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Breast cancer is prominent in Dinah's thoughts – and her daughter ruins a much-needed tipple


Meeting with practice manager. Someone's suggested getting a group together for breast cancer fundraising – is it appropriate for the patients' forum? Don't see why not; front desk is littered with collecting boxes for various charities and nobody seems to mind.

Not sure breast cancer is the one – shouldn't we support something less well-publicised?It's not that I don't suit pink, honestly (which brings us to the new staff uniforms, but discussion postponed until I'm feeling less stingy).


Surgery. Final patient is a woman I haven't seen for years, thought she'd moved away. Last time she came about her breast lump; I referred her urgently as I'd suspected a malignancy. She didn't turn up for the appointment and saw me only once more, to say she believed she had cancer but wanted to fight it 'naturally'.

Then she disappeared despite phone calls, letters and attempts to visit her at home. Today she reports triumphantly that she was cured by 'light therapy' and enthusiastically shows me her breast as proof. There is a sickeningly large mass. I can't share her optimism.What is her aversion to medical care? I plead with her to let me help as she leaves but to no avail. She's made her choice, but how informed is it?


PCT. From the ridiculous to the sublime: funding requests for treatments under the 'exceptional cases' process.

Along with various alterations to unattractive body parts considered too large, small, floppy or protuberant, there is also a patient with terminal breast cancer who requests a trial of chemotherapy that falls outwith NICE guidance. More straws for the desperate to clutch at, and who can blame them? But the evidence is against her.Half day. Appointment with 'Sadie the Bra lady' for daughter. Never underestimate the benefits of good foundation garments, my mother told me.Never underestimate the costs either – these things require serious investment and you won't find them in Tesco. An hour later, after much groaning and straining and a garment so tight she is almost fainting, we stop for a cold drink. Mine's a small chardonnay. 'Mum, doesn't alcohol cause breast cancer?''Er...' (mindful of recent publications) 'it can increase the risk, yes.''Well why are you drinking it then?' There follows a long and difficult discussion about choice and lifestyle. But at least I know what I'm doing. I hope.

Dinah Roy is a GP in Spennymoor and chair of Sedgefield PBC group

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