When breaking old rules can be healthy

His wife died following conventional treatment for cancer. Now Lord Maurice Saatchi wants to introduce a law to encourage medical innovation, but some experts say it is not necessary, Helen O’Callaghan reports.

When breaking old rules can be healthy

ADVERTISING magnate Lord Maurice Saatchi co-founded the world’s biggest advertising agency — M&C Saatchi. So he knows the power of words and — speaking to Feelgood — he doesn’t indulge in superfluous speeches about the woman whose death has propelled him to try to facilitate a cure for cancer.

Of his three decade long relationship with Mullingar-born Josephine Hart — best known for her 1991 novel, Damage — he says succinctly: “It was the most intense 30-year love affair.”

He met her when he went to work for Haymarket Publishing. She was his boss. Saatchi knew immediately this would be a relationship for life. He lost her two years ago to primary peritoneal cancer, similar to ovarian cancer. She was 69.

The staggering thing, says Saatchi, is that his wife of 27 years and mother of his son, Edward, 28, showed no symptoms at all until the very eve of her diagnosis. “She had a slight tummy ache for a few days. I suggested she go to the doctor because it was just before Christmas. She saw the doctor at 10.30am and by 5.30pm she’d received her death sentence: malignant, advanced, inoperable.”

The couple found themselves on the receiving end of statements like, ‘there’s always hope’ and ‘every case is different’. He recognises these as kindly meant. “With every fingernail in your body you hope in desperation the statements will be true for you, that you’ll be the 1%who survives. But the statements point to the fact that science hasn’t achieved sovereignty in the world of cancer. They can’t be said with an air of finality — there’s always error, doubt, uncertainty.”

He has become, he says, an expert in women’s gynaecological cancers and — having seen Josephine endure chemo and major surgery — a transmitter of a tough no-holds barred message.

“The drugs, cycles of administration and surgical procedures are all 40 years old. It’s not surprising the survival rates for these cancers are the same as they were 40 years ago.”

The impact of treatment is incremental, with hair loss being the least damaging side effect. Next is nausea, diarrhoea, vomiting and fatigue caused by drug treatment. “The bad news is the drug causes such damage to the immune system that fatal infections are allowed enter the body — the likelihood of death becomes dangerously high,” says Saatchi.

Cancer patients and those who stand at their bedside, he says, see scenes that wouldn’t be permitted in a Hollywood horror movie.

A former member of the British Conservative Party, he believes there’s no cure for cancer because the law is a barrier to finding one. He says any deviation by doctors from standard procedure is likely to result in a verdict of guilt of medical negligence. He wants to change this with his Medical Innovations Bill, currently proceeding through the House of Lords.

“The law defines medical negligence as deviation from standard procedure. This represents a serious deterrent to innovation. Innovation is deviation. Non-deviation is non-innovation. It explains why there’s no cure for cancer. The thousands of deaths from cancer each year are wasted lives — they haven’t advanced scientific knowledge by 1cm. I believe if the bill’s enacted it will encourage the person who will cure cancer.”

If made law, the Medical Innovations Bill would promote responsible scientific innovation but also protect against quackery — a hospital’s entire multi-disciplinary team approve the proposed innovative therapy in advance.

Ireland was a dominant force in Josephine Hart’s life. She suffered tragedy here: three of her siblings died when she was young. But it’s also where her life path opened up — a writer, theatrical producer and TV presenter, she learned her love of reading, literature and poetry at St Louis Convent, Carrickmacross.

Saatchi hopes “doctors and judges in Ireland will conclude with colleagues in England that the Bill is important and will save lives”.

According to National Cancer Registry Report 2012, ovarian cancer was the fourth most common cancer in women in Ireland between 1994 and 2010 — on average, 376 cases were diagnosed annually. Five-year survival rates, at 29%, ranked among countries with the poorest survival rates, close to those for England and Scotland.

Orla Dolan, director of external affairs at Cork Cancer Research Centre (CCRC), says it’s more likely that clinical load prevents clinicians in Ireland from dedicating the time they’d like to research.

“They’re overstretched and have to snatch time for research after long clinics and days in theatre. When Nobel Laureate James Watson visited CCRC, he felt worldwide it was red tape that holds back progress, preventing trials from progressing more quickly. That can also be a frustration in Ireland. When you believe a new treatment will make a difference, you want it available as fast as possible. But it’s a balancing act — patient safety is paramount. No-one wants another Thalidomide.”

Consultant gynaecological oncologist Dr John Coulter says clinicians in Cork have been pushing boundaries and utilising novel treatments in situations where other treatments haven’t succeeded. He points to electrochemotherapy — a new treatment pioneered at CCRC — which he has used to treat two patients with gynaecological cancers.

“A novel research idea is only put into clinical practice when research shows promising results and once a safety profile has been established for that treatment. Lord Sacchi’s contention that we’re afraid to try new treatments because of fear of [verdict of medical] negligence isn’t correct.

“Doctors always practice with the ‘first do no harm’ ethic and are duty bound to prove novel treatments are safe prior to clinically applying them, even if we’re convinced they’re the way forward.”

With his bill Saatchi aims to prevent other women from enduring the same hell as Josephine did. For his own personal loss, he sees no such reprieve. Is his campaign to change the law helping him deal with her death? “No,” is the stark response.

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