Hilary Thomas on living with cancer

Somebody once said of failed US presidential candidate Michael Dukakis that his idea of excitement would be rearranging his sock drawer. It was probably a fatal blow. Let me reassure you that I have always loathed rearranging my sock drawer. But such is the debilitation of chemotherapy that I have a sense of achievement at being able to undertake even this tedious task.

Six weeks into my treatment I understand why people use that dreadful term 'cancer sufferer', although it's not the cancer but the treatment from which I am suffering.

I have acquired the sobriquet 'slaphead' at home (perhaps my partner's revenge for his progressive, permanent hair loss), my eyebrows and lashes are thinning, making me prone to conjunctivitis, and - the only positive I have found - I no longer need to have my legs waxed. I have nosebleeds, indigestion, a sore mouth, fragile skin and my taste is altered for 12 of each 14-day cycle. Just when I am picking myself up I seem to be knocked down again.

But all of this is manageable. What isn't manageable is the constant feeling of nausea. And the biggest surprise is that conventional medicine is far less effective than I had realised. I had to smile at Professor Michael Baum's recent intervention in relation to evidence-based Western medicine and how 'unproven or disproved' treatments drain precious NHS funding.

On one level he is absolutely right, but ginger beer and acupuncture have been as effective as any of the conventional anti-emetics I have been doling out to patients for years. Yet these were licensed on the basis of evidence. Indeed the one treatment that suppresses my nausea was developed as a sleeping tablet.

Anyway, medicine is far more complex than evidence, which most professionals use selectively at best. The track record of the medical profession implementing scientific advances is parlous. William Harvey published his proof of the continuous circulation of the blood through a closed system in 1628, yet the use of leeches for blood-letting, based entirely on the concept of two circulatory systems, continued for another 200 years.

I am not a proponent of homeopathic medicine, but in my new-found role as a patient I do believe choice and competition are more likely to bring about a patient-led NHS than paternalism. We should be educating the public about interpreting evidence and enabling them to make their own choices.

As somebody with HER-2 negative breast cancer, I have watched the Herceptin debate with interest; I now know how those campaigning women feel. But the really heartening change has been the sea change in media willingness to tackle complex subjects. In this way we can bring the public with us when we have to make difficult funding decisions.

By teaching patients how to give themselves injections rather than plonking them in hospital, we may be able to free up the money to pay for adjuvant Herceptin in the early disease setting.

How much more sensible to give a treatment which might cure more people than invest heavily in the last months of life? The total cost amounts to the turnover of a small district general hospital.

Anyway that's enough intellectual activity for a few days I'm off to rearrange the airing cupboard.

Hilary Thomas is medical director of the Royal Surrey County and St Luke's Hospital trust and professor of oncology at Surrey University.