“A patient once described it to me as brutal, and it’s really stuck with me, because it’s difficult to go through.”

It’s the cancer remedy Prof Mererid Evans routinely prescribes to the individuals who come to her, hoping she’s going to save their lives, and which she goals to enhance with analysis she is main.

It was the identical phrase utilized by Welsh comic Rhod Gilbert when in 2022 he discovered himself sitting in entrance of the advisor oncologist after being identified with throat, neck, tongue and tonsil cancer.

Her well-known affected person immediately put her consulting room at Velindre Cancer Centre, Cardiff, within the limelight when he made a documentary about his remedy.

“Rhod wanted something positive to come out of his experience,” stated Prof Evans, 54, head and neck specialist at Velindre Cancer Centre in Cardiff, a professor at Cardiff University’s cancer and genetics division, and head of the Wales Cancer Research Centre.

“We talked about the treatment he’d be receiving and I think he felt it was an opportunity to highlight what it’s like going through cancer treatment.”

About 12,500 new circumstances are identified every year, based on Cancer Research UK, and incidences are on the rise. About 4,000 folks die from it yearly.

Prof Evans found the comic’s remedy was to be filmed just a few days earlier than it started.

“I don’t think he knew before he started how impactful him recording his journey would be. I think it was something that he wanted to do for himself because this is what he does,” she added.

“And he felt he could turn something that was a very difficult experience into a positive.

“I believe that that is how he is mirrored on having completed it, that it is raised loads of consciousness and hopefully has helped folks in an identical scenario to him.”

Prof Evans tried to carry on as normal in her interactions during their consultations, despite having a film crew present.

Gilbert was treated with radiotherapy and chemotherapy, which Prof Evans called “significantly tough” for head and neck cancer.

“When you’ve gotten a tumour or cancer behind your throat, both within the tonsil or the again of the tongue or the roof of the mouth, while you try to deal with that with radiotherapy, what successfully you might be inflicting is massive ulcers within the affected person’s mouth and throat that worsen over a six-week interval,” she added.

“The negative effects are a dry mouth, lack of style, ulcers that make swallowing very painful and tough and typically requires feeding by a tube within the tummy as we noticed [happen to him] within the documentary.”

It also causes fatigue which can take months to get over, she added, and the effects are compounded if a patient also has chemotherapy, which can cause nausea, vomiting and infections.

Another particularly significant side effect for a performer is changes to the voice.

“Radiotherapy to the top and neck does trigger some swelling and irritation throughout the voicebox,” she defined.

“It’s not unusual that individuals develop a hoarse voice throughout remedy, and that does not at all times enhance. So that was an actual concern, and that was clearly a giant one for somebody who makes their residing by utilizing their voice.”

This was echoed by Gilbert in the programme.

One of the primary issues he stated was: “I’m nervous that the radiotherapy may significantly knacker my voice. I’m a stand-up, so this remedy may save my life, however kill my profession.”

Gilbert’s cancer was caused by the human papilloma virus (HPV), more commonly associated with cervical cancer.

A programme of vaccination for girls against HPV to tackle cervical cancer, given at the age or 12 or 13, was introduced in 2008.

Prof Evans was involved in two studies looking at the prevalence of HPV cancers in men which were used as evidence for the Joint Committee on Vaccination and Immunisation to subsequently extend the HPV vaccine to boys in 2019, which was “very rewarding to see”.

The HPV vaccination programme in girls has seen a near 90% reduction in cervical cancer rates in girls who were first vaccinated at 12 or 13, and a 97% reduction in pre-cancerous cell changes that can lead to cervical cancer.

“If HPV vaccine got to everybody, one would think about the charges ought to come all the way down to nearly zero,” she stated.

“The difficulty is ensuring vaccination charges are excessive and that they are maintained in order that transmission throughout the inhabitants is damaged, however it will take a very long time.

“In the meantime, we’re going to see large numbers of people who have HPV-related cancers and we need to treat them.”

Part of her work now’s main a trial, together with Prof Terry Jones from Liverpool University, gentler remedies that will probably be as efficient.

The trial, generally known as Pathos, is utilizing minimally invasive surgical procedure carried out by robotic or laser strategies, and decrease doses of chemotherapy or radiotherapy.

Seeing how the affected person copes with remedy exterior hospital was a advantage of the documentary, Prof Evans believes.

She stated: “I think it was incredibly brave of him to open up and show honestly what the experience was like for him. It wasn’t just the physical, it was the emotional and mental challenge that treatment was for him to get through.

“We do not typically see that facet of any person’s journey as a result of once they come to clinic we discuss very sensible issues like ‘how’s your swallowing? How’s your ache? Are you utilizing the mouthwashes?’

“Often it isn’t a space where we see the reality of living with something every minute of every day, every hour of every day when it is very, very difficult.”