‘Jessica’s cancer was missed 20 times by GPs – she never stood a chance’
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On the night of Sunday November 1, 2020, Andrea Brady sat on the sofa, panic rising in her chest. For weeks, fear had gripped her happy family life. Now it was coursing through her, as a terrible realisation began to land. Andrea’s husband, Simon, came into the room. Seeing her face, he asked what was wrong. “I think Jessie’s got cancer,” she said.
For five months, the Bradys’ daughter, Jessica, had been getting progressively more sick. With every passing week, their bright, ambitious girl, who had always been healthy (in 26 years she had barely bothered her local GP surgery in Hertfordshire) was becoming unrecognisable.
In isolation, Jessica’s symptoms sound horribly uncomfortable; seen together, they would alarm even someone with no medical expertise. They ranged from stomach pains to persistent postnasal drip and a cough so bad it made her vomit. By November, she could barely keep food down and was rapidly losing weight. She was constantly breathless and physically exhausted. No amount of rest could bring relief to a body that seemed, inexplicably, to be failing her.
Sitting at the dining table that Sunday, Jessica turned to her boyfriend and asked if he could see her glands, which felt so sore and swollen. “Alex said no, but it must have been the angle he was looking from,” recalls Andrea. “From where I was sitting I could see these huge glands and I thought ‘Oh my God. This isn’t good’.”
By then, Jessica’s symptoms had been repeatedly dismissed by the GP surgery, where a roster of doctors (she rarely spoke to the same one twice) diagnosed her with everything from a urinary infection to long Covid.
Jessica first contacted the surgery in June 2020 with pain in her abdomen and back. Over the phone, the GP told her she had a UTI and recommended antibiotics – the first of five futile courses she would be prescribed over the next five months.
Andrea recalls a “niggly feeling” in her stomach even then. “I said, how do they know it’s a urine infection? Did you take a sample into the surgery? No, and she hadn’t been examined. Jess had hardly ever had antibiotics in her life. But she was 26. She seemed to think it was OK.”
That appointment set the tone for what was to come. Jessica battled to be taken seriously, receiving what the Bradys describe as “fragmented” care. Most appointments were conducted remotely, and Jessica accrued a series of increasingly debilitating symptoms.
A pattern emerged: she’d call the surgery, speak to a dismissive receptionist, and eventually be granted a phone call with a GP. The doctor would listen to the latest symptoms, prescribe medication and send her away. Jessica had 20 GP appointments and two trips to A&E in total. Not once did anyone mention the word “cancer”.
A final desperate attempt to get help via a private consultation gave Jessica the diagnosis her parents had begun to fear. By the time a doctor told her she had stage four adenocarcinoma (a cancer of the glands) with an unknown primary, it was too late. The cancer had spread to her liver, lungs, lymph nodes and spine. “She was told that it was terminal and there was no hope, that she mustn’t hope,” says Andrea. Jessica was admitted to hospital straight away; she died three weeks later on December 20, 2020.
Through those torturous months, Jessica did an extraordinary job of advocating for herself. And yet, her case still managed to slip through the net – a casualty not just of Covid but of a primary care system in crisis. Just three of Jessica’s GP appointments were conducted in person. Face-to-face consultations plummeted in the pandemic, of course. Yet, even now, nearly 30 per cent of appointments are still conducted remotely in England.
The Bradys feel doctors failed to piece together a jigsaw puzzle of symptoms. As she wasn’t in an at-risk category, her case wasn’t probed. “We think if Jess had been a different age, socioeconomic background, many other things, it would have been a red flag,” says Andrea. The case was never examined as a whole, and key moments were missed. Results from tests – which she had to beg for – should have raised alarm bells. One blood test showed that a D-dimer (a protein fragment indicative of a clot) was raised. It was never followed up; the Bradys now know a raised D-dimer can also be a sign of cancer.
The couple are campaigning for Jess’s Law, which would require a case to be elevated for review after a patient contacts their GP surgery for the third time. In the midst of unimaginable grief, the Bradys have thrown themselves into raising awareness around early diagnosis. They created a petition to improve the detection of cancer in young adults. They were invited to meet health secretary Steve Barclay and received a verbal apology for the failures that led to Jessica’s fatally late diagnosis. A Department of Health and Social Care spokesperson told The Telegraph discussions were “continuing” between the family and the department. “It is clear opportunities to diagnose Jessica sooner were missed and the Secretary of State has met her parents on two occasions to discuss how to prevent similar tragedies happening in future.”
In September 2021, Andrea addressed a Health and Social Care Select Committee meeting about cancer services, telling the committee GPs needed to be able to refer patients urgently. When Jessica asked for a referral to an ear nose and throat specialist, her GP simply laughed. He wouldn’t look down her throat, even though he was wearing a mask. Andrea also told the committee patients deserved a “named doctor – not just in principal, but in practice. Somebody who will follow through with a patient’s care”.
They stress they don’t bear a “vendetta” against the NHS. “No doctor gets up in the morning and wants to miss a diagnosis,” says Andrea. “We don’t have a thing against GPs. We know they’re professional, hard-working. We want them to be supported.”
The Royal College of GPs (RCGP) has committed to working with the Bradys to develop “new educational resources to further support GPs with cancer diagnoses”. Professor Kamila Hawthorne, chair of the RCGP, said: “It’s critical that symptoms are picked up on quickly and appropriate action taken, including rethinking the approach if problems persist over multiple consultations.”
When asked if the RCGP would support Jess’s Law, Prof Hawthorne was cautious: a “three strikes and refer” approach requires “careful consideration and wider discussion with organisations outside the RCGP”.
Next month will mark three years since Jessica’s death. Before she fell ill, Jess worked as a satellite engineer at Airbus. She lived with her boyfriend not far from her parents. She was looking forward to turning 30 and had written a “30 before 30” list filled with dreams big and small.
In their living room, Andrea and Simon are going over the sliding door moments – the missed chances to save a young woman who had everything to live for. “She never had a chance for treatment, for a cure,” says Simon. “She just deserved so much more.”
There is no roadmap for how to cope with losing a child. “You don’t feel complete joy or happiness,” says Andrea. “As a parent, when you’ve given life to someone…” she pauses. “It’s incredibly difficult to carry on.”
The couple work at the same primary school – Andrea, 56, as a teacher, Simon, 60, as a caretaker. “You put a mask on,” says Simon.
“There are certain things that become harder,” says Andrea, “because it’s been so long since you’ve touched them, and smelled them, and spoken to them.”
The couple have been contacted by a number of families who feel their loved one was let down by a late diagnosis – families who say that Jess’s Law could have made a difference. “So many people tell us it was six, seven, eight, nine times they contacted the GP practice,” says Andrea.
After months of being told she was suffering with little more than long Covid (despite negative Covid tests) Andrea recalls the moment a doctor told Jessica she had stage-four cancer. “I just burst into tears and Jess just looked at me and put out her hand and held my hand. And I felt awful that I was crying and Jess wasn’t.” From that moment on, the family sat with Jessica all day and night in a side room. “Only once did she leave that room in three and a half weeks, by wheelchair, to have an X-ray,” says Andrea.
Through it all, Jessica was “so courageous”. “She showed no anger,” says Simon, though she was “really upset with the GP surgery”. She held on to the hope of a miracle. Her parents persuaded hospital staff they “needed to allow her to believe that there’s hope. Because it’s just too awful to be told something like that. We tried everything in those three-and-a-half weeks to get a second opinion. Time was just ticking against us.”
It is impossible not to wonder how different things could have been if just one doctor had taken a step back, looked at the wider picture and referred Jessica for more tests. “I think the thing that actually crucified Jess was not being listened to,” says Andrea. She hopes Jess’s Law would give people a chance to say: “Look, I know you’ve diagnosed me with this, but it doesn’t feel right to me. Please listen to me.”
Covid “exacerbated” Jessica’s case, but hers was not, they feel, a Covid death. “We think the mindset of the GP surgery was such that it would have been delayed anyway,” says Andrea. “No one gave her time. She needed an extended GP appointment. Somebody needed to look at everything that had happened and sit down with her.”
Alongside Jess’s Law, the couple set up the Jessica Brady Cedar Trust, a charity which aims to “improve GP awareness and diagnosis of cancer”. After Jessica’s death, the Bradys wrote to the surgery to make a formal complaint. They never received an apology. If Jess’s Law means that another family can be prevented from enduring what the Bradys have, that will bring them some comfort.
On the day of Jessica’s funeral, the satellite she’d worked on at Airbus was launched from Cape Canaveral. Emblazoned on its side, the words: “Thank you, Jess”.
No one wants to hear a cancer diagnosis, early or otherwise, but if Jess’s Law becomes a reality, those words will surely be on the lips of families up and down the country.
For more details see www.change.org/p/stevebarclay-improve-the-awareness-and-diagnosis-of-cancer-in-young-adults
