Iressa and continuity in the NHS.

[annecarmel]

NHS doctors generally do not appear to understand the importance of continuity of contact in treating long term patients. In the first 8 months of my treatment for lung cancer I saw 6 different doctors. After 2 months I was placed on Iressa. At the time this was a fairly new and infrequent (still is) treatment for the NHS. Each doctor I saw was at the start of a learning curve. When Sandwell Hospital appointed a new permanent consultant oncologist (whom I'd seen earlier when he was a locum at the hospital) I was offered an appointment with his registrar. I stood my ground and, explaining my reasons, insisted on continuing to see him. This has worked well for me in the past 18 months, enabling me (and my family) to build a close and trusting relationship with him.

This problem of continuity appears to exist throughout the NHS. It is sometimes a bind having to wait to see a particular doctor at my surgery. But I learned the hard way that it is worth it.

Early in my treatment I saw a gp locum about a stomach problem, for which she instantly prescribed Lansoprazole. I handed the prescription form back to her and explained that I had been taken off this drug when I began taking Iressa. Lansoprazole, and others like it, reduces the absorbtion levels of Iressa (by 37 percent I understand).

Had she prescribed a different drug in the same group I would have been unaware of the potential risk.

Doctor-hopping is unsettling for long term patients and, in my opinion, detrimental to their treatment.