WEDNESDAY 21 JUNE 2000

MS CATHY POPE

  592. May I now call our penultimate witness, Ms Cathy Pope.

  (Ms Pope) Good afternoon. My name is Cathy Pope. I am a 46-year-old patient from Liverpool. In 1995 I was mugged by a group of youths at a petrol station. My nose was smashed and required a cartilage graft from my ears to rebuild it. It was only during my recovery that I mentioned to the surgical team about a flap of skin in the floor of my mouth. This turned out to be cancer. In 1998 I had the floor of my mouth, jaw and neck glands removed in a 12-hour operation. The surgeons rebuilt my mouth, jaw and neck glands using a living graft from my leg. I then had a course of radiotherapy, which lasted for seven weeks. Thankfully I am cured, but I have been told that if the cancer had been left for a few weeks more it would have been inoperable. In 1998 3,400 new cases were diagnosed. I was one of those cases and as such I am lucky: 1,600 patients died and this is unacceptable. This leads me to my first point: patient education and early diagnosis. Head and neck cancers are an area of growing concern with the incidence increasing year on year. It is now the fifteenth commonest cancer in this country and is as common as cervical cancer. Yet, incredibly, there is no screening programme and little education. The sharpest increase seems to be in younger patients, especially females. Like my cancer, the symptoms are quite subtle and unfortunately over 40 per cent of patients present at the initial appointment already at stage four of the disease. If we screen patients for cervical cancer, why do we not do the same for head and neck cancer patients? The mouth is so easy to access and examine with none of the taboos associated with cervical cancer screening. We need to raise awareness amongst patients, doctors and allied health professionals who can all help by promoting regular oral examinations. Oral cancer is smoking and alcohol related. There is a need for a national education strategy, in particular targeting patients who are both heavy smokers and drinkers. When I go to my GP there are several pamphlets on other cancers, for example cervical, breast and prostate, but nothing on head and neck cancer. I have found in my wide discussions with patients and support groups that there is an overwhelming ignorance as to the dangers of smoking and drinking. In addition, strange as it may seem, even nuns can present with this most cruel of cancers. Rehabilitation is part of the cancer journey. Rehabilitation and reintegration into society is important to all cancer sufferers. My type of cancer is particularly cruel but thanks to the wonders of modem microvascular free tissue transfer techniques, I have been rebuilt. You can see that for yourselves. My scarring is minimal and unless you knew of my medical history, you would have no perception of what has gone on. Fortunately I am luckier than most, as I was diagnosed and treated in one of the best centres in the UK and I have retained my ability to speak. Also the surgeons have placed titanium implants into my new jaw so that I can eat, though this still remains a daily challenge and I am still fed through a tube in my stomach. Rehabilitation involves a large multidisciplinary team, which includes oncologists, speech therapist, physiotherapists, counsellors, dieticians. Such intensive resources make it essential that patients are treated in a limited number of centres of excellence. From personal experience, if you have cancer, you are prepared to travel anywhere to get the best treatment and aftercare. Without this form of rehabilitation I should have been a social outcast and it is not difficult to imagine why, in the not so distant past, suicides amongst head and neck cancer patients were not uncommon. Even in the well-established maxillofacial cancer centres rehabilitation is delayed because of lack of funding. I appreciate that it is expensive but I feel very strongly that without this expertise being available to every patient, the cancer journey can become a never-ending nightmare. The funding for research is my third and final point. I should like to bring your attention to the lack of funding for head and neck cancer research. Compared to America where cancer research is government funded, a relatively small amount of government money is spent on cancer research in the UK. It is mainly funded by charitable donations. It also appears that there is a North/South divide when funding research. This is particularly strange when one considers that the incidence of oral cancer in the North is around twice that of the South. More money should be allocated to head and neck cancer research and this should be targeted to cancer black spots. To gain further understanding of this most disfiguring of cancers, we need not only a limited number of regional cancer centres, but also a national supra-regional centre of excellence in England, Wales, Scotland and Northern Ireland with one correlated national centre where all the data can be collected. I have an invitation for you. In summary, I hope to speak for all oral cancer sufferers. I know the Committee is visiting Christie's in Manchester. I urge you to travel a few extra miles down the M62 and visit the University Hospital Aintree so that you may witness at first hand the innovative structure of this unit and use it as a benchmark for cancer services nationally.

  Chairman: Thank you very much indeed. You have presented so well. We shall bear your invitation in mind but may I say you are a marvellous example of the courage that so many cancer patients have. Thank you for coming to speak to us this afternoon.