Tag Archives: cancer

An article on cancer and antenatal life

4 Dec

I’ve written this for the next edition of the Dimbleby Cancer Care (DCC) trust’s newsletter. The DCC provided me with essential support while I received chemotherapy for cancer in 2011, and I’ve kept in touch with them since. The theme is about how cancer still plays a role in my life, even well into remission and healthy, now that I’m having baby. I still cannot pin healthcare professionals down on precisely why having had cancer plays a role in my antenatal care, but it seems that being ‘different’ healthwise automatically puts a reg flag on your record.

Have a read.

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As I write, I’m hemmed in on all sides by old shelving, piles of CDs and books, bedding, and photo frames. The living room looks as if a jumbo jet exploded and dropped all its cargo into my living room. I’m redecorating my tiny spare bedroom because I’m having a baby – my first. Pregnancy is harder work than having chemotherapy was. I heard Jennifer Saunders narrating her new book on Radio 4 last week. She says that chemotherapy was easy, because she just did as she was told – the least stressful and easiest part of her adult life. I know exactly what she means. There’s such a thing as chemo nostalgia. Obviously, I detested giving myself a Neulasta injection 24 hours after each chemotherapy session, and the following days when my bone marrow was on fire and shattering into dust inside me. But I found that essentially, society exempted me from responsibility, however minor, for six months. Having just come out of a stressful job, it was almost a welcome break from myself. Everyone around me understood everything, and I could just be. I’m sure because of this, I recovered quickly and fully. What other time in one’s life can they expect to be given such a free pass?

Now, as a pregnant woman, shades of this reappear: I’m supposed to be tired and sleepy a lot, and as I’m told, “give in to it”. And perhaps my cancer training makes me a little too good at that. My mum spent most of a week blitzing said spare room, damp proofing, stripping wallpaper, painting, sanding, cleaning and hauling things in and out, so that my boyfriend and I can have a place that in time we’ll call our child’s bedroom. My contribution was to accompany my mum to the local hardware store to buy paint, supply regular cups of tea, and a really soggy toad in the hole with rock-hard steamed carrots. Both mum and boyfriend were complimentary about the car crash dinner anyway – something about ‘baby brain’ was my mum’s pop science explanation.

My time as a cancer patient was excellent training for my life now. It is in use every day. Before cancer, I never had time for breakfast. Lunch was a soggy Pret sandwich eaten while feverishly typing emails at around 3pm, and dinner was whatever was in the cupboards fried up together and wolfed down over Newsnight. I cannot do that now. While I was having chemo I began to have breakfasts, and now I feel sick if I don’t have it. After chemo, I became a freelancer working from home, which meant that I began to make my own lunches and stop for an hour to eat properly. The lifestyle change meant that I could luxuriate a little over making a proper dinner.

All told, I’m a lot healthier because of cancer. And now that I’m pregnant, and bloody hungry all the time, this training comes into its own. I’m doing the best by my post-cancer body – even when I do long shifts as a contractor now, I prepare plenty of healthy food and snacks to come with me, so I can eat every couple of hours – and I’m answering the call of my unborn baby for nutrients. I do get tired, and my time in chemo taught me to listen to my body telling me when to stop, or when more sleep is needed. So I can hear the messages, and act accordingly. As I learned how to articulate to those around me how I was feeling physically (I thought that keeping my partner in the loop was a logical way of tracking any potential infection or problems while having chemo, so that he could help me keep note for when I saw my oncologist or my Macmillan nurse), I do this much more now that I’m pregnant. That way those around me know that I’m not bored of their conversation – I just need to take a power nap. None of those good habits would have occurred to me before chemo. I have wondered if my inability to hear my body before that experience contributed to getting cancer, though the question of nature versus nurture (of lack of it) as a determinant of cancer is one best left to scientists.

This Christmas I will mark two years since I finished my ABVD, six cycles, for Hodgkin’s Lymphoma, stage three, and I’ll be at the latter stage of my second pregnancy trimester. And cancer, while not in my body, stays with me in both positive and negative ways. I have discovered that midwives fret about you if you’ve had a serious illness; my cancer experience could dictate which type of delivery I can endure. I’m thinking about a home birth – I live moments from my hospital, and as my obstetrician said, “you could crawl in yourself if you got into trouble”. They have said that supporting this hangs on my oncologist’s blessing and normal test results. I have since received that, but my oncologist wants me to see the obstetrician in my last trimester because of the low risk that the Doxorubicin may have weakened my heart, which may put me in danger at labour. Other than that, he downgraded me from reviews three times a year to twice a year, and is happy with my health, as he is with supporting a home birth – if the obstetrician sees no problems from my heart. My mum suggested a caesarian. She says: “it’s easy, like taking shopping out of a bag”. So even though I’m well enough to conceive two years after chemo and in my mid-30s, that cancer history is informing the way clinicians assess my pregnancy.

On the upside, seeing an obstetrician is a good thing. You want as many experts as you can get, and thank Christ for the NHS’s! But the otherwise clean bill of health my oncologist has served up means that I won’t see him until after I’ve had the baby. Again, chemo nostalgia: I really rather like him, and will miss the opportunity to catch up with him for the next 8 months. In the meantime, the 13 years of flat-sharing flotsam and jetsam I’m hemmed into my living room by will be rationalised to make way for the ephemera of a small person. And my cancer history may yet tell whether I’ll be able to give birth to the baby in this very room or three minutes down the road.

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Campen FO: How the Dimbleby family is working through its cancer charity funding crush – and the question of future family involvement

4 Sep

This has just been published by Campden FO, the magazine for super-wealthy business families and their charitable foundations across the world.

For two generations, the name Dimbleby has been associated with British journalism. The dynasty was founded by Richard Dimbleby, who made his name as a World War II reporter, sending the first broadcasts from Belsen. He was later famous for anchoring television broadcasts of the coronation of Elizabeth II and the state funerals of JFK and Winston Churchill. Two of his children, David and Jonathan, are today household names for their work on televised election coverage and political programmes, while two of his grandchildren, Joe and Kitty, are also journalists.

All very well for the pages of high society gossip magazines, you may think. But there is a largely unknown side to the family. For almost 50 years Dimbleby Cancer Care, a charity founded by the family following Richard’s death from testicular cancer, has been quietly partnering with major cancer charities and leading cancer centres to fund critical research projects. It also works with the UK’s National Health Service to run free drop-in services at two London hospitals, Guy’s and St Thomas’, for cancer patients and carers.

David Dimbleby, best known in the UK for presenting TV coverage of general elections and other major political programmes on the BBC

David Dimbleby, best known in the UK for presenting TV coverage of general elections and other major political programmes on the BBC

The Dimbleby family has dominated the board of trustees since inception. David (pictured, right) is chair, although Jonathan will succeed him in the role at the end of this year, when David will become a regular trustee. Their younger brother Nicholas, a sculptor, is on the board, while Joe and Kitty, David’s son Henry, founder of the healthy fast-food chain Leon, and daughter Kate are also family trustees. Other family members have come and gone.

Enthusiasm is not lacking. But money is. Times have changed since DCC was founded. When Richard died in 1965 the family asked people to send money so they could start a charity. They did, in envelopes stuffed with cash. But these days things are done differently, of course, and the long-term economic slump in the UK and Europe is forcing the family to rethink the way it operates. The main source of income, an endowment, is running out of cash after 46 years, while philanthropic giving is down.

DCC is run on a shoestring. Its two drop-in centres run on just £220,000 (€255,000) each year. The family’s particular corner of research – ways to help cancer patients better bear treatment, on imaging techniques to identify appropriate treatments, and on end-of-life care – doesn’t attract big money. “We’re exactly in the catch-22 of a small charity,” says Jonathan. “We can do very important work very cheaply, but because we don’t have the funds to make a huge noise about ourselves and employ fundraisers in large numbers, or spend a huge amount of money before we pull in a large amount of money, it’s quite difficult for our voice to be heard.”

The fundraising and communications expertise that DCC needs can’t be supplied by the family trustees, so they are considering bringing in outside experts. The charity is, says Jonathan, “in a state of flux”. The NHS is too, with talk about privatisation rife, and the family doesn’t know how this might affect its relationship with the hospitals. But money is the big, immediate problem. “As a family we’ve had to confront some uncomfortable realities,” says Jonathan. “We’re at a point where we have to think very hard about the best way to generate funds, and therefore the best people to be intimately involved in that. Of course this includes the family, but it must also mean other people from outside who are willing, able and have the knowledge and experience to make things happen.”

Jonathan Dimbleby, journalist and TV presenter

Jonathan Dimbleby, journalist and TV presenter

Having a board of trustees dominated by the family could be a problem for some big donors who focus on professional boards and shun any hint of nepotism. Jonathan (pictured, left) is alive to this – and philosophical about the fact that the next generation members might not be the right fit for the future. “We like to see our next generation as free and independent spirits,” he says. “One of the difficulties with young people who have their own jobs and are busy is that they just can’t find the time they want to put into a project like this, no matter how important they regard it as being. They’re travelling, they aren’t all in the same place at the same time, or their families need their time. It’s not easy. But I think the important thing is the commitment of trustees, more than anything else. It’s just romantic to imagine that because DCC was started by us it is eternally, generation through generation, run by us.”

The family did try out an external director in Malcolm Tyndall, who joined the DCC from a fundraising role with the UK’s Home Office in 2008. But when he was headhunted away two years later, the family decided not to replace him. “In retrospect we didn’t have enough time to decide whether or not a director from outside the family was a good thing,” Jonathan says. “My instinct is that to justify that post in a small charity where the principal trustees are closely involved, you have to be operating on a scale that we are not yet at.” Now, he says, they not only want this, but they need it.

“I personally wouldn’t want a situation where we have no family trustees,” Jonathan says, “but equally I don’t want a situation where merely because you are part of the family, you are in a controlling position. The work is what matters, and the funds, the delivery of the services, and the research.” That means that the board has to have people with the right calibre, and able to make a big enough commitment. “My father would not want it to be a mausoleum for his memory,” he adds. “He would want this work to progress, for his offspring to want to achieve that as effectively as possible.”

The plaque in the BBC London headquarters, commemorating Richard Dimbleby, in whose name the Dimbleby Cancer Trust was founded by his children

The plaque in the BBC London headquarters, commemorating Richard Dimbleby, in whose name the Dimbleby Cancer Trust was founded by his children

DCC – a quick view
The DCC’s service-delivery work is delivered through two NHS hospitals, St Thomas’s – perched on London’s River Thames opposite the Houses of Parliament – and Guy’s, nestled behind London’s newest landmark, the Shard.

The charity also runs three funding streams:
The Dimbleby Cancer Care Research Fund awards up to £250,000 each year, funding research into the care needs of cancer patients and is one of the very few charitable operators in that field.

The Richard Dimbleby Chair of Cancer Research, which through an endowment to King’s College London supports the Dimbleby Laboratories, is working on imaging techniques to identify the most fitting treatments for an individual patient’s cancer.

The Dimbleby Marie Curie Cancer Care Research Fund, a partnership with Marie Curie – one of the UK’s biggest cancer charities – funds £500,000 annually in research on end-of-life care, though this will end in 2012.

Where’s the money?
Despite the economic climate, charitable donations have not collapsed in the UK or the US. “In general those who give tend to have finances that change on a longer-term cycle,” says Professor Cathy Pharoah of the Centre for Charitable Giving and Philanthropy at Cass Business School. Some foundations have chosen to use up their money because they are worried that the cash, whose performance is tied to the market, is at risk. Some philanthropists have actually increased their giving because there is nowhere good to invest their money. Some charities struggle for other reasons. There is a market for charitable giving just like there is a market for anything else, and cancer charities with a strong focus – a brand, you might say – tend to attract more money than generalist ones. Those specialising in particular kinds of cancer, such as breast, skin or prostate, appeal more. “Unless it has a strong, distinct profile, then a cancer charity is going to have problems attracting money,” Pharoah says. There are two ways for smaller charities like DCC to attract more money, she adds. Firstly, they can merge with a larger one. Or secondly, they can leverage their networks and contacts to attract large donations from foundations. In the case of the Dimblebys, with their contacts and family name, that might be their best bet.

Kitty Dimbleby, one of the next generation of the family leading its cancer charity

Kitty Dimbleby, one of the next generation of the family leading its cancer charity

The view from the next generation: Kitty Dimbleby
Kitty Dimbleby (pictured, left), 32, is the youngest member of the DCC board of trustees having joined at 18.
On her reason for joining DCC As long as I can remember my father went to DCC meetings; once or twice they were even held in our family home. I would sneak downstairs and listen through the banisters, not really sure what was going on but knowing that one day I wanted to be part of it. As a child, teenager and young adult I was in and out of hospital with health problems and I met many young people living with cancer: before I turned 20, I had attended two of their funerals. It was, I am sure, this greater awareness of the illness and our mortality that compounded my childhood desire to help.
On being a teenage trustee I became a trustee at 18 but soon realised I was too young and had nothing of any use to bring to the table. I was galvanised to sign up again a few years ago when a friend was diagnosed with cancer. Now in my early 30s, having worked for a few years for the military charity Help for Heroes, I feel I could finally be useful.
On what the next generation brings to the table I think the younger generation brings something different to the charity – a fresh perspective and passion for the cause, which reignites that of the older generation. We have been able to introduce more modern methods of fundraising, such as social media. Although it is sometimes hard to get a word in, my father and uncles do listen and appreciate my input. For the charity to continue and move forward it needs us to be involved – much as they would like to, dad, David and Nick cannot keep working forever.