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Advice from a GP on speaking up

JaneAs part of our Something’s Not Right campaign to improve early cancer diagnosis, Jane, our GP trustee and herself a cancer survivor, shares her three pieces of advice when raising worries with your GP. 

1. Act Immediately

I’d always somehow known I’d get breast cancer - to me it felt like a case of ‘when’ not ‘if’.

It was therefore not a huge surprise to me when I discovered a lump one evening while watching Game of Thrones. I was only a couple of years younger than my mum had been when she received her first diagnosis.

I am a GP myself and instantly kicked into my problem-solving mode. I made an appointment with my own GP the next afternoon and ducked out of work in my lunchtime to see her.

  1. Ask for the support you need

I don’t find it easy to be on the side of the patient. As treatment progressed, my husband constantly got annoyed when he’d witness me chatting to other healthcare professionals and not letting on about my own clinical background. My health record even has me down as a ‘Mrs’!

In all honesty, I’m always a bit concerned about coming across as a bit of a know it all. Clinicians also tend to treat you differently, quite subtly sometimes, if they know you are medical. The ‘niceties’ get forgotten and there’s an assumption of knowledge when actually a lot of the little things about cancer I didn’t know!

And so, during the GP appointment, I didn’t share my profession at first. I took a deep breath and told my GP (I’d never met her before) that I had found a lump. She asked appropriate questions and examined me to confirm my findings.

My GP was perfectly pleasant and personable as she pronounced her verdict. Yes, there was a lump but in view of the lump not being tethered to the skin she felt it was nothing to worry about and she ought to have another look in six months’ time.

That sentence could have been my death sentence. My whole future could have taken a different path and I might not be here now, mother to my three children.

What if I’d taken her word for it? There’s always the part of the brain that wants to hear good news (the classic ‘do I look fat in this?’). What if I’d smiled, wished her a good afternoon and forgotten all about it?

I suspect the majority of patients would have done just that. It would have felt lovely getting back in the car, going back to work and thinking, ‘fantastic, nothing to worry about.’ Given my busy job and the logistics of three children, I know the six months would have stretched into a year, maybe two… maybe never.

So, luckily for me, I felt empowered by my job and possibly my age - I am almost 20 years older than my GP. I felt I could speak up. I said that actually I’d rather be referred given my perimenopausal status, my knowledge of these things and my terrible family history.

I swear I detected an eye roll at that point but that could have been my imagination getting carried away living with teenage girls. I certainly left the consultation feeling I’d been a bit bossy and not at all my usual self.

When I’d been seen on the urgent pathway for cancer diagnosis: the ‘two week wait’, and been told the lump was almost my entire right breast and then that it was HER2 positive, I did have quite a few episodes of collywobbles and ‘Oh My God’ moments.

But I am one of the lucky ones. I would say to anyone and everyone - you know your body, if something doesn’t feel right talk to someone about it.

3. How to make yourself heard

Professionally, I am not great lover of taking a list to the GP’s. Lists are our nemesis. Every doctor has a story where patients get to the end of a long list of issues and then they said, ‘well the reason I’m really here is I’ve got this chest pain!’ There’s a knack for us to help deal with a list - establishing what is on the list at the beginning and finding out which bit is the most important to the person.

Despite my aversion to lists, it does sometimes help to write things down - my job involves spotting patterns, if you have written down even the smallest symptom that you’re pretty sure might just be because you’re working too hard it may be the key or the clue necessary to get the help and investigations you need.

If you come out of the consultation concerned that you haven’t been listened to or been taken seriously, ring the surgery and see if you could speak to one of the other doctors. You could also try one of the practice nurses who could advise you about the best thing to do.

JaneDon’t feel embarrassed about asking to see someone else - we would all rather you got the correct diagnosis than spared someone’s ego.

Junior GPs are being trained to deal with patients’ ideas, concerns and expectations. Setting these out might help get your point across. If you are worried that you may have cancer tell your doctor clearly that that is what is worrying you.

About Jane:

I am a 51 year old GP with 3 young daughters. Like most of us I thought I knew where my life was going until it was thrown off course by a group of cells that decided to misbehave!

Since my breast cancer diagnosis I have refocused and now say yes to every opportunity that comes my way.

...Jane is our clinical advisor, a GP, and cancer survivor. Read more about her experiences here

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Discussion

Michelle Main-Miller (not verified)

My GP told me my lump was a milk duct infection.I told her I would like it cgecked out.She lectured me about if we referred every women who had a lump the NHS precious resources would be wasted. I demanded a second opinion.She gave in and referrebegrudginglyingly. 2 weeks later diagnosis of stage 3 cancer her2+ and in my lymph nodes too. I exho your advice.A great article

Christine Lewis (not verified)

How bad is HER 2 and how likely is it to come back? I had stage 1 grade 2 HER positive.No spread to lymph glands. Lumpectomy, 4 chemo sessions, 18 sessions of radiotherapy and 18 injections of Herceptin. I'm almost 3 years post diagnosis and feeling well. Have had two mammograms which have been clear.