A suspended breast cancer consultant fears women are being
wrongly denied a new form of treatment which she claims is ten
times more effective than conventional methods.
Dr Elisabeth Whipp has conducted a six year study into a
new way of administering radiotherapy to kill breast cancer
cells at the Bristol Haematology and Oncology Centre.
Since Dr Whipp's suspension in November 2002, women in
Bristol are no longer being offered this choice of treatment.
In conventional treatment, after a tumour is removed
through surgery, doses of radiation are targeted at the whole
breast to try and make sure all the cancer cells are killed.
The MRI scanner could better detect
But sometimes doctors miss the target, and might even hit
the patient's heart and lung, causing long-term damage.
Since 1997, Dr Whipp has been using a new type of open MRI
scanner to give a detailed 3D picture of exactly where the
tumour bed is.
This means she can can use higher doses of radiation to
kill off remaining cancer cells.
Dr Gareth Rees, Dr Whipp's clinical director, said the
conventional treatment on offer at the hospital was still
"This is an experimental form of radiotherapy planning
which has not yet been published and the audit we have
conducted in a conventional way shows our results compare with
the best elsewhere in the world."
The hospital is not prepared to comment about her
suspension because of an ongoing external investigation into
Areas that this inquiry is looking at include the level of
radiation doses being administered in the new treatment and
the claim by Dr Whipp that she was suspended partly for
prescribing the latest breast cancer drug, Herceptin.
Dr Whipp says guidelines issued by the National Institute
of Clinical Excellence (Nice) should have allowed her to give
the drug to a patient to help prolong her life by up to two
Dr Rees, said: "If we allow unfettered clinical freedom to
take place we will end up with situations where patients will
receive treatments which are not in accordance with Nice
The original trial of the new radiotherapy treatment was
approved by the hospital's medical ethics committee.
So far of 542 patients given this experimental treatment,
there have been only two cases where the cancer came back.
Dr Whipp said: "I think most people would agree that it
looks as though we are getting fewer occurrences, and because
patients who recur are more likely to die, obviously I'm
distressed that it isn't going on, and hope that it will be
restarting as soon as possible.
"Surgeons sometimes do mastectomies (the surgical removal
of a breast) but increasingly nowadays, they're avoiding that,
and they just take the tumour out. This leaves a cavity in the
breast - and that's our target.
Susie Morgan: health improved after
"We find that actually 19 out of 20 cases have to have
their treatment altered from what we would've done if we
hadn't had MRI."
One patient singled out in the dispute is Susie Morgan, a
war correspondent who developed breast cancer after sustaining
shrapnel injuries to her chest.
She said: "It seems to me it's terrible if I've been picked
out by the hospital as being one of the patients who's
considered to be at risk because I feel fantastic.
"I would've thought I should be one of the people
considered to be a great success," she added.
The findings have been peer reviewed for presentation to
the society of radiologists on Tuesday 11 April and have also
been submitted for publication in the prestigious 'RED'
Professor Michael Baum, Emeritus Professor at University
College Hospital London, has been using a new technique which
involves delivering radiotherapy at the same time as surgery.
He said Dr Whipp's research was a very valuable study.
"As a surgeon, I have been deeply sceptical about the
radiotherapist's claim that they know where the tumour bed is
for the radiation dose.
Further trials needed
"I've never understood how they know where it is, because
the position on the operating table is completely different to
the position when they're having radiotherapy.
"The breast is a very pliable organ, and it flops around.
So I think her work confirms numerically what we have always
Dr Baum believes the initial results in terms of recurrence
are promising but need further trials.
He also said there was much disagreement in the medical
world about the question of the level of radiation to
"It's very complex to know what is the optimum and for
anyone to dig their heels in and say, 'This we know for sure'
I think is very wrong. The subject is moving and is complex."
Real Story: Monday, 7 April, 1930 GMT, on BBC One and
the Real Story website. The United Bristol Healthcare
Trust has set up a hotline for anyone concerned about the
issues involving cancer treatment raised in this story. The
number is: 08451 205 580.