Helping breast cancer patients move forward after treatment

A new clinic supporting breast cancer patients after their treatment at the Norfolk and Norwich University Hospital (NNUH) has helped 400 patients in its first year.

The Moving Forward clinic ensures that patients have the knowledge, skills, confidence and support to live well and beyond their cancer diagnosis and treatment with access to a dedicated number to call should further symptoms arise.

During the clinic appointment, which is held with a Nurse Specialist, patients can be signposted to other support services and are offered access to the Big C Supportive Self-Management programme to assist with workshops on fatigue, finances, returning to work, exercise, diet and nutrition, psychological support, and body image.

Joann McGrath, NNUH Breast care nurse specialist, said: “There is no strong evidence to suggest that regular follow up appointments increase the chance of picking up recurrence of cancer. We also found that routine clinical appointments were a source of unnecessary worry and anxiety. Patients tend to notice new signs and symptoms through self-monitoring and self-examination in between routine appointments.

“At the Moving Forward Clinic we talk about the diagnosis; the treatment received and possible side effects; how to be breast and body aware of new signs and symptoms and discussion about self-examination. We also offer a holistic needs assessment, a care plan and a treatment summary. Patients have all been very keen and feel that it is a good initiative that promotes a better experience. The clinic is a time when patients can reflect on their cancer journey and identify any unmet needs that they may be struggling with at end of treatment which may inhibit them from moving forward.”

Sam Glee, Senior Cancer Information Clinical Nurse Specialist at Big C, said that the charity was looking to roll out the Supportive Self-Management programme to other areas of cancer care at NNUH following its success with breast cancer patients.

“We know that the period when treatment ends can be a very lonely place for someone who has had cancer. The routine of treatment and contact with medical staff changes and people often feel guilty that they do not feel elated with the news there is no longer evidence of cancer in their body. Instead they often feel anxious about the future, worried about longer term side effects, and how to recognise if the cancer has come back. NNUH and Big C worked in partnership to develop a programme to give ongoing support for those living with and beyond cancer,” she said.

Michaela’s story

Michaela was diagnosed with stage 2 breast cancer in February 2019 when she was 45-years-old and was the first person to be referred to the Moving Forward Clinic after receiving surgery, radiotherapy and hormone therapy.

She said: “Having had a breast cancer diagnosis it makes you more self-aware and I knew that any potential changes or worries I had I could be seen sooner rather than later. I now know that I will receive yearly mammograms for five years which is an added safety precaution.”

“There is a lot of support if you need it and now having been referred to the Big C Centre for follow on support it helps with moving on with life, especially the psychological effects of having had a cancer diagnosis and coming to terms with what you have gone through.”

“There is no need to be worried about not being seen at further intervals, as patients we know our bodies best and what’s normal and not and if you have anything which is troubling you then you can contact the clinic for advice or to be seen to get yourself checked out.”

“As an additional source of support and a welcoming place to either relax in-between appointments or just to have a coffee and chat I would recommend patients make use of the Big C Centre. You can get involved with the support on offer as much or as little as you feel comfortable with.”