Sunday Panorama - hospital which failed women
Sunday Panorama - hospital which failed women an expose of a hospital which failed to give all the treatment women with breast cancer needed, wonder which it is? I think this was meant to go out a while back and was going to concentrate on a particular surgeon
Mole
Hi Mole Saw this advertised as simply “The Hospital which failed women” and wondered if it related to BC treatment, shall watch with interest.
BTW nice to note that our funeral arrangements are same, never seen the point in wasting all that dosh on a fancy wooden box which is going to be turned into charcoal or left to rot, much prefer the cardboard box under a tree 
Rgrds/Siggy
Panorama 10.15, Sunday It is about a hospital which treated breast cancer patients inappropriately for many years, it is being advertised on Radio 4.
Jenny.
It’s my hospital There was an article about this in my local paper today. It looks like it is about my local hospital and there are references to the surgeon who did my operations. I’ll be watching, but I have to say I have no complaints personally.
Jo xx
Seems like some node-neg women didn’t get radiotherapy From a Guardian article, it sounds like some women at a Bradford-area hospital didn’t usually get radiotheraphy if they were node-negative because a surgeon had concerns about its safety.
My sister-in-law had a book on health care economics, written in the 1990s, that pooh-poohed the idea that radiotherapy did more harm than good. The problem with this view now is that 1) the big benefits of radiotherapy tend to take a long time to show up so someone fixated on the five-year survival figures will miss them and 2) radiotherapy has gotten much safer in recent years.
just watched this WElLL…didnt think much of the so called sugeons who were trying to cover up this mistake…nor did I think much of the ones who said they couldnd tell how many were affected surely that should have been a priority
I’ve just watched it too. I was operated on by the surgeon mentioned, and have absolutely no complaints whatsoever about him or anyone else at the hospital.
In my opinion the programme was very biased, and seemed like a bit of a witch hunt to me. Maybe I woudn’t be saying the same if I’d had my treatment in the 1980/90’s, I’m sure there are some people who are very upset after watching it.
Forgive me if I am wrong, but didn’t they say they couldn’t identify patients and surgeons from the information they collated yet in the next part of the programme they made out surgeon 39 was definitely the one?
Jo
Panarama Well said Jo - I too thought the probram biased - one question - Whey did it take so long for the doctors involved to come forward with the information and if they thought it was wrong - why did they conform?
David W
one small add on - no mention of men again !!!
— i was treated there jan this year. they went straight away for a mastectomy. it scares you cos you put your trust in dr’s , surgeons etc, however my sister is a dr & rang different surgeons, but unlucky 4 me lump in wrong place. treatment was same countrywide! what i will say about bradford is that you (i) got no emotional or physic support. just another statistic - and nothing for the younger patient. even had to make own breakfast & drinks. i appreciate the thinking behind this…but it is not always appropriate.
what I thought They were a bit slow in changing their policy on radiotherapy and it did go against the prevailing practice in other units surrounding Bradford. With new radiotherapy machines and planning the side effects are reduced so maybe they had rubbish machines up there. Or maybe it was just reluctance to change the way they worked. Teams have a dynamic which may make it difficult to go against the norm, and where does responsibility lie? In this case it seemed no-one was willing to say it was one person i.e. surgeon 39. But if there isn’t one person they can go on in their own sweet way.
The consultant who was sacked obviously had an axe to grind, since he appears to have falsified some aspects of his job application I am not sure how much credence we can give him.
Professor JR Sainsbury is my consultant now, so he seems to have come out of things quite well. He’s well away from Bradford in UCL but they’ve got their financial crises to manage so maybe he has his own cross to bear.
Professor JR Sainsbury’s report on outcomes being dependent on where you lived influenced “Improving Outcomes for Breast Cancer” the NICE guidelines published in the 1990s and updated in 2002. There are now clear standards of care for each kind of breast cancer. Not that all of these are followed, as they are guidelines rather than requirements. But at least it means strange practice can be questioned.
I wonder how many women are around who didn’t get radiotherapy in Bradford who are now traumatised. The programme went on and on about women having to have mastectomies if they had recurrences after not having radiotherapy, but maybe not. If you have not had radiotherapy in the past, you may be able to have re-excision and rafiotherapy. If you’ve already had radiotherapy and get a recurrence, you definitely have to have a mastectomy as you can’t have radiotherapy in the same place twice.
I also thought that getting a local recurrence does not add to your risk of dying earlier from breast cancer but I may be wrong.
Oh what a can of worms
Mole
That’s what I thought too, Mole Yes, Mole, thank you for pointing out that the problem highlighted was a very specific one. The report was not saying that the surgeon was entirely rubbish at all things, just that his team seems to have not followed crucial national guidelines on radiotherapy after breast-conserving surgery.
Having said that, I was glad that I go to Leeds rather than Bradford, even though I live in Bradford district. I found the secrecy over not following national guidelines to be very disquieting.
I can understand why this revelation came out now. Dr Phillips, after all, had brought the issue up a long time ago, in the mid-1990s, and seems to have been in great danger of losing his job. I wondered whether his retirement had made him a bit freer to get the story out.
My understanding was that radiotherapy only showed a survival difference after ten years and they even alluded to the study that said this in the programme. The lower five-year survival rate of the Bradford group seems to have been a bit of a red-herring really. It may be that women in Bradford have cancers with worse profiles, for whatever reason. I think that poorer areas of the UK tend to have more hormone-independent cancer, so maybe that’s it.
I felt that the programme puffed the matter up a bit. The music was designed to heighten the tension and sometimes complex issues got muddled (even if the data is as strong as that used against Shipman, there is no way that the two cases are similar).
— There were other differences - e.g. in mastectomy rates and in whether surgeons offered patients chemo or not. So I would say that radiotherapy is only the tip of the iceberg. General surgical hospitals appear to have been worst, with surgeons who were more interested in breast cancer giving better treatment. See below for abstract from Medline
Does it matter where you live? Treatment variation for breast cancer in Yorkshire. The Yorkshire Breast Cancer Group.
Sainsbury R, Rider L, Smith A, MacAdam A.
Royal Infirmary, Huddersfield, UK.
Over 27,000 patients with breast cancer were identified from cancer registry data from 1978 to 1992 and differences in treatment practice across the 16 districts of Yorkshire studied. A total of 50 surgeons treated more than an average of ten cases a year. Surgeons who expressed an interest in breast cancer were more likely to treat a greater number of patients than those who had no special interest in the disease and offered patients chemotherapy, hormone therapy and radiotherapy more often. The average regional mastectomy rate fell from 70% to 44% over this period, but the rate varied between districts from 13% to 87%, with those at the extremes occupying these positions year on year. The rate of uptake of radiotherapy varied between districts from 13% to 58% over the period 1978-92. The use of adjuvant chemotherapy increased from 5% to 19% and hormone therapy from 19% to 80% over this time period. An audit of the facilities available within each district carried out in early 1994 also showed considerable variation, although all districts now have access to a nurse specialist. There were wide variations in treatment offered to patients with breast cancer. Patients in some districts were denied access to chemo- and and radiotherapy despite published guidelines showing these modalities to be useful. It is recommended that patients are referred to units with an interest in breast cancer rather than to general surgical out-patients.
Radiotherapy Perhaps all ‘Surgeon 39’s’ patients were older women, in which case, research has shown that radiotherapy does not add to their survival. (Which would tally with the view that it really aids long term survival.)
Nice to know someone is aware of the dangers of radiation and prepared to act accordingly. The program gave out a help line number for women traumatised by finding out they had not been treated appropriately, but by Tuesday night, no-one had rung it. Or could they not be here to complain?