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Richard Branson and kissing frogs

2 Oct

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“Hello, I’ve have had some very bad news. On Monday I was told by my consultant that not only has the cancer returned its spread to my pelvis and there isn’t a lot more they can do for me, therefore I am now terminal” Michael, 54, bowel cancer patient

“I had a meeting and scan on Friday.  Not good news major spread in the liver and other places. We agreed no more chemo.  It looks like it’s taking hold now” Tony, 50, bowel cancer patient

I really hate bowel cancer.  During my first few days back at work after my long summer break I caught up with my patient friends. Three recurrences, one told now inoperable, one with just a week or two left, three with spread, several with severe reactions to chemo.  Desperation, despair, occasionally acceptance. Bugger.

What makes this harder is that really bowel cancer should be a good news story. It is one of the most treatable forms of cancer.  If it is diagnosed at its earliest stage you have a 93% chance of surviving.  However that can be difficult to achieve for a host of reasons including:

  • low levels of awareness leading to patient delays in seeking advice;
  • GP delays in referring for diagnostic tests because it can be difficult to identify who to refer;
  • low take up of screening and the need for a more sensitive (and easier) screening test:
  • poor surveillance programmes for those at highest risk.

At Bowel Cancer UK we are working flat out to address some of those issues – we run awareness programmes, we train public health and health care professionals, we promote screening, we campaign where we see issues that should be addressed, we provide information and support to people affected by the disease. At the same time we are carefully monitoring and evaluating what we do so we can do it better and share our learning with others. Yet we are still hampered by our lack of scale.

Sir Richard Branson

The need to grow the charity has led to my developing a mild obsession with transformation, change and money!  I’ve started to study the habits of wealthy entrepreuneurs and successful businesses to try and figure out how they made the breakthrough that led them to success, money, influence. I’ve felt vaguely re-assured by the hard graft so many describe prior to take off but I can’t help but wonder what Richard Branson would do if he were CEO of Bowel Cancer UK?

Don’t get me wrong, it is a pretty healthy obsession because all I want is to enable Bowel Cancer UK to do more, for more people. Yet after 22 years working in the voluntary sector I’ve come to realise that money is the charity workers curse.    We don’t have gadgets and gizmos to sell (usually), we only have our issue.   I’m selling an opportunity to be part of saving lives.  Sometimes I’m gobsmacked that it’s such a tough pitch, that so few seem to want to buy into it.

Bowel disease study day

It’s particularly frustrating when we know that there is a real need for what we do – the patients and their families I speak to every day are a constant reminder of that.  I also know that our work makes a tangible difference. For example the independent evaluation of our recent pilot GP study disease days in Birmingham and Manchester commissioned by Cancer Research UK showed that 92% of the GPs attending intend to make positive changes to their clinical practice as a result.  That’s good news as we wanted to support GPs and provide them with the opportunity to consider their practice and to make changes where needed.  Yet we struggle to find the funds to run them.

In our joint Train the Trainer programme with Breast Cancer Care we trained around 100 health care professionals in areas with high incidence and mortality of the disease and the evaluation was fantastic.  It showed that trainees knowledge about and confidence to share information /raise awareness was dramatically increased and as a result they went on to reach over 10,000 people and that number continues to grow.  Clearly this is positive yet the fundraising process to get the necessary funds to run them is long and arduous and there is no guarantee of success.

Never Too Young banner

We are having influence too.  We have worked hard to ensure there is depth and substance behind our Never Too Young policy recommendations and are fortunate to have the support of leading academics and clinicians.  Yet to turn those recommendations into practice requires money to fund the necessary research.  Bids of course have been duly written and submitted and now the agonising wait begins. What a waste of time.   After all, people are dying and this might help change that.

Most days (and too many nights!) I wrack my brain to try and work out what we need to do differently and I am always on the look-out for ideas and open to advice and guidance.  Of course it’s in the wee hours of the night, the self-doubt and self criticism bites and there are times when I long to run away and work in a Cotswold tea room.  When I dream of clarity and simple transactions… you want coffee…here it is.

Yet I just need to think about patients and their families and the impact of losing someone you love and my own feebleness melts away.

My friend Neil, who lost his wife Lindsey to bowel cancer, described it to me so movingly.

‘The whole journey of losing a partner and best friend is very odd. At first the shock protects you a little.

Then you throw yourself into work with unbelievable mania just to avoid thinking about it.

Only now 10 months on has reality kicked in. The loneliness is awful, the sense of there being no purpose to anything any more is high

I am sure this is all part of the process but it is such a painful part

But I am ok – really I am’

I feel such anger that people are going through this and I am bored rigid by steady incremental growth. We need step change.

What makes it feel more urgent is that in my re-networking of the new NHS in England it appears that many politicians and key decision makers in the new organisations have moved on or at least distanced themselves from cancer, as their budgets have shrunk and their portfolios expanded except for where there are big headlines.  Yet many of the changes required are not news grabbers.  For example, increasing endoscopy capacity isn’t really media sexy but it might enable us to detect people quicker when treatment is more successful, yet who is prioritizing that?   Well we are.

Today around 43 people died of bowel cancer and tomorrow another 43 will die and the reality is that many of those deaths could have been prevented.  That’s why money and transformation is so important – to ensure we can dig deep and find meaningful sustainable solutions.  This is definitely not the moment to move on and give up.

Oh dear, I guess the tea room will have to wait and I will just have to keep hunting for that breakthrough moment and ‘kissing frogs’  just in case one turns into a generous benefactor.

I also better finally settle on a new fundraising challenge – it isn’t the solution, but right now every penny helps.

Star of hope

“Never doubt that a small group of thoughtful, concerned citizens can change the world.  Indeed it is the only thing that ever has”

Margaret Mead

If you would like to donate to Bowel Cancer UK you can do so online via our website  www.bowelcanceruk.org.uk or visit my Never Too Young  JustGiving page: www.justgiving.com/deborah-alsina

If you are experiencing any symptoms of bowel cancer, please tell your GP or call our nurse run information and support line in confidence on freephone: 0800 8 403530 or email support@bowelcanceruk.org.uk

Bowel Cancer UK aims to save lives and improve the quality of life of anyone affected y bowel cancer

Bowel Cancer UK aims to save lives and improve the quality of life of anyone affected y bowel cancer

Victim or Survivor?

13 May
struggling image

Struggling…

To have striven, to have made the effort, to have been true to certain ideals – this alone is worth the struggle’

William Osler

 

I’ve been struggling recently.  Struggling with loss, struggling with frustration and a sense of impotence and struggling with anger.   Wonderful, beautiful Katie Scarbrough, who I wrote about a couple of posts ago, died at just 32, leaving two young children aged 4 and 8.   I never met Katie but we spoke, emailed and tweeted and her determination to raise awareness in such difficult circumstances moved me.  I’ve seen it before and if I’m honest I don’t really want to see it again.  I don’t want people to have to turn such deep desperation into positive action.  I want them to laugh freely and be happy.  I want them to live.

Katie looking fabulous in her purple wig with husband Stuart

Katie looking fabulous in her purple wig with husband Stuart

Hearing the terrible news about Katie has also made me reflect on my own reaction to difficult news.  I remember all too vividly when my husband was diagnosed with leukaemia and my father’s diagnosis and death from bowel cancer and how damn cruel and unfair it can feel.  It’s amazing how the ‘why’ questions take over – why me, why us, why now?   Until you find your way forward. That process taught me that you have to make a choice about whether you are a victim or a survivor.

I think what impressed me about Katie – and reminded me of another patient we lost, Rosi Kirker Miller, who I wrote about in my first post – is that even though the disease eventually took them away physically, it didn’t beat them, their spirit remained intact.  They were survivors.   They made sure that out of something dreadful, good will happen.  I admire that tremendously.

Never Too Young bowel cancer patients

Never Too Young bowel cancer patients

So that’s what we are trying to do at Bowel Cancer UK with our Never Too Young campaign.  We are trying to take something really difficult and turn it into something positive.  We embarked on the campaign because we were hearing too many stories like Katie’s.  We thought long and hard about the campaign because we didn’t want to do something trivial – yes the stories will inevitably get media attention – but that’s just not enough.  There has to be substance.  People are struggling and dying so we need to make change happen.

We worked hard to get our recommendations right – we’ve consulted patients and their families and we’ve consulted some of the UK’s leading academic and clinical experts about what could make a real sustainable difference and I think we are on the right track.  You can read more in our campaign briefing.

In short there are two particularly important sets of issues which we believe need addressing:

1. Why are more younger patients developing bowel cancer and is there anything different about bowel cancer in this young age group.  Do they present differently? Are there any genetic links? What is the trigger?  So we are recommending that a registry of younger bowel cancer patients is set up so we can study the epidemiology of cancer in this group.  We also want all younger patients and their families routinely genetically tested.

2.  How can we identify these younger patients more quickly?  So many people have bowel symptoms, but few (thankfully) will have bowel cancer – so who should we be referring for diagnostic tests and what is the right diagnostic test?  That’s why we are recommending that a new risk assessment tool on bowel disease (but including bowel cancer) is developed for use in primary care to help GPs identify which patients to refer and clear guidance developed on which diagnostic test should be used.    We MUST also ensure that screening for high risk groups, for example for those with an inflammatory bowel disease or genetic condition is in place as bowel cancer in this group often presents earlier.

If we can get our recommendations implemented I genuinely believe that we can make a significant difference to younger bowel cancer patients.

You can really help us too by signing our petition asking David Cameron to meet us to discuss this and to take action.  We’ve targeted the Prime Minister directly because this must be an issue for the UK as a whole to address. We cannot simply look at these issues separately in England, Scotland, Wales and Northern Ireland, even though in policy terms, health is a devolved issue.   People are dying or being diagnosed late when treatment is more gruelling but together WE CAN change this.

Katie was a wonderful ambassador for the Never Too Young campaign through her blog, her tweets, her extensive media interviews and when we created the petition I thought about her.  I wanted her to know that we would continue her campaign after she was gone and that her fighting spirit and eloquent articulation of her experiences – often terrible despair at leaving her children – will continue to drive us forward.  We couldn’t save Katie – she was diagnosed too late – but I think at the very least, she would want us to learn from her passing and to work hard to stop it happening again.

So in Katie’s memory, please take action.  Sign our petition now.

Katie Scarborough – Rest in Peace, you will not be forgotten.

 Katie FB1

‘She is Gone’ by David Harkins

You can shed tears that she is gone

Or you can smile because she has lived

You can close your eyes and pray that she will come back

Or you can open your eyes and see all that she has left

Your heart can be empty because you can’t see her

Or you can be full of the love that you shared

You can turn your back on tomorrow and live yesterday

Or you can be happy for tomorrow because of yesterday

You can remember her and only that she is gone

Or you can cherish her memory and let it live on

You can cry and close your mind, be empty and turn your back

Or you can do what she would want: smile, open your eyes, love and go on.

If you would like to donate to our Never Too Young fundraising appeal and help us raise funds to continue this campaign and improve services for younger bowel cancer patients, please visit my JustGiving page: http://www.justgiving.com/deborah-alsina

For more information on Bowel Cancer UK, please visit our website: www.bowelcanceruk.org.uk

If you are experiencing any symptoms of bowel cancer, please tell your GP or call our nurse run information and support line in confidence on freephone: 0800 8 403530 or email support@bowelcanceruk.org.uk

Bowel Cancer UK aims to save lives and improve the quality of life of anyone affected y bowel cancer

Bowel Cancer UK aims to save lives and improve the quality of life of anyone affected by bowel cancer

Gravity, fear and friendship

22 Apr

in the air‘I want to fly like an eagle
To the sea
Fly like an eagle
Let my spirit carry me
I want to fly like an eagle
Till I’m free
Oh, Lord, through the revolution’
Steve Miller, Fly Like an Eagle

in the air 2in air 3 

with canopy IMG_2937     coming in to landlandingOMG .. we really did it!  Niki and I threw ourselves out of a plane and found friendship. I am counting my blessings that Niki stepped up to my twitter cry for help and offered to skydive with me. With the benefit of hindsight I don’t know how I’d have managed without her.

Niki and Dave

Niki and Dave

What can I tell you about Niki? Well clearly she’s amazing.  One of the warmest, bubbliest and most lovely people I’ve ever met.  She has done a series of fundraising challenges, including running the Edinburgh marathon and trekking the Great Wall of China to raise money for Bowel Cancer UK.  She started this after her friend James died of bowel cancer aged 28.  Her remarkable support is a moving reminder that cancer affects more than just the patient.  Having met on twitter (you can find her @nikinom) a year earlier, I felt instantly blessed to have her and her boyfriend Dave with me along with my husband and daughter. What made it easy was that she understood and shared my motivation to take action.  We also shared misgivings about what we were embarking upon.

The whole skydiving experience was incredibly emotional right from the outset.  It was a perfect beautiful sunny day but I was reduced to tears by messages of support from patients and those who have lost loved ones and whose grief is still so raw.  My dear friend Lesley’s comment (Laura’s mum) on this blog quite frankly finished me off but it also made me even more determined.

We can do this!

We CAN do this!

Niki and I met at the airfield which was in a beautiful countryside location just outside Swindon.  We signed all the relevant disclaimer forms and then waited until we were called for training!   The training was brief but we chuckled our way through it, lying on your tummy in a field practising free fall positions is a bit random after all.

Practising my free fall position with Matt

Practising my free fall position with Matt

Niki looking glam!

Niki looking glam!

We laughed as we struggled into our ‘boiler’ suits and at our deeply unflattering hats and eventually just held hands as we climbed to 10,000 feet in a plane that felt too small to be in the air.

Quite frankly everything felt wrong… being in a plane with 5 blokes (the pilot, two tandem partners and two cameramen) telling unrepeatable jokes full of sexual innuendo whilst strapped to one of them and eventually sitting on their knee, with another resting in-between our knees was certainly ‘cosy’.  Add that we were preparing to jump out of a perfectly (well reasonably) good plane as well, then it definitely felt counter-intuitive to all we had learnt about safety during our lifetimes!   Yet my tandem partners repeated checking of my harness and calm words about what was going to happen next were oh so welcome.  As we climbed higher and higher so did the butterflies in my stomach…  Deep breath, tightly hold Niki’s hand and put on presentation face… I can do this, I CAN do this….

Niki jumped first – seeing her terror and hearing her fearful cry of ‘this is so scary’ as she dangled on the edge of the plane in free fall position and then a scream as she fell (was pushed) was mortifying and then it was my turn…. We jumped from 10,000 feet, that’s two miles up – yikes!  You free fall for the first 5,000 feet at 120 miles an hour.  The first few seconds of the free fall were quite frankly horrific to a non-adrenalin junkie wimp like me. The speed and spinning until the instructor gets it all under control was way way outside of my comfort zone.  Actually, for a few seconds I literally felt total panic, but then gave myself a stern talking to and determinedly opened my eyes and controlled my fear.  After all, people had kept telling me, I was going to love it – the least I could do was try.  But most importantly I was doing this for a reason.  I didn’t want to let everyone cheering me on across the twitter waves and my colleagues down.

I suddenly remembered the cameraman and tried to look at the views and smile as if this was what I did all the time. Trust me, it’s tough to smile at those speeds with your cheeks flapping attractively! Then, suddenly, a big jolt and the parachute is open pulling you upwards… unexpected serious feelings of nausea ensued but I controlled it and realised how wonderful it felt that we had slowed so much.  Finally it felt under control. The quiet under the parachute canopy is amazing after the loud noise of the wind at 120 miles per hour and the views were clear and spectacular over beautiful countryside.  If I hadn’t felt nauseous at every turn it would probably even have been enjoyable… It was most certainly awesome.

Never Too Young bowel cancer patients

Never Too Young bowel cancer patients

As we ‘floated’ down from 5,000 feet I talked to my instructor about why I was doing it. I told him about Laura and Lesley all the other young patients and their families I know and care about. I told him that even though this absolutely wasn’t my thing I was proud to be facing my fears and doing something.  That I hoped by taking action and raising funds I could make a difference.  I told him how the stories of loss and grief hurt and how moved and humbled I felt by all the support I’d received.  So many people I care about were on that jump with me.   Poor bloke – he was probably expecting small talk about the view and I’m telling him about death, late diagnosis, grief and why it has to stop.  It’s silly but it makes me well up just thinking about it because as I looked out over the beautiful countryside repressing my fear, I wasn’t alone.

Landing is remarkably controlled but I still felt alarmed as the ground got closer and closer and I couldn’t get my legs up – my face in the pics is comical, my anxiety clear for all to see!

Yah! I did it.

Yah! I did it.

Even though I jumped second we were down first and then I had to wait for Niki.  Bless her she was white as a sheet and I felt terrible guilt having persuaded her to sign up.

Relief...

Relief…

I think it’s fair to say we both felt rather emotional, shell shocked and in disbelief about what we had just done.

Did we really just do that?

Did we really just do that?

As we watched someone else land we realised we’d just done something pretty darn amazing… entirely foolish but amazing…

I so want to tell you I loved every minute of skydiving – I feel a bit of a failure that I didn’t. It was genuinely an amazing experience which will always stay with me, but I can’t claim to have ‘enjoyed’ it in a traditional sense of enjoyment.  However as well as the wonderful donations for Bowel Cancer UK, I have gained a lot.  I have a lovely new friend in Niki and a deep sense of pride that together we faced our fears, held our nerves and took action for younger bowel cancer patients.

Neither Niki nor I longed to go up and do it again straight away as we were told we might, yet I would absolutely do it again in a heartbeat if it would make a real difference and help save lives.

Niki & Deborah

PS

Thank you to everyone who has sponsored me… If you haven’t don’t worry you still can!  Justgiving.com/Deborah-Alsina

If you are  new to my blog and would like to find out why I’m taking action by fundraising for younger bowel cancer patients, do visit Bowel Cancer UK’s Never Too Young campaign website pages or simply read the posts in my blog archives.

Mid Life Crisis?

20 Mar

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My closest girlfriend called me the other day to tell me she was worried I was having a mid-life crisis.  She had just heard that I’d signed up to do a skydive and called to talk me out of it – bless her.  My dear friend of 26 years had decided I’d lost the plot finally – maybe she’s right. I mean – why else would you offer yourself up to be thrown out of a plane?

Well I had some reminders recently of why I’m relatively confident about my sanity levels …

Never Too Young

This week Bowel Cancer UK launched a new campaign. ‘Never Too Young’ with the aim of improving the diagnosis, treatment and care of younger (under 50) bowel cancer patients in the UK.  Our campaign film highlights just why this is so important. 

To inform our campaign we conducted research into the experiences of younger patients which we summarised in our Never Too Young report. 

One of the findings that stood out for me was that younger patients are experiencing delays in diagnosis for two main reasons.  Firstly, GP’s are delaying referring people through for diagnostic tests and in fact 42% of women,  compared with ten per cent of men either saw their GP more than five times before being referred to a specialist, or were diagnosed as an emergency before being referred.

Secondly, over half (60%) of patients were not aware of the symptoms of bowel cancer prior to being diagnosed, and were not aware of bowel cancer as a disease younger people could develop. A quarter of people (25%) waited over 6 months to see their doctor as they didn’t realise the significance of their symptoms or felt reluctant to discuss them.  This can have terrible consequences and has for Laura.

Laura was 30 when she was diagnosed with bowel cancer.  She had symptoms for nearly two years before she was diagnosed.  Unfortunately, she didn’t understand their significance and was re-assured when her doctor told her that it could not possibly be bowel cancer because she was too young.  The terrible pain in her tummy was put down to painful periods and the bleeding she experienced on and off for two years wasn’t investigated.  Unfortunately when she was finally diagnosed at the age of 30, the disease had already spread to her liver and her lungs and is now in her bones too.

Laura happy on her wedding day

Laura happy on her wedding day

Despite gruelling treatment, on the 1st March, Laura married her fiancée Alan at their dream wedding in Scotland.  Yet instead of going on her honeymoon, she had to go to hospital to start a new round of palliative chemotherapy instead.  Every contact I have with Laura and her lovely Mum Lesley makes me ache, because I can feel their pain and grief, yet they are amazingly supporting our Never Too Young campaign because they want this to stop.  After all, this should not be happening to Laura, to anyone.

Laura and Alan

Laura and Alan

 

Bowel cancer is treatable but early diagnosis makes that much easier.

Finding Solutions

I know that some will think that our focus on younger patients is a ‘red herring’ because the number of people diagnosed only represents 5% (c. 2,100) of the 41,000  diagnosed each  year in the UK.  I strongly disagree.

To me those c.2000 patients, represent, 10,000 patients over 5 years, 20,000 patients over 10 years – and each one has hopes, dreams and family and friends who love them and whom they love.  They deserve the same chance of and have the same right to life as anyone else.  I resolutely refuse to give up on them simply because they are difficult to target or detect.

However I do acknowledge that the solutions are not straight forward.  GPs for example, have an incredibly difficult job to identify those patients they should be referring on for diagnostic tests.   They will see many young people who have symptoms that could be bowel cancer but may only see a few cases (if that) during their career in the under 50s.   They are also under pressure to refer less people through to endoscopy teams who are over-stretched and under-resourced.

We need to find a solution that empowers and enables GPs to make those difficult decisions and build the capacity of our endoscopy units to ensure they can provide high quality services to meet rising demand.   That’s why we are calling for the development of a risk assessment decision aid tool to be developed for GPs around bowel disease, sustained investment in endoscopy services so this is not a barrier to diagnosis and a registry of younger patients to be set up, so we can better understand the epidemiology of cancer.

Information and Support

Our report also highlights gaps in information and support for younger bowel cancer patients. Only 1 in 4 women and just fewer than 1 in 2 men were happy with the levels of support they received.

Isolation and loneliness is felt by many younger bowel cancer patients. Although peer support was identified as a major factor that could have improved treatment more than half of patients felt that they had no-one their age with bowel cancer to talk to.

Younger patients inevitably have different concerns from older patients – many have concerns about how treatment will affect their fertility, their body image and sexual relationships.  Looking after young children is also a major concern for some.

Katie, husband Stuart and children Sophie 4 and Sam 8

Katie, husband Stuart and children Sophie 4 and Sam 8

Katie, 32, a former national junior ice skating champion has been highlighting the issues she is currently facing in her moving blog, as she tries to come to terms with the reality of  having terminal bowel cancer.   Several recent newspaper articles have highlighted her despair at the prospect of leaving her young children of 4 and 8 without a Mum.

Katie now

Katie now

Katie and her family and friends are currently fundraising for Bowel Cancer UK and remarkably despite all that she is going though she is determined to raise awareness and is supporting our  Never Too Young campaign.

I so wish she didn’t have the personal insight about why this is so very important.

The skydive approaches…

So as I told my lovely friend, I’m OK about jumping out of a plane, despite the fact this is not in my job description and I am absolutely not doing this for ‘fun’.  I’m not an adrenalin junky, I’m not into heights and have no personal desire to put my life in the hands of another person whilst hurdling towards the earth and I’m particularly petrified of landing.  Skydiving has NO appeal to me whatsoever BUT if our amazing patient supporters show such determination to raise awareness and funds, how can I not also face my fears and join them.

So as I have said before, if this resonates with you, if this matters to you and you want to be part of ensuring that younger cancer patients have a bright future please support or join Laura, Katie and me.  Please help us raise awareness and funds so Bowel Cancer UK can continue to campaign for younger patients and further develop our information and support services for them.

Or just sponsor me. http://www.justgiving.com/deborah-alsina

You can also donate via Bowel Cancer UK’s website by following this link. 

Thank you in advance for your support.

If you are concerned about any aspect of bowel cancer, Bowel Cancer UK’s information and support line, staffed by specialist nurses can be reached on freephone: 0800 8 40 35 40 or you can email: support@bowelcanceruk.org.uk

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