My name is Lisa Ashmore and I am joint project lead on the GRACE project. I am a social scientist, working in Lancaster Medical School. I am also a Therapeutic Radiographer. This blog post is taken from an after lunch speech held on International Women’s Day 2025.  

I trained and worked as a therapeutic radiographer. Some of you might not know what that is – therapeutic radiographers are one of 14 professions allied to health, or allied health professions (AHPs). They are often confused with nurses but are very different. Highly trained and skilled professionals the same but focussing on specific areas of work – physiotherapists, occupational therapists, etc. Therapeutic Radiographers work in the delivery of radiotherapy treatment – they are skilled in radiation physics, biology, and patient care. 

I had been working in radiotherapy for about ten years before I started to question why we were doing certain things – why were we signing people up to some clinical trials and not others? Why were we buying equipment that no one has evaluated? Why are some people offered radiotherapy and others not?  

These questions led me to the Department of Sociology at Lancaster University where I did a PhD in Science and Technology Studies (STS). STS looks at the creation, development, and consequences of science and technology in historical, cultural, and social contexts.  

Using STS for over 15 years, I have built a research programme that looks at the emotional or felt aspects of radiotherapy as well as the ethical, legal, political and social aspects. What STS tells us is that you cannot simply look at facts, or science, without understanding the politics and social forces that are driving practice, change, and innovation. There is much that is done on technological advancement in radiotherapy. New machines that can increase accuracy, reduce the time needed for treatments or help teams understand where to deliver the treatment but little has been done to explore patient experiences alongside these developments.  

That was why we applied to North West Cancer Research (NWCR) for some research funds. We wanted to know, what is it like to have radiotherapy? How does treatment change people’s perceptions of themselves and their bodies, particularly related to social and sexual lives? How can we use patient experiences to inform policy and practice? 

With NWCR funding, we collected narratives, or stories, from people who were having radiotherapy for six months – from their first day of treatment. We also collected narratives from people who had treatment at any point in the past. We created a report from the project with recommendations on how we could improve conversations about radiotherapy treatment for gynae cancers. These were conversations about the treatment, about life, about sexual selves, about late effects, dignity, communication and trauma. 

All the women experienced worry when going through treatment but many were told not to worry or described how practitioners made them feel they were worrying needlessly. Sometimes well-meaning loved ones and practitioners attempted to reassure patients by downplaying a worry, or using phrases like “be brave” or “grin and bear it” or “you’ve got this.” The narratives told us that, while well-meaning, these phrases can stifle important communication and dismiss significant feelings and experiences. Feelings and experiences that they shared candidly with us in the project. Including how the effects of treatment meant they were unable to have a satisfying sex life, work, or look at their own body. 

Several women described planning their days so they could be near a toilet, carrying spare underwear, liners, pads, water for washing and changing their whole daily routine. Some late effects of treatment start way after follow ups have finished can be decades after treatment. Often people don’t associate late effects with their cancer treatment because they are so delayed. Late effects clinics for radiotherapy are not mandated and so provision is patchy across the UK. It means they can’t access support, intervention or care. 

Some people described how, if they had their choice again, they wouldn’t consent to treatment, given what they know now. It was this final aspect of the narratives that prompted us to seek funds from the National Institute for Health and Social Care Research (NIHR) for a larger study to look at how we can better consent people for gynae radiotherapy, GRACE. A cancer diagnosis is a terrible, life-changing conversation and we need to put more support in place to ensure people are fully informed of what they are consenting to and how life after treatment might be. That’s why I am so proud to be a part of GRACE.  

Funding from NWCR enabled us to collect the experiences into a book, which has been shared extensively across the UK and internationally, with both patient groups and practitioners. It has been added to induction training for staff in Clatterbridge cancer centre to promote dignity for patients having internal radiotherapy, brachytherapy. It has been used in south tees to support practitioners have conversation about sexual wellbeing and pleasure. People in Lincolnshire, from this work, now have a patient informed late effects service. From that small project, we have made, and continue to make a difference to care and patient experience but we want to do more. 

Like our gynae narratives project, research projects time and time again find that women are not taken seriously when they discuss health concerns. There is stereotyping and what is called diagnostic overshadowing, where women of all ages have their health concerns dismissed – be that as menopause, anaemia or exhaustion. Where older women are made to feel invisible and younger women not believed. 

In February 2025, NHS figures for England showed that the gynaecology waiting list in England stands at 590 thousand. There are about 29million women in England. This means that 2% of women in England are currently waiting for gynaecological services. 

Of course, this is just women who make it onto waiting lists. There are hundreds and thousands of others who are battling through the months, if not years, of trying to be heard. Behind these numbers are real women living in extreme and often avoidable pain. Some waiting for cancers to be diagnosed. 

For people who face multiple disadvantages, inequalities in their health and health care are exacerbated. What happens when we don’t attend to the social, legal, ethical and political side of inequality is that we create a language that suggests that people who face inequalities are uneducated, or make poor choices. Current evidence points to the need for broader thinking – beyond individual choice and responsibility – to thinking about the design, implementation and evaluation of policies and services.   

My plea is that if we are to improve women’s health, we cannot stay silent or hidden. We must stop praising each other for being brave. As our work showed, it silences fear and the sheer horror of experience. We must talk to each other candidly. We must do more to ensure women’s health is a priority.