31st January 2022

Get lung cancer services back on track, urges James Brokenshire’s widow

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As Cathy Brokenshire readied herself to name a train in memory of her beloved husband James, she admitted her emotions were as raw as the wind whipping across Cannon Street Station.

‘’This is so special’’, she said, ‘’because ever since he was a boy James just adored trains. Having one of his very own would have made him laugh with delight.’’

It’s a rare honour, but a measure of the esteem in which he was held, that James Brokenshire should have a Southeastern Railway train named after him.

But James, who twice served as Secretary of State, first for Northern Ireland and later for Housing, Communities and Local Government, sadly wasn’t there to savour this special moment.

Last October, at the age of just 53, he died of lung cancer. Cathy and their three children remain bereft, but proud of him and his many achievements.

James was first diagnosed with the disease after coughing up a small amount of blood in late 2017. He stepped down from the Northern Ireland post on 8 January 2018 – his 50th birthday.

He underwent surgery to remove a lobe from his right lung and, in April 2018, he used a debate in Parliament to call for a national programme to improve lung cancer survival rates.

In February 2020 he resumed his government career, taking up a new role as minister for Security at the Home Office. He was having regular scans and it seemed that he was making a full recovery.

However, as the effects of the pandemic and lockdown took hold, one of his scans was delayed for a few months. In December 2020 he again coughed up blood, and his oncology team immediately sprang into action.

2021 began badly for James. On his 53rd birthday it was confirmed that the disease had returned. Within days, surgeons removed the remaining sections of his right lung.

In March, he began a three-month course of adjuvant chemotherapy intended to destroy any remaining cancer cells. Sadly, a CT scan revealed that, rather than being ‘’all clear’’, the disease had spread to other parts of his body.

James again took the decision to step down from his ministerial post, concentrating on his family and fighting the illness. He had radiotherapy and then therapy designed to target genetic elements of his tumours. In September, he started a course of immunotherapy, which aims to help the body’s immune system fight the cancer. 

Although he was fit and healthy and had never smoked, an infection developed in his remaining lung and his condition began to deteriorate.  He was admitted to hospital, and died on 7th October.

His wife Cathy was able to see him and tell him how much she loved him, but even though she recognised he was by then seriously ill, his death still came as a complete shock to her

‘’It really was totally unexpected,’’ she said, ‘’but I’m greatly relieved that he never suffered. Right to the end, he was still James, still laughing and joking and chatting to everyone.’’

Her loss highlights the impact of the coronavirus on lung cancer patients. ‘’I’ve often wondered about the delay between his scans. It was an aggressive cancer, so how much did it progress in that time? I’ll never know. The pandemic definitely changed the whole landscape for people with lung cancer – including James’’, she said.

Coronavirus has taken its toll on lung cancer care across the country. For many people, a persistent cough seemed more likely to be a symptom of Covid than a possible indication of lung cancer.

Fewer people who noticed symptoms that could indicate lung cancer were able to access face to face consultations with their GP, two-week referrals plummeted by 75% during the first lockdown while surgery with curative intent plunged by a quarter between 2019 and 2020.

Dr Robert Rintoul, of NHS England’s Lung Cancer Clinical Expert Group, said, ‘’Just before the pandemic, we estimate that the five-year patient survival rate had gone up to around 17.6%, from 16% in 2016, so we were on an upward trajectory.

‘’However, for those diagnosed during the pandemic, we estimate that may have fallen to around 13%. There’s a lot less surgery taking place and that is one of the main drivers to a cure.

‘’We need urgent action to get us back on track to where we were in the pre-Covid era and then drive forwards our target of 25% survival by 2025.

“In 2019, NHS England launched their Targeted Lung Health Check (TLHC) programme, and they were just getting going when the pandemic came along and stopped them. But they have restarted again, and, by April, there will be 40 lung health checks running across England.

‘’We believe that the roll out of a full lung cancer screening programme across all four UK nations will do more to improve lung cancer survival than any other intervention.’’

Cathy Brokenshire echoes that call for urgent action. She is now working with Roy Castle Lung Cancer Foundation who are supporting NHS England and the TLHC programme and campaigning for a national screening scheme.

‘’We can’t let this situation continue’’, she said, ‘’it has to change. James was determined to make that change happen, and now I’m picking up the mantle. If I can stop just one family going through what happened to us, it will all be worthwhile.

‘’That’s why we support Roy Castle Lung Cancer Foundation. Like us, they are desperate to get lung cancer services ‘back on track’ and give people the greatest chance of the best possible outcome. That’s the finest way to honour James and his legacy.’’

Paul Chadwick, chief executive of Roy Castle Lung Cancer Foundation, added, ‘’James Brokenshire was a wonderful advocate for all those affected by this disease. We will do all we can to see that the work he started is seen through, so that more people are diagnosed early and have the best chance to live well for as long as possible.’’