Mother-of-two, 38, died after suffering rare complication after radiotherapy for cancer, inquest hears

Alana Shaw, 38, responded well to 2013 treatment for carcinoma of the cervix
Last year she felt discomfort while out on a run and decided to seek medical help
Early scans did not find cancer, but later tests showed a rare mesothelioma
She was admitted to hospital on May 13, 2021 and passed away two days later

Published: 09:07 BST, 24 June 2021 | Updated: 10:01 BST, 24 June 2021

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An apparently fit and healthy mother of two died from a cancer normally related to asbestos after she suffered a rare complication to successful radiotherapy treatment she underwent for another strain of the illness.

Pensions and mortgage advisor Alana Shaw, 38, had seemed to respond well to 2013 treatment for carcinoma of the cervix but last year she mysteriously fell ill when she felt discomfort in her stomach while out running six years later.

Initial scans did not diagnose any further cancer but when symptoms persisted doctors subsequently discovered she had peritoneal mesothelioma, an illness normally related to continued exposure to asbestos.

Ms Shaw, pictured, was successfully treated for carcinoma of the cervix in 2013. Medics think she may have suffered a rare side effect of the radiotherapy as there is no evidence she had been exposed to asbestos

Alana Shaw, pictured with her partner Steven Peel, right, died two days after she was admitted to Wythenshawe Hospital in Manchester on May 13, 2021 having been diagnosed with a rare form of cancer normally associated with exposure to asbestos

Ms Shaw died in Wythenshawe Hospital in Manchester on May 15, 2021 of peritoneal mesothelioma

However, a review of Ms Shaw's medical records could not find any exposure to asbestos, so medics believed she suffered an incredibly rare reaction to her earlier radiotherapy treatment.

Research has shown that in very rare cases, prior radiotherapy can alter the DNA in cells in the targeted area. These changes can cause the cells to grow in an 'out-of-control' fashion.

Her inquest heard she was admitted to Wythenshawe Hospital in Manchester on May 13, 2021 and passed away two days later.

An investigation took place into whether Miss Shaw, of Bowdon, near Altrincham, Greater Manchester was ever exposed to the toxic material but experts concluded she developed the illness as a result of radiotherapy.

An inquest in Manchester heard Mrs Shaw who worked for the finance giant Prudential had worked her way up the company ladder after starting as a cashier. She had previously worked for the NatWest bank.

Police coroners officer Joseph Keys said in a statement: 'She enjoyed running and days out walking with her family and together, she and her partner Steven have two children.

'In 2013, she was diagnosed with carcinoma of the cervix and received treatment for that, including radiotherapy. She was later diagnosed with peritoneal mesothelioma, which can be linked with working with asbestos.

'Her partner, Steven, confirmed that upon her diagnosis, Alana looked into the possibility that she had worked with asbestos, but couldn't really pinpoint when she could have worked with asbestos and they did not make further inquiries.'

Dr Paul Taylor, a consultant in medical oncology, at Wythenshawe hospital said he first became involved with Mrs Shaw's care in May 2020 at his oncology clinic after she was referred by one of his colleagues, a surgeon.

He added: 'She was diagnosed in 2013 with carcinoma of the cervix and was treated. She received a combination of chemotherapy and radiotherapy, which was given with curative intent.

'A follow-up scan showed an excellent response to the treatment but in February 2020, she felt lower abdomen discomfort following a run. There was an MRI of her Pelvis in March 2020. At that time there was no evidence of cancer and she also went to have a CT of her abdomen and pelvis.

How can radiotherapy cause mesothelioma

Exposure to asbestos is the cause of mesothelioma in eight out of ten cases, according to the American Cancer Society.

However, studies have shown that radiation therapy for other forms of cancer can cause problems.

In rare cases, the radiation can alter cell DNA leading to 'out-of-control cell growth'.

According to Cancer Research UK: 'Some research studies show an increased risk of mesothelioma in people treated with radiotherapy for a previous cancer.

'But other studies show no increased risk.

'If radiotherapy does increase the risk of mesothelioma, this is likely to happen only in a very small number of people.'

'But the symptoms persisted and she had further scans, which in turn lead to a diagnosis of peritoneal mesothelioma. There were discussions at Wythenshawe hospital as to whether this was linked to asbestos or whether it was a diagnosis of malignant peritoneal mesothelioma.

'It appeared from Alana's past medical records that she had a history of carcinoma of the cervix and there was no history of working with asbestos. Peritoneal mesothelioma is typically due to previous exposure to asbestos, but in Alana's case, there is no clear history of exposure to asbestos, although people can be exposed to asbestos without being aware of this.

'Typically, the term of exposure to asbestos is thirty years but it can be as short as twenty years or considerably shorter. Previous radiology treatment to the pelvis could have been a contributing factor but it's a rare complication.'

The cause of Miss Shaw's death was peritoneal mesothelioma contributed to by carcinoma of the cervix. Recording a narrative conclusion Manchester coroner Zak Golombeck said: 'In 2013, Alana was diagnosed with carcinoma of the cervix and received radiotherapy to treat that.

'She was diagnosed with peritoneal mesothelioma in April 2020 and she died on May 15, 2021. The radiotherapy intended to treat her carcinoma of the cervix contributed to her death and she died from recognised complications from necessary medical treatment. I find that peritoneal mesothelioma was contributed to by the radiotherapy and not by asbestos exposure.'

At the time of Miss Shaw's death her fiancee Steven Peel a company inspection manager said: 'Our hearts are completely shattered. The past 12 months have been incredibly difficult but she remained focused and fought so hard. Even on the darkest and hardest of days she managed to stay so positive and never lost sight of what was important.'

WHAT IS MESOTHELIOMA?

Mesothelioma is a type of cancer that develops in the lining that covers the outer surface of some of the body's organs. It's usually linked to asbestos exposure.

It mainly affects the lining of the lungs (pleural mesothelioma), although it can also affect the lining of the tummy (peritoneal mesothelioma), heart or testicles.

More than 2,600 people are diagnosed with the condition each year in the UK. Most cases are diagnosed in people aged 60-80 and men are affected more commonly than women.

Unfortunately it's rarely possible to cure mesothelioma, although treatment can help control the symptoms.

The symptoms of mesothelioma tend to develop gradually over time. They typically don't appear until several decades after exposure to asbestos.

Mesothelioma is almost always caused by exposure to asbestos, a group of minerals made of microscopic fibres that used to be widely used in construction.

These tiny fibres can easily get in the lungs, where they get stuck, damaging the lungs over time. It usually takes a while for this to cause any obvious problems, with mesothelioma typically developing more than 20 years after exposure to asbestos.

The use of asbestos was completely banned in 1999, so the risk of exposure is much lower nowadays. However, materials containing asbestos are still found in many older buildings.

Source: NHS Choices