Emma Manners is enormously excited: her eldest daughter Violet is pregnant with her first child, and the Duchess of Rutland is going to be a grandmother for the first time. It is a precious gift for the chatelaine of Belvoir Castle in Leicestershire, who once feared she would not live long enough to see her daughter tie the knot with her husband, the Scottish Viscount William Lindesay-Bethune, let alone have children.
On July 25, 2024, the day after hosting a lavish celebration for her youngest son Hugo’s 21st birthday, Emma (then aged 60) was given a diagnosis of breast cancer. There then followed a year of almost constant bad news, with one arduous procedure following another and a series of surgeries that tested even this famously stoical grande dame.
Now, having undergone both a mastectomy and hysterectomy, the Duchess can at last look forward to a happier, if noisier, future with a new baby in the family.
Speaking from Belvoir Castle, which she runs with her partner Phil Burtt – the castle’s former estates manager – and her estranged husband David, 11th Duke of Rutland, she says: ‘I feel like it’s the end of one chapter in my life and the beginning of a new one.
‘I can’t wait to set up a nursery for the next generation of the family. It’s a wonderful and special time for us all.’
Certainly, Emma, now 62, who has five children – Violet, 32, Alice, 30, Eliza, 28, Charles, 26, and Hugo, 22 – is in a more upbeat mood since we last spoke in the midst of her treatment.
Emma Manners, the Duchess of Rutland, is famously stoical – but even she was tested by a year of frequent bad news and arduous surgeries. (Pictured at home in Belvoir Castle)
It is now 18 months since Emma sat opposite consultant oncologist Monika Kaushik, in the Spire Hospital in Nottingham, to be given the news she had breast cancer. ‘A month or so earlier, I’d discovered a lump in my left breast,’ she says. ‘I’d thought nothing much of it. Maybe it was a pimple, cyst or similar. I remember waking up and feeling a niggling sensation and thinking: “What is that?” But it didn’t hurt. When I mentioned it to my partner Phil, he said: “I’m sure it’s nothing to worry about.” So, I put it out of my mind until after Hugo’s birthday party.
‘I’d foolishly missed my last mammogram so booked another at the Spire Hospital. Phil kindly offered to join me, and I was happy for him to come along. But I wasn’t overly concerned. It was just a routine appointment. Until I heard the words: “I think there’s something that’s not right here. You have a shadow on your left breast.”
‘We were immediately ushered in to see the consultant. As we sat opposite her desk, she asked how I’d like to be addressed. “Oh Emma,” I blurted out. “Well, Emma,” she said. “I have to tell you that you have breast cancer. You will need to do a biopsy – we have found three areas.”’
Known as the ‘accidental duchess’ – because she was born the daughter of a Welsh farmer and had no idea David Manners was heir to a dukedom when they met – Emma is now CEO of the busy commercial and events management business that is Belvoir. She is famously down to earth and ferociously well-organised – yet here was a problem she could not immediately solve.
‘At that moment, everything stopped, as it must do for so many people diagnosed with any life-threatening illness,’ she says. ‘I partly felt I was acting in slow motion. But, at the same time, my mind was on fire. The thoughts came thick and fast: “Can we fix this? What can I do right now? Who can I chat to?”
‘Then came the deeper considerations. I’d committed myself to bringing up my children until my youngest was 21, and I had achieved that goal literally the day before. A mother’s greatest fear is losing her life when her children are in the process of growing up. So, I couldn’t have asked for more – life didn’t owe me a penny.
‘Yet I still thought: “I’m only 60. I’ve got a bit of living left to do. I want to see my children get married and have their own children.”’
After her diagnosis, Emma threw herself into an endless treadmill of hospital appointments. She talks openly about intimate medical detail in order to show the realities of treatment for a cancer that will affect one in seven UK women.
First of all, for example, before any other drugs or surgery could start, she had to have her HRT implant and coil removed. The former is a slow-release oestrogen pellet, usually placed beneath the skin of the stomach or buttock, and the latter releases progesterone to protect the lining of the womb.
In fact, Emma blames the combined form of HRT for her cancer – a belief reinforced by her long-time friend, the GP Dr Sarah Myhill, whose treatments for Chronic Fatigue Syndrome/ME, it should be said, have proved controversial in the past. (Few nowadays dispute a link between the combined form of HRT and breast cancer, though most doctors say the risk is low, and even lower when taking bio-identical as opposed to synthetic forms of HRT).
Emma partly blames the combined form of HRT for her breast cancer, although most doctors say the risk is low. (Pictured in hospital)
‘I was having an awful time with the menopause,’ she explains. ‘I had a terrible sleep pattern and dreadful night sweats. My gynaecologist discussed the option of gel or implants. “The implant is better for me, otherwise I’ll forget to take it,” I said. Now I wish I had never been put on it. Not only did I get breast cancer, but from the moment they removed [the coil], the bleeding wouldn’t stop, which left me juggling cancer while also needing a hysterectomy.’
Once off the HRT, Emma had a biopsy – a fine needle was injected into her breast without an anaesthetic to take a tissue sample to find out whether the two other nodules were cancerous – and an MRI scan. ‘The biopsy was the most painful of all my procedures,’ she says. ‘I bled for five days.’
At this stage, she still hadn’t told her children, and in fact was under-playing the situation to protect them. ‘Vi had just got engaged to William, and we had invited his family down from Scotland for the weekend to meet my clan. It was a magical weekend, and I didn’t want my news to overshadow the festivities.
‘I’d mentioned the mammogram to my youngest daughter, Eliza, who was studying in New York. When she called to ask how it went, I told her a white lie because I didn’t want to worry her unnecessarily.
‘It was a difficult decision, but I think it’s important to try to protect your children, especially when they’re on the other side of the world.’
After getting the results of the biopsy and scan, Monika decided that Emma would need a mastectomy: although the other two lumps were benign, the cancerous tumour was 2.5cm and fast-growing. Emma’s reaction was typically matter-of-fact. ‘For some reason, I had no fear,’ she says. ‘I said “Let’s get on with it.” Actually, I remember clearly asking Monika: “Can you fit me in next week and get the replacement done the following week?” How naive I was!’
The operation took place on September 3, 2024, a day after her 61st birthday. ‘I finally told the family, individually, just before,’ she says. ‘Eliza was understandably upset that I had kept the truth from her, so I said: “OK, that’s it. I’ll set up a WhatsApp family group, and everybody will find out everything at the same time.”
Emma was diagnosed with cancer after her son Hugo’s 21st birthday party, but under-played the situation to her family, saying, ‘I think it’s important to try to protect your children’
Cancer of course cares nothing for titles, money or privilege, and now the family was facing what so many others do: the serious illness of the woman who held it all together. The mastectomy would not include an immediate reconstruction – that would happen later, using flesh from her abdomen.
And at first all went well.
‘I was in theatre for hours and hours. As I came to after the operation, I remained in a meditative state for nearly five hours. Nurses came and went, but I just continued in a calm trance. Of course, it may have been the drugs but, honestly, it felt like the start of a new beginning.’
In mid-September, she was given the news she was praying for – and slips into a characteristically mischievous anecdote…
‘“It hasn’t gone into your lymph nodes,” Monika told me. “Good,” I replied.
‘“You will need radiotherapy,” she said. “Good, I think.”
‘“You may need chemo. They need to do more tests.”
‘“Is that good?” I asked. “Yes,” she said.
‘“When can I have the reconstructive surgery?”
“Not for a year.”
“Damn. No new boobs and tummy tuck for Vi’s wedding.” We all collapsed in uncontrollable laughter.’
But Emma was still not out of the woods. The following day, she had a biopsy of the womb to investigate the continued bleeding and discovered she needed a hysterectomy to stop it.
‘The next day was the killer,’ she recalls. ‘When I got home, the only thing left was to sob. I never had a problem with breeding. The problem was stopping breeding.’
With a series of iron infusions under her belt, Emma went into the Spire Hospital in January last year to have her hysterectomy. The two-hour operation was done by keyhole surgery. ‘I felt very emotional afterwards,’ she admits. ‘I didn’t really know who I was any more. I don’t feel that now. You have to move on.
‘Having had five children, I knew my womb had well and truly completed its job. But I had this longing to save it. I had no idea where this came from until I was introduced to a fascinating spiritual teacher called Collette Corcoran, who explained that the loss of a womb can feel profoundly devastating as it holds the deeper feminine intelligence and the intuition of a woman.
‘Losing it touches a woman’s emotional, symbolic and ancestral body knowledge and power.’
Despite her endless hospital visits, Emma decided to undergo another, rather less vital procedure – this time, veneers on her teeth. Crazily, in retrospect, she did it the day before Violet’s wedding, which took place at Belvoir Castle last June.
‘When people mentioned that I was the mother of the bride, it sent me into a wet sweat,’ she explains. ‘So, I had everything pumped and pummelled before the wedding. I had Botox for the first time in my life, and microneedling to make my skin more youthful. I then thought: “I’m going to get some decent teeth.” God knows why. The children say it’s so ridiculous, and I couldn’t speak properly on the wedding day itself.’
Emma went through more procedures the day before her daughter Violet’s wedding, including veneers and microneedling. (Pictured: The newlyweds, Violet and William, in June last year)
Belvoir Castle is at a wonderful stage, says Emma, who has been there for 25 years and has plans to open a wellness centre. But the duchess admits, ‘I need to stop pushing myself’
She then made another ‘discovery’ – one that does not necessarily bear much scientific scrutiny but illustrates her inimitable spirit. ‘I’ve since found out that when you die, the veneers fall off, and you have these horrible black fangs. So I’ve decided I want to be cremated now. That will solve that problem.’
She did not need chemotherapy, but had ten days of radiotherapy. Having been told she would need to be on the medication Letrozole for the next five years – a drug used in post-menopausal women to stop hormone-sensitive breast cancer returning – finally, it was time for her reconstruction operation.
She went into London’s Harley Street Clinic on July 15 last year and spent a week in recovery before she was allowed to go home. The ten-hour operation was conducted by consultant plastic surgeon Stuart James, who also operated on Sarah Ferguson, rebuilding Emma’s breast with flesh from her stomach.
‘He was a wonderful red-headed Welshman,’ she says. ‘He listened to heavy metal music when he was doing my surgery. As I came out, he said: “I think it’s a brilliant job,” and I said: “I’ve no idea. I won’t be looking at it for a long time.”
‘I felt so dreadful coming out of that operation. I really felt my body had been pushed from pillar to post.
‘I guess I was looking a bit wiped out. I’d gone in looking really chirpy, but I came out of it thinking: “I have such respect for any woman on this planet who has cosmetic surgery because they want a tummy tuck or because they want new boobs – because it’s so painful.”’
With it all in the past, she can at last reflect on what it’s taught her about her own mortality.
‘I’m like The Bionic Woman. I’ve had my womb removed, my ovaries removed, a breast implant and tummy tuck. I’m on this drug Letrozole for the next five years.
‘Cancer has definitely changed my outlook. I’ve got a wonderful team [at Belvoir Castle] and I need to stop pushing myself and micro-managing everyone.’
She has been at the castle for 25 years and in that time seen its commercial arm expand from weddings to ranges of furniture, shooting parties to mineral waters and country wear – with plans afoot for a wellness centre.
‘Belvoir is at this wonderful stage,’ she says, before adding surprisingly: ‘In some ways, I’ve held it back. I have to get the right team to help it really find its wings and fly. I don’t think there’s any limit because we’ve got a worldwide brand. We are very closely involved with the community and want to build on that. You’ve only got to look at France or Russia to see what happens if aristocracy loses touch with the community.’
It’s a characteristically dry comment – and yet clearly pragmatic too.
For now, she is looking forward only to changing nappies, though others are not. ‘The person who is really nervous about it of course is Phil, who has done his very best to avoid changing nappies for his own grandchildren – he certainly didn’t do his own children,’ she laughs. ‘And to be absolutely clear, the Duke didn’t take to it either!’
It’s all change at Belvoir then – perhaps at the highest levels of management as well as in the nursery. But whatever happens, you can guarantee the accidental duchess will be at the heart of it.
