brief guide: cancer specialists

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A woman in her early seventies who had a recurrence of her breast cancer was admitted to a London hospital for a second mastectomy, writes Celia Hall. Three hours before her surgery, she was sent home.

The hospital had booked too many operations and her breast cancer was given low priority. Devastated by the experience, she resolved to find someone more sympathetic to treat her close to her home in Worthing, West Sussex. She had no idea where to start, and her GP was also uncertain about how to refer her to a "specialist" cancer centre outside his usual referral habits. She tried to obtain the names of specialists, but failed. Finally, her daughter phoned a friend who was a hospital consultant. He suggested some names, discreetly. This happened five years ago, causing great distress to the woman and her family.

From now on, however, patients who have been diagnosed with cancer can help themselves with the first guide to cancer specialists, launched last week.

It is not yet the complete answer, since it lists only physicians, not surgeons. However, it gives patients who have a cancer an opportunity to take back a little of the control over their lives that disease removes from them.

The Directory of Cancer Specialists is set out geographically. It lists 55 specialist cancer centres and more than 400 cancer specialists, noting their areas of particular expertise, throughout the UK.

Directing patients towards these doctors does not guarantee a cure, but it does improve the odds of obtaining the most appropriate treatment available at the hands of medical men and women who are dedicated to treating cancer.

This is important. There is plenty of evidence that cancer specialists do get better results. Currently, fewer than 50 per cent of patients are referred to a cancer specialist. The Department of Health has taken this on board and instigated a three-tier system for cancer units and centres to raise and unify standards. This will take time to put in place.

In the meantime, the guide may help. It suggests that patients use it in this way: "Patients with a diagnosis of cancer who want a referral can, and should, ask support from their GPs to obtain this. They can also ask their current hospital specialist for a consultation with, or a referral to, a cancer specialist."

Given the new climate, which encourages treatment by cancer specialists, such requests should not be seen by doctors as unreasonable.

The guide is the brainchild of Becky Miles, herself a cancer patient who founded the National Cancer Alliance, which has published it. The alliance is a small but powerful group bringing together patients, relatives, cancer specialists - many of them eminent - nurses, GPs, therapists and other professionals dedicated to improving treatment.

Ms Miles says: "Patients assume they are automatically referred to the most appropriate experts. Often they are not. We hope the guide will help them to identifyhe most appropriate specialist."

'The Directory of Cancer Specialists' is available from National Cancer Alliance, PO Box 579, Oxford, Oxon OX41LB for pounds 5 (plus 70p for p&p).

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