Woman DENIED breast reconstruction after cancer due to funding cuts.

[HelenaDove]

inews.co.uk/news/mum-denied-breast-reconstruction-nhs-cancer-mastectomy-funding-cuts/?utm_source=fb&utm_medium=fb&utm_campaign=ijp&fbclid=IwAR2SK1n5MW35jGdA4cT9g1XwPA3tw2POnqhW3O3v0Z3Poo8bmjtoLkCI4DM

and some of the comments on the fb page are fucking disgusting misogyny.

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.

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.

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.

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

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?

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.

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.

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.

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)

From print media about multiple scelerosis

"MS is most commonly diagnosed in people in their twenties or thirties and it affects three times as many WOMEN as men.

One of the big breakthroughs has been DMDs (disease modifying drugs) For people with relapsing remitting MS these can mean fewer less severe relapses and can reduce the damage that MS does to nerves. One of the newest ocrelizumab
is also the first licensed treatment in the UK for primary progressive MS. Its not currently available for that purpose on the NHS. There is a funding row going on. But clinical trials show it could give people an extra seven years before they need to use a wheelchair. "

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!

YY @Smotheroffive.

As a woman who lives locally its good to know where i stand if (God forbid) i should get ill. Now my choices would be informed!

And i wonder how different the responses would have been if she was in her twenties rather than her fifties.

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

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

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

I don't understand how this has even been linked to the trans issue.

This lady had her mastectomy and chemo (so no issue caused by any trans men wanting mastectomies).

The waiting list has been closed because of the large number of women needing this post mastectomy reconstruction (again no issue with trans women or men).

The issue is lack if funding and post code lottery within the NHS surely?

I don't understand how this has even been linked to the trans issue.

I explained this. It has been linked due to the relevence of increasing demand on limited resources.

Feeling a bit ignorant, but IVF for transwomen?

No, provision of available fertility treatments in toto.

There's cosmetic and there's cosmetic.

As PP stated, addressing a big hole in your face would be "cosmetic".

In the case of breast cancer, it's not about changing something that has always been to something they would prefer,
But returning something to the state it was before massive surgery.

That's not quite the same.

There is also the fact that rightly or wrongly, womens breasts are heavily sort of focussed on in our culture, they are seen as signifying a lot of things, and women report feeling really very much not themselves, not right, not whole when one or both are removed.

There's also being lopsided which must be a very unpleasant sesntation especially if you have larger breasts.

It would not really be publically acceptable to go out with one breast visibily missing > so there's time and ?money involved + the reminder of it all every time you get dressed.

Women's confidence, mental health can suffer also their relationships etc

In short it's not trivial at all and the oh it's only a tit it's pretty trivial type attitiude I think is maybe a bit misogynistic.

A child has bad squint, corrected on NHS, deemed cosmetic. But if it's not done, a massive effect on their whole life.
A person who has a realistic prosthetic instead of a very obvious one. Cosmetic.
A person who loses an ear in a fight. Cosmetic.
A person who has facial deformity treated. Cosmetic.

etc etc etc

I tihnk because it's breasts and women, it's easy for poeple to see it as vain, fundamentally because society is fucked up about womens breasts really.

The trans thing is not to say that this women didn't get her treatment becasue of transpeople.

But to make a passing comment that there was a complaint / action by some trans people who were not happy that mastectomies for transmen were prioritised lower than ones for cancer.

If people are talking priorities (including those saying this womans reconstruction should not be a priorty) then I suppose it's related if not 100% relevant.

I explained this. It has been linked due to the relevence of increasing demand on limited resources.

Please link to the evidence that shows that this woman's surgery has been delayed because of trans men?

There is also the fact that rightly or wrongly, womens breasts are heavily sort of focussed on in our culture, they are seen as signifying a lot of things, and women report feeling really very much not themselves, not right, not whole when one or both are removed.

There was a very interesting segment on Woman's Hour recently interviewing a woman who chose not to have reconstruction or wear a prosthesis. She described the considerable barriers & pressures she experiences:

"Melanie Brown refuses to hide her mastectomy. She asks why society, and bra makers, still struggle to accept or cater for women who have one healthy breast and don’t want reconstruction or to wear a prosthetic. Melanie doesn’t want to pretend she hasn’t had a mastectomy and wonders why, when so many millions of women go through this, it is something she is expected to disguise."
www.bbc.co.uk/programmes/m0001xpc

see also Woman's Hour 4/1/2018
"Consultant Plastic & Reconstructive Surgeon Ruth Waters is a specialist in a complex type of breast reconstruction - the DIEP flap procedure, which takes tissue from a woman's stomach to reconstruct her breast after a mastectomy. So how can tummy fat be used in this way? Jenni is joined by Ruth to discuss the operation, other options available and the pros and cons of having reconstructive surgery immediately."
www.bbc.co.uk/programmes/b09k0nk3

Ruth Waters:
www.dailymail.co.uk/health/article-5227429/Why-women-denied-breast-reconstruction.html

I don't know if it has been delayed.

The trans people who were complaining wanted it to be delayed.

It's a different point.

People thought it was quite astounding that they wanted women with cancer pushed down the queue .

Excuse me,but I wasn't referring to a pimple I was referring to taking out the side of your face and possibly eye socket leaving a massive hole, this would mean you couldnt eat, lost teeth, cheek, etc. due to cancer.

So, no, in the same category as breast cancer.

It is multilating and very traumatic to be left that way, apart from the dysfunction.

It can hit very hard at the heart of ones sense of gender, and I would think that all trans people can understand that very easily.

Weetabixandshreddies

I am not required to manage your lack of understanding.
I have responded in good faith to both your misunderstanding of the article re NHS trusts and the reason for my posts.

If you don't understand, that's not my responsibilty.