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The BBC's Fergus Walsh
"A thirteenth doctor finally diagnosed his cancer"
 real 28k

Steven Harley
"Diagnosis of cancer in its early stages simply is not good enough"
 real 28k

Dr Jim Watson, Addenbrookes Hospital
"Throat cancer can cover a multitude of malignant conditions"
 real 28k

Thursday, 11 May, 2000, 17:12 GMT 18:12 UK
Cancer 'missed 19 times'
Steve Harley and family
Steve Harley's cancer was missed by doctors
The government is being urged to review cancer care services after a man suffering from oral cancer was misdiagnosed by different doctors on 19 separate occasions.

Cancer: the facts
Father-of-three Steve Harley, 41, now faces a far tougher fight against the disease because the tumour has spread.

Whereas doctors might have been able to remove the cancer if he had been diagnosed earlier, it is currently inoperable, and specialists are using chemotherapy to try to shrink it before trying surgery.

Mr Harley is now facing an intensive seven-week course of radiotherapy.

If that fails, he faces losing his tongue, larynx and voice box - and his overall chances of survival are far lower.

Mr Harley's MP, Eric Illsley, warned the government in the House of Commons on Wednesday that Mr Harley's case highlighted serious failings in health provision in England.

The businessman, from Barnsley, south Yorkshire, first developed throat pains in July last year.

I went privately to try and speed the system up. I think the education of GPs and consultants is obviously sadly lacking

Steve Harley

He says he visited his GP, who told him it was probably an infection and sent him home with antibiotics.

However, it failed to clear up, and he visited the GP on seven further occasions, each time being told that nothing could be found.

He says he was not sent for further investigations despite reporting symptoms that were clear signs that something could be wrong - a persistent and agonising earache in addition to the earlier sore throat.

He eventually saw four different GPs, five hospital doctors and three specialists.

"I did ask fairly early on whether the GP thought I had cancer, and he said no."

Even if he had been referred, specialist services in Barnsley were less than ideal - one ear, nose and throat expert was off sick, and the other had left.

Mr Harley said: "I went privately to try and speed the system up. I think the education of GPs and consultants is obviously sadly lacking.

"I understand that there is a test that could be done fairly early which could have spotted it."

Intense pain

He made repeated trips to accident and emergency departments to request stronger painkillers.

He said: "I was given low priority - all they did was take my blood pressure."

He says the doctors believed that, despite reporting intense pain, he was simply seeking attention.

He told the BBC that on one occasion, a doctor said to him: "If I were your brother, I would tell you to go home and live your life."

The cancer was eventually spotted after he had lost two stones in weight because the tumour was beginning to block his throat.

What this comes back to is the need for education and training of doctors

Professor Mike Richards, National Cancer Director

Mr Illsley told the Commons: "This was a man with private medical insurance. I wonder what it would have been like for anyone who was a NHS patient in these circumstances.

"I am becoming a little tired of standing in this chamber complaining about poor health treatment that my constituents receive."

Professor Mike Richards, the newly-appointed "National Cancer Director", said that while he could not guarantee that cases like this would not happen in future, the service overall would be improved.

He said: "We certainly need to invest more in communication skills because we know from patients that all too often they weren't adequately heard by doctors and the way they were treated was not as good as it should have been."

Oral cancers can initially have the appearance of ulcers or other normal mouth problems. If such problems fail to clear up by themselves or to respond to treatment, doctors are advised to be suspicious and refer for further tests.

Professor Mike Richards
Prfoessor Mike Richards admitted reform was needed
Oral cancer is one of the more dangerous cancers, as only one in two people survive - early diagnosis improves survival chances.

Approximately 3,400 people are diagnosed with the disease every year in the UK.

Sue James, chief executive of Barnsley District General Hospital NHS Trust, described the case as a "tragedy", but said the hospital had done all it could on the occasions when Mr Harley attended its casualty department.

She said: "The A&E department is there to treat accidents and emergency situations. It's much better for people with long term conditions to be referred to their GP."

Professor Gordon McVie, Cancer Research Campaigns Director General, said: "Throat cancer is rare but this is no excuse.

"While GPs are not used to seeing a patient's mouth as often as a dentist is, for example, specialists should know better."

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28 Feb 00 | Scotland
Mouth cancer awareness bid
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