2nd opinion leads to tumour cure after NHS refused treatment

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A 78-year-old diagnosed with terminal bladder cancer in 2008 was "sent home to die" after a hospital consultant ruled that he was too old to treat.

Due to Kenneth Warden's age, the consultant at the unnamed hospital in the north-west also refused palliative surgery and chemotherapy, either of which treatments could have eased the patient's symptoms.

While Mr Warden's daughter Michele Halligan accepted the consultant's prognosis, she paid for her father to be seen privately by another doctor to find out what might be done.

On receiving the medication and treatment he needed, Mr Warden's cancer was cured, giving him a new lease of life which he continues to enjoy 4 years later.

"You could call his recovery amazing," said Ms Halligan, 51. "It is certainly a gift. But the fact is that he was written off because of his age. He was left to suffer so much, and so unnecessarily."

Mr Warden is not the only elderly patient to whom the NHS has refused treatment on the grounds of age. According to Macmillan Cancer Support (MCS), thousands of older people are denied life-saving NHS treatments every year, with family members often fighting in vain for their relatives' rights.

Mr Warden first noticed blood in his urine in September 2008. His GP sent him to a consultant urologist at a hospital in the north-west of England and a sizeable bladder tumour was diagnosed.

An MRI scan showed that the tumour was advanced and had breached his bladder wall and muscle.

Minor surgery enabled Mr Warden to pass urine. However, he had to do so every 20 minutes day and night, the lack of sleep exhausting him.

"It was making him more ill than the tumour," said Ms Halligan. "The pain was like having permanent cystitis."

"But when I asked for Dad to be given help for this, the consultant said there was no treatment available."

As a former midwife, Ms Halligan was confident she had the knowledge to conduct her own online medical research. According to 1 website, radiotherapy would shrink the tumour and provide relief from its symptoms. Further bladder surgery could help still more.

"I was not looking for a cure, just a way to give my father some quality of life for the time he had remaining," said Ms Halligan. "We went back to the urologist and asked about radiotherapy. I also wanted to know why my father could not have an operation to relieve his urinary symptoms."

"The doctor said that as my father was 78, these treatments would not be appropriate because he was 'too old'."

"But my father was very fit and muscular. He regularly went running and worked out at the gym. He was also a lifelong rower who held competition records. But all the consultant would say was: 'You have to accept that your father is dying.'"

"I had no issue with the hospital — it is very good — but I could not believe the surgeon. We went back to our GP, but they believed the consultant."

The family had no option but to pay almost £3,000 for private tests and a 2nd opinion from a Birmingham consultant. He agreed with Ms Halligan that her father should receive chemotherapy to shrink the tumour, then have a radical cystectomy: a procedure which involves removing the bladder, the surrounding lymph nodes and the prostate gland.

With private medical insurance unavailable to Ms Halligan and her father, the consultant arranged for Mr Warden to have NHS-funded treatment at Birmingham's Queen Elizabeth Hospital.

"The treatment there was superb," said Ms Halligan. "Dad went for chemotherapy every week for nine weeks, followed by one month off. Then he went back in March 2009 and had the radical cystectomy."

"The operation went well. We felt it would relieve so much of Dad's anguish during the time he had left."

Besides relieving his symptoms, the chemotherapy and surgery also removed Mr Warden's cancer. 4 years after surgery, a full body scan showed him completely free of the disease.

"He is back rowing and working out at the gym," said Ms Halligan. "He has enjoyed 7 holidays abroad and bought himself a sports car."

The former midwife, who lives in Chester and is married with 2 children, remains disappointed that the NHS seems routinely to discriminate against elderly people.

Reporting the earlier consultant to the General Medical Council (GMC), she believed that his actions constituted 'pure ageism'. "But the GMC said he hadn't acted wrongly as it was a 'matter of professional opinion'."

Recent studies highlighting similarly "shocking" standards of NHS care have been published by the Patients' Association and the Care Quality Commission.

According to Nat Lievesley, an investigator at the Centre for Policy on Ageing, such attitudes are illegal and should have been banished from the NHS. He explained that the 2010 Equality Act outlawed age discrimination, such as age limits for treatment, in all official NHS policies.

But Mr Lievesley, who has long researched into care for the elderly, said in a study that while official rules have changed, the same cannot be said of the attitudes of individual doctors and nurses.

"Evidence of the under-investigation and under-treatment of older people in cancer care, cardiology and stroke is so widespread and strong that we must conclude that ageist attitudes are having an effect on overall investigation and treatment levels."





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