Mind the generation gap

I’m glad I had cancer in 2018. Is that an insane thing to say? Objectively, I know it sounds like it. At the time, it could not have felt more inconvenient. I was in my mid-twenties. I had no family history to prepare me. It came out of nowhere. I had just got a new boyfriend (a nice one! finally!), a new flat (again, nice, finally) and a new job (again!). The diagnosis completely derailed my life. Even now, nearly five years on, I find it difficult to separate my life decisions from the fact I had cancer. If it hadn’t happened I would be a different person, I would have made different choices. There was the person I was before cancer, and the person I was after. But I’m still glad it happened at that time, because I felt confident in the NHS’s ability to take care of me and keep me alive.

From the Saturday night when I found a lump, randomly, to the point I met with an oncologist to discuss my treatment plan, scarcely days passed. I made an appointment with my GP on the Monday, was referred to the hospital by Wednesday, and by the weekend was called in for an MRI. Within weeks I was being treated by Barts Hospital and my life was unrecognisable. Confident in my ability to handle treatment – because I was young and healthy, aside from having cancer, obviously – and believing it was better to be safe than sorry, because they didn’t know why I had cancer, the NHS threw everything they had at me. My diaries at the time are a chaotic list of treatments and centres.

Conservatively, I cost the NHS a million pounds

I had scans for bone density and a full cycle of IVF, crouching alone in pub toilets to stab myself in the stomach with hormones. Counsellors prepared me for how horrible life was about to become. I had chemotherapy for five months, with the NHS providing a cold cap so I could keep most of my hair and therefore most of my sanity. After chemotherapy the cancer in my body had disappeared, so I had a small, “just-checking” surgical procedure, followed by a month of radiotherapy. This was the end of my “active treatment” but today I still rely on medication to regulate my hormones, stop my bones from crumbling and generally keep me alive. I did not pay for any of this.

Over the past five years I’ve looked into how much I cost the NHS. A single round of chemotherapy – I had eight – costs around £30,000. From hours spent on cancer forums I know American patients usually opt for mastectomies rather than smaller surgeries with radiotherapy, because the treatment is too expensive to be covered by private health insurance. Private lumpectomy surgery costs around seven grand. During my year of Herceptin, a stranger from Venezuela DM’d me on Twitter, desperate to find it for her mother, asking if I could help (I could not).

The injection I still receive monthly is £235 a pop, and the IV drip to strengthen my bones is £20,000 for a full three-year course. I have conservatively cost the service over a million pounds – and hopefully I will live long enough that this figure increases exponentially. So the systematic dismantling of the NHS is terrifying to me; the only option, we’ll eventually be told, is to get rid of it and find something else.

Since few others my age have had this experience – the odds of getting my type of cancer at my age were around one in 1,200 – most of my peers treat the dissolution of the NHS under the Tories as just another tedious fact of life, like death and taxes. If you’ve never experienced the breadth of care it offers us, for free, perhaps you won’t feel so moved to keep it. It’s easier to discuss the NHS theoretically, even callously, if you haven’t seen it first-hand.

On one of my first nights out after chemotherapy, a period when I’d isolated myself to rebuild my immune system, a friend of my boyfriend casually told me in a pub that “too many people use the NHS”. I blinked, without eyelashes. It felt like a mad thing to say, a madder thing to say so casually. But today that mentality has become commonplace. Even Keir Starmer is now steeling the public for its dissolution, telling us “the NHS must reform to survive”, as though it’s the NHS’s own fault that it’s dying, the result of stubbornness and a failure to modernise rather than lack of funding and creeping privatisation.

Latest figures show the UK “facing its biggest cancer crisis ever”, with treatment delays costing patients’ lives. The doctors, nurses and NHS staff who treated me so well in 2018 would undoubtedly do the same in 2023, but they are hampered by long waiting lists and lack of funding. During the pandemic, in one of my frequent Zooms with my parents back home in Ireland, my mum lamented this growing gap in care by saying something that sounded mad at the time. “Aren’t you lucky you were sick before all this?” In a way she was right. I do feel lucky to have been treated so well, so quickly. But our healthcare shouldn’t be left to concepts as flimsy as luck or timing. It’s a right, not a privilege.

Róisín Lanigan is a writer and editor based in Belfast and London