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ROLE MODEL

From script to screening

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Victoria Harmer has used her specialist breast cancer knowledge to script several soap operas

Victoria Harmer

Angelina Jolie told the world of her double mastectomy and it sparked interest. Wanting to know whether they’re at risk of breast cancer, people started researching the BRCA gene and got tested for it. It’s the “Angelina effect”.

With the introduction of breast cancer and the BRCA gene to the soap opera EastEnders, there is a chance this will create the “Carol effect” because the show’s character has recently been diagnosed with the condition and has increasing concerns for her daughters.

“It’s a very serious issue because you don’t want to scare anyone,” says clinical nurse specialist Victoria Harmer, one of four specialists involved in scripting the EastEnders storyline. She contributed insight and expertise from her experience as a breast care specialist to make the story as accurate as possible.

“You have to come up with the plot and biologically what disease they would have according to the treatment the drama wishes to illustrate - essentially the entire medical situation,” she says.

Ms Harmer worked closely with the writers of EastEnders to make sure the cancer type and treatment were medically realistic. As the writers wanted the character, Carol Jackson, to have chemotherapy followed by a mastectomy, Ms Harmer had to figure out what type of breast cancer would call for that kind of treatment - it was node-positive disease partnered with either a small breast with a large tumour in it or many small tumors within the same breast.

“The worst thing would be for people to be alarmed,” she says, adding that it is important to write the story in a detailed way because, not only do they not want to scare viewers, but they have an obligation to those who are currently in treatment.

“It’s a huge responsibility,” she says. “There is much ‘behind-the-scenes’ work associated with this; it must be researched properly.”

The help Ms Harmer gives the show writers is extensive. When they told her what they wanted, she responded with a 14-page email describing what factors would make their storyline accurate.

They wanted Carol to go to the breast assessment clinic on Christmas Eve but not get her results until later in January. In reality, her results wouldn’t take that long so they had to have her miss an appointment to avoid inaccurately representing the cancer diagnostic pathway.

Another example of Ms Harmer’s attention to detail is the issue regarding informed consent.

“On screen you can’t go through every side-effect of treatment but you have to make it seem like you did,” she says. “I draw from experience and try to illustrate how someone might react and what would happen.”

Ms Harmer works as team leader and clinical nurse specialist at Imperial College Healthcare Trust. She manages a team of seven experienced breast care specialists, is heavily engaged with service improvements and won Cancer Nurse of the Year in the 2013 Nursing Times Awards.

She got involved in storyline writing through Breakthrough Breast Cancer, the UK’s leading charity in breast cancer prevention and awareness, and has also been involved in writing cancer scripts in Coronation Street, Family Affairs and The Archers. In Coronation Street, the awareness helped actress Sally Dynevor discover her own breast cancer.

Ms Harmer is involved in several advisory boards, charities and cancer projects such as previously assisting in the wearer trials for Marks & Spencer’s swimwear line for post-mastectomy patients. She writes extensively for nursing and medical press, and lectures nationally and internationally. She has an MBA and hopes to complete her doctorate later this year.

“Outside of work I try to do as much as I can. It all assists with raising breast awareness and hopefully positively impacts on the profile of the trust where I work,” Ms Harmer says.

She says it’s tough to tackle breast cancer and entertain viewers. After all, the show is not supposed to be a documentary. But there are ways to lighten the mood.

“When helping them write the storyline, I asked them to name the breast nurse specialist Vicky,” Ms Harmer says. And they did.

Sara Barba

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