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Thanks to campaigning by Radiotherapy Action Group Exposure, men and women in England who have developed consequences to radiotherapy treatment can now access a highly specialised national service. The service is run in collaboration with oncology colleagues from The Christie, Manchester, and Barts Health, London.
The Breast Radiotherapy Injury Rehabilitation Service is available to anyone registered with a GP in England and is run by the Royal National Hospital for Rheumatic Diseases (RNHRD), a specialist rehabilitation hospital with an international reputation in pain management.
Radiation-induced injury to the adjacent side of the affected breast (ipsilateral-axiliary tunnel and brachial plexus) is a rare condition arising from previous radiotherapy techniques. An estimated 250 people currently have this syndrome. Symptoms can include:
-severe and constant pain on the side of the affected breast
-paralysis of the arm or hand with a significant impact on functional activities
-lung damage, breathing problems or chest infections
-osteoporosis and other musculoskeletal problems
The condition has no cure and is exacerbated by age-related co-morbidities. Radiation damage to the brachial plexus cannot be reversed. Untreated, patients develop secondary complications, resulting in a significant deterioration in health, mobility and social function.
The needs of this group were evaluated following national clinics and an RNHRD pilot in 2011. Professor Candy McCabe said, ‘Feedback was extremely positive, with patients appreciating the ability to talk to clinicians who understood their problems.’
The service started in April 2012 and is delivered in partnership with three oncology centres: The Christie, Manchester, Royal United Hospital, Bath, and Barts Health NHS Trust, London. A separate service is available in Scotland and Wales.
The team is made up of clinical oncologists, nursing and therapy specialists, psychologists, respiratory physicians and rheumatologists. It has established a referral pathway that enables patients to access the service at their nearest hospital.
Following telephone assessment by a specialist nurse, patients attend a two-day clinic. They see clinicians who best meet their individual needs, and address issues such as fatigue management and exercise in a group. The team agrees a discharge plan that is implemented through the patient’s GP, using local services. Also available is a two-week intensive programme option, focusing on particular aspects of an individual’s rehabilitation.
The service aims to provide continuing support for patients and is endorsed by NCAT and Macmillan.
Denise Moorhouse|, Service Manager, Breast Radiotherapy Injury Rehabilitation Service, Royal National Hospital for Rheumatic Diseases.
For all referrals, email Professor Candy McCabe| at RNHRD or call 01225 473462.
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