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The Guardian - UK
The Guardian - UK
Entertainment
Lucy Mangan

Super Surgeons review – the cancer doctors who really should have God complexes

Prof Vin Paleri performs cancer surgery on Jade, assisted by robotic tools, at the Royal Marsden hospital, London.
Prof Vin Paleri performs cancer surgery on Jade, assisted by robotic tools, at the Royal Marsden hospital, London. Photograph: Channel 4

Such innocuous beginnings: a sore throat that doesn’t go away. A thing on your hand that doesn’t hurt but begins to spread up your wrist. Changes in your toilet habits. And you find yourself with cancer. If you are both very unlucky and very lucky, you may go on to find yourself at the Royal Marsden hospital, under the care of one of the doctors there, who lead the world in providing innovative approaches to hard-to-treat cancers. “We understand that this is their only hope,” says one. “We have to push the limits of what is surgically possible.” Without intervention, most of the patients who arrive there will die within three months.

The first episode of the trio that comprise Channel 4’s new documentary series Super Surgeons: A Chance at Life follows three patients and their doctors. When 41-year-old Jade took her baby to a routine GP appointment, she mentioned that she had had a sore throat for five weeks. The GP sent her for investigation and Jade was diagnosed with squamous cell carcinoma. She has had chemotherapy and radiotherapy but the cancer is now back, deep in her throat, behind her larynx. The standard treatment is a laryngectomy but Jade does not want to lose her voice. Her surgeon, Prof Vin Paleri, is going to try to remove just the tumour by going in through her mouth using robotic tools he can manipulate from outside. Once there, he finds he has to change his plans to something that has not been done before.

The thing on 32-year-old photographer and film-maker Dimitrios’s hand was found to be a rare and aggressive type of sarcoma. The usual treatment would be amputation of the arm, possibly including the shoulder. He would be unlikely to be able to continue in his work thereafter. Dimitrios’s consultant surgeon, Andy Hayes, is going to detach his circulation instead of his flesh, blast the arm with enough chemotherapy drugs to kill him if it got into the rest of his body (the vessels involved are tiny and delicate and any mistake is “potentially catastrophic”), and then reattach everything when it’s safe to do so. “It took me years to build up the courage to start doing arm perfusions,” Hayes notes. Which, counterintuitively perhaps, only increases your regard for and confidence in the man. I understand surgeons developing God complexes, but a touch of humility is far safer.

Jade, 41, who has a squamous cell carcinoma behind her larynx and does not want to lose her voice.
Jade, 41, who has a squamous cell carcinoma behind her larynx and does not want to lose her voice. Photograph: Channel 4

A similar moment occurs when 35-year-old Lizzie’s consultant, Ricky Bhogal, looks off to the side, as he says, “They are actually putting their lives in our hands.” It’s as if he can’t quite believe it. Then there is Paleri’s almost bitterly voiced comment: “The longer I spend in this field, the more the unfairness of it [cancer] strikes me.” Given that you can’t divorce treatment options from an individual’s context, to stay engaged with more than the merely medical side of the disease is surely the mark of the finest doctors.

Lizzie, first diagnosed in 2018, has terminal bowel cancer. Bhogal’s job is to keep the final blow from falling for as long as possible. His immediate task is to remove three new tumours, hemmed in by scar tissue from multiple previous surgeries, with one situated dangerously close to major blood vessels. “Oh. Oh. Shit. Stitch please,” he says with clipped, polite fury during the operation as the cavity fills with blood. “Hold it. Hold it, hold it … I need another one of these. Quick, please.” A few minutes later we hear a relieved “Bloody hell”. “Nicely controlled,” says a colleague. “Thanks,” he says. And on they go.

The documentary is made in partnership with Macmillan Cancer Support, and alongside Lizzie, Dimitrios and Jade’s stoic accounts of living with cancer, we hear calls from other patients and survivors to the charity’s helpline, wrestling with their new realities, their mixed feelings of anger and gratitude, their absolute fear of leaving children and others behind.

The unspeakable unfairness of the disease is brought sharply home to us again by the closing captions. But the series overall promises to lift us out of the slough of despond. Without becoming mawkish or losing sight of the human suffering involved, it focuses on what can be done, what is being done and what shall in the future be done. Robotic arms are made to snip tumours away from healthy flesh, pull them out and lay them – harmless now – on white gauze pads. A photographer loses a finger instead of an arm and shoulder, and continues working. He sees it as “a terrible journey”, but one along which he found himself. “Something good has happened to me.” Lizzie’s operation was successful but a new spot has been found on her liver. “It should be treatable,” she says. “We’ll just carry on carrying on.”

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