Exclusive: James Brokenshire on his fight with lung cancer and hopes for future after remarkable recovery

James Brokenshire was enjoying a weekend break with his family in Northern Ireland last September when the first warning sign came.

Despite being fit, healthy and a non-smoker, he started to cough up blood - the result of what he would later discover to be a cancerous lesion on his lung that would require life-saving surgery.

It was the beginning of a six-month ordeal that made him re-assess his life and career, forcing him to give up his job in the Cabinet to put himself, and his family, first.

"It makes you take a step back and think about what is important," he told The Telegraph in his first interview since his return to the green benches of the House of Commons this week.

“Health is imperative, but also family and your responsibilities to them,” he said. "It does remind you of your fallibility at times like this but that was always there. I am strong, I am resilient, I look to the future with confidence.”

He today takes the opportunity to thank his family and colleagues for their “love and support” and hint that he wants to make a return to the Cabinet.

He also gives his backing to calls by Dame Tessa Jowell, the Labour peer who has brain cancer, for terminally ill patients to be allowed to take experimental drugs.

Mr Brokenshire’s return to work capped a remarkable recovery for the former Northern Ireland secretary, whose future looked anything but certain when his health led to his resignation just a matter of weeks ago.

The 50-year-old said it had been “slightly surreal” when he realised he had coughed blood into a tissue during his weekend in Ulster, which had been intended as a much-needed break from the intensity of trying to restore power-sharing at Stormont.

"I felt fine,” he said, “but I did need to follow this through. I don't think it's right to leave this, for myself or my family."

The day he returned from his family visit to Northern Ireland Mr Brokenshire booked an appointment with his GP, who sent him for tests including X-rays and CT scans which failed to detect anything amiss.

A consultant at St Thomas's hospital in London booked him in for a bronchoscopy - an invasive examination of his lungs, which took place on December 7th - the day the Prime Minister announced her breakthrough in the first phase of Brexit talks, a process with which Mr Brokenshire had been intimately involved.

He only told the Prime Minister about his hospital appointment the day before. “We were working out of Downing Street with the Prime Minister into the later hours," he recalls. "I said ‘I can't be around tomorrow because I've got a bronchoscopy’.

"I could have said ‘do you know what, I've got all these things going on, can we put this [hospital appointment] off for a week or two?’ I could have just said no. But I went off to have the bronchoscopy. It was a no-brainer.”

Mr Brokenshire worked on until midnight, then watched the big Brexit announcement on television the following morning. Hours later he was at St Thomas’s, where the lesion on his lungs was discovered.

It was only when he returned from a Christmas holiday in Australia with his wife and children that he was told the lesion could be cancerous and would require surgery to remove part of his right lung.

“It was a once in a lifetime trip,” he said. “But it was still having this very much hanging over you. "The mind starts to race at that point. You are thinking about all of the what-ifs, in some ways thinking about what the worst case scenario would be.

"Of course you think about family, the future. Not knowing what you are dealing with at that point. That period in some ways was the hardest."

After being told he needed surgery, with a potential recovery period of months, he told Theresa May he could not continue in his Cabinet role.

"We spoke on the phone,” he said. “We had two or three conversations but concluded that I needed to stand down, that I felt that was the right thing not just for me but in the best interests of Northern Ireland and the Government as a whole."

The Prime Minister, he says, could not have been "more kind and more supportive". "She is very human, very supportive and genuinely concerned about my health and well-being. I could not have wanted or expected any greater support from the Prime Minister at this really difficult time in my personal life."

Mr Brokenshire announced his resignation on January 8. Until that point only a handful of people know about his illness, but suddenly it became very public.

"It came as a huge shock not just to colleagues here but more generally. It was a really odd day, a hard, emotional day of effectively saying goodbye to the colleagues I had been working with."

His surgery came a week later, and the procedure was such a success that just a month later Mr Brokenshire is back in his office and getting to grips with life as a back-bencher.

Since his return to the Commons this week he has been inundated with messages of support from all sides of the house, with MPs stopping to hug him as they pass following his remarkable recovery.

Mr Brokenshire says he has been "humbled" by the experience. "This is an uncompromising place at times, the cut and thrust of frontline politics is like that. You have to project this resilience.

"But this place equally can be incredibly warm. They show you that sort of emotional, human side. It has meant a lot, it really has at a difficult, crappy time in your life when you're not quite sure where things are going to go."

He puts his recovery to his family - his wife, Cathy, and three children - and the immense outpouring of support he received. The letters, emails and cards flooded in.

Throughout it all, he has been guided by his faith. "My faith has been important to me. Having faith, having that strength - you know that there are others, whether that be in your local church community or others that have been praying for you."

He is supportive of Dame Tessa Jowell's calls for terminally ill cancer patients to be given access to novel treatments. "Thinking through on novel therapies that are there, how they can be more accessible? Of course equally ensuring you are not abusing that situation and taking advantage of people in hard, difficult circumstances. "But I think we do need to challenge the thinking around all of this and assess what more can be done."

Asked if he wants to return to the Cabinet, Mr Brokenshire insists he is taking it one day at a time. "I'm taking things step by step, finding my feet, making sure I'm fit and well. I'll see where it takes me. But there is still plenty in the tank.”

Donations to the Roy Castle Lung Cancer Foundation can be made at www.roycastle.org or by calling 03333237200