Britain in 1965 was not a country that talked about cancer. Strange as it may seem in 2014, all the more so after the tragic death of Stephen Sutton – the teenager who made no bones about his terminal condition, spoke frankly about it on social media and inspired the country to give millions to charity – the disease was once of those things that was kept behind closed doors; muttered about in hushed euphemisms and rarely mentioned publicly.
So when one of the most recognisable men in Britain, the veteran broadcaster Richard Dimbleby, decided in October 1965 to go public with the fact that he was suffering from it, the announcement stunned the country.
“The newspapers, when he said: ‘I have got cancer’, responded with front-page stories,” says his son Jonathan Dimbleby, himself now a veteran broadcaster. “A lot of them said this is an extraordinary breakthrough, because cancer really was taboo then. It was not something you discussed. It often didn’t go on to a death certificate, rather like HIV later in the century.”
The reasons for the taboo are complex, but were in part because people were “terrified”, Dimbleby believes. “There was also a vague association with the idea that the sins of the fathers are visited on the sons; that there was some punishment involved with cancer. People understood it very little and it was treated as a secret. He broke the taboo and, I think, was the first public figure to do so. It had great impact.”
Dimbleby was 21 when his father died from testicular cancer later that year. Had he seen how openly the disease is now discussed in British public life, his dad would have marvelled at how far the country had come – and “unquestionably”, he would have admired and been moved by the life of Mr Sutton, says the 69-year-old.
“He was embarrassed by the fact of having testicular cancer and he took a long time to go and see his doctor, with the result that the cancer had spread,” Dimbleby says.
If he had gone sooner, there is a good chance he would have survived. Our increasing openness about cancer; the fact that it encourages more people to know and understand the symptoms and not to feel ashamed is, in Dimbleby’s eyes, an “entirely positive” phenomenon.
In the years after Richard Dimbleby’s death, the family established a cancer charity in his name. Dimbleby Cancer Care is still funding research and supporting NHS care to this day. Jonathan is its chairman and his older brother David is president.
In the 50 years since then, not only has the cancer taboo begun to break down, but huge leaps have been made in the treatment of cancer.
This year – for the first time – Cancer Research UK has predicted that half of all people diagnosed with the diease today will survive.
Treatment, Dimbleby says, is “light years better” than that which his father received.
“The research is producing better and better results. Those who deliver the care here, I think, are as good as any in the world. The researchers, the clinicians and the specialist nursing care is as good as anything.” But Britain still lags behind many similarly wealthy nations in its cancer survival rates. For many common cancers – of the lung, colon, stomach and ovary – we are below the European average. Most experts believe that the reason is late diagnosis.
The responsibility for that, Dimbleby believes, must be partly shouldered by GPs.
“Some GPs are extraordinarily sensitised; keep themselves very well informed; work around the clock to make sure they’re delivering a fantastic service – they’re worth every penny of their £100,000,” he said. “Others, I’m afraid – and I have come across them – are too casual; don’t bother to keep up to date with latest information and tend towards a hearty, robust, ‘You’ll be alright, mate’ attitude. They are a liability.”
Patients, he says, should be more willing to seek assurance, even about innocuous-seeming symptoms – a persistent sore throat, constipation or diarrhoea – that might point to an underlying cancer.
“I think if I had to choose between a little bit of hypochondria which means you’re safe and an ebullient disregard and death, it’s quite an easy choice for me,” he said. “There will be people that [visit their GP] on a repetitive basis, but part of me says that’s the name of the GP’s game.”
As for his own health, he verges “toward the hypochondriac end of the spectrum”.
“I take my blood pressure pills, I take exercise, I walk, I play tennis,” he says, and his young family (he has two children with his second wife, the publicist Jessica Ray, whom he married in 2007) keep him running “up and down stairs all the time”.
He also watches his diet and has noticed the impact on his general wellbeing of losing six pounds in recent months – and with one in every 20 cancers linked to being overweight or obese, he is unflinching in his diagnosis for further reducing the UK’s cancer rates – cigarette packet-style health warnings on sugary and fatty food.
“What do we do with smoking? We say: ‘Smoking kills you’. Why don’t we say: ‘Too much fat kills you’, ‘too much sugar kills you’? Perhaps that is a bit extreme, but why not ‘this is a high-fat product’, ‘this is a high-sugar product’? That’s what we need: health warnings on food. I don’t see why not.
“We have more than 50 per cent of the adult population overweight or obese – this is devastating for cancers, for heart disease, for diabetes. It makes you shake your head in frustration. The Government, he says, is guilty of “pussyfooting” around the food industry and needs to take a “much tougher line”.
His family’s own commitment to cancer patients is unwavering.
A fortnight ago he and David were present as the foundation stone was laid for a new cancer centre at Guy’s Hospital in London, supported by a £2m grant from their charity, raised entirely from public donations.
The Dimbleby Cancer Care (dimblebycancercare.org) facility in the new centre will be the home for the practical and psychological support services that the charity specialises in. It was their father’s own experience of cancer care in the 1960s which led to the focus on supportive therapies. “At that time, in hospitals there was very little – if any – supportive care of any kind,” Dimbleby recalls.
Diagnosed five years before he died, in the intervening years his father received radiotherapy treatment in the “subterranean dungeon” that was, in those days, the basement ward at St Thomas’ Hospital, often leaving to present Panorama the same evening.
“My father was extraordinarily stalwart in his last days... but he did complain how uncomfortable hospital pillows were,” Dimbleby remembers.
“That set in train an idea: that there must be something done to alleviate the unpleasantness of being very ill. We pioneered, or at least we were the agents by funding, ways of helping patients. Things like complementary therapies; psychological support therapies which were regarded as bizarre at the time and are now totally embraced by the NHS.”
The charity’s new facility at Guy’s, fittingly, will also provide specially designed pillows.
“Right as you walk in, Dimbleby Cancer Care is going to have its centre,” he says with a glimmer of pride.
“That’s part of an absolute commitment to the belief that support services which we provide are essential services, as important as anything we provide clinically – a sign of how far we’ve moved on.”