Friday, June 06, 2008

We should not let them die.

This is a Bowel Cancer post - so look away now if talk of bottoms disturbs you. Being doing multiple interviews today, following the admission by the National Assembly Health Minister that her Government's Bowel Cancer screening programme is not going to be delivered as advertised. Very disappointing for those of us who care about this issue. Wales is lagging behind both England and Scotland.

The screening programme will begin later on this year. It will involve sending out testing kits to everyone between 60-69. In two years time the programme will extend to those aged 70-74. The Assembly Government is making much of the fact that the programme is to be extended to everyone 50-59 in 2015 - something that is not proposed at all in England. Personally, I don't attach much significance to any Government promissory note which falls due in seven years time. The reality is that the timetable for introducing screening in Wales is way behind England and Scotland.

Reason I'm a campaigner is that I was a man in my 50s when I went down with Bowel Cancer in 2002. Actually it was Colorectal Cancer, which includes tumours of the bowel and the rectum. These days I usually say that I suffered from Bowel Cancer to avoid confusion. My tumour was so low down in my rectum that it could not be rejoined, so I underwent a lower bowel resection, which involved removal of my rectum, anus and associated bits and pieces, and the construction of a colostomy. But good news was that its position meant that I'd become aware of the tumour's existence at a comparatively early stage. If it had been higher up, I may have kept the bits that I lost, but I might not have known about the problem until the cancer had spread to other organs.

Which brings us to the screening programme. Its pretty basic stuff - and not very expensive. All that happens is that a card is delivered (every two years) which requires faeces to be spread on it. Tumours leak blood, and the card identifies traces before it becomes obvious to the human eye. Its the next steps for which there is insufficient capacity in the Wales NHS. Every 1000 tests throw up 2 tumours, which often require a colonoscopy (a camera around the bowel). This is not like using a set of draining rods. It requires skill and training. We don't want some cowboy poking holes in the colon - that kills people. And the there's the follow up surgery. We need oncologist capacity to deliver all the extra operations needed. So whats going to happen is that all these tumours are going to left undisturbed, to develop from the stage where full recovery is likely to a stage where complex, debilitating treatment, and often death is the prognosis. Sounds nasty when put like that. Now you know why I'm disappointed.

There are hundreds of people in Wales working, playing, laughing, loving and even blogging who have tumours busily growing in their bowels, without anyone knowing. If they were to be treated now, the chances of full recovery would be good. But because we are not even going to try to find these evil little aliens, they will break out of the bowel wall and spread to the liver and other places. Eventually, they will show themselves, but only when they have much more of a grip. 16,000 people die of Bowel Cancer in the UK every year. The official policy of turning a blind eye has gone on for long enough. Yes, talk of bottoms is embarrassing, but so many deaths is a very high price to pay for it..


Anonymous said...

Glyn, I think the dignified and open manner in which you have spoken up about this issue shows why Montgomeryshire needs a sensible, mature, serious yet does-not-take-themselves-TOO-serious, respected Member of Parliament and not the bufoon they are inflicted with at present. You'll be an asset to the Welsh political sphere once more.

Glyn Davies said...

anon - thats very kind of you. The aspect of this that made me keen to 'go public' was my own stupidity. It remains difficult for me to understand how a man (me) involved in the range of issues an Assembly Member is, did not have an inkling that I was suffering from Colorectal Cancer, despite having the classic symptoms. Some human beings have an almost unbelievable capacity for denial and not seeing the elephant in the bathroom.

Dr. Christopher Wood said...

Second anonymous's comments. Difficult subject matter for me; a close relative was operated on at CRI (Cardiff Royal Infirmary) some years ago now for bowel cancer. It seems the cancer was not caught in time. Appropriate screening can't come too quickly.

Anonymous said...

Glyn, I lost both my parents and a very dear uncle to cancer, my father at 76 to prostate cancer that had been allowed to spread to bowel and bladder, my uncle died of bowel cancer at the age of 56 so I know only too well the importance of early diagnosis.
What annoys me greatly is that Edwina Hart sees fit to give failed asylum seekers free healthcare, whilst people born and bred in Wales and having paid into the system all their lives are left to suffer.

Glyn Davies said...

Christopher and anon - Bowel Cancer kills 16,000 every year. It is a common disease. We all know someone. Its no good blaming the current Minister for not introducing screening. The blame lies with previous Ministers, who have not ensured that the capacity to deal with the tumours screening would reveal is in place. Edwina Hart is only telling us the way it is. The area that I might be critical of would be if some stupid prejudice against the private sector is slowing things down. I had a call this morning from a company that offers private colonoscopys, which could speed up the system, but I need to know more before I can make an issue of it.

Dr. Christopher Wood said...

Something maybe to think about if only for a limited time. Factories usually run on a shift system. There are even government labs and parts thereof that run on a shift system. So why not speed things up by doing colonoscopies day and night? So much invested in such expensive assets which lie largely idle at night. Yes, hospitals do have night staff, yes NHS med lab scientists are on call, etc. etc. But the labs are only fully staffed during normal business hours - but steelworks typically run 24 hours because of the cost of reheating or keeping things hot, what of 'life-cost'?

... 'and another thing', the colonoscopy can be done by less trained staff or by using the swallow technology (also fitted with cameras) - colonoscopies can be done at night, recorded data sent to a medical specialist in say India, and the results ready for review by a NHS consultant within 24 hours.

Frankly, the spare capacity is there, just got to tap it.

I remember being told during my first days working as a junior med lab technician in a large hospital on the outskirts of south London, a Senior tech told me that the work we do was once limited to preparing a bench area for the specialist to do the actual testing, then it was realized that the technicians could do the work, thus tapping into the spare capacity already in-situ.

Hope these ideas help Glyn.