GPs will receive new training to spot cancer in young adults after a 27-year-old woman’s fatal tumour was ignored for five months.
Jessica Brady died three weeks after she was admitted to hospital in December 2020, after her symptoms were dismissed by her local surgery more than 20 times via virtual appointments with four different GPs.
The satellite engineer from Stevenage, Hertfordshire, first presented at the surgery in June 2020 with abdominal pain. Over the following months, as her symptoms escalated – a persistent tickly cough, sore throat, upper back pain, fatigue and weight loss – she was repeatedly reassured that she had long Covid, despite never having had a positive Covid test.
She was later diagnosed with a kidney infection ‘in the absence of any diagnostic testing or any physical examination at all’, her mother Andrea previously told the Health and Social Care Committee, and was prescribed with antibiotics.
When she became extremely fatigued and her symptoms worsened, she was only prescribed more antibiotics, steroids, and an inhaler.
One set of blood tests even revealed Jessica had high D-dimer levels, which can be a signal of solid cancers, the mother told MPs.
And subsequent tests identified concerns regarding her liver function – which her mother said makes sense now as she had liver cancer – but medics decided to wait six weeks to see what happened.
Doctors didn’t put ‘the pieces of the jigsaw together’ that it was cancer until five months later, by which point the stage four adenocarcinoma – an aggressive cancer of the glands – had spread around her body and become untreatable.
It was not until she sought private health care that she was diagnosed. She died less than a month later on December 20, 2020.
Jessica’s parents, Andrea and Simon, have since launched a campaign for ‘Jess’s Law’, which would require all GP’s to review their diagnosis if a patient has had three consultations with no progress or health improvement.
On launching the campaign, Mrs Brady said: ‘We feel if it is in the form of guidelines, it will be forgotten.
‘We know that GPs often do not deviate from their initial diagnosis – we need them to be curious and empower them to rethink. If Jess’s Law is ratified, then they will feel supported in ruling out the worst-case scenario at the earliest opportunity.’
The Royal College of GPs has now said it will roll out free training which encourages all GPs to change their approach, in a bid to raise awareness of the rise in cases of cancer among young adults.
The number of people aged between 25 and 29 who have been diagnosed with cancer in the UK since the early 1990s has risen by a quarter.
New guidance for GPs will introduce the concept of ‘three strikes and rethink’, urging GPs to review their cases following three appointments without improvement.
A review could include referrals to other services for second opinions, or getting specialist advice.
It will also delve into the risk factors which GPs should be aware of, and provides guidance and possible interventions to be considered when diagnosing young adults.
Mrs Brady told the Telegraph she viewed the proposed changes with ‘mixed emotions; both of sadness and of pride’.
‘We don’t want to be here, we don’t feel celebratory, but we do feel that this is the right thing to do and we won’t give up’, she added.
Professor Kamila Hawthorne, the Chairman of the Royal College of GPs, also told the newspaper: ‘Unfortunately, many conditions – including many cancers – are notoriously difficult to identify in primary care because the symptoms are often similar to other, less serious and more common conditions.
‘This is why it’s been important for us to work with Jessica’s family and the Cedar Trust to highlight that, for reasons that are unclear but are likely multi-factorial, we are seeing more cases of cancers in younger adults.’