“Research in Yorkshire gave me the chance to keep living my life normally after cancer and for that I feel incredibly lucky.” – Christine's experience

As a former midwife, nurse and professor, Christine Skinner from York has long understood the importance of research in driving progress in healthcare and improving people’s lives. That understanding became even deeper when, following a diagnosis of rectal cancer, she took part in APHRODITE, a pioneering clinical trial funded by Yorkshire Cancer Research.

Now, she is sharing her experience to raise awareness of the life-changing impact clinical trials can have on people with cancer and encourage others diagnosed with the disease to consider taking part.

Christine moved from Glasgow to York more than 40 years ago and has cherished the city ever since.

A registered nurse and midwife by background, the 69-year-old went on to build an academic career at the University of York. After completing a degree and PhD, she became a lecturer and later a professor specialising in family and social policy.

Now retired, Christine says York's strong sense of community is one of the reasons she has chosen to make the city her home. 

In early 2024, Christine's new life in retirement was disrupted when she began noticing changes to her bowel habits. The previous year, she had completed and returned an at-home bowel cancer screening test - known as a Faecal Immunochemical Test (FIT) - used to help detect bowel cancer, but the result was negative. However, when she later began experiencing mucus, she decided to visit her GP to get checked.

She said: "The symptoms I was experiencing weren't on the NHS list of bowel cancer symptoms so I didn’t initially think anything could be that wrong. There was no bleeding for example. I did a self-examination and could feel something wasn’t right, so trusted my instincts and went to see my GP.”

One of the GPs at Christine’s surgery examined her and requested some routine tests which indicated signs of cancer. Further investigations, including a colonoscopy, a biopsy and scans confirmed she had rectal cancer.

Christine said: “Coincidentally, my family GP whom I had known for many years was able to conduct the colonoscopy in the local hospital as he was specifically trained in these procedures. Being told I had cancer was never going to be easy, but it was helpful to have a familiar face delivering the diagnosis.”  

She continued: “I remember walking into the hospital with my friend feeling incredibly nervous. When I was told the cancer had spread to my lymph nodes, I was frightened. Like many people, I immediately started questioning myself. You wonder whether you should have acted sooner, even though there wasn't anything obvious to suggest it was cancer.

I think there needs to be greater awareness of rectal cancer symptoms, particularly when they don't fit the more commonly recognised signs. I'd experienced general bowel sensitivity for years, but I never would have imagined it could be cancer.” 

Fortunately, Christine was surrounded by support from family and friends. Her son, who works in California as a medical physicist in a cancer department, helped her navigate complex information around her diagnosis and the treatment options available.

She said: "My son was incredibly important throughout the whole experience. He could explain things to me, discuss my options and speak to colleagues who had specialist knowledge.

He was on the phone during my appointment with the consultant at York Hospital, and she was very accommodating! Having that level of support meant I wasn't as frightened as I might otherwise have been."

Most people diagnosed with early-stage rectal cancer are treated with surgery to remove the rectum. However, for some people, surgery is not suitable or may not be their preferred option.

The APHRODITE trial, jointly led by Professor Ane Appelt at the University of Leeds and Professor Simon Gollins at the North Wales Cancer Treatment Centre and Bangor University, explored whether giving people a higher dose of radiotherapy than the current standard treatment could increase the likelihood of the cancer disappearing completely, while avoiding significant additional side effects. The trial aimed to offer more people the possibility of successful treatment without the need for surgery.

Before deciding whether to take part in the APHRODITE trial, Christine met with a surgeon to discuss the option of having surgery.

Christine said: "The discussion was very honest about the possible outcomes of surgery. There were risks around urinary incontinence, bowel function and nerve damage, as well as the possibility of needing a temporary or permanent stoma. I found that quite overwhelming. The thought of having a stoma bag and how it might affect my quality of life was particularly upsetting.”

For Christine, participating in the trial felt like the right choice, both for her health and for how she wished to see cancer treatments for rectal cancers improve. 

She said: "I've spent my career involved in research, so I know how important clinical trials are. We only improve treatments by testing new approaches and by people volunteering to take part. I also knew that being part of a trial meant I would be monitored very closely."

After being told she would be trialling the higher dose of radiotherapy through the trial, Christine began her five and a half weeks of radiotherapy treatment which involved travelling from York to Leeds every weekday.

Initially, Christine was concerned about the logistics of travelling between cities so frequently. However, a dedicated minibus service between York and St James’s Hospital in Leeds, run by the charity ‘York Against Cancer’, meant she could attend her appointments each day at the scheduled time, making the journey straightforward and stress-free.

She said: "I have wonderful friends who offered to help, but I felt anxious about relying on people constantly. The minibus service was fantastic and meant I could focus on my treatment rather than worrying about the journey."

Throughout the APHRODITE trial, Christine was supported by specialist clinical and research teams and closely monitored to assess both her response to treatment and quality of life. She experienced very few side effects until the end of her treatment, when she developed some mild skin reactions and increased bowel movements, which resolved shortly after her radiotherapy finished.

Now, two years after completing treatment, tests continue to show no evidence of cancer and Christine has been able to continue travelling, spending time with her family and enjoying an active retirement without undergoing major surgery. She will continue to have regular scans to hopefully confirm the cancer has not returned.

Christine said "The doctors are understandably very careful with their language and won't say you're cured yet. As time passes, the risk of recurrence gets lower and I hold onto that.”

What she doesn't think about, however, are the life-changing side effects she might have faced had she needed surgery.

Instead, she has continued travelling to California to visit her son and grandchildren and maintained the active lifestyle she enjoys. She has also just welcomed a granddaughter into the world – exactly two years after finishing her cancer treatment - and looks forward to beginning her duties as a grandma.

Reflecting on her experience, Christine believes research has transformed cancer treatment and is vital to improving more treatments for people in the future.

She continued: "If I'd been diagnosed 10 years earlier, my treatment options might have looked very different. The boundaries are being pushed all the time and that's because of research, including the APHRODITE trial, taking place here in Yorkshire. I'm incredibly grateful I had the opportunity to take part in the trial.”

When asked about why it is important research happens in her region, she said: "Yorkshire has its own cancer challenges and its own population needs, so it's important that research is taking place here, for people living here. What works in London or Glasgow, might not work here in Yorkshire. Research in Yorkshire gave me the chance to keep living my life normally after cancer and for that I feel incredibly lucky.”

Find out more about life-saving cancer research in Yorkshire: Saving lives through research - Yorkshire Cancer Research