"The care of my close friend following a breast cancer diagnosis"

It is almost 3 months since my close friend had a diagnosis of breast cancer and has been awaiting surgery. The staff that have dealt with her have been caring & professional (I have accompanied her to some of these appointments so can speak first hand in addition to observing & trying to be supportive of the impact) 

However the management of my friend’s case has caused her unnecessary stress & anxiety on top of the fear & uncertainty a cancer diagnosis brings.

My friend has just been told, by letter, that the second surgeon she had been allocated, formed a trusting relationship with and agreed a way forward with has been replaced, without warning, with a surgeon (no. 3) she has not met and importantly, has not met her.

Prior to this my friend had already had to contend with being prepared for theatre (gowned & hat) when it was decided they could not take her, as information regarding previous chemotherapy was not recorded. I was there & heard this discussed at the pre-op assessment visit so am unclear why this occurred . Of greater concern was a member of staff trying to convince my friend that the planned surgery, part of which was aesthetic, was unnecessary and the outcome of which was something that would hardly be noticed. 

I feel that this discussion surely overstepped their remit, certainly surpassed their skill-set, took place at a time when the patient was particularly vulnerable and paid no cognisance to the shared decision-making between patient & surgeon which had already been undertaken.

There have been numerous occasions (>5) when a promised update phone call from healthcare professionals has not transpired, twice on a Friday, leaving mounting fear & uncertainty going into another weekend. I feel that the rationale of telling a patient with cancer, waiting for an operation date, they will be phoned and not carrying this through, sometimes because there is no news, is both unkind and apparently thoughtless in addition to being unprofessional & causing unnecessary suffering (terminology I do not use lightly). No news is not good news when you are convinced the tumour is growing and you have been told you’ll be called with a theatre date, when the call that has dominated every waking moment doesn’t come, when you have shelved everything so you could speak. Surely the fear and stress this provoked is anticipated?

The current focus on patient-centred care and cancer prehabilitation is ironic as my friend’s preparation for surgery could hardly have been more torturous and stress-provoking and is certainly far from ideal.

I sincerely hope these circumstances will be reviewed and I look forward to your reply.