Thursday, July 24, 2008

Handling Cancer on the NHS

The NHS boasts it is "best in the world". So why do we have one of the worst post cancer survival rates in Europe?

Possibly this is partly our fault. Most people diagnosed with cancer in Britain meekly accept what doctors offer; they feel it is wrong to challenge a diagnosis, and as one doctor told me "patients should ask for a second opinion".

My favourite medic told a conference at the Royal Marsden, Britain's flagship cancer treatment centre, "doctors don't know how to talk to patients": loud cheers from patients in the audience, whilst medics sat stony-faced. Revd. David Brown was Chaplain at the hospital for 21 years, and said doctors would come to him and say "David, I don't know how to talk to patients".

So it is up to patients to talk WITH their doctors. Don't worry about being a nuisance, as privately oncologists admit patients that "kick up a fuss" generally recover better. We need to get over NHS arrogance, and copy what is offered to patients in Europe. As a patient, I became incensed when doctors in Britain dismissed blindness in one eye, caused by one of the drugs I was on, with "I have never seen this before". It was a French professor who said this was a rare but well-documented side effect of the drug I had been put on, Tamoxifen.

I saw what help I could get in Europe, mostly common sense, but denied to patients in Britain because doctors just won't look abroad and copy procedures and treatments. If we find information on the Internet that will help us, we don't have to meekly accept arrogant decisions and advice from our medics. We should demand treatment and products European cancer patients receive - so hopefully we all survive longer.

For most patientss, everything goes relatively well. Yes, you are going to get tired for no apparent reason. Yes, you get nauseous and have problems with chemo, but as time goes on these are much better handled. You get used to talking to medics, and find whilst you arebeing treated in hospital your problems get sorted. Complicatons come when you are given a hormonal drug such as Tamoxifen, and told you don't have to come back for three months.

5% of patients won't get any side effects, and sail through the next five years. The other 95% do, and these can include temporary blindness and peeling, bloody and painful skin eruptions. These made me the patient from hell. I didn't believe attempts to fob me off with "it's your age" and demanded to know "why?"

Eventually it became obvious that the NHS is overstretched; it concentrates on primary treatment, leaving cancer charities to pick up the aftermath.

So, why not take advantage of a short break holiday and go to Europe? In most EU countries patients live longer post cancer, and I suspect this is because their doctors don't dismiss side effects from hormonal drugs, but help patients throughout the five years they take them. I had a lovely time learning about good post cancer treatment. Who could complain joining German cancer patients having free massages, or French women getting skincare advice with lovely clinically-tested products proven to do cancer-skins good?!

Currently the UK ranks between 17th and 25th for life expectancy post cancer (depending if it is NHS or World Health Organisation survey), I asked the Dept of Health if the NHS were sending people to Europe to see what we could copy. Their arrogant reply "we have no plans" beggars belief.

Pound for pound, euro for euro, French cancer treatment is probably the best in world. Overall their health service (state and health insurance top ups together) costs roughly the same as our NHS. But when private insurance companies are involved, they demand accountability. No insurance company would allow hospitals get away with the expensive administration we have in the NHS. The Sunday Telegraph wrote recently that in the past ten years "NHS administrator numbers increased 64%, as against 43% for doctors and 25% for nurses", yet "productivity has fallen by 10%".

With administrators on £150,000+ salaries we still have the worst MRSA figures in Europe. So instead of giving us similar treatment to Europeans, the NHS is paying for the extra administrators, and, as cancer guru Prof. Karol Sikora says, "the depth of pile in their carpets".

But there is no reason why we can't copy some of the European treatments, and have fun after cancer. These aren't 'airy fairy' treatments or 'miracle foods', but clinically approved products, some of which we can obtain on NHS, but doctors don't have time to tell us, and things such as massage that Macmillan surveys have proven to be very helpful. But before trying anything, tell your doctor or oncology nurse - there might be contra-indications.

And HAVE FUN!

Verité Reily Collins

http://after-cancer.com

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