Mum-of-four's rapid diagnosis calms cancer fears after specialist clinic steps in
A patient who feared she “ticked a couple of boxes for cancer” has praised the work of the Health Board’s Rapid Diagnosis Clinic for quickly establishing what was wrong with her.
Laura Jones, from St Asaph, is a Type 1 diabetic and decided to see her GP after her husband remarked on her dramatic weight loss over the period of a month last year.
After dropping two clothes sizes, she worried she was perhaps doing too much in her new job, working for a large leisure company and also looking after her four children.
However, as her GP questioned her she began to worry there might be a more sinister reason for her weight loss and she was immediately referred to the Rapid Diagnosis Clinic at Glan Clwyd Hospital.
Rapid Diagnosis Clinics - Betsi Cadwaladr University Health Board (nhs.wales)
She said: “That was on a Thursday and I had an appointment to see the clinic the following week. It was very, very quick.”
Within two weeks, Laura had been to her GP, been to the clinic and had her first MRI scan, which revealed two masses in her liver.
“I think I ticked a couple of the boxes for cancer, possibly,” she revealed. “I expected to hear ‘slow down, you’re doing too much, look after yourself’.
“You don’t expect it do you really? It’s denial at first, isn’t it? You think ‘no, it can’t be’.
“I genuinely thought I was going to go for that scan and they were going to say ‘you need to look after your diabetes better’. I didn’t think it was going to be cancer at all really.”
Laura said she was talked through the whole process and staff were “lovely” but admitted to being “in a bit of a bubble” after seeing the doctor.
“Before leaving they gave me a load of information and Nicky Grayston, the clinical nurse specialist in the clinic, gave me her number and said to call any time,” she said.
“You just think ‘oh, okay’. I got to the car and phoned my husband and he came home straight away. It was all a bit of a blur, really.”
The weekly half-day clinic assesses patients who present in primary care with vague symptoms and whose GP suspects there is a reasonable risk of cancer. The majority of patients will have a CT scan on their chest, abdomen and pelvis.
Approximately 50% of patients diagnosed with cancer present with these vague symptoms. These can include weight loss, appetite loss, non-specific abdominal pain and fatigue.
Around 23% of the 220 patients referred to the clinic, since it started in March 2022, were referred onwards to cancer pathways.
Approximately 21% of those patients referred to cancer pathways eventually received a cancer diagnosis, which represents just five percent of all referrals to the RDC.
It is possible many patients referred to the RDC have non-specific abnormalities on blood tests, such as abnormal liver function or thrombocytosis – a condition caused by too many blood clotting platelets, which can indicate an underlying disease or infection.
The clinic’s aim is to give all patients either a diagnosis of cancer, a serious non-cancer diagnosis or the reassurance of a non-serious diagnosis. They will also have a management plan, where appropriate.
In all, 81 patients have been discharged by the service since it started and onward referrals have been made to a large number of specialties other than cancer. They included the bone clinic, breast clinic, memory clinic, dietician, lung nodule clinic, speech and language therapy, smoking cessation team, inflammatory bowel disease clinic, gynaecology and cardiology.
Fortunately for Laura, like most attendees of the RDC, her symptoms turned out not to be cancer. Further tests revealed she had two abscesses on her liver but she praised the speed of the service in putting her mind at rest, at what was a stressful time.
She said: “I’m fine now. It’s the reassurance the clinic gives you. It’s not just the speed at which they work, it’s the support. Nicky was brilliant, always on the phone, always available if I had any questions.
“It was nice to have the consistency of being able to refer back to the Diagnosis Clinic if I needed to know something. They would do the digging for me and find out.
“I genuinely thought it was diabetes related but when they find something you think ‘ok, I’m going to go on a waiting list’. The media portrayal is you’ll be waiting for ages but it was so quick.
“I do feel, if it had have been bad news for me, I would have started treatment quicker. For someone of my age and my situation, with four children, it can buy you time.”
Rapid Diagnosis Clinic clinical nurse specialist Nicky Grayston said: “The Rapid Diagnosis Clinic is a really valuable service for patients who present with vague symptoms who may have an underlying malignancy or cancer.
“Early cancer diagnosis is crucial, but the RDC offers so much more than that. Our patients tell us how the speedy service gives reassurance and reduces prolonged stress, strain, upset and worry when diagnosed with cancer.
“If it isn’t cancer, that reassurance is also really appreciated – as Laura’s story clearly illustrates.”
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