out and take the breasts off again. And they said I could never, ever have another implant. The only way around it is to, like, take stuff from another part of my body and, like, rebuild rebuild it and I just said can't go through that again I just cannot go through that again so I just said can you

possibly just take the other one off then so there's no nipples there's actually nothing there's just like a straight line all the way across top of my. And are you getting used to how you look? Yeah, yeah, I suppose so. I'm still, well, not embarrassed really, but I don't like anyone to see me without any clothes on and that does quite gloat my husband, although he's not bothered at all. Obviously, you've been through a lot, but what made you decide that you would sue Allegan Implant Manufacturers? Because I'm thinking, not so much me, I mean, I'm nearly 70, but there's young girls, you know, because they wanted breast augmentation. They're walking around like time bombs. They have no idea what's in their body now. You know, it's happened to me and a few other people. You know, they can be walking around like that.

And they knew this, Melanie. They've known this for years, that there's a chance that this could happen. But they did nothing about it. They need to be brought to justice. They really, really do. You told me you coped very badly when you first had the mastectomy. So how are you coping now? I still get problems with my anxiety and my depression. You know, so it's never gonna wait it's never gonna

go away. Susan Axelby and I would like to thank her for sharing her story upsetting as it obviously was to talk about it and she has made a full recovery from the lymphoma now if you've been affected by this there is information on our website about where to get support and there's also a link to the health regulator for medicine and healthcare products, the MHRA, for advice about this kind of cancer. Yes, indeed. Thanks very much to Susan for sharing her story. Has the surgeon who operated on Susan commented?

The surgeon who gave her the Allergan implants. I have been in touch with her and she does say that unfortunately, we routinely used Allergan implants at the time, and indeed for many years afterwards, because as she says, we didn't understand the association, I'm quoting her there, and she says they were widely regarded as high quality implants. We know there are class action suits underway to sue Allergan in the United States. What about Europe? Yeah, in the Netherlands, 60,000 women are taking part in a case against Allergan.

And I should stress they don't all have this BIA-ALCL cancer. For some, they fear developing this lymphoma, and so they want to be compensated for that worry and for possibly having the implants removed. The lawsuit's being brought by a women's rights organisation called Bureau Clara Wickman, and their head of strategic legislation is Linda Brick. She told me they're only able to bring this joint action because of relatively new laws introduced in the Netherlands

in 2020. It is quite relevant in a case like this, as you can imagine, because we're talking here about women who are carrying an implant that they feel might be defective and that they want to get explanted or that actually is causing them injuries and damages. And they want to file a claim against a major company, a major pharmaceutical company, who will have unlimited access to funds to defend themselves in court. And so what you see is that normally these cases are almost impossible for women to bring, but this legislation enables them to get together and to make a stand and to actually step up. Were you surprised that so many women in a relatively small country had these implants. Yes, I was. I mean, of course, you know that there are a lot of women with breast implants.

And we're also not necessarily against breast implants, but we are against implants that are defective and that can cause risks. To be clear, not all of these women are suffering from this breast implant associated cancer. No, no, no, no, no. The lymphoma cancer is a rare type of cancer in itself. But if you have a textured implant, such as the ones that Allergen has been producing, your chance on that rare type of cancer is higher. So you have to see that, for example, in the Netherlands, we know that around 100 or so women have this type of lymphoma cancer, maybe a bit more. Allergen should have, at the time when there was the global recall of its products, warned those women in a better fashion and allow

those women to be able to say, listen, even though the chances are rare that I contract this lymphoma cancer, I still get the opportunity to have these implants expanded. And the problem is that under the healthcare system in the Netherlands, at least, if you don't directly show very severe complaints, you do not get it covered by the health insurance. And this lawsuit enables those women to actually have a choice to say, okay, I want to get them explanted. Fine. Here is a sum and you can use that. What's your hope then for the outcome? Well, I mean, the case looks both at women who have suffered from the lymphoma cancer. It also looks at women who have a fear of developing that type of cancer and want to be able to have the control over their own bodies

by being able to cover expenses should they wish an explantation. And it is for women who suffer from complaints that we would call breast implant illness, tiredness, chronic muscle pains, joint inflammation, feverishness, difficulty of concentrating. There is still some dispute in the medical world over breast implant illness though, isn't there? Of course, it's always difficult if you have health complaints that can also happen in society itself without those types of products. What we have to show is that indeed, this is a defective product. What we do see is that there is a large group of women that once

they have these implants removed, their health condition improves. So that can demonstrate such a link under the law. And so, yeah, we have to see how this procedure is going to play out. But we are in it with this entire group of women. And yeah, for us, it's really important that these women get heard and that they actually get recognized. Linda Brick speaking to me from the Dutch Women's Rights Group. Now, I did, of course, ask Allegan to comment. They sent a pretty brief statement saying, in 2019, Allegan issued a voluntary global recall of biocell textured breast implants and tissue expanders and no longer manufactures these type of implants. And you did hear there, of course, about breast implant illness, excuse me, from Linda, and we'll be reporting on that next week on next week's

Women's Hours programme. Thank you very much, Melanie Abbott. Well, I want to stay with this story and particularly the lymphoma we're talking about. I want to speak to Sarah Moore from Lee Day Solicitors, who acted for Susan Axelby, who we heard earlier in the programme, and to Professor Suzanne Turner from the University of Cambridge, who's been studying this rare form of lymphoma. Sarah, let me begin with you, and welcome to Women's Hour. I know you've had other women in contact with you. Do you expect to see many more cases?

Yes, I think we do. I mean, how many is a really good question, and I can't answer it personally. Sure, of course not. But what we know is that this product was suspended from the market in 2018 and then removed from the market in 2019. We also know that this particular type of cancer from which Susan suffered has a latency period of about eight to nine years.

Oh, a long time then. Yeah, so quite a long time before it can present. So on that basis, we might be expecting to see cases of ALCL being reported up to 2028, 2030, potentially, even though the product's now suspended. And what about that case that we were hearing about from Linda Brick, a class action suit, the laws had changed in the Netherlands. Is that possible in the UK? No, it's not. And that's a really significant issue for women in this country who have exactly the same problem as being reported

in the Netherlands. But because we don't have access to the kind of class representative system that they have in the Netherlands, we can't do that here, which means that we have to either bring singleton claims or we have to try and group them together. But there are big issues with that. There are issues in terms of the way the law is structured, but also because we cannot act for people unless they have presented with the actual cancer. So in the Netherlands, their group is very large. Well, I was really interested in that part of many of the women do not have the cancer, have not presented with the cancer, but for the worry that they feel they have experienced and also potentially

having those implants removed. Yes, which, you know, you can see, I mean, Linda and Susan use the expression time bomb. You know, if you've got these implants and you have this potential risk, albeit small, it's there, it's in your body, you know, and potential cancer is waiting to develop. Or even if it is not, you're worrying that it might. Absolutely right. So in the Netherlands, you can act on the basis that, or you can bring a case on the basis that this cancer may present later.

In the UK, you cannot. Until you have that cancer, you do not have a viable claim. So the numbers are smaller here. And because we don't have the class representative system where you can group women together, all those with these implants together, we haven't been able to date to bring this kind of case. And that's a real access to justice issue.

You know, we are hoping to bring more claims. But at the moment, the odds are stacked against women in the UK in a way that they're not in the Netherlands. Interesting. Let me turn to Professor Turner. Welcome also to Women's Hour. You were one of the first to begin researching this type of lymphoma. It is rare. I do want to stress that the MHRA, the regulatory body that Melanie had mentioned, reports there have been 104 cases in the UK. I'd be curious for your thoughts on how rare it is and also what causes it, if we know.

Yeah, good morning. So, of course, it is quite a rare cancer, fortunately, in that women that have these types of breast implants, the risk of developing this type of disease ranges from about one in 300 women, up to one in 14,000 women that have these implants in place. So it depends on which study you look at. So it is rare. And we're not completely sure what's going on, why it's occurring. And there have been a number of theories floated around without much evidence to back them up. But in our lab in particular, we've been looking at the role of chemicals on the surface of these particular types of breast implants, and how these may be acting to promote cancer development in certain women. And I was very glad to hear that Susan has made a full recovery from the lymphoma, although obviously has been through so much. She did talk about a swelling. Is that what women should look out for?

Because we don't want to cause unnecessary worry this morning, but some might be wondering, how would you know? Yeah, absolutely. So the most common symptom is a sudden swelling in one breast. So it can occur in both breasts in very, very rare cases, but it's that sudden swelling in one breast. And that can be anything from one to two years after having your implants put in, all the way through, as was mentioned previously, 10, 11 years after having the implants placed. So it's quite a long incubation period, if you like, for this cancer. It's normal to have a swelling immediately after surgery. That's just your body trying to repair itself

from the surgical process. So these are what we call delayed seromas or later swellings. At the same time, there have been some women who have presented with lumps and bumps, like you get in any breast cancer. So the advice is really to just be very aware of changes to your breast as you would if checking for breast cancer in general. So always go to your doctor if you do have any concerns. The official guidance from the regulator, the MHRA, is that women do not need to have them automatically removed if they have these Allergan implants. I'd be curious for your thoughts on that. Yeah, so, of course, in the current status of things, is not really going to be something that we can do in the NHS. And of course, this is also a highly treatable cancer. And so being aware of the symptoms,

looking out for those symptoms, and then going to your GP, should you be worried about any of the symptoms you're experiencing is really the advice at the moment. Tricky though, I can imagine for women just as you say that and also, I don't know, I suppose it brings up that divide between NHS and private perhaps as well for those that can afford it. Absolutely, yes. And, you know, there's lots of controversies around plastic surgery and what's taken a place abroad and all these other wider issues at the moment. And where does the NHS pick up on that, on those sorts of issues? And of course, having a national health service,

we are limited in the finances we have and what can be done, which again argues towards the company perhaps needing to take responsibility to pay for these removals and replacements. And listening is Sarah Moore, who represented Susan Axelby. You know, Professor Turner is touching on how the ramifications of this particular case might be. What do you think about that?

Action against other implant manufacturers or do you think it'll stay with Allergan? So we know that with ALCL, this particular type of cancer, that 85% of this cancer presenting worldwide is in relation to Allergan. It seems to be an Allergan problem largely. There are other textured implants that have the AALCL associations, but they are few and far between. So we think it's largely an Allergan problem in the UK at least.

If I can just say as well, in terms of the importance of getting help, what we've seen with Susan's case is that it took a long time for her to get to the point of diagnosis. And other women that have come forward as well have had the same problem. So they've gone back to see their initial plastic surgeon. They haven't necessarily been very quick to diagnose or help in any way. And then they've been referred back into the NHS and eventually have come to the point of diagnosis. But that's been sometimes six months or even 12 months

after the symptoms are first presented. We know with any cancer, obviously it's important to get treatment as swiftly as possible. But that creates another issue from a legal perspective as well, if I may, which is that when you bring a claim against a manufacturer in the UK, you have 10 years from the date at which the product is produced to bring legal action. So you can see here, well, we have instances of cancer presenting at sort of 8, 9, 10, as Susan says, 11 years, then you may already be after the point at which a claim is viable, even when you've been diagnosed within that 10-year period.

Because some of these implants sit on the shelf before they're implanted. That was going to be my next question, exactly how long are implants, from the time they're created to the time that they're actually put into a body it could be a year so if you are presenting with this cancer at nine years and the implant was on the shelf a year before it was put in then you're already right up against that time limitation period in terms of being able to bring legal action which is another problem that we face here in the uk um so again if if people are interested in bringing legal action,

we need to have that confirmed diagnosis and obviously clinical treatment must be your first priority. But if you do want to look at legal action, then really the clock is ticking and time is of the essence. That is Sarah Moore from Lee Day who is representing Susan Axelby. I want to thank my colleague, Melanie Abbott,

also who has been investigating this story and will be back again next week with another episode talking about some of the illnesses related to implants. Also, Professor Turner, thank you so much for joining us. I do want to say there is a link on our website on today's episode page. Just scroll down to the bottom and you have there the MHRA, the regular true body's advice about this lymphoma, about anyone who may be concerned about it. Coming up a little later is the nonna, Mariana, lovely woman, 85 years of age. She's the Italian nonna. She's on Instagram cooking up a storm. She came in with her grandson, Giuseppe Federici. We're going to hear from them a little later.

But I was asking you if you have granny's recipes that you want to share with the rest of the Women's Hour listeners. What is it? What memory does it conjure up? Here's one from Bridget. My granny Ashton

baked the most delicious parkin. Am I pronouncing that correctly? Am I going to get pulled over the coals for that one? Parkin. Northerners will know, but it's known by southerners

as ginger cake. Nobody could make it quite like her until we found the recipe, which included a peep, meaning that the oven door needs to be opened during baking. Result? A sunken middle of gooey deliciousness. Okay, Bridget

has put hers out there. 84844. If you'd like to get in touch and share your memory. I'm Sarah Trelevan, and for over a year, I've been working on one of the most complex stories I've ever covered. There was somebody out there who was faking pregnancies. I started, like, warning everybody. Every doula that I know. It was fake.

No pregnancy. And the deeper I dig, the more questions I unearth. How long has she been doing this? What does she have to gain from this? From CBC and the BBC World Service, The Con, Caitlin's Baby. It's a long story. Settle in. Available now. That would be lovely.

Now, my next guest is known on stage from Maiden Dagenham to the Duchess of Malfi. On screen, St Trinian's to Tamara Drew. Lots in between as well. But for this role, she turns to the 1960s,

to the time where the TV series Funny Woman is set. It's back for a second series. It follows a female comedian and actor that's played by Gemma Arterton, trying to get her voice heard in a world almost solely occupied by men. Here's just a little taster for you.

Hi, it's good to be back. Oh, I see the vicar's in. I don't understand what a young woman feels like. I don't care about everyone else. I just want to be with you. You want me to go in the rules? No, I want you to break them. Gemma Artisan there.

You can hear her voice. She's in Funny Woman. I got to speak to her earlier and I asked for anyone who hasn't seen the first series if she'd give me a quick summary of what has happened so far. I play the nation's comedic sweetheart Sophie Straw

and actually her real name is Barbara Parker and she's from Blackpool and in season one it's about her journey from you know Blackpool down to London and coming from completely nowhere and sort of taking the comedy world by storm. She's a sitcom comedian and that's what the first season's about really and getting her opportunity in television and then when we come to season two she is very very famous, very successful, she's on a high and she has her own TV show now called Just Barbara. And yeah, and that's where it starts. That's where it starts.

But immediately as we go into it, I think it gives us a real window into what women were up against in the TV industry, particularly maybe in a sitcom sphere, shall we say. Yeah, it was a really pivotal time in comedy. We had so much amazing stuff coming from, you know, Gorton and Simpson, these writers that were writing quite sort of satirical, working-class sitcoms, but there wasn't that much going on for women at that time

in terms of women in sitcoms. Usually they were the foil or the butt of the gag or, you know, we had to carry on films. This was like the time of carry on. So they would be sexualized. And that was something that prevailed for a long time until the 70s when we had the Liverbirds, which was a real game changer in terms of a british sitcom and then finally when we moved into the 80s and we had you know victoria wood coming through and and french and saunders and that's when it really did start to change for women in comedy in sitcoms before that where we are right now in in 1960s sort of eight in funny woman um and sophie has these things that she wants to say her experiences and they're just absolutely not identified with in the people

that run the comedy show that she's in just want her to you know be the kind of pretty sexy um wearing a cat suit and uh you know for even apparent reason. And also wanting, I like this one, when they wanted her in the sitcom to be part of a group of women burglars. I was like, oh, maybe that's something different. But they wanted to call them knickers. Yeah. Yeah, knickers with an N.

Yes. Yeah. So she has to navigate all of that. And I think it's something that's, you know, thankfully we don't, it's not like that anymore. But I still feel like there's that kind of, you still have to navigate through these things as a woman. And I think it's just a few decades as you talk about Gemma as well, how things have changed so much. Let's talk about some of the other aspects as well. There are, it's really, I think, funny

kind of an illustration of what Britain was like at that time. Yeah. And the late 60s was such an incredible time of change culturally, but also politically. And, you know, towards the end of the 60s, you know, in terms of being a gay person, it was illegal at this point to be out. And that was about to change. We also had the Divorce Reform Act that was coming through at the end of the 60s. That was about to change. We had all of the women's rights, equal pay.

We go into that in this season. So it was a time of change. But I think in our show, it's that time just before it. So there was still a lot of repression, but a lot of a lot of voices coming through trying to fight against that. So it was an amazing time. It's a great time to kind of portray on film. Let's talk about accents. Oh, yeah. How I actually had to go and ask where is she from when I was watching Funny Woman and trying to figure out where you're from because the accent was so spot on. Oh thank you well I love doing accents I'm a working class girl that's sort of changed my accent and over time it's become this other thing which isn't really what I am and I don't know so I have. Or is it what you are now? I don't know

it's just so I it's and my husband always says no matter where I go, I pick up the accent of whoever or wherever I am, which must be so irritating. But a great skill for an actor. Yeah, it's a good skill for an actor. And I love doing them and I always have. And yeah, so in this show, I'm playing someone from Blackpool. It's a very specific accent. Lancastrian accents are so varied. There must be about 25 in just this tiny region. So fascinating why that is. But yes, so I had to do Blackpool in this one. And it's very much her. Her voice is very clear. And it's what makes her who she is. And it's part of her comedic toolkit in a weird way is that she can use accents and she's very adept at flipping. How do you do accents? How do you learn? It's a musical thing. So what I usually do is there's an amazing database, actually,

if you're doing a British accent. The BBC have an archive of just people that they've interviewed over the years that you can access. And so it's people that are unselfconsciously talking, so they're not putting on any sort of effect. And with, for example, this one, I had these women from Blackpool in the 60s talking about just stuff like childbirth and being mums and things. And I would listen to that over and over and over and over again. It does also help that one of my best friends is from Blackpool. So she's never seen the show. She's going to give you a review. I know that certain things I do in this are just basically her accent and the way she speaks. But it's so funny that she's never seen the show. She'll have a whole, no doubt, what would I say, critique. But how much of you is in the character

of Sophie Straw? Do you know, I think there are many aspects to myself and as we all have many aspects to ourselves. But this is, Sophie is one of the closest to who I am, actually, in that she's quite scatty and hyperactive and and erratic and but also fun. And I think it was really nice for me to get this part because for some reason I would get these very serious, in-control people quite a lot, and that's really not who I am. And it was just great to be able to let loose and play and be silly. Is it fun on set? Yeah. Oh, it's just the best. And especially when we do anything relating to the show, rehearsals, making the show,

working, there's two characters that are the comedy writers called Bill and Tony, and then there's our producer and director, Dennis, who's also her sort of love interest. And when we're all together, that's when it really is the most fun. But, yeah, there are these moments of drama, and I think in season two it's much more so for me at one point I thought oh I feel like it's too serious now

you know Sophie's going through all this very very big emotional stuff and I wanted to make sure that she was still funny but I think she can't help but be and even in moments of you know upset and turmoil she still finds the funny, which is also that's where Moana Banks, who is our writer, has real skill there, I think, in finding, especially working class people in the bad times and Irish people, actually.

My husband's Irish and I noticed this a lot. Sorry for your sins. But no, finding the humour in bad times to kind of get you through it and um and so more when i has kind of infused that into sophie so even when it is uh dramatic uh there's still that there are still little moments of of of humor in there and the it's a real gang the the team both the crew and the and cast, you know, it's a real family feel. I've worked with the director, Oliver Parker, before. He was on my first ever job, St Trinian's.

And he's sort of like my TV and film dad. Nice that you have somebody going through your career with you. Yeah, and it's nice. Like he really, he's really understands the character and me and how those two meet. And yeah, and it's a lovely crew. And so it's a fun job. I understand that you have a passion for women and equality. Also, you brought your mum. Is this right? Time's up, March in 2018.

As part of the Me Too movement? Yeah, I did. Yeah, she absolutely had a complete blast just bringing her on that march. It was such a hugely inspirational and I was very proud to bring her along. Do you think things have improved for women in the industry since then? I mean, it's interesting. I say 2018, actually. Yeah. Here we are we are I suppose six years later I think so I mean I started working professionally in 2007 and I mean the difference in for so many you know not not only

in the kind of more women working in all sectors but also just you know the way women are portrayed on screen and uh and all of that is it's changed so much um I I always feel like there's there's more that can be done but it's a since 2018 it's definitely there's definitely been a sea change and I've really really noticed that um so that's. That is good. There was an interview with you it's a couple of years ago now but it was in the Guardian and I found this line interesting I'm not afraid of the word feminism or feminist I just think we need to come up with a new word. What is it you're getting at? I think that sometimes I worry that the word feminist excludes men. And I understand why it had to be that way, because we needed to kind of fix our bit and empower ourselves.

But also now what I think it needs to be is about balance and equality and inclusivity. So sometimes the word feminism can feel like a kind of angry word or a divisive word or, yeah, it's got this connotation, which sort of I don't see it as negative, but I know there is a kind of negative connotation to it. For some people. Yeah, for some people. speaking about some of those aspects and having more power as a woman you and two other women in the industry Jessica Malik and Jessica Parker set up your own production company Rebel Park Productions why at the time it was 2016 pre-me too pre-times up we were really frustrated with the lack of representation of women but women's stories and so therefore you know women directors

writers um and just how how women were portrayed on screen then me too and times up happened and there was this huge change um in terms of commissioning and um and now you know it was a bit box ticky for a while but i think it had to be like that to kind of get people in the room and and change what we were viewing um so we we created it before that and um our agenda at the time was to only make stuff that was female centric and now it's sort of still that but not so much so so now we will work with you know we will say yes you can have male director but our our aim is to create parity on gender parity on on on screen and behind the camera so we always try and um on our productions make sure

that there's a 50 50 balance of men and women that's a struggle though it's really i was just about to ask you, is that challenging? It is challenging behind the camera. Why is that? I think there are certain jobs which are very male-dominated. Camera department, for example, sound department, technical and makeup department tends to be, and costume tend to be female domains. It's changing and i think by

making sure that we have for example a funny woman we have a female dop um dop sorry director of photography and she operates um the camera and um and we you know we're not we're not employing people for that reason but we're just mindful of when we are interviewing crew members that we have, you know, a balanced men and women. You know, we're trying to make sure that there's opportunity to always have a woman heading up a department. But, yeah, there is definitely it's still hard to especially in the camera department to find female crew there is a database though this amazing database um which uh you know we go to all the time which has you know your female grips and your that's the person that pushes the camera around and sets up the camera um very very labor intensive job but there are some really really amazing women that do that job too. So there are

ways of always being mindful of employing women in those departments, but it is also really, really hard, especially regionally, because we shoot funny women in Liverpool. So a lot of the crew that we could have got, we couldn't because we had to get local crew and therefore you're kind of more limited. But yeah, we do try. Coming back to you, you've had a little boy. Yes. Congratulations. Thank you. Just wondering, are you thinking about how to raise him as a feminist or whatever the word may be?

Yeah, I do think about those things. I think I just want him to be, I see it now with the younger generation and especially where we live in East Sussex we live quite near Brighton and these kids that are so progressive you know way more than I was when I was younger and they're so liberally minded and open and I think I just want him to be

you know treat everyone equally and be respectful of everybody but you I haven't, you know, I haven't thought about it in great detail, but maybe I should, maybe I should write it down. But I just want him to, I guess, you know, lead by example and the women in his life, I hope will be, you know, he will be around empowered women so that could he's all of his aunts and and um and his grandparents and and me and they're all doing their what they want to do so um hopefully he'll just be sort of surrounded by this which is wonderful before i let you go jemma what's next for you i have a film out the week after this comes out called The Critic with Ian McKellen and Mark Strong and

Leslie Manville. And that was written by Patrick Marber. And that's coming out. And then next year, hopefully, I'll be doing some cool stuff, which I can't tell you about, obviously. Well, you'll come back. And I'll just come back and tell you then. We'll chat then. Lovely having you in. All the best. Thank you. Gemma Arterton there speaking to me.

Her series Funny Woman is out on Sky this Friday. And we do have a clip of Gemma online as well if you go to the BBC social media pages. Particularly that question about feminist and feminism, whether a new word is needed, I found interesting. 8-4-8-4-4. I've also been asking for some of your nonnas, your grandmother's recipes.

Here's one from Paddy. My nan's recipe. Morning martini, three measures of vodka, 70% proof, to one dry martini on ice. Forget the olive, serve in bed. Long gone, but endlessly memorable. She sounds amazing. Right, my next guests may

have also appeared on your social media feeds. Food blogger Giuseppe Federici and his 85-year-old grandmother or nonna, Mariana. They have millions of views on Instagram. They cook together there. They began making videos back in 2022 sharing recipes inspired by

nonna's Italian home cooking and the foods that Giuseppe grew up with. Now they have made their first cookbook together. It's called Cooking with Nonna and it's 100% plant-based. I caught up with them ahead of the book launch and began by asking Giuseppe, who as Nonna refers to as Giorgio,

how their family collaboration came about. I started doing videos on my Instagram about six or seven years ago when I first went plant-based, just to basically show people what I eat, how I get protein on a plant-based diet. And it kind of grew a little bit. And then two years ago, I had a cool idea

of basically doing some videos with Nonna. So I think the first one we did was pasta with aglio e olio e peperoncino. Mmm, so yes, garlic. And chili, etc. And yeah, so, yes. Garlic. And chilli, etc. And yeah, it basically blew up overnight. It got like 5 million views in a week. Hang on, but what were you thinking at that point?

I was honestly so shocked. I remember calling Nona saying, guess how many views you think it has? And she was like, 100, 200. I was like, no, it's 5 million, which is quite funny because that's a population of Sicily where Nona's from. So that was two years ago. And then since then, we've obviously done hundreds more videos it's blown up we've had incredible opportunities we've met the king and queen we've won awards we've been on tv and now

obviously we've got a book out I guess you do and it's gorgeous and it's making me very hungry as I look at it but Mariana what about five million views of that video of aglio olio, pepperoncino pasta? Well, I don't know. Maybe they like it. I don't know all the time. Because when you want something quickly, they make this kind of pasta.

Aglio olio, pepperoncino. It's more quicker than anything else. Quick, cheap. And I think, though, it was something about your relationship that really got people interested. Have you always been close? Yeah, I think so. Because obviously when I was growing up,

you used to babysit me, didn't you? Yes, oh yeah, yes. I look after him when he was a baby. He's nearly growing up with me. Yeah. Because I've been working in a restaurant for 25 years. Yes, you had that restaurant

that was in different iterations, whether it was the fish and chips and then the Italian. I've had enough, really. After 25 years with the family.

But with that, were you always watching Mariana cook? Were you picking up the tips from her? Yeah, absolutely. So growing up, I mean, we used to like make tiramisu together or I used to lick the bowl with tiramisu

and get in trouble because of the raw egg and also bread every time I'd go home and you could just smell. Yeah, yeah. I make some bread, I make pizza, I make everything. Miscati, that's nice. That's one of the recipes in the book as well, like a bread roll, Sicilian bread roll.

So when I think of Italian, even though there are so many vegetables in it, I don't think of it as primarily plant-based and that is the twist you have in this book. Mariana, what did you think when you heard vegan? Well, I don't really mind, OK. So I think it's nice, lovely, I eat something. It's interesting, though, isn't it?

Because I suppose if we think of peasant food, as it was often... La cucina povera. La cucina povera. There wouldn't have been meat. It would have been expensive, too expensive, you know, back in the day. The meal we do sometimes's like a vegan. We don't pass it with the soup or lasagna with the

veggie or something else. Or lentils. And also growing up you didn't have a lot of meat, did you? No. Because it was expensive. What was it like, Mariana, to come from Sicily to the UK? You came 65 years ago. Yes.

That must have been a shock. Well, before I was living in a village in Favara. Favara in Sicily. I saw my husband the first time and we fell in love. Fell in love on the first date? Yes. But he was in England before.

Right, he was working. Working in the mines. Before, yes. You come back in England. After one year, he come back to Sicily. We married. I'm here. Just love at first sight, got married, and came back to England then with him. So what was it like when you first moved to England?

The first time, I didn't like it because everything was dark. Yeah. Now I live here for 65 years. I've got six children, 12 grandchildren and seven great-grandchildren. Oh, congratulations. That is wonderful. So your life is here now.

Yeah. And I'm wondering, what do you remember of Giuseppe when he was a little boy and cooking with him? I remember when he was a little boy and cooking with him? I remember when he was a little boy because he opened the cupboard. Yes. The first bottle I saw it was like clinic kitchen. Oh I'm making me panic at that time. Since he was two years old. What about all the packets of biscuits I used to eat as well? Oh, yeah.

I used to have a whole packet. All the packets in one cup of tea. One cup of tea, dunking the biscuits in. Into the spoon. So a sweet tooth. And we heard about the tiramisu as well. But how does it feel now, Giuseppe, that both of you, Mariana and yourself,

are social media superstars? Honestly, I mean, it's a bit crazy. I still don't really understand how many people it reaches. And can you give our listeners just a sense of that? Yeah, I mean, so I think in total, our videos have had over 200 million views. It's just incomprehensible, isn't it? What I love so much is that every day I get messages saying, oh, I love your videos because I lost my grandparents a a few years ago or I never had a relationship with my grandparents and this this video has made my

day just things like that and even if it just affects one person in a positive way each day that just like makes my warms my heart and makes me feel like I've got such a good purpose. Let's talk about also Mariana was talking about her life you know moving from Sicily to the UK but you went back to Sicily with Marianne. We did. To shoot this cookbook. And I wonder what was that like? Yeah, so we went to Sicily last September, didn't we?

Last September we was in Sicily. And what did we do there? Oh, we did a lot of things. You did a lot of things. It is, I mean, it brings us right to sun-drenched corners of Sicily out at, you know, fresh vegetable markets or maybe some of the little restaurants where people are getting together to meet and eat. Do you feel a connection with

Sicily when you go? Absolutely, yeah. I mean, obviously, I have the northern accent, even though I've got an Italian name, so I was raised in the Midlands, but I definitely have a strong Italian identity. I grew up pretty much going back there every year. Obviously, all of Nonna's sisters, all your sisters are there, aren't they? Oh, they're in the book as well. I loved reading about them. Oh, yeah. So we basically have, each of the sisters have one of their own favorite recipes in it. And what's interesting is that, again, they're all naturally vegan.

We have a recipe called Minestra di San Giuseppe. San Giuseppe. Yeah. Your namesake saint. It's named after me, but it's basically a pasta dish that all, again, like cucina, povera, cheap ingredients that all the village would traditionally bring together with all that leftover scrapped pasta bits. That's why it has loads of different shapes of pasta in it. And it's just a beany stew with loads of different shapes of pasta.

Mariana, do you have a favourite recipe? Yes, yeah. I would say it's your pasta broccoli, isn't it? Pasta broccoli, pasta with aubergines. And for you, Giuseppe? I would say, aside from the tiramisu, because that's really, really good, I love pasta al forno, which means pasta in the oven. Yeah.

And it's just such a simple bake. It's like a lasagna, but a bit easier, basically. And that's a really tasty one. Well, I've just been led to spaghetti con polpette in the book. So pasta with handmade temper meatballs. How do they taste they're actually really good so i did about three or four iterations and i tested them with my friends because obviously pasta with meatballs is you can't really yes it's a bit of a classic meat

dish shall we say so what i've tried to do in the book is keep it as whole food as possible so you won't really find many like vegan cheeses or meat alternatives in there or like things like that that are processed because obviously everyone at the moment is super focused on avoiding ultra-processed foods and me as well so a lot of the foods are now made from like whole food plant-based ingredients so tempeh is a traditionally indonesian um food similar to tofu but it's high protein fermented soybean product and it works really well in things like meatballs you just blend it up you mash it with your hands and then you've got a high protein alternative which is just as tasty as the real thing mariana how does cooking make you feel enjoy it still enjoy it all these years later i enjoy it

every day i cook every day for my husband oh so what are you going to make tonight i make pasta for every day you love it. I can't eat any meat anymore. He doesn't like anything at all. So pasta, pasta with just a little bit of oil. He's very picky, isn't he? Yeah. He doesn't like much. Now he's getting old.

He's 91 years old. So you're adjusting for him as he gets a little bit older. But what about you? You're 85, a young 85. Oh, thank you. And you must get recognised now. You're famous now. What's that like?

Nice. Thank you to Jojo. You've been recognised, haven't you, a few times? Yeah. Was it in the supermarket? Yes, especially I got an Asda near where I live. The Asda near you, the supermarket? And everybody says, oh I got an Asda near where I live. The Asda near you, the supermarket? And everybody says, oh, I saw you.

Oh, I saw you. And then when we went to the Italian restaurant. Yeah, as well, yeah. As soon as we walked in, they were like, I know you. We've seen your videos. In fact, they said they recognised her, but not me. Yes, well, I recognised you immediately. But you're a natural in front of the camera mariana and i'm just wondering how

much is staged or how much are you going with the flow giuseppe because obviously her generation she's never grown up with cameras in front of her face so she doesn't really like she just ignores them essentially so even when we're cooking and i have a phone in her face she doesn't mind you don't mind the cameras do you no, completely at ease with it. A natural. Like natural. Yes. What is the best thing you've learnt from Mariana, your nonna?

I would say the best thing I've learnt from nonna is that cooking and food is the best way to express your love for family, for anyone, because it just brings people together. The amount of incredible experiences we've had through food, whether that's through celebrations and Christmas events, everything is always surrounded by food. And all of my fondest memories growing up are all at the dinner table. You must be very proud of your grandson.

Oh, yes, of course. I'm very proud of him. I don't want to say the best, but every grandson is the same for me. She has to say that because you have an awful lot of them. So, you know, I don't want to start any family feuds on Women's Hour. Grandmother and grandson, Mariana and Giuseppe, talking to me about their book, Cooking with Nana. And if you want to see them in action, there is a video of them cooking away on the BBC Woman's Hour Instagram page.

Lots of comments coming in about your grandmother's recipes. Here's one from Great Grandma's Christmas Pudding Recipe from the early 1900s. Saved from a paper cutting, the recipe consists of mashed potato, carrot and suet. Our expectations were low, but it turned out

absolutely delicious and now we make it every year. Love that. I want to go back to our first story this hour, our report on breast implants and a rare form of lymphoma at the beginning of the programme. Some of you have been in touch asking how you can find out if your implants are Allergan, that's the manufacturer. You would need to ask the clinic or the surgeon who fitted them. If you don't know they should have

a record um i also want to let you know about a program coming up on tuesday the 10th of september as the new school term gets underway we're going to be dedicating an entire program to send how mothers are bridging the gaps in the special educational needs and disabilities system more than 1.5 than 1.5 million children in England, we know, have special educational needs and disabilities. But mums have told us again and again that it is a broken

system. There's these constant and exhausting battles that they say they fight, trying to get a suitable education for their children. For the programme, we're going to be joined by EastEnders actress, that's Kelly Bright, whose son has autism spectrum disorder, ASD, also ADHD and dyslexia.

We'll also have the 17-year-old campaigner, that's Katie Nellis. She lost years of education due to her poor experience off the SEND system. And we'll also be joined by head teachers and special needs teaching assistants. And we crucially we want to hear from you.

I want to say a huge thank you to all of you who have already got in touch. I know this means so much to so many of you. And we want to talk about what happens when your child with SEND does not get an appropriate school place. We want to talk about the quality of provision for those who do and what it feels like to be a mum who is navigating the system. I want you to contact us in all the usual ways with your questions about the quality of provision for those who do and what it feels like to be a mum who is navigating the system. I want you to contact us in all the usual ways with your questions or the experiences that you want to share.

And do include a line, this is important, in your message to say that you are happy for us to keep your contact. That way we have more time to get back to as many of you as we can. So that is Woman's Hour asking, is the SEND system? September 10th, 84844 on text, on social media at BBC Woman's Hour, or indeed you can email us through our website. Really looking forward to that one and hearing all your thoughts on it. More comments.

Nasturtium soup, that beautiful flower. I use a recipe from my great great grandmother says Fiona another one Nan's toad in the hole had to be Cumberland sausages cooked in dripping that one from Colin

thanks very much for all of them Anisha's here tomorrow from 10 join her to hear more about the women emerging as big drivers of far right movements

in the United States plus the medical and religious history of women's bodies all coming up. Instead, I will see you on Monday. That's all for today's Woman's Hour. Join us again next time. It's the 1980s and a young bodybuilder named William Dillon leaves rural Illinois behind for sun-drenched California in search of a supersized American dream, to get absolutely jacked. When you're muscular, when you're big, you get respect.

But he's about to discover the secret to why so many of the bodybuilders around him are getting ripped quick. This is the story of the biggest illegal steroid operation the United States had ever seen. Literally hundreds, if not a thousand needles, came down like the heavens were falling. I'm Natalia Petruzzella. From BBC Radio 4, this is Extreme. Musclemen. Listen first on BBC Sounds.

I'm Sarah Treleaven, and for over a year, I've been working on one of the most complex stories I've ever covered. There was somebody out there who was faking pregnancies. I started, like, warning everybody. Every doula that I know. It was fake. No pregnancy. And the deeper I dig, the more questions I unearth.

How long has she been doing this? What does she have to gain from this? From CBC and the BBC World Service, The Con, Caitlin's Baby. It's a long story, settle in. Available now.