"What Cancer Treatment at a Public Hospital Taught Me:"

I never imagined I’d be in the position to write about cancer treatment from personal experience. But after going through two rounds of chemotherapy in a public hospital, I feel compelled to share what my experience was really like — especially for those who are just beginning this journey and have no idea what to expect. This isn't medical advice. It's a wake-up call — a warning for anyone who believes the system will catch them when they fall. Based on my experience, it often didn’t.

From the outside, the hospital staff I saw seemed compassionate and professional. But as I went through treatment — vulnerable, sick, and scared — I began to see a different reality. I feel the system is cold, rigid and worst of all, I believe it’s indifferent. I was given an information booklet at the start, but it didn’t help me when bedridden with side effects or struggling to make sense of a delayed or missed medication.

In my experience, I found that no one was really there to guide me through the emotional and practical aftermath of treatment. I felt left to manage the confusion, the fear, and the pain — alone. After the second round of treatment, I came to a harsh realization: I believe there’s no point in asking the nurse for help — the apparent “wolf in sheep’s clothing.” I believe that all they’ll do is tell me to go to my GP or the emergency department. Both options are terrible. I was too sick to explain myself clearly, and it seems to me that neither GP nor ED staff often know how to properly manage a patient in the middle of chemotherapy, even when told.

Here’s what I’ve learned through painful personal experience:

•If running a high temperature (38°C or higher), go to the ED. I believe there is no choice. It may be a neutropenic infection (low white cells), and will need blood tests and intravenous antibiotics immediately.

•If the nurse forgets to give medication to support white blood cell production, there is serious risk of infection. If that happens, I believe it is likely to end up in ED from 9 a.m. to 9 p.m., followed by a week in hospital, being pumped with antibiotics three times a day — and still, I felt I was treated like an inconvenience.

•After chemo, flu-like symptoms may develop; sore tonsils, dry choking cough, fatigue. If you can still function, go to the GP, ask for; a blood test (to check white cell count), a virus swab, a temperature check, a chest X-ray (to rule out infection or pneumonia) and oral antibiotics, if indicated.

•I expected my oncology nurse to tell me this. They didn’t. I believe it was unlikely to get advice beyond “go to your GP or ED.” That’s all they seem to say. The rest, it seemed I was left to figure out on my own. Sadly, it seems to me that even GPs are often unequipped. Many I have seen have little knowledge of what to do with chemo patients and will play it safe by telling me to go to ED — which, as I’ve said, is time-consuming, traumatic, and inconsistent in care in my experience. No disrespect to all GPs — I’m sure there are good ones out there. And I think if you have one, you are lucky. I’ve experienced forgotten medications — essential ones. I’ve had nurses forget to remove cannulas, poke me repeatedly, and then treat me like I was being difficult when I was simply trying to survive. I believe it is expected to respect the staff, no matter what happens, but my pain, my questions, my fear? It seems to me that it is often seen as a burden.

I wish this wasn’t the reality of my experience of public cancer care, but it is. And if you are going through it too, please know: you are not alone, and your feelings are valid. I believe there is nothing disrespectful about advocating for my health and well-being — even if the system tries to make me believe otherwise.

I hope that by sharing this, others will feel less isolated and more empowered to speak up, document their experiences, and demand better care — because we all deserve it.

Nursing staff: I feel you need to be more understanding of your patients’ pain, fears, and uncertainty. I believe that many of us don’t know what’s normal or what to expect, and we rely on you for guidance.

•Don’t be a “dobber.” Don’t run to your superior to report patients who are, I believe, simply advocating for themselves — I feel you should help them first.

•Instead of seemingly repeating yourself "go to your GP or ED,” I think you could try:

o“Let me check with the treating doctor and get back to you.”

oOr: “If you see your GP, ask them to request a chest X-ray, virus swab, blood test (including white cell count), temperature check, and potentially antibiotics.”

•I think you should ask the treating doctor what specific antibiotics are recommended for patient in this condition. In my experience, you are the oncology team — you are the specialists. Don't seemingly pass everything on to a GP who, in my experience, doesn’t have the full picture.