Monday, 24 July 2017

Less Survivable Cancers

When I ran the London Marathon in 2015 I asked friends and family to donate to  Core – the Digestive Disorders Foundation, a cancer research charity that focuses on cancers of the digestive system including stomach cancer which my dad, Dugald Orr, died from. Thanks to everyone who donated we raised over £900 (see previous post about  my dad and my reasons for this choice).

 I was pleased to hear from the charity again recently - they told me that they sometimes use a picture of me and my dad in their presentations which was touching. Last week they invited me to the London launch of a new campaign called the Less Survivable Cancers Taskforce  which they have started with a group of other charities concerned with lung, liver, oesophageal, brain, pancreatic and stomach cancer, which make up half of cancer deaths in the UK. A cancer diagnosis is devastating for anybody, but for those with these cancers the prognosis is particularly poor. They have just a 14% chance of surviving for more than 5 years, compared with 64% for more survivable cancers.

My dad's death in 1997 at the age of 61 came at the end of a period of more than six months of lost opportunities to diagnose his stomach cancer. When he started losing weight and having eating problems he was already in the system for arthritis and his symptoms were initially viewed through the lens of the rheumatology specialists he was seeing at the hospital. He then had an operation for a benign tumour on his thyroid and it wasn't until after this that he was finally given an endoscopy and diagnosed. Within a few weeks he had died -  too weak to cope well with surgery, he never fully recovered consciousness after an operation.

Nobody lives forever, and with the present stage of medical knowledge a magic bullet cure for all cancers might not be on the immediate horizon. But with timely diagnosis and treatment I'm sure my dad could have lasted a few more years, time at least to have met all his grandchildren for instance.

As I head  towards that age myself I find it depressing that in respect of these less survivable cancers there seems to have been relatively little progress in the 20 years since. Hence the need for the Taskforce with its five objectives:

1. Raise awareness of symptoms
2. Speed up paths to treatments
3. Remove barriers to treatment trials
4. Set government backed survival targets for each cancer
5. Increase investments in research

The Taskforce launch was held at Westminster's Portcullis House on Wednesday and featured contributions from people affected by these cancers whether as survivors or as relatives of those who didn't survive. The campaign seems to have some political support, such as through the All Party Parliamentary Group on Cancer, and with clear and achievable aims there is no reason why it shouldn't make an impact.

But improvements for people with cancer cannot be achieved in isolation from the state of health services more generally. If early diagnosis and treatment is a key factor in survival rates, then getting into the system quickly is essential. At present many people seem to be struggling to get to the first hurdle - getting a GP appointment - let alone getting referred on to appropriate specialists.

Here's a few comments from a facebook discussion last week about trying to get an appointment at my local GP practice in South London:

'I've tried every day this week and been variously: cut off after ten minutes on hold (twice); left on hold for an hour; unable to get through at all; getting a "the surgery is now closed" message for a whole day'.

 'I needed an appointment the next one is 26th august I was told Monday' [17 July]

'Few months back I couldn't get an appointment and the receptionist was asking all kinds of intrusive questions. I was in a bad situation and paid to see private at work and I needed to go to hospital for a scan... Even though I answered and told the receptionist I had lumps in my breasts she still wouldn't book me in!' 

'have just spent 38 minutes on hold again. Got through eventually and was told they are only taking emergency appointments. They could offer me a telephone appointment in 3 weeks (when I'm on holiday)...  Almost cried with frustration'.

I wish this was just a local problem at my doctors, but talking to other people this doesn't sound untypical - overwhelmed admin. staff rationing limited appointments. Knowing how hard it can be for many people to acknowledge their symptoms and seek help, anything that deters them from seeing a doctor can only reduce their chances of survival if they are unfortunate enough to be suffering from one of the less survivable cancers.

Primary care needs resources so that people can see their GP - not just money, but a supply of suitably trained and rewarded staff at all levels from receptionists to doctors. Around one in eight GP posts are vacant, and there is a national recruitment crisis: 'Almost one in five practices has had to abandon searching for a new GP as vacancy rates have hit their highest ever' (Pulse, 12 May 2017)

But I would also like to see more self-referral to cancer screening services, with more active surveillance for people at risk. One of the speakers at last week's event put his survival down to the fact that he was on a programme where he was having an endoscopy every six months, so his condition was picked up early. I fear that many, just like my dad 20 years ago, never get near such a procedure until their symptoms are too severe to treat.

Sunday, 16 July 2017

Dulwich Midsummer Relays 2017

52 teams of three took part in the Dulwich Runners Midsummer Relays on July 12th 2017, held for the second year in Dulwich Park. In previous years the club organised a midsummer 5k - I ran it in 2015 (see report here) - but with the park hosting a 5k parkrun every Saturday it makes sense to try something a bit different.

The start of the first leg
 This year I ran with people from work who I sometimes join for a Wednesday lunchtime run around the Tower Bridge area. We fielded two teams as 'Tooley Street Runners', each of us taking our turn at one lap of the park - just over a mile.

Tooley Street Runners
Finsbury Flyers were the winning men's trio in 14:52, and a team from London City Athletic Club won the women's competiion in 17:43. The mixed team prize was won by three Peckham parkrunners in 16:34. Full results here.

Tuesday, 11 July 2017

The Outrun - Amy Liptrot

Amy Liptrot's The Outrun (2015) is partly another fine example of the new nature writing - urban dweller rediscovers connection with the wild between nicely illustrated covers, in this case through returning to her native Orkney where, among other things, she helps her farmer father in the lambing season and gets a job tracking corncrakes. The Outrun of the title 'is a stretch of coastland at the top of the farm where the grass is always short, pummelled by wind and sea spray year-round... where the ewes and the lambs graze in summer'. That aspect has a not entirely unromantic appeal to me, with my fond memories of my shepherd grandfather in the Hebrides.

But the book is also a memoir of addiction, to alcohol in particular, and the author's struggle to recover after some very messy years in London. Her relationship with the landscape is part of this process. Struggling to believe in 'a power greater than ourselves' as envisaged in the Alcoholics Anonymous 12 step programme, she thinks 'about the forces that I have experienced living on the islands: The wind and the sea. I think of erosion and corrosion… I think of the power of animal instinct, guiding the corncrakes to Africa and me to my lover's house, dead drunk, late at night… I decide that I can accept the existence of some "powers greater than myself" – not God, just the things I've always known, the forces I've grown up with, strong enough to smash up ships and carve islands'.

She walks all over Papay, one of the smaller islands where she lives for a while, including circumnavigating St Tredwell's Loch where once pilgrims seeking relief for eye troubles came to visit the chapel dedicated to a saint who legend claims gouged her own eyes out.

She joins the Orkney Polar Bears who go swimming every Saturday morning in the sea and manages to find through this the beginnings of new compulsions: 'Once after being out all night at a party in a squatted East London warehouse, Gloria and I decided, high and wide eyed, that what we needed was a dawn swim in Hampstead Heath ladies pond. We had grimy rave skin and sleep deprivation and thought the cold water would provide refreshment and even salvation... In the past when I was under stress, my first impulse was to drink… Now, sometimes, I'm not just fighting against these urges but have developed new ones. Even back in the summer, set free after a frustrating day in the RSPB office, my first thought was sometimes not a pint but "get in the sea". Swimming shakes out my tension and provides refreshment and change... The motivation is the same but my methods of dealing with the way I feel are changing. I used to confuse my neurotransmitters on a Friday night in a hot nightclub. Now I shock my senses on a Saturday morning in the biting sea, plunging warm skin into cold water, forcing a rush of sensation, cleansed'.

Interesting how culturally embedded this idea of water as medium of baptism and rebirth is, to swim in the sea or even the Hampstead ponds is to literally plunge into the landscape (or waterscape) and perhaps to emerge with a sense of being somehow cleansed or transformed.

The Outrun is certainly not another rehab through fitness memoir, but the author recognises that part of her recovery is also about a new relationship to her body in movement, including through walking, swimming and scuba diving: 'When I am in motion I am at ease, able to move forward mentally as well as physically. I use walking and swimming to calm my churning thoughts. My sea swims are increasingly important in relieving the non-specific low-level anxiety I often feel. The cold water shocks out any mental stress – my body suddenly has something more immediate to deal with'.

Sunday, 9 July 2017

Bewl15 2017: 15 very hot miles

Last weekend - Sunday 2 July 2017 - I  took part in a 15 mile race on the Kent/Sussex borders. My clubmates who had run it before told me that the Bewl15 was a great race, and they weren't wrong....

Everybody said it was well organised, and Wadhurst Runners did a great job, seemingly supported by signficant parts of the local community. Plenty of car parking and good facilities at the Uplands Sports Centre, sufficient toilets, water stations throughout and lucozade at two points on the course.

Everybody said it was a friendly and fun event - and yes, there was a piper to lead people to the start, free beer and cake at the end - not to mention a brass band  and a technical t-shirt and medal. The race was started by Olympic legend Dame Kelly Holmes too. She let everybody start and then joined in, swiftly moving through the field - she passed me at about mile three.
Kelly Holmes and piper

Everybody said it was an amazing course -  and yes we warmed up in a field with sheep bahing across the way, always good for us townies. After a start downhill along a country lane the course made its way around Bewl Water, the largest inland water in the South East of England (its actually a reservoir created by the flooding of a valley in the 1970s). The course, at least for the first ten miles, alternated between sections of shaded woodland and trails  on the shores of the reservoir, where boats sailed in the sunshine. There were horses.

Photo by Mark Reese of Hastings Runners - @the_real_reesey

All very good but I must admit by the end I was reminded of that 1980s anti-drugs advert -  'when they told me how good Bewl15 would make me feel they didn't tell me how bad it would make me feel'.

Entirely my own fault of course.  I headed off close to the front at a cracking pace that I knew I couldn't sustain, but I wanted to avoid a bottleneck in the first mile where the field has to file through a narrow gate - and where last year people further back had had to stop and walk. The heat was tough - I didn't put sun protection on and really should have, as I ended up with sunburnt neck and shoulders. I found myself slowing and then, at about ten miles in, the hills reared up. There are three significant ascents in the last 5 miles, including running back up the hill you run down at the start, all the way up to the finish line.

In the last couple of miles I got full on cramps in my quads, and while I was determined not to walk, I did have to stop a couple of times as first one leg then the other stopped working.  I finished in  2:25:34 behind 458 others - many of whom streamed past me in the last third of the race. There were 835 finishers in total.

The finish line

Bottom line is I failed to respect the distance, not for the first time. I only entered a few days before and had to google whether it was 15k or 15 miles - believe me it's the latter. I figured I still had the fitness from my London Marathon training but that was two months ago and though I'd run plenty since I hadn't done any long runs at any kind of pace.

Congratulations to Danny Kendall (Cambridge Harriers) who won the men's competition in 1:27:37, and to Tina Oldershaw (Paddock Wood AC), first woman in 1:44:46. Tina is a W50, so can't really blame my woeful run on my age category! Some great runs from my Kent AC clubmates, including medals for Che Compton (5th place overall and first male vet) and Zuzana Nemeckova (2nd female vet).

So yes, I strongly  recommend Bewl15 but do some training - and wear sunscreen!

Hard earned medal and t-shirt