Recently diagnosed - nhs moving slowly what to expect?

Thanks to anyone who can offer some insight

My mum (58) was falsely diagnosed with IBS by her GP and a couple months later ended up in the emergency room with crippling pain, an intestinal blockage, severe bloating they thought was ascites, sepsis, coffe ground bile by the buckets, bowels were malfunctioning and CT / MRI found a large adnexal mass. She was admitted for surgival evaluation and deteriorated quite quickly until they rushed her in to theatre middle of the night and gave her a stoma and took fluid and biopsies which led to her improving to the point after a lengthy stay in itu and ward where they let her discharge herself even though they wanted to her to stay. Her bowels seem to be working ok again (they were very surprised) so the stoma has allowed it to heal (mass remains)

11 days after the op and a few days before she asked to leave they told her that the mass is indeed cancerous but that it seems local (no secondary tumours) and that her various fluids they extracted from her lungs and stomach tested clear for cancer, she was told she would require an op to remove the mass and medicinal treatment (chemo).

The nhs was amazing up to this point she but since the cancer diagnosis they seem to have somewhat lost interest and urgency. She was told by a doctor to return to ward today to be admitted but after arrival we were told it was a mistake by a doctor who did not understand the MDT and she was just going to clinic for a discussion .... that meeting had apparently been cancelled anyway but noone informed her.

They then told us she has an appointment in 1 week with her consultant and she should have received a letter (no letter) so they can explain their decisions and results in more detail, they could not contact either the consultant or his secretary to find out any additional info. The doctor we saw basically had no information to give us at all, we asked if we should be concerned, if the cancer was aggressive and if waiting so long could cause any issues but the doctors refused to say anything and we asked if my mum would still be admitted for an operation (she is petrified and suffering extreme anxiety over this) the doctor just shrugged. It felt like a giant blow off to be honest like we were a nuisance for showing up when we were told to show up ....

My questions are ....

Is it a good sign that they are in no rush to remove the cancer / begin treatment? Does the nhs prioritize more dangerous cancers for treatment or later stage cancer that are more likely to spread (bad histologies?) or does it not matter?

Will the fact my mum wasnt referred by her GP work against her due to targets?

The 31 day wait time target for first treatment does it begin from when she was informed in hospital by the MDT team who came to see her that it was indeed cancerous mass or will the clock start ticking from when she eventually sees the consultant as an outpatient since they already cancelled once and added a week?

Is there any advice anyone can give? obviously we have read horror stories about people waiting months for cancer treatment to begin and if we got lucky (we think we did after the false IBS diagnosis) and the cancer has been caught before it has gone metastatic then we obviously want treatment asap.

We just do not know how to read what happened. They went from being attentive and wanting to keep her in ward to as soon as she discharged herself because she felt she would heal better at home (she has) to poor communication, cancelled appointments, delays and no answers to quite simple questions it was quite an eye opener.

Do people who have more experience of the NHS and cancer services think that the MDT is unconcerned by her cancer or is she just a victim of targets ?

Sorry for the essay the 180 has thrown us through a loop as it were and the confusion is very stressful to my mother,

 

 

  • Hi there, welcome to the forum and people who know what you are dealing with.   Our case is lung cancer, which took months to diagnose and some consultants with no bed side manner at all.  From the date you are diagnosed with cancer there is a time limit to be treated for chemo.  We were waiting for a visit and cancer chat to the chemo ward when they rang the same morning asking if we would have the chemo that day as they had gone beyond the time scale set and would be fined by the people in charge.  This was not our fault but like your Mum delays had occurred that we hadn't contributed to.  Forms lost,  signatures missing and other delays.  However once chemo began we were looked after.  She will have Mc Millan nurses allocated to her, they will talk to all of you, especially if Mum gives permission.   Telephone numbers direct to them are supplied, they help with forms and give advice as they will have her records.  So don't despair,  we've all been through it in some form, it's not helpful when it's your Mum but don't sit back and take it, fight on her behalf as she will be coping with a lot.  Good luck for the future.  Carol 

  • Thank you Carol and thanks for the warm welcome I am so glad I found this place, I am very confident they want to operate first to remove it so I cannot imagine chemo will be soon but it is nice to know they take the time limit seriously. She hasnt been anywhere near a cancer / chemo ward yet or seen an oncologist even though she was diagnosed almost 3 weeks ago when they cut her open... so far a pretty large team of various colo-rectal and lung docs who were brilliant until recently and kept pushing back meets.

    They seem to be fairly poorly organized, they couldnt even tell us where she was after the emergency operation and she was missing for hours but they saved her life and her recovery is going well. Just worried now about the NHS and bureacracy, we will indeed fight for her.

    thanks again

     

  • Hi sorry about your mum you must worried sick.if you feel that your mums not getting treatment.you can ring the mc.millen nurse helpline.theres also the marie currie nurse helpling you can get numbers from google .but theres a system in place at all hospitals called pals the patient liason service you can get number from the hospital they are independent and unbiased but carry a lot of weight .have a word with them and see what they say they can investigate for you and give you some answers . Regards p 

  • If I remember rightly it's six weeks from diagnosis and you shouldn't have to fight for it.  Once treatments start you will be on a roll and the Oncologist will keep in touch to see how it's going, so you will have appointments in between.   If radiotherapy is given that will all be organised as well by the Oncologist.   Ours was very good but they are only interested in treating you for the cancer.  Any problems in the meantime,  call the Mc Millan nurses or your GP as a back up.  Our GP has been marvellous , so speak to them if any problems arise.  You will also be allocated a ward number to ring if you are worried at any time during chemo.  Don't look for problems that aren't there, you will wear yourself out!!  Virtual hugs your way.  Carol 

  • Thanks I will look into it, its only been a few weeks since diagnosis so we will wait and see what the consultant says but the recent slackness and failing to inform us of changed appointments and that my mum wasnt going in has thrown us into a spin and made us wonder if it was good news ie they werent worried or a taste of things to come

    PALS I am googling it up now thanks for the info we have never heard of them before :)

  • Thanks again Carol we are still within the 6 week timeframe, today just concerned us cos the hospital is quite a trek and my mom is still weak. To arrive and be told it was all a mistake and not only that the appointment was cancelled too and noone had bothered to inform us was quite stressful and confusing ... that plus the doc who did explain it was cagey.

    Fingers crossed they do not cancel again and they will operate soon. Thanks again

  • I know it's stressful,  we got called back, not knowing what for, my husband is an amputee so not easy to park,  find the reception and get to room, it turned out they'd lost the signed papers we'd done previously, could we sign them again.  They obviously haven't heard of Royal Mail!  So not much consolation but it's happening to us all. Sometimes it's the straw that broke the camel's back.  Hopefully all will fall into place.  

  • Yes its not on realy . If you just give them a ring they may gee them up . Your mum deserves better treatment try to get a ds1500 form out of them entitles you to disabled parking badge and extra money but you will have to investigate that you should have been appointed a mc millan nurse who gives advice but you seem to be falling through the cracks best wishs .p

  • Hi Dean,

    I'm so sorry to read about your Mum's condition. I can relate to how slow the NHS can appear to be in moving from diagnosis to starting treatment as I've been through something similar with my Mum and with myself. Once treatment starts, time will seem to pass very quickly - it really is a roller-coaster ride.

    I'll try not to repeat what other people have said, except to say that you or your Mum would do well to keep in touch with the hospital until you are convinced that arrangements are in place and that appointments are being made and kept to. Don't be rude but ask as many questions as you need to until you are satisfied that things are on track. The waiting seems to take forever and we all worry about whether the damned thing is growing and spreading.

    The fact that your Mum wasn't referred by a GP initially will have no bearing on how long she will have to wait - the clock starts from the instant a referral is received and a referral from A&E is just as valid as a GP referral. There is a 62 day referral to first treatment target which applies to most cancer cases - this is for first treatment, not for diagnostic tests. The only time this is stopped is if the patient knocks back treatment - amazingly a lot of people delay things if they have holidays booked.

    After I had finished my own tests and scans I had a consultation with my surgeon during which my treatment options were discussed. Your Mum will not be told what has been decided, she will be asked which options she prefers. In my own case, surgery was ruled out because my cancer had grown around my aorta and I was referred to an oncologist who after discussion with me proposed a care plan and explained the risks and benefits offered by the treatment options open to me. I'm not a medic or anything, just a patient who has been through the process, but if surgery and chemo are offered there often needs to be a gap of around six weeks between any surgery and chemo to allow the surgical scars to heal as the chemo attacks fast growing cells and cannot tell the difference between cancer cells and cells which are growing rapidly as scar tissue helps mend the surgical incisions.

    Good luck!

    Dave

  • It really is a rollercoaster and we will take your advice and we will be calling the consultant to confirm the appointment, diagnostic tests are done so yea hopefully wont be too long to wait and the mdt put a plan and timetable together which they let us know about lol so she can choose a path

    Thank you everyone you guys are wonderfully knowledgable and friendly :) cheers Dave