Help for my lovely Mum - Papillary urothelial carcinoma (sorry it's a long first post)

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Hello all. 

New here and desperately seeking some help and advice for my Mum who has been diagnosed with the above. Will outline the rough order of events below (sorry it is a long one) but we feel we have been failed by the NHS and we are not sure what way to turn. 

Christmas 2023 - she started passing blood in her urine. Underwent tests.

March 2024 - cancer diagnosis (2 tumours G3 pT3, R0) and then booked in to have her kidney, ureter and small part of bladder removed.

May - pre kidney removal was told she had an imparied heart - left ventricle failure and ejection fraction 35%. Consultant said 'if we had more time I would like to check this out before surgery, but as sugery is urgent we will have to investigate post surgery.  Surgery took place. Histology report took 11 weeks and she was told in early August that 'they had not got a good margin in the resectable' areas when they removed the tumours, so chemo was needed as a precaution. They said they would liaise with cardiology but that her heart may not cope with the chemo.

August - Mum was booked in for chemo after having the assessments the day before. She got there and was kept waiting for 3 hours eventually with the chemo nurse saying they would not agree to chemo going ahead until they had the go ahead from Mums consultant who at this point was on hols for about 3 weeks. Mum at this point is regularly chasing cardiology for an apt. Chemo nurses also trying to chase this.

Whilst this is happening she has also had a biopsy and rigid cystocopy. Eventually gets a call with oncologist on 21/09 (one whole month after first two chemo sessions were missed). Oncologist essentially blamed Mum for halting her treatment even though she was turned away due to it not being clear if she could have chemo with her heart condition. We have just received a copy of the letter to her GP from the oncologist where he writes ''I have advised her the delay in chemo may mean that there may not be much benefit as it is coming to four months since she had surgery'.

My poor Mum feels like she is being blamed and that they are covering their backs. They turned her away from treatment and I think they have dropped the ball by not referring her to Cardiology back in May when the heart problem was discovered. I really don't know how we go from here - we have so many questions and she does not feel like she can trust her oncologist. He has never even sat with her to discuss the cancer, what it means, prognosis etc. She has been given no point person throughout.


Her apt with cardiology is in a weeks time and she has had her first 2 chemo sessions already. I am beside myself with worry at the comment that the chemo might not work, and that the time we have lost due to their failings might mean the worst.

I am sorry this is so long. I am just desperate for some help! Thank you. 

  • I'm so sorry you and your mum are going through all of this, it sounds like the communication throughout has been pretty dreadful.

    A first port of call might be contacting the PALS service at your hospital, as they can help with complaints, encouraging communication between different departments and general support for you and your mum. They can also help you request a copy of the medical records to help you find out what was said when the initial sessions were cancelled.

    If the trust between you and your oncologist has completely broken down then you're ok to ask to be referred to an alternative consultant, you can speak with your GP about this, or ask the CNSs for advice.

    As for the comment about further treatment not working, that's a really unhelpful thing for your consultant to say. A lot of the studies about immunotherapy/chemotherapy are based on people starting treatment within 12 weeks of having had surgery, and therefore that's the protocol they can give you the most evidence about. However, plenty of people don't have surgery - either because they aren't able/suitable, or by choice, and may still go on to have immunotherapy with good effect.

    It sounds like good news that they have finally started your mum's treatment. With the NHS being as cash-strapped as it is right now, you should take heart in the fact that they don't spend money on expensive treatments like chemotherapy if they don't expect them to have at least some benefit. They must think it is worthwhile starting your mum on treatment.

    The other thing to add is that if your mum is struggling with how this is making her feel, Macmillan do offer some support sessions (www.macmillan.org.uk/.../bupa-counselling-and-emotional-well-being-support). If you're near a Maggie's then they also do support for patients/relatives.

    Best of luck to you and your mum

  • Thank you so much for your words and that’s a really good way of looking at it. I’ve started to draft a message to PALS and my mum said she would call the hospital complaints dept in the morning. She hasn’t even been given a CNS, when she asked the oncologist about getting one, he told her she needs to request this with the secretary’s! Who of course never answer the phone. It’s so draining!