A perfectly normal life

`The funny thing about that whole survival business with cancer is that everyone tells you you're really brave

`The funny thing about that whole survival business with cancer is that everyone tells you you're really brave. Yet you haven't done one single thing that could amount to bravery. The doctors make you survive. Yes a chronic illness will return from time to time and you have to take care. But basically it's a perfectly normal life. So it's very strange. You bask in this glory and you feel like this terrible humbug."

The perfectly normal life Liz Tilberis has returned to after surviving ovarian cancer (three times in five years) is running arguably the most influential fashion magazine in the world, Harper's Bazaar. Before we begin our interview in the tea room at Claridges in London she cancels a later interview. She is clearly very tired.

At 50, Liz Tilberis looks the ultimate 1990s fashion plate: grey trouser suit ("last year's Gucci"), charcoal, short-sleeved jumper (Armani), Manolo Blahnik heels and a skull cap of short grey hair. The photographs in her just published memoirs, No Time To Die, show that it was not always so. Before the cancer hit she was a good size 16.

Then comes the very public wasting away, caught in the inexorable glare of fashion's lens. She is now as skinny as any model, a beneficiary of "the ovarian cancer diet", specifically from the bone marrow transplant (BMT) which she says completely changed her metabolism. She had been clear of the cancer for 18 months when a cell count showed it was back. BMT was the only hope.

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"I said: `I can't take the time off work because it will mean a month in intensive care. I phoned my brother who's a GP in the south of England. He said: `If you don't do this there won't be a you to go back to a job'." The transplant didn't work. Nine months later a tumour appeared on her neck. Then came the chance intervention of another doctor whose views on cancer treatment were radically different.

The snakes and ladders of the disease and its treatment are all chronicled in her book, as is her gynaecological history, which she believes held so many clues to the trajectory of the disease. It began with an article in Harper's Bazaar written by the magazine's writer on health issues, Aimee Lee Ball.

"I didn't really want to do it. But my staff said: `Don't be so silly. This is information. This is America. You're not showing off, stop being a stiff-upper-lip British person.' So we did it. The response was quite extraordinary. Women panicked and fertility doctors stood up and said `the woman's mad, it's nothing to do with us'."

Such a response was due to one of Tilberis's main contentions in the article, and subsequently the book, that the major contributing factor to her cancer was the fertility treatment she underwent in the late 1970s, fertility treatment that ultimately failed: she and her husband of 30 years have two adopted children.

Liz Tilberis was 43 when she was appointed editor-in-chief of the then failing Harper's Bazaar. She had been headhunted from British Vogue, having first joined it in 1968 when she won a summer's work experience in a competition while still at fashion college. So began a 22-year climb up the Vogue career ladder to the dizzy heights of editor. She has now been editor-in-chief of Harper's Bazaar for seven years. She owes her life, she says, to that move.

"If I'd been in Britain I would have gone to my local GP and been told to `go home and rest'. The thing with ovarian cancer, you feel bloated, you feel depressed, sometimes people bleed but not often. All classic symptoms of the menopause." However the top job at Harper's had catapulted her into the upper stratosphere of the American fashion world, where one of her guides was Evelyn Lauder, wife of Leonard, son of Este.

"When I arrived in America Evelyn gave me a list: the best place for children's birthday cakes, the best place for dry cleaning, the best place to get the best fish, and on top of that a gynaecologist, an internist." One morning in December 1993 Liz Tilberis knew something was wrong. She should have been feeling on top of the world: in 18 months she had completely turned Harper's around; the next night she was hosting a party for 250 of New York's glitziest (Ralph Lauren, Calvin Klein, Linda Evangelista, Donna Karan, Isaac Mizrahi, Paloma Picasso et al). Yet she felt extremely rough.

"For the first time in my life the word `cancer' flashed across my eyes." She called the gynaecologist, got an appointment the same day, underwent surgery two days later, the morning after the party. ("The fastest round of medical pre-examination ever.")

No Time To Die skates over none of Tilberis's gynaecological history, including an abortion, the pain of infertility, the indignity of years of fertility treatment, and then the unmentionables of cancer itself: the loss of hair, the loss of libido, the despair. Surviving cancer, as Tilberis contends, may not be brave in itself, but writing about it with such honesty and in such forthright and unsparing detail most certainly is.

The contraceptive pill, usually regarded with suspicion, she claims to be a life-saver. Anything that cuts down the number of times a woman ovulates in her life - including of course pregnancies - is a natural safeguard. Every year you are not ovulating, she says, the chances of developing ovarian cancer reduce by 10 per cent.

Fertility treatment, of course, is the direct opposite. She began the treatment that finally seemed to work on the day that Versace - a great friend - was murdered. And it's no wonder that the film rights have just been sold to Meg Ryan, because the backdrop to this highly personal story, is a highly public one, the world's fashion stage, from 1960s London to 1990s New York, from Jean Shrimpton to Princess Diana, who became a personal friend. All as seen from the perspective of an insider, yet someone who has never lost her objectivity.

Far from being the cut-throat world portrayed by the press, the beauty and fashion industry, she says, is an extraordinarily nice place to work. "They may be immensely powerful but they are all incredibly kind." It was that combination that, she believes, that Diana was drawn to. "She felt at home. She found in the fashion world people who were terribly like her, people who could tell dirty jokes. She had a wonderful sense of humour. But fashion is not brain surgery and you can have a really good laugh. It's very serious if somebody goes bankrupt but if somebody has a success it's fabulously wonderful and we all share in it. "The designers are extremely nice, intelligent, people. Otherwise they wouldn't be where they are today. And they treated her as an equal. There was that kind of shared celebrity. I mean Karl [Lagerfeld] would talk straight to her, and Ralph. They all enjoyed seeing her and being with her." Liz Tilberis still has blood tests every month - every week if the doctors are worried. She intends to go on living.

"There are not many survivors of ovarian cancer. The longer you live with it the more they find out about it."

No Time To Die by Liz Tilberis is published by Weidenfeld & Nicolson. £18.99 in the UK.