After NICE's decision to refuse to allow cancer drug TDMI to be diagnosed through the NHS, one Truro mum explains what the 'miracle' treatment has done for her:
IN September, Jude Small will see her little girl Elizabeth go to school.
It will be a very precious moment – and one she never thought she would see.
Diagnosed with an aggressive breast cancer in November 2010, Jude was given just months to live.
But then she was offered what the 44-year-old from Truro calls "a miracle" by the Royal Cornwall Hospital – a trial of a new breast cancer drug called TDMI.
The National Institute for Health and Care Excellence (NICE) says the drug is too expensive to be made available on the NHS.
That has prompted brave Jude to tell her story and plea that other women are given a chance of having their lives extended.
Jude and her husband Matt had already been through every parent's worst nightmare – the loss of their first child, Catherine – before her diagnosis.
Jude had noticed her breasts had become very sore but, with caring for their daughter and the arrival of Elizabeth – known as Lizzie – on December 23, 2009, she pushed it to the back of her mind.
"I was breast feeding a new baby and looking after a very sick child. With everything else that was going on it never occurred to me that I might be in the firing line as well.
"I wasn't ever aware that I had breast cancer."
Catherine lost her battle on February 24, 2010, aged 3, and it wasn't until November that Jude finally went to the Mermaid Centre in Truro.
She thought it was just an inflammation of the breast, known as mastitis. By this point she already had a substantial lump on her breast. The team took one look at Jude and knew the situation was dire.
She was diagnosed the same day with advanced breast cancer, known as HER2+, which is a form of cancer where the aggressive tumour spreads through the body.
"It had travelled to the spine, the liver and just about everywhere else," said Jude. "I immediately thought 'oh dear this is it'. However, despite the shock of the diagnosis, losing Catherine remained the worst thing that could have happened."
It was Catherine's spirit that was her inspiration. "She was such a brave little girl and her life was transformational for us all. I couldn't help thinking that if she could be so courageous, I could learn from her example.
"And so I always thought of cancer as an inconvenience."
But it was an inconvenience that medics said gave her just a 50 per cent chance of surviving for two years with treatment and a matter of months without.
That was until clinical oncologist Duncan Wheatley suggested Jude took part in a drug trial. She thought about the alternatives; chemotherapy that would make her sick and in pain, losing her hair, and being unable to look after Lizzie, who was then just 10 months old.
"I had everything to gain and nothing to lose," she said.
Jude had to go through a random selection process and, in her own words, was "by some small miracle accepted".
"Dr Wheatley told me that if I got on the trial there was a strong possibility that the new therapy would allow me to lead a better quality of life.
"It has been a revelation. It was immediately obvious that it was working.
"The first time I took the trial drug I felt a little unwell. My muscles ached like I had gone three rounds with Mike Tyson, but that passed and I never looked back."
A year after her diagnosis Jude was back at work. She praises the hospital's oncology team, who have been by her side every step of the way during the trial of the drug, now known as Kadcyla.
"They are an incredibly hardworking, committed and sympathetic team. I feel fortunate and privileged to be in their care.
"I have been given time that I never expected to have. And they have not just given me time, but they have given me quality of life.
"Almost four years down the line and I'm still here. I am going to see my little girl into school; I never thought I would reach that milestone and I am so, so pleased.
"It is an incredible drug and it would be great if it were available to everybody who needs it," added Jude, who enjoys horse riding and cycles to her hospital appointments.
Although she is now on a different treatment regime – like all drugs used to treat the disease, it eventually becomes resistant – she is hopeful that the drugs company and NICE can meet somewhere in the middle so that soon Kadcyla will be available on the NHS.
"Why should women suffer when there is an alternative?" she asked.
"It's thanks to the brilliant, brilliant oncology team and this drug that I was given this incredible chance.
"I have not won my battle but I am not giving up yet."