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Sue Kernaghan Diagnosed with breast cancer on 9/11 2002 Basal cell carcinoma in 2007 GIST Gastrointestinal stromal tumour in July 2009 Different experience each time in my care The Friday evening after biopsy under mammogram Passed from one place to another, nobody would accept responsibility I ended up in A&E, in a queue which was totally inappropriate Listen to what the patient is saying. Do not assume a diagnosis if symptoms point to a diagnosis. It was assumed I was a drunk as had an upper GI bleed Hair loss is horrific: one patient said it was worse than diagnosis Chemo brain is alive and well in patients and sometimes it does not go away Relevant and timely Do not overwhelm if lots of information e.g. breast cancer Do give information even if rarer cancer even if it is a written diagnosis Important after treatment: transition Encourage the patient to help themselves: This is not “think positive” or “fighting the disease” We are not brave! Self help: ◦ Exercise ◦ Complementary therapy They are important too They can help manage the patient Listen to their concerns Nurse in chemo suite ignored the body language yelled depression. Could she see it? Radiotherapist: sometimes have to refer patients for admission even if the patient wants to go home Should have a fellow professional to talk to communication is key Not just at diagnosis, and during treatment but at the end of treatment and beyond The transition from a patient to a survivor is a real scary time and some low level psychological support at this time would alleviate anxiety. Many pts are prescribed SSRIs yet at this time support and talking therapy will bring long term benefits and would be cheaper