No 8. Excerpts from Chapter 10: Nothing Personal, disturbing undercurrents in cancer care. Radcliffe Publishing.
Winner, Medical Journalists’ Association Open Book Award; essay prize, RC Nursing; ‘a landmark for the patient voice’ – Macmillan Cancer Support, Exchange.
‘This is a remarkable book…essential reading for all who deal with cancer patients – health professionals, politicians, health service developers, carers and, of course, patients themselves…will surely inspire change.’ Professor Karol Sikora, in his Foreword.
“Eating and sleeping have become things of the past. Nothing matters except survival, for the children’s sakes…
…Diarrhoea and insomnia are draining me. I feel increasingly unwell and have to lie down each afternoon. If they wait much longer there won’t be anything left of me to treat. When my GP phones and suggests she could try to get treatment started earlier, I’m grateful and ask her to tell the oncologist I want to know everything. He will listen to her. Later that day she phones to say I’m being admitted in three days’ time. It’s frightening, but such a relief to know the fight is about to begin. She asks me to call and see her.
“It’s very unusual, Mitzi,” she says of the cancer, smiling tentatively, as if its very rarity should somehow make this killer disease more acceptable. Playing things down? Self-justification? Either way, I’m not blaming her for not recognising cancer. Trust me to get the unusual one.
I remember hearing that cancer feeds on hormones and she agrees I should stop taking HRT. She offers sleeping pills, but I don’t want to take strong drugs, so she gives me a sample of something mild left by a drugs representative.
“Do you know what my chances are, now that it’s spread to the lymph nodes?” I ask.
Is there any chance, or are they are stringing me along?
“Apparently, your chances have dropped to fifty-fifty.”
The impact of bad news is overridden by gratitude for her honesty. Someone is not afraid to tell me the worst. And I’ll make sure I choose the right fifty…
“It’s very unusual, Mitzi…”
You were not angry that your GP had not recognised cancer?
No. I felt quite sorry for her, especially when I learned how little cancer training GPs were given and how few cases they saw each year.
Your consultant did not tell you to discontinue HRT?
No. Later I learned that anal cancer does not feed on hormones and if I had continued to take HRT it would probably have alleviated the side effects of treatment.
How did that make you feel?
Unnecessary suffering is hard to accept.
What needed to change?
Doctors involved in cancer care need to communicate fully with each other so that information does not conflict.
Interdisciplinary education could strengthen partnerships and improve communication in multidisciplinary teams and between primary, secondary and tertiary care.