Why vital Northern Ireland cancer units must be saved
In response to proposals to withdraw breast cancer assessment services from two major hospital sites here, Stephanie Bell talks to two women about their experiences and why they are battling to prevent the changes.
Thousands of people have now shown their support for a campaign to save two local breast cancer assessment centres from closure. The charge to keep clinics at Craigavon and Belfast City hospitals open has been led by local breast cancer charity Knitted Knockers.
The charity was set up in America by breast cancer survivors to supply free hand-knit breast prosthetics to patients and its popularity spread throughout the world, with many more groups being established.
Through its social media platforms, Knitted Knockers in Northern Ireland has managed to collect more than 40,000 signatures for a petition calling on the Government to save the assessment clinics.
The Department of Health launched a public consultation on cutting the vital service from Belfast City Hospital and Craigavon Area Hospital in March. Assessment centres are for those referred for further tests after an initial cancer screening at a local health trust.
Under the proposals, the number of breast cancer assessment centres in Northern Ireland could be reduced to three from five.
That means some people will have to travel further to be seen for follow-up assessments at clinics in Altnagelvin, Antrim and the Ulster hospitals.
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As the Save Our Breast Cancer Services campaign gathers momentum, public meetings have been set up across Northern Ireland in the coming weeks.
Joanne Harris, who heads up the NI branch of Knitted Knockers, says: "Whenever the news broke of the proposed closures, we were inundated by extremely distressed service users and carers of both men and women that do not want to lose their local breast clinics. These local clinics are a lifeline to patients.
"The closures will affect all breast cancer units and could affect the physical and mental health and wellbeing of our population. To date we have more than 40,000 signatures and we would love to achieve 100,000 in order for a possible parliamentary debate.
"We encourage people to not only sign our petition but to please answer the public consultation and email their personal letters to form part of a lobby document which we are currently preparing."
Today, two of the thousands of local women who will be affected by the closures if they go ahead add their voices to the charity's urgent call for the clinics to be saved.
‘It’s number crunching rather than the reality of quality of care it gives people’
Cathy Robinson (43), a dentist who lives in Portadown with her partner Rhyan Wilson (44) and daughter Lucy (15), is being treated at Craigavon Area Hospital for breast cancer after being diagnosed in January.
Cathy came through a cervical cancer battle four years ago when she was treated at Belfast City Hospital. The fact that she lives just a five-minute drive from Craigavon Area Hospital has greatly reduced the stress of going through treatment.
The dentist has just had her first round of chemotherapy treatment at Craigavon - and going through treatment at both centres proved to be a very different experience because of where she lives. Long commutes for patients are just one of the objections being raised about the threatened closures.
She says: "I have experienced first hand what it is like to travel to hospital in Belfast - I was diagnosed in 2015 with cervical cancer and had a radical hysterectomy followed by six rounds of chemotherapy and 30 days of radiotherapy.
"The chemo for cervical cancer is pretty brutal and I had seven hours of infusions every three weeks. I also had to go to the City Hospital the day before to get bloods taken so that was another day of travel.
"I usually had an appointment at 10am and I would have had to leave home around 7am to avoid the bottleneck of traffic at Sprucefield and then queue for around 30 minutes at the Belfast City Hospital car park to get a space.
"I would then spend the whole day getting treatment and then hit the traffic again going home, usually not arriving there until around 6pm or 7pm.
"It was really a 12-hour day and you had three hours either side of your treatment to allow for traffic and parking. The treatment itself wipes you out and it left me fit for nothing.
"I had to rely on family to drive me and it was a lot of pressure on them - my parents were brilliant."
Although thankfully the treatment worked and Cathy was given the all clear from cancer, the radiotherapy had a huge impact on her body.
It caused her to have acute appendicitis which required surgery and also damaged her bladder and bowel which required two further surgeries.
She says: "Last year was the first since I was diagnosed that I didn't have any surgeries and I felt things were finally on the up and I was getting better."
Tragically, just before Christmas, Cathy took a pain in her right breast and felt a lump.
As someone who has always been breast aware, she immediately went to her GP who referred her to the breast clinic in Craigavon Hospital for tests.
She says: "I've always been prone to cysts in my breasts and had four mammograms in the last decade so I was pretty au fait with the whole diagnostic clinic - or so I thought.
"I had the mammogram and was sent to the ultrasound room as usual but they came back to me quite quickly and brought me back in and I thought 'this is new'.
"When I got into the ultrasound room, which is usually quite subtle and quiet, it appeared theatrical as staff were standing around in surgical scrubs with equipment out."
Cathy had a biopsy taken and was advised to return in an hour for the results - and to bring someone with her.
She says: "Rhyan came down and we went to the canteen for coffee and I just thought - it's only three years since I had cancer, surely I couldn't have it again, people don't get cancer like they get the cold."
She was stunned to be told that she had breast cancer and immediately asked for a radical bilateral mastectomy to minimise chances of recurrence.
She says: "I just thought that every time I found a wee lump or bump I would be thinking the worst and I couldn't have coped with that psychologically."
Surgery was straightforward and Cathy was relieved to discover that the cancer hadn't spread to her lymph nodes.
She was told she didn't need radiotherapy but started six rounds of chemotherapy three weeks ago.
The difference in attending Craigavon as opposed to driving to Belfast was apparent during one particular meeting with her oncologist when she expressed concern about how her wounds were healing.
She says: "This time is so different. I go and get bloods taken and can go home again and get things done and then return later that day for my chemo so there is no waiting about or sitting in traffic for hours.
"When I asked my oncologist about my wound he sent me straight over to the Ramone unit to see my surgeon who then sent me to the breast cancer physiotherapy unit where I was seen straight away. In the space of half an hour I had seen two consultants and a physiotherapist. Had that been another hospital, that would not have happened and I would have had to wait for appointments and go back - probably twice.
"The quality of care in the unit is remarkable and it runs like clockwork. The nurses are outstanding. It doesn't make any sense to close such a well run and busy unit.
"People will have further to travel and I think it has been number crunching rather than looking at the reality of the number of people who rely on it and the quality of care it gives."
'Hopefully I won't need the service again, but others deserve the same access that I had'
Lisa Hutchings (53), a business manager at the NHS, is married to Drew (54), a nursing assistant at the Royal Victoria Hospital, and has two children, Tom (15) and Jack (10), and three stepchildren, Rebecca (29), Matthew (25) and John (23).
Lisa was diagnosed with breast cancer at the age of 47. She was treated at Belfast City Hospital's breast cancer unit and underwent a rare treatment using leeches after her reconstructive surgery.
She says: "I had three friends diagnosed with breast cancer under the age of 50 so I went voluntarily to the Action Cancer screening service, first when I was 45 and again at 47 when something was picked up.
"I was referred to Belfast City Hospital where I had tests done and I really didn't think it was anything sinister as cancer doesn't run in my family.
"I was told I had a 10cm tumour in my milk duct and would need a mastectomy. It was a massive shock and once you hear the word cancer your first thought is you are going to die and leave your children.
"It was coming up to Christmas and the kids were three and eight at the time and it was difficult going through the motions and organising Christmas with that hanging over me."
Surgery in January 2013 proved an emotional rollercoaster. Surgeons performed a mastectomy and reconstruction in the same procedure, taking skin from Lisa's back to form her new breast.
However, following the five-hour surgery, there was alarm when the new skin appeared to be dying and Lisa had to have leech treatment to stimulate blood flow to her new breast.
She explains: "It was pretty radical stuff to save the breast. I had leeches put on my skin five times a day for 11 days.
"At that point I was in a lot of pain and in a morphine haze.
"They would suck my blood for 15 minutes and then drop off, helping bring the blood supply to where it is needed.
"It was a real showstopper in the ward as it had been rarely seen before and I had other patients, visitors and nursing staff coming over to have a look."
While the treatment worked, Lisa faced further complications post-surgery and seven more operations on her breast.
However, her lymph nodes were clear and she feels fortunate that she did not need any follow-up treatment. And today she can't accept that the unit which worked so hard to save her life is now under threat of closure.
She says: "It is an absolutely lovely breast care unit, they are so caring and you really couldn't meet a better group of people even though I met them through awful circumstances.
"I am extremely saddened that such a great service is under threat.
"The alternative would probably be Dundonald and it is horrendous going down there because there is not enough parking."
Lisa added: "The staff at the City Hospital have all worked together so well for so long that it is devastating to think that could be shattered.
"Hopefully I will never need the service again but for people who do they deserve to have the same treatment as I did."
Help save breast cancer services
To sign the online petition to save the breast cancer assessment services at Craigavon and Belfast City go to http://chng.it/vVJSPd5TN6. Personal letters of support can be sent to firstname.lastname@example.org to be attached to the charity's lobby document.
A printable version of the petition is also available at https://drive.google.com/file/d/1K90pYhURAtu1Sd3QIDT3PIPGYSW2ih2q/view?usp=sharing.
People are also urged to go along to one of the charity's public meetings at the Europa Hotel on Friday, June 7 at 7.30pm and the Greenvale Hotel on Sunday, June 9, for an afternoon event with time to be confirmed.
Details will be posted on Knitted Knockers' Northern Ireland Facebook page.