Article from today's Telegraph

As far as I am concerned, treatments for breast cancer however mild stink. The best treatment is surgery. I didn’t want to have part of my breast cut off. I still think I look mutilated and my operation was partial mastectomy in Dec 2003.

I also absolutely loathe hospitals which are now dirty and run as far as I can tell entirely for the benefit of their staff at least if you are of working age and want to continue working. They don’t hold appointments on time, out of normal working hours or at weekends. Unless of course you stump up for private medicine or live in a nice posh area, preferably outside London.

They’d have to do a lot better than they do now for me to be happy about having my particular chronic disease. Also you have to give false optimism all the time.

One book I read said you don’t have to worry about cancer now because about half of people who get it survive it for more than five years. How fantastic. Whilst that was talking about all cancers and breast cancer takes longer to run its course than most, I don’t think that’s particularly reassuring. I wrote to the publishers of this particular book but got no reply. It’s called Cancer at your fingertips I believe. I’d rather not have it at my fingertips, in fact I’d rather not touch it with a barge pole.

Mole

Just to let you know the telegraph article is three pages long and you can read the lot if you go to

telegraph.co.uk/health/main.jhtml?xml=/health/2007/07/23/hbreast123.xml&page=1

I do find it very patronising. I was treated at Barts and they have the idea that they can help you pick up the threads of your life. Personally i couldn’t discharge myself fast enough given the length of time hanging round waiting way past my appointment time.

I’d also like to ask Chan why they take off the breasts of women with cancers that are completely inert and won’t ever kill them. Could it be that they need to get their act together in research terms to stop the unnecessary surgery, or would it put surgeons and doctors and nurses out of work?

I’m sure they’d find other bits to operate on as they do in the United States.

Mole

Unfortunately, despite Belinda’s instructions, I couldn’t find on this website, the statistic that 50% of breast cancer patients eventually dying of their disease. Perhaps the moderator can give us a hyperlink? While I know the statistic is correct (because it was quoted by NICE a few years ago) I can’t be sure of accurately phrasing it.

I think it should also be added to to the Statistics and Facts section, because there is little point in giving out incomplete information.

So, if 50% eventually die from breast cancer, how can an oncologist (see an earlier post) say that the majority survive? Unless we are back to 5 year survival statistics again of course (but so many health professionals fail to finish their sentence with saying it is a 5 year statistic. Neither do they mention you only have to be alive to count, rather than alive and well. I’m yet another who contributed to the improving 5 year statistic but isn’t well (at Stage 4).

There are too many half truths given out in order to keep patients “uplifted” and “positive”. However, many need to make important decisions and arrangements post diagnosis and being kept ignorant is not helpful. Breast cancer is increasingly hitting women with young children (a mixture of it affecting more young women and also women delaying having children) who need to know the bald facts so they can make arrangements for their children.

People also need to be made aware of how exactly women die from breast cancer and BCC is not very effective in putting this across. A Secondaries Taskforce has been in place for over a year but no sign of it generating much publicity. Most members of the public think the worst that can happen to you is a mastectomy or losing your hair and BCC should be educating them otherwise. I suffered neither a mastectomy nor much hair loss during my primary treatment and found that most people felt I had a milder somewhat trivial form of the disease. Even now when I’m Stage 4 and terminal, people look at me in disbelief and say things like “But you look so well”. Others pat me on the hand and say “They can do wonderful things these days”.

Sometimes I want to SCREAM!

Hi Holeybones, if you go to the homepage, click on Breast Cancer News, then go to page 3.
‘‘New voice for advanced breast cancer patients.’’ Release 8.05.06
Here’s the actual text…
Whilst the number of people currently living with secondary breast cancer in the UK is not recorded it is estimated that about half of people with early stage breast cancer will go on to develop the advanced stage of the disease

I too was extremely frustrated over this article, has anything we have said in these pages and BCC questionnaires been read and noted, sadly this is the latest of a long line of press releases full of meaningless and contradictory statistics which doesn’t appear to bear any resemblance to my disease.

I was diagnosed at 46 with primary grade 3 triple negative and 11 months later with secondary breast cancer to my bones, a local recurrence 18 months ago and a 2nd local recurrence in the last month, despite all this if I can hang on until the 7th November this year I will be a success statistic having survived 5 years and will be part of the 80%, of course I am already part of the unsuccessful 50% that developed advanced stage of the disease. I also suffer from another “chronic” disease, asthma, if I was to die during an asthma attack (a situation that happens to 4 people every day in the UK) then of course I could be considered to have been cured of BC having died of something else.

Statistics can be made to suit every occasion and viewpoint but I feel that the representatives of BCC should check their data and at least use the same percentages as they print on this website, unless of course they are the inaccurate ones.

Does anyone get The Telegraph, has there been any responses in the Letters page to the article?

Thanks Belinda, I’ve now found it and also the original source of the statistic which was:

“NICE. Guidance on the use of trastuzumab for the treatment of advanced breast cancer. March 2002”

So it has been known for about 5 years but BCC has done little to publicise it? Why? Shouldn’t it be pointed out at least once a year?

Holey

Had a thought, if “it is estimated that about half of people with EARLY stage breast cancer will go on to develop the advanced stage of the disease” then that means those diagnosed immediately at Stage 4 are added on top?

Definitely sounds more of a killer disease than a chronic one!

Holey.

BCC:

It would be great if we could hear your point of view regarding this discussion, the newspaper article and the stats cited in ‘‘New voice for advanced breast cancer patients.’’

Jenny.

For Holeybones, yes exactly, it would make a significant difference.

Another statistic:

10% of newly diagnosed breast cancer patients are diagnosed at Stage 4. (so roughly 4400 in the UK each year.)

Jane

Only somebody who has never experienced the shock of a cancer diagnosis can say that we are not getting on with our lives because of fear.Its a bloody scary thing,and although thank God,the treatment is so much better than in days gone by,this disease is still a killer.Im not going to feel guilty about being scared,I am scared…but I am getting on with my life as best as I can…found some of the comments in the article patronising ,and i refuse to feel guilty for having feelings of fear L.

No one should ever have to feel guilty of living with fear. Fear is real!! I don’t think anyone can say they are cured of this disease. How do you know you are until your dead and it hasn’t come back. Many women are dx with mets years later, when they thought they were cured. A chronic illness!! If it is a chronic illness then why are we labeled terminal? Funnyface

I find the honesty of the comments on this thread extremely refreshing. So often I’ve held back from discussing scary topics which have bothered me for fear of upsetting other forum users. It’s a huge relief to know so many of you can acknowledge that it is important to be able to tell it like it is.

Would anyone know how to email this entire thread to Dr Chan? I would like to read his comments.

Dear All

I was really interested to read all the responses to this article, and I’m going to see what I can do about passing the thread along to Dr Chan.

Wishing you all the very best.

Cecelia. x

Cecelial - I was upset by your remark " chronic disease could be considered Crohn’s or something relatively controllable", sounded very dismissive. Do you have any idea how difficult it is to “control” it? I would guess not, unless you know someone who has had 37 yrs of intractable Crohn’s. That seemed a rather patronising remark to some of us who have breast cancer and Crohn’s. Do you actually know anyone with Crohn’s, and have listened to their problems? I know it is still a taboo subject in England - nobody wants to hear about bowel problems. Cancer, in whatever form, is a relatively easy subject to discuss compared to IBD.

I got Crohn’s at 24 yrs of age, very frightening when you only weigh 5 stones, and have diarrohea 20 times a day, and consequent severe malnutrition, with a tube in your stomach to get essential nutrition. I was given a 50% chance of coming through the laparotomy and my parents drove some 500 miles through the night the day after I was operated on. The early meds of steroids, over some 30 yrs, have played havoc with my bones and I am now on weekly self injected chemo to put my Crohn’s into temporary remission, as well as bisphosphonates and Calcichew/Vit D tablets to strengthen my bones.None of these meds are without serious side effect.s.

This is not like asthma, (with all due respect to quackers) where known drugs can control the situation, but a trial and error complex problem. My gastro said I have “empirical problems”, which I had to look up in the dictionary as I didn’t understand what he said. Hubby said: “he doesn’t know what to do, is flying by the seat of his pants”. Luckily I am married to a bright man. However, there is some hope on the not too distant horizon - medics in the US are already doing leukapharesis for Crohn’s as well as stem cell transplants - they found recently, quite by accident, that autologous stem cell transplants given to patients for leukaemia CURED their Crohn’s - not ammeliorated it, or put it into remission., but cured. Music to my ears. So this is an exciting developement for me.

To me, my long term Crohn’s problems are no different than being dx with mets from bc. My bone marrow is in a mess,with enlarged red cells, my haemoglobin too low but my current treatment is to continue with cytotoxic methotrexate.because there is nothing else available. At least with bc, there are numerous alternatives meds… My gastro said two weeks ago: "Liz, you have to decide whether you want quality or quantity of life. How do I choose? My breast cancer surgeon said to me 4 years ago, when dx with bc: “You will most probably die of Crohn’s than bc”. I think that puts my bc disease in perspective. I now have a recently found stricture of my small intestine and my gastro says it is life threatening if it bursts. I am currently having tests to see how far the narrowing has become, and dreading each mouthful of food I take.

I have found dealing with Crohn’s so much more difficult than breast cancer - and I had 4 months of hospital prescribed Frutijuice, not one morsel of solid foods, when on FEC chemo.

There is so much knowledge around about bc, but very little about Crohn’s, which is still classified as an orphan disease by the National Institutes of Health in the US. My gasto said that people like me, with panCrohn’s Colitis (ulcers and crypt abscesses through the whole gastro tract, from mouth to anus) according to a Mayo Clinic survey have as diminished quality of life as stage IV terminal cancer patients. I live with the constant fear of recurrent severe rectal haemorrhages (have been hospitalised more times than I can remember with these), live daily with constant diarrhoea and abdominal pain, and that my stricture will burst. So, tell me please, how much more difficult it is to live with breast cancer? I have to live with both. I know breast cancer kills daily, but so does Crohn’s, although in less than significant numbers. The numbers do not mean that we are not at as much risk of dying a dreadful death from bleeding, as bc patients with mets. We probably don’t even get onto any stats.

Quackers - I am with you - if I die from Crohn’s, which I probably will, the fact that I had invasive breast cancer, with local spread to my nodes, will count for nothing in the statistics.

Mole - I was actually seen on a Saturday morning in my breast care centre in Plymouth - for suspected IBC, which turned out to be Mondor’s disease. Really surprised at such good treatment, and I think I live in the back of beyond here in Cornwall.

Sorry for the rant - but I don’t know anyone I can talk to positively about bc and Crohn’s - I met a lovely young Scottish woman 35 yrs old on an American Crohn’s site, 4 yrs ago - she went onto get a pancreatic tumour and died this past February. Crohn’s is an insidious disease that no-one wants to know about.

Liz.

Hi Liz

I thought of you when I saw the earlier post about Crohns and wanted to say something about the unfortunate comparison. Thanks so much for your informative and forthright post. You are absolutely right. I was at a party last Sunday and talking to a woman whose 15 year old son has Crohns. His life is heavily restricted and miserable…he is struggling to come to terms with this awful disease at an age when he should be enjoying his youth and freedom.

Jane

Hi Liz and Jane RA

I do apologise from the bottom of my heart for any upset I caused by mentioning Crohns as a comparison to breast cancer in the discussion re. chronic illness. I am obviously ill informed on the subject, I have a friend who has it but has got it very much under control so I am not qualified to talk about it.

Again, sincere apologies

Cecelia. x

i have what is considered a good prognosis, technically i’m “cured”…and i’m still terrified. i’m only 50 and i don’t want to be chronically ill, or die. the only way i can keep the fear at bay is to think, well, i *am* going to die…but not today. i’m having to work really hard to feel in any way “positive”…i don’t like the physical changes, feeling tired and miserable and overweight…i’ve gone back to work to try and grab at some sense of normality, but it’s been so hard that i’ve several times been on the verge of giving up…however, one of my friends was in hospital last year with a flare-up of inflammatory bowel disease, we were in and out of the same hospital like Cox and Box and spent the summer visiting each other in different wards. it put things a bit in perspective for me, she was terribly ill and at one point nearly died…and although having BC was awful i was inundated with support, which just wasn’t there for her. let’s face it, having any kind of illness is bloody awful, painful, frustrating, distressing and frightening…and we’re all on that moving pavement and one day will have to step off, but if you think about it too much you just go mad. i took my health for granted most of my life…that carefree assurance is gone now for ever, i can’t bound about like i used to…but i can still do most of the things i enjoy, i just have to do them more slowly and less often!..

JaneRA

Sincere thanks for your post and support. I am a long time member of the National Association for Colitis & Crohn’s from whom I have received a lot of information and help. Their press officer rang me this week to ask if I will do an interview with our local paper on the difficulties in living with Crohn’s. She mentioned a new forum on their website, directed at young people 16-29 yrs. It is called IBDandME, which they are trying to promote. If your friend’s son is interested he can join the forum by filling out a simple form on their website. You don’t have to be a member of NACC to do this. The URL is: www.nacc.org.uk They also have a Smiley’s People organisation, with branches throughout England, which gets kids together socially and does a lot of fundraising for research into Crohn’s. NACC costs £10 pa to join, and for this we get regular newsletters and a “Can’t Wait” card for us to use in shops, bars, restaurants, etc. when we can’t find a public toilet. It has been invaluable to me on occasions, and I have never been refused the use of employee toilets. I even get upgraded on long haul flights, as I need an aisle seat near the toilet, and often this type of seat is not available at check-in.
I hope your friend’s son’s Crohn’s is not intractable - some patients only get one or two inflammatory episodes, others like me, unfortunately get flares very regularly.
Liz.