Woman DENIED breast reconstruction after cancer due to funding cuts.

Feeling a bit ignorant, but IVF for transwomen? Is that a thing? How is that possible? Or have I misread?

Janie143
The protocols I am referring to are clearly with regards fertility treatments.
What's your point?

These 'gold standard' NICE protocol guidelines have being used for the basis of TRAs challenge to the NHS to provide comparable treament for people who identify as transgender:. So comparable treatment for transwomen wanting breasts, IVF etc is none

If cancer left a huge hole in someone's face, which happens also, part of the treatment is to reconstruct surely...if it took away an arm, prosthetics would be part of 'the treatment'.

NHS has varying approaches on prioritising (postcode lottery), but I don't think it can be downplayed because its a breast, it is horrifically mutilating for a woman to go through, think losing testicles for men, but they have prosthetics done [as part of the procedure?].

To have any part of your body mutilated in this way can be deeply traumatising,even having reconstruction surgery, still knowing its not your breast, but its infinitely better than none!

It is important to recognise that in this case, Alison Goulding was told by her surgeon that the reconstructive surgery was a possible option and the importance knowing this played as she dealt with the gruelling cancer treatments:

(extract)
"The only alternative option was a DIEP Flap reconstruction, which involves taking muscle, fat and skin from the abdomen and using it to form a new breast. This, Alison’s surgeon explained would be a much bigger operation, with a longer recovery period, but would be less risky and greatly reduce the risk of her needing further surgery.

Reassured, the shop-worker from Essex underwent her mastectomy in May 2018. “I remember looking down and seeing a dip where my left breast used to be. I felt sad but kept reminding myself of the bigger picture, and that I wouldn’t always look that way.”

Chemotherapy hell
Four weeks later Alison began chemotherapy – which she describes as the worst experience of her life. “I’m quite a strong person and usually just get on with things,” she said. “But this was just awful. It was like death, that’s the only way I can describe it. “I had six sessions of chemotherapy every three weeks, and it really took its toll on me. I was in bed for four days straight each time and couldn’t do anything. “My daughters and friends were wonderful and helped with the cleaning, cooking and brought me cups of tea and kept me company. I don’t know what I’d have done without them.”

During her treatment, Alison also developed an agonising deep vein thrombosis and blood clots in her arm and jugular vein. Her husband, Roy, had to give her injections in her stomach every day for three months to break the clots down. And despite wearing a special cap during chemotherapy, her hair fell out too. “It came out in clumps in August and, while I didn’t think it would bother me that much, it did. It’s hard losing your hair as a woman. It feels like losing a bit of your femininity.”

Next came a three-week course of radiotherapy, after which Alison was ready for reconstructive surgery. “I couldn’t wait to have it,” she said. “I’d had to wear a prosthetic breast in my bra which was so uncomfortable and didn’t look good. After going through so much I just wanted to feel and look normal again.” (continues)

It is effectively a cosmetic procedure, and while I am sympathetic to women who are posy cancer treatment and would like this surgery, I can rationally see that funds are not infinite and there has to be some rationing.

And that rationing needs to be open and fair.

Not all cosmetic surgery is the same. The nhs has a duty to provide for people's mental as well as physical health.

I think maybe it's you who is twisting things

No I'm not.
Please don't make unsubstantiated allegations.

I've linked to a previous thread and discussion about how surgeries for various types of breast surgery are under pressure due to limited resources and increasing demand.

This is how I post.

Please don't start twisting things here.
The waiting lists for mastectomies are long for a number of complex reasons.

One would presume that any right thinking person would think operations for breast cancer should be a priority.
I think maybe it's you who is twisting things. This lady is waiting for reconstructive surgery, not surgery for breast cancer.

I think it's terrible that we have long waiting lists. Whatever the treatment, every name on that list is a person with a need.

As we do have them though, I don't think anyone can say that this type of surgery should get priority over life saving surgery.

There are two issues here:
Firstky the postcode lottery system we all exist under, whereby local ccgs can find or not fund treatment, instead of nationally agreed rules. This is fundamentally unfair on patients.

The second issue is whether reconstructive surgery should be funded at all.
It is effectively a cosmetic procedure, and while I am sympathetic to women who are posy cancer treatment and would like this surgery, I can rationally see that funds are not infinite and there has to be some rationing.
The NHS cannot afford everything the public would like.
We need to start thinking about the NHS being a needs based service not a wants led service.
As someone else has said what gets cut to provide the funding for reconstructive surgery?

People with Cancer don’t always qualify for free IVF in all trusts either (despite NICE guidelines) - though the freezing of gametes can be offered. You need to draw the line somewhere.

The NICE guidelines for fertility treatments for people diagnosed with cancer are as Cherries says a 'postcode lottery' as well as being differently offered by oncology teams for many reasons including sex.

These 'gold standard' NICE protocol guidelines have being used for the basis of TRAs challenge to the NHS to provide comparable treament for people who identify as transgender:

31/12/2018 BBC segment about fertility services for people who identify as transgender:
www.mumsnet.com/Talk/womens_rights/3465629-the-bbc-have-just-peak-transed-the-nation

August 2018
www.mumsnet.com/Talk/womens_rights/3326933-NHS-told-give-trans-patients-equal-access-to-fertility-service

www.mumsnet.com/Talk/womens_rights/3333708-NHS-faces-lawsuit-for-not-funding-fertility-services-for-transgenders-who-want-kids

Yes of course this surgery is important but what should it take priority over? Life saving surgery or treatments?

The nhs isn't just about emergency and life saving surgery, the nhs funds dentistry and IVF too.

Part of the problem is the inequalities across the country, as arranbubonicplague mentioned. It's unfair that we are all expected to contribute to a service, yet it's down to luck whether many treatments are available in an area or not.

The nhs is never going to be able to pay for everything everyone wants and needs, but it can be fair and offer the same quality and services to everyone.

Honestly, I think as it’s not a life saving op, it can wait. People with Cancer don’t always qualify for free IVF in all trusts either (despite NICE guidelines) - though the freezing of gametes can be offered. You need to draw the line somewhere.

Is that why the waiting lists have been closed then? Because of transmen requesting mastectomies?

Weetabixandshreddies
Please don't start twisting things here.
The waiting lists for mastectomies are long for a number of complex reasons.

One would presume that any right thinking person would think operations for breast cancer should be a priority.

That there was protest by TRAs is a matter of record.

Yes of course this surgery is important but what should it take priority over? Life saving surgery or treatments?

I have a friend sitting in a hospital bed waiting for a decision about funding for life saving treatment. Why should people like her not be the top priority? Not everyone can be a priority.

The NHS has limited finances and resources and tough decisions have to be made.

LAst year there were protests by TRAs that elective mastectomies by transmen were being delayed due to women needing surgery following cancer diagnosis:

Is that why the waiting lists have been closed then? Because of transmen requesting mastectomies?

The postcode lottery for the NHS has been a problem since the outset but it's becoming more egregious because of the sophistication of treatment that is readily available to some but not others. It's been exacerbated recently by CCGs and their own localised priorities and funding problems.

My cognitive dissonance is that I'm a staunch supporter of the idea of the NHS and think that overall it's a more equitable and relatively affordable health care system than most but I'm horribly aware of the gross disparities that people encounter despite paying comparable amounts into the system.

LAst year there were protests by TRAs that elective mastectomies by transmen were being delayed due to women needing surgery following cancer diagnosis:

September 2018:
www.mumsnet.com/Talk/am_i_being_unreasonable/3368777-To-think-that-in-the-current-dire-state-of-the-NHS-finances-its-a-no-brainer-that-first-priority-for-mastectomies-goes-to-cancer-patients

CCG’s are trying to save money and describing treatments as cosmetic when they are actually reconstructive. This stance has been applied to other reconstructive procedures that don’t only affect woman but it is disgraceful

I agree.

You can always contribute to her fundraiser if you’d be willing to pay extra tax to fund these kinds of procedures.

Women needing breast reconstructions after cancer should be the top priority. I wonder why they're evidently not?

What exactly would you prioritise funding this over? Treating patients with active cancer? A&E services? Mental health services? Treating broken bones? Immunising children?

I don’t think this should be a priority, and I also wouldn’t prioritise extra funding for this kind of treatment over funding schools or police or rubbish collections.

It is a simple fact of life that there are limited funds for public services and I don’t think this is a priority. Whilst i’m sure there is wasted funding which could be reallocated, there are other places i’d reallocate extra money first before this.

Saying it should be a priority is meaningless unless you can say exactly where you’d take the money from.

CCG’s are trying to save money and describing treatments as cosmetic when they are actually reconstructive. This stance has been applied to other reconstructive procedures that don’t only affect woman but it is disgraceful

Many people are referred for cancer treatment at larger centres.

Err, do you know Queens hospital? A failing hospital and certainly not a large centre that anyone would want to be referred to.

Pythagonal I had a similar distance to travel and all my oncology treatment was in a different NHS trust.

It is very common.