National Rare Cancer Conference

Since my foray with cancer I have done exactly what many of you would have expected me to… try to really understand more about Phyllodes, to ensure that there is some education on the part of the medics and the NHS, an acknowledgement that although rare, we do exist and also (really unsurprising bit) to put myself forward for posts whereby my voice can be heard and, I hope, make a difference for anyone else entering the world of cancer.

Through the South West London Cancer Network Partnership I was invited to attend the National Rare Cancer Conference today.  It doesn’t cease to amaze me that I learn yet more at each event I attend and sadly that I sat amongst people who had been diagnosed with equally rare cancers and the frustrations that this lack of knowledge leads to for a patient.

Some quick facts that I learnt:

In 2007 in the UK approximately 300,000 people were diagnosed with cancer.
In 2007 in the UK approximately 140,000 people were diagnosed with a rare cancer.

Approximately 50 in every 100,000 people are living with a rare cancer in the UK.

Sir Mike Richards (National Director, National Cancer Action Team) was speaking at the event and asked us to consider a few questions:

1/  What is a rare cancer?
2/  What are the outcomes for patients with rarer cancers?
3/  What would you want to see in a Cancer Reform Strategy ‘refresh’?

Ray Murphy (National Cancer Partnership Forum) used this phrase, which I just love and struck a huge great big bell for me… “Add years to life and where we can’t, we should add life to years”.

We also heard from Andrew Wilson, Chief Executive of the Rarer Cancers Foundation and from Simon Davies, Executive Director of Cancer52 (so called because 52% of the UK cancer deaths are from the less common cancers).

We discussed how we could increase awareness to some of the rarer cancers, perhaps therefore ensure that people are referred tested and diagnosed earlier. We discussed an equality of care and how this can be improved. We talked about where we felt tests, diagnosis, treatment and post treatment areas can be improved. The most distinct area that we felt needed improving was communication and sharing of information between medical groups and also with the patient. An informed patient is, mostly, a happier patient and an empowered patient.

We were also told of a wonderful new resource available to doctors and patients. Information pathways for differing cancers.  The information is constantly being reviewed and updated however there is already a great deal of information available at  NCAT Pathways.  You can look and download pertinent information and locate resources and support in your area. I suggest that if you come across a great service in your area you urge them to contact National Cancer Action Trust to be listed. All good resources deserves referral!

Personally I discovered there are many many rare cancers and then there are rarer cancers. It struck me just how rare phyllodes is and how those diagnosed are simply rarer than rare! However no matter how rare a cancer is, there should be a resource, specialist or information available. I’m on it!

Everyone I spoke to about Phyllodes and my experience was shocked that I hadn’t been referred to a sarcoma specialist.. apparently this should be done with any sarcoma diagnosis in order to obtain the best possible care and follow up…. and of course raise awareness that there’s yet another case of Phyllodes out there!

Paula Lloyd, Associate Director of the National Cancer Action Team spoke very well in summary of our discussion feedback but also provided us with an update on progress within the NHS and the Govt for understanding and improvements for those diagnosed with rare or rarer cancers.

My summary of the event was that there were most definately frustrations amongst people diagnosed with different rare cancers.  Lack of information, resources and support is paramount.  In addition, the lack of ‘joined up writing’ between the medical arms involved – why shouldn’t anyone involved in patient care have access to the information via technology?  It’s insane that letters are typed, put in envelopes, stamped and posted to our GPs and that nurses and cancer care specialists don’t have the information at all.  This means that everytime a patient meets someone new they have to repeat their story which can be emotional, tiring and perhaps misleading as the patient may not verbalise important facts that perhaps they hadn’t understood or were too much like medical speak.

However all that said, the people attending the conference are amongst the strongest, most inspirational and amazing people.  Mostly they don’t have an axe to grind or a whinge to air but simply want to make it all better for anyone else.  They have and do live with the most unusual symptoms and pains to live with but the loudest sounds in the room were from laughter and looking around smiles.  Amazing.

I was so bushed by the end of the day that I headed off home (using 3 different buses) and it wasn’t until I reached my front door that I remembered I was meeting friends for drinks… quick change and out again!

GP Film for Macmillan

I have been asked to take part in a film about my experience of primary care with regard to my cancer diagnosis. As you know from this blog, I have an exceptionally wonderful GP. If you read any media referencing primary care you might well think that every cancer patient has a bad rapp with their GPs… but I guess only the bad news stories get reported!

So I was happy to ‘put myself out there’ in the hope that there’s a good story too.

Dr Pawan Randev who is a wonderful GP with a speciality of cancer. He is an inspiration to listen to. His role as a GP having received extra training from Macmillan has meant that attends conferences, speaks to patients, doctors, clinicians and healthcare groups alike. Obviously he’s been aware of the media that puts GPs in a bad light with regard to delays diagnosing cancer. As part of this, he’s obtained funding to put some short videos together. He’s then proposing to use these videos in the training of new GPs and clinicians.

Today they were filmed. The easiest place to see them is within Macmillan Learn Zone “Cancer in Primary Care – a Toolkit – Resources“.

I’m so pleased I added my voice which I hope demonstrates the positive message that good primary care interaction can have on a patient.

I understand that Dr Randev has been working with the medical deanery to include these videos into the new GP training courses.

NB – I’m aware that when cancer symptoms are harder to identify i.e. not ‘lumps’, some patients are sent away from the GP often on more than one occasion. The difficulties in cancer diagnosis is in many cases that the symptoms can be very similar to other illnesses – flu like symptoms, upset tummy, sporadic bleeding, headaches etc etc. For GPs seeing so many patients in a day, these can often mean that the true diagnosis is hidden behind ‘ordinary’ symptoms. GPs do an amazing job but often a truly difficult one too.

The Internet is my friend too

Today I realised (although I’ve worked and used the internet for 20 years) how it really can be an invaluable tool for research and support at times like this.

I hope and pray you’ll never need to use it in the same way that I have. Faced with virtually no information available to me via the hospital, nurse or on the UK cancer sites, I had to google different questions to get a good cross-section of information and to be able to sieve out the unnecessary information, to learn how to not always read the worst case scenario and more importantly find as much validated medical information about my longterm health.

Trish posted a message on her Facebook wall which just goes to prove that there are angels alive and amongst us:

…ATTN: My fellow phyllodes friends – request Anna Wallace on my friends list,she’s brand new and recently diagnosed with a malignant phyllodes tumor and needs our support! Let’s show her how beating breast cancer is done! WONDER TWIN POWERS ACTIVATE!

I now have quite a few friends who understand what I’m going through and understand the daft insecurities and concerns, the frustration at not being able to easily get information about this type type of tumour, about why post-operative bras have to be quite so hideous (why can’t underwear manufacturers realise that we (and there’s quite a few of us) would buy buy buy something practical and sexy – we’re still women who want to be feminine!!).

I can’t stress enough how fantastic it has been to have friends who are going through a similar experience to exchange thoughts with and to ask questions of.

Pain

There’s a post on the forum answering my question about the sharp stabbing pain.

“I think the pain is probably caused by the op but I have had a couple of bouts of fat necrosis which can be caused by trauma to the breast either in something like a car accident or as in my case with lots of surgery and I have to tell you, you certainly know when you feel that.”

I also received a response from Trisha;

“I got these pains after my 2nd surgery. It’s called “mondor’s disease” which is a fancy way of saying I had a blood clot in my breast. The clot was occluding bloodflow to various veins in my breast which is what led to the hardened “strands” throughout my breast and ribs. After meds for 2 weeks the strands are getting softer and pain is getting much better. I was only on anti-inflammatories and that’s the only treatment. It may take as long as 6 months for the strands to completely soften up. These veins arent going anywhere too important so the chance of the blood clot breaking free and getting into my heart or lungs or brain is not as issue. Easy fix!”

I’d never heard of Mondor’s Disease and have now done some more research on it. I’m not sure if the pain I have is either of the above or more intensified version of the pain I was getting before treatment. BUT just to know I’m not alone and that it will pass has helped enormously.

I received a further email through the forum from Trish which gave me the most enormous support:

“I’m so sorry you’re going through this right now. I used this site to get me through and you will do the same. That’s why we’re here! I’ve even met a couple of friends on here and have met in person. We phyllodes friends have this special little bond, and I’m sorry you’ve found us, but welcome to the family!”

Trish also asked me if I was registered on facebook. I ‘friended’ her.

AND I didn’t cry today. This is the first day that I haven’t cried since Mum died. Yippeee

Trisha

Desperate to find some answers I resort once again to the internet and start searching through the forums on the Rare Cancer Support Alliance website.  After a few hours reading postings and also searching other sites, I find a posting from Trisha in Vegas that sounds similar and a link to her blog.  On Trisha’s blog I find the below text and email her through the site:

“”I celebrated the VERY first day of awareness month with a visit to my doctor. I kept getting these insane tearing/ripping pains just below my surgical breast on down to my ribs. Sometimes for no reason but usually with movement these horrible pains would strike. The other day I attempted to pull my shirt over my head and HOLY SMOKES!! Out of reaction I grabbed my breast and rib area and felt the craziest things. If you were to run your finger from the middle of my chest just below my breast and out towards my armpit, it would feel like you were strumming a guitar. Underneath my skin were these very thick, hard, ropey strands that ran up and down my ribs. Some even extended as far as down to my waist. Freaked me out. My doctor felt these strings, smiled, and said to me “Boy it’s always a pleasure to see you!””