PlanBe: a programme for people living with advanced stage cancer
The uncomfortable truth is that there is no simple fix for
advanced stage cancer. Unfortunately, no
drug, no therapy, no treatment , can be relied on to magic away this condition
in the vast majority of patients.
Yes, there are one or two (rare) cancers and the tiny minority of patients with the common cancers who can be cured by chemotherapy. For reasons we still do not understand, they do far better than we would predict, beating all the odds. But it’s rare.
Yes, there are one or two (rare) cancers and the tiny minority of patients with the common cancers who can be cured by chemotherapy. For reasons we still do not understand, they do far better than we would predict, beating all the odds. But it’s rare.
But that’s not to say that advanced stage cancer is not treatable - far from it. All patients with advanced stage cancer can be treated - can be helped - with their condition. And, as a cancer doctor, my daily job is making sure that my patients get the best possible treatment and help so that they can live longer and better with their cancer, even if it cannot be cured completely.
But it’s not a simple business: there is no quick trip to
the repair shop and back to being as new again.
The best outcomes come from a concerted effort on many fronts: pharmacological, physical, psychological, behavioural, spiritual and social.
The best outcomes come from a concerted effort on many fronts: pharmacological, physical, psychological, behavioural, spiritual and social.
It may appear that my job, as a medical oncologist, is
constrained to the pharmacological. And
it’s true that most of my day is taken up in overseeing the delivery of
chemotherapy and engaging in research to improve it for the future. But I don’t see myself as a chemotherapist - restricted to a single technology. I am
an oncologist, with training, experience, and understanding of a particular
range of medical conditions, and I see my role as helping those patients who
come to me with those conditions in whatever way I can.
Not all my colleagues would agree with this view. Some would say that their job is to deliver the treatments that have been shown to be effective by clinical trials, and anything else is up to the patient – it’s not their business. And it’s certainly the case that some patients need no encouragement to explore all the other options that exist outside hospital in their search to keep well. In my experience, these patients often do generally better in various ways than those who simply take their medical therapy and look no further.
My view is that I do have a responsibility to look wider than the pharmacy and the operating theatre to help my patients. My patients often ask me about what else they can do to help themselves and in focus groups they are clear that they expect the hospital to provide guidance and information. I believe that we should help people with these choices and also to encourage those who have not thought about their own role in their wellbeing to see the benefits of self-management.
And that’s why we have come up with the PlanBe programme. PlanBe provides patients with information, support and tools to help and encourage them adopt a range of other activities (in addition to any medical therapy given at the Hospital) and organise them into a day by day regimen to help them live better and longer with their cancer.
For some patients the choice facing them seems bleak – "it’s chemo or nothing" they say. But this is a false dichotomy. There is a third way, it’s called PlanBe. PlanBe is not an alternative to “chemo”, it’s an alternative to “nothing”.
PlanBe is a framework divided into six domains: body; mind and spirit; diet and supplements; complementary therapy; resilience and empowerment; and medical therapy. Patients are guided through choosing options under each of these headings and putting them together into a health and well-being programme to follow each day.
Consultant Medical Oncolgist
The Christie NHS Foundation Trust
We'd love to hear your views. Please comment below, or contact us at PlanBe@christie.nhs.uk
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