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Can a capsule sponge change how we diagnose oesophageal cancer?

Tim Gunn
by Tim Gunn | Analysis

11 January 2024

28 comments 28 comments

An image of a capsule sponge, a test for Barrett's oesophagus and oesophageal cancer
An example of a capsule sponge.


The BEST4 trial, which started this week, will show if a capsule sponge (‘pill-on-a-thread’) test can be used to monitor people at high risk of oesophageal cancer. Ultimately, it could give the NHS a quick and simple way to screen for the disease. Researchers say that would save thousands of lives every year. 

Tim Cowper, a 49-year-old brewer from Cambridgeshire, has Barrett’s oesophagus. That means he has abnormal cells in his gullet, or food pipe, which have an increased risk of developing into oesophageal cancer cells.  

It’s still rare for Barrett’s oesophagus to lead to oesophageal cancer, but, thanks to Tim’s diagnosis, his doctors know they need to monitor him for any dangerous changes.

So, at least once every three years, they guide a long tube with a camera on the end (an endoscope) down his throat into his oesophagus and take a sample of his cells (a biopsy).

This kind of test is vital for accurately diagnosing many types of cancer. Tim’s endoscopies could save his life.

That doesn’t make them any easier to endure. 

“It is not pleasant at all,” Tim explains. “Each time I have a thick tube pushed down through my mouth. I can feel every single one of the biopsies taken by the camera.”

Endoscopies take a lot of NHS time, money and effort, too, which can mean long waits for tests. Soon, though, finding and monitoring Barrett’s oesophagus – and, ultimately, screening people for oesophageal cancer – could look and feel more like swallowing a vitamin pill than a snake. Researchers say that the change could halve the number of people who die from oesophageal cancer in the UK every year.

Diagnosing oesophageal cancer earlier

It’s all thanks to the capsule sponge, a pill on a thread and lab test developed and refined by Professor Rebecca Fitzgerald and her team at the Cancer Research UK Cambridge Centre. 

Tim’s the first person to join the multi-million pound BEST4 trial, which we’re funding with the National Institute for Health and Care Research. It’s the final step to seeing if this humble sponge on a string can help prevent oesophageal cancer when used to screen or monitor those most at risk of the disease. 

The trials we’ve already funded have shown that the capsule sponge test is safe and accurate. It’s been piloted for people on endoscopy waiting lists in parts of England, Scotland and Northern Ireland. We’ve even learned it can detect 10 times more cases of Barrett’s oesophagus than standard practice. 

Now we’re on the home straight. If the BEST4 trial is successful, the capsule sponge could become a national screening programme across the NHS, in the same way mammograms are used to screen for breast cancer.   

Professor Rebecca Fitzgerald
Professor Rebecca Fitzgerald, a doctor and researcher at Addenbrooke’s Hospital and the University of Cambridge, led the team that developed the capsule sponge test.

That could be vital. Although oesophageal cancer isn’t one of the 10 most common causes of cancer in the UK, it’s the 7th leading cause of cancer death. Around 8,000 people die from oesophageal cancer in the UK every year, partly because the disease is so often diagnosed in its later stages, when it’s much harder to treat successfully. 

“The capsule sponge could halve the number of deaths from oesophageal cancer every year,” says Fitzgerald.

On average, only 12% of patients [in the UK] live more than 10 years after diagnosis. Most don’t realise there’s a problem until they have trouble swallowing. By then it is too late.”  

Monitoring Barrett’s oesophagus

As part of the BEST4 trial, Tim will be tested with the capsule sponge alongside his regular endoscopy. 

In practice, that means he has to swallow a specially designed pill on a thread and wait for it to reach his stomach, where it expands into a tiny sponge. Then, a trained nurse carefully removes it by pulling on the thread. On the way, the expanded sponge collects cells from the lining of the food pipe, which scientists can test for signs of Barrett’s oesophagus or cancer. 

Collecting the cells takes less than 10 minutes at a local GP’s office, whereas endoscopies usually require specialist hospital units. And in terms of comfort? “Swallowing a capsule sponge is a much better experience,” says Tim. 

Tim’s story

Tim has had acid reflux, or heartburn, every night since he was 16. A routine health check when he was at university revealed that it was a symptom of Barrett’s oesophagus.  

“I was alarmed when I was told that having Barrett’s meant having pre-cancerous cells in my gullet,” he says. “Cancer is never a nice word to hear, especially when you are so young, but luckily, I’ve had my condition monitored. 

Tim Cowper
Tim joined the BEST4 trial at Addenbrooke's Hospital in Cambridge. That's also where Professor Fitzgerald works.

“I’m really lucky as my own condition hasn’t got worse and there are no signs of progression to full cancer. I take care with my diet to keep my acid reflux in check, but I can still have the odd curry and, most importantly, taste the beer I make!  

“Taking part in this study means a lot to me. My condition was caught before it even became a fully-fledged cancer. Sadly, many others aren’t so lucky. The capsule sponge could help others whose acid reflux is causing something more sinister.” 

Testing tens of thousands for oesophageal cancer

BEST4 is split into two parts. BEST4 Surveillance, which Tim is participating in, is investigating whether the capsule sponge test could replace endoscopies as a way of monitoring Barrett’s oesophagus. 

“The first phase of the trial looks at whether the capsule sponge can be used as a cancer early warning system for patients diagnosed with Barrett’s,” explains Fitzgerald. “Using the capsule sponge and a new set of lab tests, we will be monitoring patients to see if we can prevent more cases of cancer.” 

The second stage of the trial, BEST4 Screening, opens in the summer and will recruit 120,000 people aged over 55 on long-term treatment for heartburn, a common symptom of Barrett’s oesophagus. That will help us understand whether the capsule sponge could be used for an oesophageal cancer screening programme. 

Around 59% of all oesophageal cancer cases are preventable,” says Dr Iain Foulkes, our executive director of research and innovation. “Yet endoscopy, the gold standard for diagnosing and treating this cancer, is labour-intensive. We need better tools and tests to monitor people most at risk.  

“Backed by funding from Cancer Research UK, the capsule sponge has become one of the most exciting early detection tools to emerge in recent years. It’s a remarkable invention by Professor Fitzgerald and her team, and previous trials have shown how powerful it can be in identifying cancer earlier.  

There are 9,400 people diagnosed with oesophageal cancer in the UK every year and the capsule sponge will mean they can benefit from kinder treatment options, if their cancer is caught at a much earlier stage.” 

Tim

    Comments

  • George Georgiou
    9 February 2024

    What a fabulous invention by Dr Fitzgerald. This is one of the many reasons why I donate to Cancer Research and other Cancer charities.

  • Marie McGinley
    7 February 2024

    Fantastic news well done Dr. Fitzgerald. My husband died in 2016 with this cancer. The treatment was harsh it was awful to see him struggling to eat. He lasted 13 months after his diagnosis.
    I wish this capsule had been available then but I’m truly grateful for this breakthrough, it will give hope to many

  • Penelope Aldridge
    7 February 2024

    There is cancer in my family my father died at 48, lung cancer, my mother died with oesophageal cancer at 70. I think I’ve been worried most of my life about developing this disease. I do have a problem with my throat, and been tested. The results showed that I had a balloon type flat in my throat exacerbated by a bit of arthritis in my neck., therefore fully support anything that could determine this terrible disease. I’m 74 at the moment

  • Elizabeth Crisp
    7 February 2024

    I heard about this many years ago when I was a patient volunteer for London Cancer. I would be interested in the trial. I have had oesophageal cancer, survived it by 14 years but have Barratts, diagnosed 2015. can this test still be used. I have had an Ivor Lewis op.

  • reply
    Jacob Smith
    12 February 2024

    Hi Elizabeth,

    Thanks for your comment. To join a trial like this one, or discuss your eligibility, you need to speak to your doctor. If you’re eligible, they can then refer you to one of the doctors working on it. This is called a medical referral. You can find a bit more information on how to join a clinical trial here.

    I hope that helps,
    Jacob, Cancer Research UK

  • Nicola Smith
    7 February 2024

    This is amazing and will make such a difference. Is this a concept that could be adapted for colonoscopy alternatives?Something you could do at home or at a local surgery would be a game changer.

  • Robert Taylor
    7 February 2024

    esophagus Cancer has been at the forefront of my mind for many a years having lost fellow Mineworkers with this awful disease and often wondering about the links from mineworkers and this type of cancer. I too would like to participate in any tests that could help control and ultimately cure this type of cancer. A great breakthrough nonetheless well done CRUK

  • Terence Pope
    7 February 2024

    Excellent research programme. What is the criteria for the test programme ?

  • Susan Rooney
    7 February 2024

    I have a Hiatus hernia & suffer from acid reflux. I am taking 20mg daily of omeprazole, been on them for years with no follow up appointments being made for me… GP just keeps prescring them..This new sponge is a wonderful idea. I dont have regular check ups. Which i think i should have.

  • 7 February 2024

    I am a 54yr old female who was diagnosed with oesophageal cancer in December 2019. I have had an operation and radiotherapy and copious amounts of chemotherapy…but it’s still there and now it’s terminal. So I am now under my oncologist for palliative care and pain management but feel very lucky indeed that I’m now 4yrs down the line and have managed to get all my finances in order, arrange my funeral and make sure that my children do not have to do too much once I’m gone. I’ve travelled more in the last 3yrs than I’ve ever travelled and feel very lucky indeed that I’ve got the chance to make some lovely memories with my family and friends…. its good to know that diagnosing and catching oesophagus cancer early is on the radar! Mine was diagnosed VERY EARLY and I think that is why I’m still here. I hope that they develop this and it soon becomes widely available for everyone.

  • Gwyneth Rushton
    7 February 2024

    This sounds truly encouraging my dear cousin died from undiagnosed oesophagal cancer just 5 years ago. This will bring hope and encourage many to be tested.

  • Mrs L Burke
    6 February 2024

    My sister died from oesophageal cancer only 6 months after diagnosis. It will be fantastic if a simple test can be introduced. This has the potential to save many lives.

  • Mrs Mary Cooke
    5 February 2024

    This is an amazing breakthrough and really hope it is successful. My husband had suffered from Barrett’s oesophagus for many years and was supposed to have endoscopy every 3 years. His last endoscopy was 18months late due to waiting list and tragically he had developed stage 4 oesophageal cancer and passed away 3 weeks after diagnosis. I would hope that this new investigation would be so much easier to access

  • Emma Stowe
    5 February 2024

    Anything that can be done to prevent this awful disease is a must. My father has been suffering with oesophageal cancer for 3 years now. This would be a fantastic step forward for both the patients and the NHS. Keep up the good work.

  • Richard Greenough
    4 February 2024

    I lost my wife of 57 years to oesophageal cancer last October some 2 years after first diagnosis.
    I have suffered from GORD for many years with my symptoms of heart burn being kept to a minimum by pi’s. One of my close friends had Barrets oesophagus for several years and he unfortunately was one of the unlucky ones and eventually died of oesophageal cancer. I would be more than willing to participate in the next phase of this trial and will let my GP know.

  • HELEN GRIFFIN
    4 February 2024

    What a fantastic find. I lost my dear father to this awful condition 15 years ago. I’ve also had 2 tests since then and although they are unpleasant the results have reassured me that at the moment I am OK. I’m hoping that Tim goes on OK and send him my prayers that everything goes well for him in the future and for those who take part in any investigations.

  • Mike Kemp
    4 February 2024

    This is interesting, I have what was described as “ scaring” of the esophagus after having an endoscopy because I have difficulty in swallowing certain foods. This was carried out around 2021 and things are not improving. I would be interested in helping with trials.

  • Hilary Sennitt
    4 February 2024

    My husband died in September 2023 after being diagnosed with oesophagus cancer almost four years previously. I think, after seeing him struggle to eat the last few months of his life, anything that can prevent this happening to anyone is a real breakthrough

  • Sue Ryding
    4 February 2024

    This is a wonderful break through which could have made such a difference to my life ten years ago. I was diagnosed with oesophageal and stomach cancer in 2014 having suffered with refluxes for a long time before. I went through chemotherapy and a life changing oesophagectomy in 2015 but I’m doing well now – one of the lucky ones so far! I urge anyone with the symptoms to get a diagnosis as soon as they can, regardless of the discomfort. Anything that makes this easier is very much to be welcomed.

  • Sue
    4 February 2024

    After watching my husband going through so much with this type of cancer I think this is absolutely amazing and I hope the trial does prove to be beneficial to diagnosing the disease and help future patients to be able to not have to go through one more uncomfortable procedure patients have so much to endure along their journey ..Well done all at cancer Research you are all so much appreciated for your work .

  • Jo Gooch
    4 February 2024

    My Dad died of oesophageal cancer only 3 weeks after being diagnosed (even though he had been complaining for years to his doctor). I do wish this test had been available back in the 1970s.

  • Shirley Tracey
    4 February 2024

    I had oesophageal cancer nine years ago I was one of the lucky ones but I do worry about it returning so anything to make it easier to detect I am all for thank you for never giving up.

  • Douglas Baillie
    4 February 2024

    Brillant that an easy test can now be done. I was diagnosed in 2020 with cancer of the esophagus. Had a cough for weeks and then started to find swallowing difficulty. August 2020 confirmed, stage 2/3. Chemo and radiotherapy in Oct/ Nov 2020 and despite feeding tube in December, operation on January removed entire esophagus. I’m fairly fit and it took me over a year to recover weight wise and strength. At 65 my life style with eating is nearly normal albeit less in quantity which isn’t an issue. I still cycle, ply 5 a side football and tennis so in that area my life is back to where it was. I cannot thank the medical team at Wishaw University Hospital under the direction of Mr Kasem enough. Their care, attention and overall aftercare is and has been incredible. My father died of esophagus cancer way back in 1979 and the advanced diagnosis and treatment proves this is a survivable cancer if caught. I hope anyone that is diagnosed takes comfort in my story.

  • Jason Shepherd
    4 February 2024

    I have Barrett’s Oesophagus and was diagnosed in 2008 after treatment for Non-Hodgkins. I do have to have regular endoscopies and feel this is an amazing invention. I would for sure be interested in the trial. Funny thing is that I am also waiting on my regular screening, I moved recently and because of that I have to wait and have been told the waiting list is long. I’m 48.

  • Elizabeth Packer
    4 February 2024

    I lost my Husband to oesophageal cancer within thirteen months of his diagnosIs, so anything to detect and treat this cancer is a wonderful step forward.

  • Shane murray
    23 January 2024

    Wow Dr. Fitzgerald, this is an amazing invention. I have asymptomatic Barrets esophagus and regularly endoscopies are not pleasent. Removing biopsy tissue from one’s esophagus using a “micro type tweezers’ looks and feels so invasive and in my personal non medically trained opinion, surely leaves more damaged scare tissue than the cyto-sponge would. Please can you contact me ASAP to discuss whether its possible for me to join the trial.

  • reply
    Tim Gunn
    23 January 2024

    Hi Shane,

    Thanks for your comment. We’re also excited about Dr Fitzgerald’s invention! To join a trial like this one, you usually need to speak to your doctor, who can then refer you to one of the doctors working on it. This is called a medical referral. You can find a bit more information on how to join a clinical trial here.

    I hope that helps!

    Tim

  • Anonymous
    12 January 2024

    Absolutely fantastic !! I am hoping this trial is a success. I lost an immediate family member to this cancer, If only this was an option at the time !! I am in full support, raising money myself for this !!

  • Paul Ricketts
    11 January 2024

    I was treated for 7 years lucky they caught it in time they test yearly now
    This new test will benefit the patient and the NHS

  • Paul Ricketts
    11 January 2024

    Anything that will help the patient and the NHS I was being seen for 7 years but I only get seen yearly now for the cameras down the throat not pleasant really

Tell us what you think

Leave a Reply

Your email address will not be published. Required fields are marked *

Read our comment policy.

    Comments

  • George Georgiou
    9 February 2024

    What a fabulous invention by Dr Fitzgerald. This is one of the many reasons why I donate to Cancer Research and other Cancer charities.

  • Marie McGinley
    7 February 2024

    Fantastic news well done Dr. Fitzgerald. My husband died in 2016 with this cancer. The treatment was harsh it was awful to see him struggling to eat. He lasted 13 months after his diagnosis.
    I wish this capsule had been available then but I’m truly grateful for this breakthrough, it will give hope to many

  • Penelope Aldridge
    7 February 2024

    There is cancer in my family my father died at 48, lung cancer, my mother died with oesophageal cancer at 70. I think I’ve been worried most of my life about developing this disease. I do have a problem with my throat, and been tested. The results showed that I had a balloon type flat in my throat exacerbated by a bit of arthritis in my neck., therefore fully support anything that could determine this terrible disease. I’m 74 at the moment

  • Elizabeth Crisp
    7 February 2024

    I heard about this many years ago when I was a patient volunteer for London Cancer. I would be interested in the trial. I have had oesophageal cancer, survived it by 14 years but have Barratts, diagnosed 2015. can this test still be used. I have had an Ivor Lewis op.

  • reply
    Jacob Smith
    12 February 2024

    Hi Elizabeth,

    Thanks for your comment. To join a trial like this one, or discuss your eligibility, you need to speak to your doctor. If you’re eligible, they can then refer you to one of the doctors working on it. This is called a medical referral. You can find a bit more information on how to join a clinical trial here.

    I hope that helps,
    Jacob, Cancer Research UK

  • Nicola Smith
    7 February 2024

    This is amazing and will make such a difference. Is this a concept that could be adapted for colonoscopy alternatives?Something you could do at home or at a local surgery would be a game changer.

  • Robert Taylor
    7 February 2024

    esophagus Cancer has been at the forefront of my mind for many a years having lost fellow Mineworkers with this awful disease and often wondering about the links from mineworkers and this type of cancer. I too would like to participate in any tests that could help control and ultimately cure this type of cancer. A great breakthrough nonetheless well done CRUK

  • Terence Pope
    7 February 2024

    Excellent research programme. What is the criteria for the test programme ?

  • Susan Rooney
    7 February 2024

    I have a Hiatus hernia & suffer from acid reflux. I am taking 20mg daily of omeprazole, been on them for years with no follow up appointments being made for me… GP just keeps prescring them..This new sponge is a wonderful idea. I dont have regular check ups. Which i think i should have.

  • 7 February 2024

    I am a 54yr old female who was diagnosed with oesophageal cancer in December 2019. I have had an operation and radiotherapy and copious amounts of chemotherapy…but it’s still there and now it’s terminal. So I am now under my oncologist for palliative care and pain management but feel very lucky indeed that I’m now 4yrs down the line and have managed to get all my finances in order, arrange my funeral and make sure that my children do not have to do too much once I’m gone. I’ve travelled more in the last 3yrs than I’ve ever travelled and feel very lucky indeed that I’ve got the chance to make some lovely memories with my family and friends…. its good to know that diagnosing and catching oesophagus cancer early is on the radar! Mine was diagnosed VERY EARLY and I think that is why I’m still here. I hope that they develop this and it soon becomes widely available for everyone.

  • Gwyneth Rushton
    7 February 2024

    This sounds truly encouraging my dear cousin died from undiagnosed oesophagal cancer just 5 years ago. This will bring hope and encourage many to be tested.

  • Mrs L Burke
    6 February 2024

    My sister died from oesophageal cancer only 6 months after diagnosis. It will be fantastic if a simple test can be introduced. This has the potential to save many lives.

  • Mrs Mary Cooke
    5 February 2024

    This is an amazing breakthrough and really hope it is successful. My husband had suffered from Barrett’s oesophagus for many years and was supposed to have endoscopy every 3 years. His last endoscopy was 18months late due to waiting list and tragically he had developed stage 4 oesophageal cancer and passed away 3 weeks after diagnosis. I would hope that this new investigation would be so much easier to access

  • Emma Stowe
    5 February 2024

    Anything that can be done to prevent this awful disease is a must. My father has been suffering with oesophageal cancer for 3 years now. This would be a fantastic step forward for both the patients and the NHS. Keep up the good work.

  • Richard Greenough
    4 February 2024

    I lost my wife of 57 years to oesophageal cancer last October some 2 years after first diagnosis.
    I have suffered from GORD for many years with my symptoms of heart burn being kept to a minimum by pi’s. One of my close friends had Barrets oesophagus for several years and he unfortunately was one of the unlucky ones and eventually died of oesophageal cancer. I would be more than willing to participate in the next phase of this trial and will let my GP know.

  • HELEN GRIFFIN
    4 February 2024

    What a fantastic find. I lost my dear father to this awful condition 15 years ago. I’ve also had 2 tests since then and although they are unpleasant the results have reassured me that at the moment I am OK. I’m hoping that Tim goes on OK and send him my prayers that everything goes well for him in the future and for those who take part in any investigations.

  • Mike Kemp
    4 February 2024

    This is interesting, I have what was described as “ scaring” of the esophagus after having an endoscopy because I have difficulty in swallowing certain foods. This was carried out around 2021 and things are not improving. I would be interested in helping with trials.

  • Hilary Sennitt
    4 February 2024

    My husband died in September 2023 after being diagnosed with oesophagus cancer almost four years previously. I think, after seeing him struggle to eat the last few months of his life, anything that can prevent this happening to anyone is a real breakthrough

  • Sue Ryding
    4 February 2024

    This is a wonderful break through which could have made such a difference to my life ten years ago. I was diagnosed with oesophageal and stomach cancer in 2014 having suffered with refluxes for a long time before. I went through chemotherapy and a life changing oesophagectomy in 2015 but I’m doing well now – one of the lucky ones so far! I urge anyone with the symptoms to get a diagnosis as soon as they can, regardless of the discomfort. Anything that makes this easier is very much to be welcomed.

  • Sue
    4 February 2024

    After watching my husband going through so much with this type of cancer I think this is absolutely amazing and I hope the trial does prove to be beneficial to diagnosing the disease and help future patients to be able to not have to go through one more uncomfortable procedure patients have so much to endure along their journey ..Well done all at cancer Research you are all so much appreciated for your work .

  • Jo Gooch
    4 February 2024

    My Dad died of oesophageal cancer only 3 weeks after being diagnosed (even though he had been complaining for years to his doctor). I do wish this test had been available back in the 1970s.

  • Shirley Tracey
    4 February 2024

    I had oesophageal cancer nine years ago I was one of the lucky ones but I do worry about it returning so anything to make it easier to detect I am all for thank you for never giving up.

  • Douglas Baillie
    4 February 2024

    Brillant that an easy test can now be done. I was diagnosed in 2020 with cancer of the esophagus. Had a cough for weeks and then started to find swallowing difficulty. August 2020 confirmed, stage 2/3. Chemo and radiotherapy in Oct/ Nov 2020 and despite feeding tube in December, operation on January removed entire esophagus. I’m fairly fit and it took me over a year to recover weight wise and strength. At 65 my life style with eating is nearly normal albeit less in quantity which isn’t an issue. I still cycle, ply 5 a side football and tennis so in that area my life is back to where it was. I cannot thank the medical team at Wishaw University Hospital under the direction of Mr Kasem enough. Their care, attention and overall aftercare is and has been incredible. My father died of esophagus cancer way back in 1979 and the advanced diagnosis and treatment proves this is a survivable cancer if caught. I hope anyone that is diagnosed takes comfort in my story.

  • Jason Shepherd
    4 February 2024

    I have Barrett’s Oesophagus and was diagnosed in 2008 after treatment for Non-Hodgkins. I do have to have regular endoscopies and feel this is an amazing invention. I would for sure be interested in the trial. Funny thing is that I am also waiting on my regular screening, I moved recently and because of that I have to wait and have been told the waiting list is long. I’m 48.

  • Elizabeth Packer
    4 February 2024

    I lost my Husband to oesophageal cancer within thirteen months of his diagnosIs, so anything to detect and treat this cancer is a wonderful step forward.

  • Shane murray
    23 January 2024

    Wow Dr. Fitzgerald, this is an amazing invention. I have asymptomatic Barrets esophagus and regularly endoscopies are not pleasent. Removing biopsy tissue from one’s esophagus using a “micro type tweezers’ looks and feels so invasive and in my personal non medically trained opinion, surely leaves more damaged scare tissue than the cyto-sponge would. Please can you contact me ASAP to discuss whether its possible for me to join the trial.

  • reply
    Tim Gunn
    23 January 2024

    Hi Shane,

    Thanks for your comment. We’re also excited about Dr Fitzgerald’s invention! To join a trial like this one, you usually need to speak to your doctor, who can then refer you to one of the doctors working on it. This is called a medical referral. You can find a bit more information on how to join a clinical trial here.

    I hope that helps!

    Tim

  • Anonymous
    12 January 2024

    Absolutely fantastic !! I am hoping this trial is a success. I lost an immediate family member to this cancer, If only this was an option at the time !! I am in full support, raising money myself for this !!

  • Paul Ricketts
    11 January 2024

    I was treated for 7 years lucky they caught it in time they test yearly now
    This new test will benefit the patient and the NHS

  • Paul Ricketts
    11 January 2024

    Anything that will help the patient and the NHS I was being seen for 7 years but I only get seen yearly now for the cameras down the throat not pleasant really

Tell us what you think

Leave a Reply

Your email address will not be published. Required fields are marked *

Read our comment policy.