They told me it wasn't cancer

A lump

A characteristic bit of provocative shit-stirring from the BBC under the alarming headline, "they told me is wasn't cancer". I take a deep breath before reading BBC articles like this for they always start with some GP bashing along the lines of "I went to my GP eight times before he noticed my broken leg...". This article starts:

Richard, now 21, waited 10 months before doctors correctly diagnosed him as suffering from Hodgkin lymphoma, affecting the lymph nodes in his neck. Swollen lymph gland in the neck. A lump can be an early sign of cancer. He had first noticed a lump in March 2007, after a rugby accident in which he had broken his leg. Richard assumed it was a muscle tear, but when it had not disappeared by early July, he went to his GP. His doctor acted swiftly, and referred him for an ultrasound, which showed abnormalities. But he was sent to see an ear, nose and throat specialist - rather than a cancer specialist - at a general hospital and the tests he was given would not have been able to spot a tumour. He was eventually given the diagnosis of Hodgkin lymphoma in January this year. (BBC)

Strewth! The BBC has found the one competent GP in the country. He did some prompt and appropriate investigations. And don't you love the way the BBC tells us that "a lump can be an early sign of cancer". I must write that in my new fact book.

ENT surgeons are cancer experts. You may think they spend all their time taking out tonsils and doing nose jobs but in fact ENT tumours are the most important part of their work. The diagnosis of lymphomas is not as straight forward as the BBC implies. I don't know exactly what happened in this case to explain the apparent delay in diagnosis. The BBC must be sure of their ground as it would not be difficult to identify the surgeon involved. Whatever happened, it was perfectly reasonable for an ENT specialist to see a patient with a lump in the neck.

The much vaunted "cancer doctors" are not primarily involved in cancer diagnosis. They see patients after the cancer has been diagnosed and usually after the surgeons have done their bit. Their particular skills are in staging and treating cancers.

And then more guff from the BBC with the usual ludicrously up beat trivialisation of Hodgkin's Disease. Modern treatment has improved the prognosis of Hodgkin's Disease enormously but it is not "easy" to "cure"

Dr. Mitchell Smith, director of lymphoma service at the Fox Chase Cancer Center in Philadelphia.

"In a favourable group, you get close to 95 percent five-year survival with the right treatment," Smith said. "In the unfavourable group, it is close to 80 percent. Very few people relapse after five years."

Most people with Hodgkin's Lymphoma are young. Early diagnosis is important. But oncologists (cancer doctors) have a different framework of reference when it comes to prognosis. Teenagers do not like to talk of "5 year survival rates" and whilst a "5 year survival rate" of 80% may be wonderful in the oncology world, it is not good news for a teenager. I have had a number of patients over the years with Hodgkin's Disease. All were promptly diagnosed and all bar one are still alive. Managing the one who died was made particularly difficult as, from the outset, both she and her parents had more or less been guaranteed a cure.