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Acid Attacks and Corneal Grafts, Bowel Cancer Screening, Sports Prosthesis for Children

Acid attacks are at a record high in the UK. Dr Mark Porter talks to Andrew, blinded by a robber who stole his car, and to the eye surgeons using donated corneas to save his sight.

The UK has one of the highest recorded rates of acid attacks in the world, nearly 500 cases in 2016. Most of the victims are men and most have corrosive liquid, typically acid or bleach, squirted into their faces while they are being mugged for their phone, bag or car. Andrew Keene was attacked in London last year while he sat in his car, and blinded by a robber who then drove off in his car. He's had five operations, including two corneal grafts, to try to restore the sight in his right eye. Dr Mark Porter talks to Andrew at Queen Victoria Hospital in East Grinstead, where sight-saving eye surgery was pioneered over sixty years ago. This hospital set up the UK's first Eye Bank for donor eyes and it is from these donations that eyes, damaged like Andrew's, are repaired using grafts. Mark hears about the shortage of donated corneas which mean long waiting lists for eye surgery and Eye Bank head Dr Nigel Jordan tells him they're having to import donor eyes from the USA to meet demand.

成人快手 News anchor George Alagiah has gone public with the news that his bowel cancer has come back three years after it was diagnosed at an advanced stage. He has questioned why screening starts at different ages in different parts of the UK. If he lived in Scotland where the bowel cancer screening programme starts at 50, up to 10 years before the rest of the country, he would have been screened earlier and his cancer might have been picked up earlier, making it easier to treat. Inside Health's Dr Margaret McCartney discusses the complexities involved in rolling out national screening programmes and tells Mark why there's a difference in Scotland and the rest of the UK about the starting age for bowel screening.

Until a couple of years ago, children who were born without a limb, or those who lost a limb after illness or injury, could get a traditional prosthesis, or artificial limb fitted, but it was a limb of the most basic kind which would enable them to walk, but not to run or do sports. But thanks to money released into a special fund by the Department of Health in England, for the last 18 months these children have been fitted with the high-tech futuristic-looking prostheses - racing blades - that allow them to run, jump and compete in all sorts of activities and sports. Mark visits a paediatric rehabilitation clinic at the Royal National Orthopaedic Hospital in Stanmore and meets the children who are benefiting from these new activity blades.

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28 minutes

Programme Transcript - Inside Health

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THE ATTACHED TRANSCRIPT WAS TYPED FROM A RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT.听 BECAUSE OF THE RISK OF MISHEARING AND THE DIFFICULTY IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE 成人快手 CANNOT VOUCH FOR ITS COMPLETE ACCURACY.

INSIDE HEALTH 鈥 Programme 11.

TX:听 27.03.18听 2100鈥2130

PRESENTER:听 MARK PORTER

PRODUCER:听 FIONA HILL

Porter

Coming up over the next half hour:

Screening for bowel cancer 鈥 why does the programme start at 50 in Scotland, but later across the rest of the UK?

And sports prostheses for children 鈥 how making high tech blades available on the NHS is transforming the lives of those with artificial limbs.

Clip

For him, his confidence is a lot to do with sport, Soffyan the striker, the boy that can play football.听 So, for him his mobility is everything.

Porter

More on blades later.

But first eyes and acid attacks. 听The UK has one of the highest recorded rates of corrosive liquid attack in the world, nearly 500 cases in 2016. 听Four out of five of the victims are men, and most of them had the liquid 鈥 typically acid or bleach 鈥 squirted in their faces while being mugged for their phone, bag, scooter or car.听 For many, the resulting facial scarring and damage to their eyes will change their lives forever.

Andrew Keene was parked at the side of the road in London when somebody decided to steal his car. What happened next was brutal.

Keene

It was quarter to seven in the evening and someone got into the car and it was a split second 鈥 I sort of turned around and he kind of 鈥 sort of a squeezy bottle, basically squeezed a jet of some sort of acid mixture 鈥 hair dye they think, with something else in it 鈥 straight into my eyes.听 And how I turned around to the passenger door most of it 鈥 the jet of it went into my right eye.听 It was a couple of split seconds.听 I was blinded straightaway, burning sensation.听 All I remember thinking was I need water in my eyes.

Porter

Terrifying 鈥 under attack and blinded.

Keene

A, you鈥檙e in a situation where you鈥檙e being attacked and you鈥檝e not got any vision.听 So, it鈥檚 not a great spot to be in and the you think, right I鈥檝e heard about these attacks, this is in my eyes, I need to be at hospital very quickly.

Porter

At what stage did you realise that it wasn鈥檛 just about temporary blindness and pain but this could have serious long-term consequences for you?

Keene

I think when I saw a surgeon, probably two or three days later, he was very direct with me and said this is serious, it鈥檚 going to take a long time for this to heal up, it鈥檚 a serious injury.

Porter

Andrew suffered extensive alkaline burns to both eyes, but his right eye was much worse 鈥 his cornea, the delicate see-through membrane at the very front of the eye, had been badly damaged.

After the attack he was referred to the specialist centre at Queen Victoria Hospital in East Grinstead. 听Consultant eye surgeon, Damian Lake, is one of the team at the hospital that repair damage corneas using grafts 鈥 transplants taken from donor eyes.

Lake

The cornea should be clear, it should be a nice even curve, so that it focuses light precisely on to the back of the eye.听 So, if you think of what鈥檚 now an old-fashioned camera, which was just a camera, when I was growing up, you have a lens at the front, you have a lens in the middle which moves and then at the back of the eye you had a film.听 So, the lens on the front of the camera equates to the cornea, it鈥檚 the clear focusing mechanism of the eye.

Porter

If the cornea鈥檚 injured how good is it at healing itself?

Lake

It鈥檚 very good at healing itself but not in a way that is conducive with being able to see afterwards.听 The main way that an eye heals is through scar formation but of course scars are opaque and you can鈥檛 see through those, so therefore people lose their vision.

Porter

Queen Victoria Hospital pioneered sight-saving surgery using corneal grafts. 听The story goes back to the Second World War, when badly burned spitfire pilots were being treated by the renowned plastic surgeon Sir Archibald McIndoe, who was based at the hospital. 听Up until then eye transplants had been illegal, thanks to restrictions imposed on the use of body parts introduced to combat grave robbing by the likes of Burke and Hare. 听But many burned pilots had scarred corneas so in 1945 McIndoe asked Sir Benjamin Ryecroft to establish the Corneo-Transplant Unit here in East Grinstead.

He led a national campaign to get the law changed: the 1952 Corneal Grafting Act was the result and this hospital set up the UK鈥檚 first eye bank to collect and store donated corneas, and surgeons here started transplanting them.

Lake

The main reason that we require to repair the cornea is because it becomes cloudy for some reason or distorted in shape.听 The main groups are elderly people, in which it becomes thick and cloudy because the cells wear out in the cornea and in young people it becomes distorted in shape because they have a weakness of the cornea, something called keratoconus.

Porter

Can you explain in simple terms what corneal grafting involves, what are you trying to do?

Lake

What we鈥檙e trying to do is to deal with the problem so that we鈥檙e left with a cornea which is clear and which is also the correct shape, so that it focuses the light properly.

Porter

Let鈥檚 use the example of someone who has a damaged cornea through the acid attack, as in Andrew鈥檚 case, do you actually have to remove the damaged cornea that鈥檚 there and then replace it with the graft 鈥 is that essentially what you鈥檙e doing?

Lake

In that case it becomes more complicated because yes, in the end, we will need to remove the opaque cornea and put a new one in, which is clear, but when you have particularly acid or chemical attacks it damages a lot of the supporting cells around the cornea, so we need to also replace those first.听 So, it can often be a multi-stage process over a number of years unfortunately.

Porter

And one year on from the attack, Andrew has had five separate operations including two corneal grafts.

Keene

My anatomy of the eye was probably GCSE biology, so I鈥檝e learnt quite a lot since.听 But yeah, I mean I didn鈥檛 really know these operations existed.

Porter

How long ago was the graft put in?

Keene

This graft was done about six weeks ago, at the same time that I had the stem cells put in, so a little ring of stem cells goes around the cornea鈥

Porter

To help the healing?

Keene

That helps grow in, because I鈥檝e not none of my 鈥 no cells of my own.听 And that鈥檚 taken well, so it鈥檚 time, it takes time.

Jordan

Okay Mark, well welcome to our eye bank, I鈥檓 Nigel Jordan and I鈥檓 the eye bank manager.听 We鈥檙e just walking through the doorway into the lobby of our eye bank.

Porter

And there it is.

Jordan

In front of you, you can see a window looking into our nice clean room.

Porter

And just describe what we鈥檙e looking at then, so what do you actually have in there at the moment?

Jordan

In the first room we have incubators and some fridges and freezers where we store the corneas after they鈥檝e been processed.听 Through the transfer hatch you can see six cabinets and we perform all of our tissue processing, corneal storage, in those cabinets.

Porter

What鈥檚 actually happening?听 Whole eyes are arriving here from the donors?

Jordan

Sure, so we retrieve eyes from Kent, Surrey and Sussex mainly and we bring the whole eyes back, we have a great team of retrievers who are very dedicated and go out at all times of the day and night and will retrieve eyes, bring the whole globe back.听 So, we have 24 hours from the time of death from a donor to remove the eyes and then we have a further 24 hours to then process the eyes.

Porter

And by processing 鈥 which bits of the eye are you interested in?

Jordan

Sure, okay.听 We鈥檙e mainly interested in the cornea, which is the front clear section of the eye, those are the pieces that we transplant mostly.听 The cornea that we鈥檝e removed is then placed into a storage media, which contains nutrients that keeps the cells on the back of the cornea alive and we can store those corneas for up to 34 days before use.听 And they sit in an incubator at 30-31 degrees.

Porter

What about the rest of the eye, the cornea鈥檚 obviously the see-through bit right at the front of the eye, is any of the rest of the eye of any use?

Jordan

Yes, other eye banks store the sclera and use that for鈥

Porter

The white bit.

Jordan

鈥he white bit, for patches for glaucoma surgery.听 We can use other sections of the eye because we grow limbal stem cells from diseased donor corneas and we can grow sheets of corneal epithelial cells which are then applied to the surface of a recipient eye.

Porter

So, these you would hope would take seed and grow and heal the scar or a wound naturally, is that the鈥?

Jordan

They stabilise the surface of the cornea which then following the stabilisation process a corneal graft can be performed.

Porter

Looking at you now, your left eye looks normal but your right eye is, as anyone would notice, is closed.听 And is that stitched closed at the moment?

Keene

Yeah, I鈥檝e had Botox in the 鈥 which I didn鈥檛 ever thought I鈥檇 say 鈥 but Botox in the eyelid to relax it and to keep the eye closed.听 And I鈥檝e got a stitch in the far corner.听 I mean the idea being you鈥檙e trying to create the best environment for the stem cells to grow and also for the graft to take.听 So, if the eye is closed to the elements the better really.

Porter

Andrew was treated as an emergency but for less pressing corneal problems there鈥檚 a waiting list. 听Three thousand families agree to donate relatives鈥 eyes every year but units like Queen Victoria Hospital need 70 donations a week to meet demand, that鈥檚 a shortfall of more than more 500 a year.

Dr Nigel Jordan at the eye bank told me supply is a real problem, so do they ever run out?

Jordan

We do, we do and we鈥檝e resorted to importing from the US, in the tens this year, never done before.

Porter

To meet demand.

Jordan

To meet demand.

Porter

How do you identify people that might be potential donors?听 I mean if I 鈥 if I put myself on the donor register and I鈥檓 happy to donate my eyes and I鈥檓 in your hospital or a hospital locally round here, will you get to know that I鈥檓 a potential donor?

Jordan

Only if we鈥檙e called by the referring staff at the hospital.听 So that鈥檚 one of the main problems in sourcing enough corneas.

Porter

So, I might be on the register but unless the staff actively ask about the possibility and contact you it鈥檚 not going to happen.

Jordan

That鈥檚 one of the main problems we have.听 So, we really urge medical staff to think about donation at the time of death.听 We know it鈥檚 a difficult question to ask or we know that some of them find it a difficult question to ask but without asking and then without contacting us we鈥檒l never be aware of a potential donor.

Porter

So, it seems that signing yourself up for the organ donor register isn鈥檛 enough. 听Unless you talk to your family about your wishes and unless hospital and hospice staff talk to families and ask the difficult question, there will continue to be a shortfall in cornea donations. 听On top of a national shortage of donors, one in 10 who do register tick the 鈥渆xcept eyes鈥 box on the register form. 听Why? 听Some are squeamish, some mistakenly believe their religion forbids it, and others worry that they will need their eyes for whatever they think comes next.

But before you tick that box, eye surgeon Damian Lake has a request.

Lake

If you could just sit still and cover your eyes for 10 or 15 minutes and then try and think what it鈥檚 like to not be able to see for a prolonged period of time and then think about the fact that we鈥檙e not producing enough donations and we鈥檙e not doing enough transplantation, when quite simply you could give the gift of sight.

Porter

So, what鈥檚 the future hold for you, when鈥檚 that stitch going to come out and when are you going to be able to look through the eye to see how well it鈥檚 all worked?

Keene

It鈥檚 an ongoing process.听听 So, I had a check up this morning and the growth is good and we come back in a week and we鈥檒l see how far that鈥檚 gone again.听 But hopefully, we鈥檒l get the skin of the eye healed and then the vision again is 鈥 it could take our time on that.

Porter

So, they鈥檙e focusing on the front of the eye at the moment.

Keene

Yeah, yeah so we鈥檒l get that safe and then we鈥檒l take a bit of time and hopefully we鈥檒l see how the vision is from there.

Porter

The remarkably stoic Andrew Keene and we wish him well.听

There is more information on becoming a donor on the Inside Health page of the Radio 4 website. And, please, if you already on the register do tell your family, so that, should the worst ever happen, they can respect your wishes and help transform another life or lives.

成人快手 news anchor George Alagiah has gone public with news that his bowel cancer has come back three years after it was diagnosed at an advanced stage. 听听And he has questioned why screening starts at different ages in different parts of the UK. 听Had he lived in Scotland, where the bowel cancer screening programme starts at 50, up to 10 years before the rest of the UK, he would have been screened for nearly a decade before he eventually developed symptoms, and the cancer might have been picked up much earlier, making it far easier to treat. So why the difference?

Margaret McCartney is in our Glasgow studio.听 Margaret, setting a programme up like this is complex.

McCartney

It is and we鈥檝e discussed on the programme a lot about screening and the fact that what might seem very sensible sometimes turns out to be much more complicated and counterintuitive than we鈥檇 first thought.听 But what we probably haven鈥檛 talked about enough is just how massive an operation it is to set up a screening programme.听

So, the UK National Screening committee, who makes all the decisions about what it鈥檚 useful to screen for and not in the UK, they decided in 2003 that bowel cancer screening looked as though it was cost effective, it would help to reduce deaths from bowel cancer and they recommended implementing a programme.听 But that meant that millions of people were going to have to be invited for screening tests which means a system has to be set up, there would have to be enough trained colonoscopists, people who could look into the bowel for positive results from the screening, would all have to be trained and in place before that programme could be properly rolled out.听 So, although the UK National Screening committee made the decision on starting screening in 2003 it actually took until about 2006, 2007 to get the first roll outs happening.听 And because it鈥檚 such a massive thing to do the four nations all did it slightly differently, they take charge of how the system is going to be organised, how it鈥檚 going to be supported and how quality assurance is going to be done.

Porter

Is this how we ended up with a difference.听 Scotland, are they ahead of the game effectively?

McCartney

Well I think it鈥檚 more confusing and more complicated than that.听 So, the intention, as far as I can see, from both Scotland and England had been that they would do the screening programme between the ages of 50 and 74, that was the initial sort of concept.听 But that鈥檚 a huge population.听 So, what had started in England was a kind of roll out, bit by bit, they started off with the middle population, the 60-69s first, then the 70-74s and then they plan to do the 50-59s.听 And the reason for that is that bowel is more common in the older rather than the younger population.听 So, they thought we鈥檒l start rolling this out in the population most likely to benefit.听 And remember England is a much bigger area than Scotland is, so there鈥檚 a huge amount of organisation in actually getting the staff, the equipment and the training up to spec in all of that.听 But what happened was in 2009, just as roll out was really progressing, a paper came out in the Lancet.听 Wendy Aitkin and colleagues looked at the effect of once off flexible sigmoidoscopy, looking at the lower end of the bowel in people aged between 55 and 64.听 And she found that that reduced bowel cancer by a third, which effectively means a 191 people had to be screened to stop one cancer diagnosis.听 And this was felt to be effective and better than the offer already recommended for the bowel cancer screening in that age group.听 And England went ahead with that, so England now are up and running with a once off invitation for 55-year olds.

Porter

Now it鈥檚 funny you should mention that because I鈥檓 actually going for my screening next week, so I just turned 55 at the end of last year and I鈥檝e been invited for that.听 So, that is what鈥檚 happening in England and that鈥檚 why there鈥檚 this apparent disparity.听 But it鈥檚 unclear what we鈥檙e going to have going forward because this is all still being piloted at the moment isn鈥檛 it.

McCartney

Well this is the thing.听 So, you had these massive randomised control trials, that were done, very high-quality trials, looking into bowel cancer screening, that were done in the late 1980s, 1990s and all that research was done and rolled out into a programme.听 And then what happens is more research starts coming in and of course you have to start responding to that.听 So, if you鈥檝e got something that you think is better you鈥檙e obviously going to start offering that rather than what you鈥檇 already planned to do.听 And of course, there鈥檚 also been another change to the programme, as it鈥檚 been rolled out, the first test that was done was faecal occult blood testing and that鈥檚 now changed to FIT testing, which is a more sophisticated type of test that is more user friendly and has less false positive results.听 So, again that鈥檚 another improvement that鈥檚 been made.听 So, what you鈥檙e seeing is a system that鈥檚 always trying to improve to the best of its capability but it鈥檚 never really doing what it originally set out to do because the science has moved on since then.

Porter

But you could understand Margaret how frustrating this must be for people like George Alagiah, we don鈥檛 know whether the cancer would have been picked up earlier, but there鈥檚 a chance that it would have.

McCartney

Well this is a really big issue I think when we talk about these public screening campaigns because they鈥檙e designed for populations but of course they鈥檙e done on individuals.听 And when you鈥檙e doing a population screening programme, a mass programme, you have to make sure your system is robust enough, you have to make sure that you鈥檙e offering high enough quality tests and you have to make sure you鈥檙e offering really high-quality information for people, so they can make a decision about taking part in it or not.听 And we know that bowel cancer screening often struggles to get the numbers that it really needs to be cost effective.听 To begin with it was kind of 50%, it鈥檚 up towards about 60% participation rates now.听 So, as time goes on, I think, as the tests have improved perhaps more people will want to take part in it.听 But there are always going to be gaps, there are always going to be areas that are catching up, there鈥檚 always going to be areas that are not in the pilot鈥檚 area for example or the system changes just before you would have been allowed in.听 Whenever there鈥檚 a big public programme like this there鈥檚 always going to be people who are in or not just by chance.听 And I think what that says to me is that these are useful and important programmes in many ways but they鈥檙e designed for the population, they鈥檙e not really designed for the individual.听 And what is I think consistent with wherever you sit on bowel cancer screening or whatever you think about it, if you have symptoms always go and speak to a doctor, get some advice about that.听 But screening can only ever help a bit with many things.听 We know the sensitivity of the original test for bowel cancer was only approaching 50% in many instances, so we know that there are lots of errors, we know that the test doesn鈥檛 perform 100% of the time, these are things that can only help, they鈥檙e not going to offer an assurance of a cure all the time, very unfortunately.

Porter

Thank you, Margaret.听 And as ever you鈥檒l find more information on our website.

Now we鈥檙e used to seeing Paralympic athletes competing with blades 鈥 high-tech futuristic looking prostheses that allow them to run, jump and compete at the highest level. 听But they are not the only ones who can benefit.

For the past 18 months children in England, born without part of a limb or those who have had an amputation after accident or illness, have also been able to get these blades on the NHS.

Up until 2016, when special funding was released by the Department of Health, the only prostheses that children could get on the NHS were standard artificial limbs that enabled them to walk, but not to run.

I went to a children鈥檚 clinic at the Royal National Orthopaedic Hospital in Stanmore to see just what a difference the new blades are making. 听In the gym, Dr Imad Sedki, Consultant in Rehabilitation Medicine in the Prosthetic Unit, is playing football with one of his young patients.

Actuality 鈥 football game

Porter

Fourteen-year-old Sasha is giving Dr Sedki the run-around in the gym, deftly twisting and turning as she chases the football.

Watching her it鈥檚 hard to believe that just two years ago she lost both her feet below the ankle because of sepsis.听 Not only is she a mean footballer, but since her surgery she has also taken up trampolining and she only went and finished second in her category at the British Schools Gymnastic competition.

Sasha, what other sports are you planning on dominating then?听 So, we鈥檝e got trampolining, you鈥檙e talking about running.

Sasha

叠补诲尘颈苍迟辞苍鈥

Porter

Because that鈥檚 quite tricky 鈥 badminton 鈥 because it鈥檚 fast and lots of direction changes and things鈥

Sasha

No, it鈥檚 quite easy.

Porter

Oh right, okay.听

Sasha has carbon fibre C shaped blades and switches prostheses depending on what she鈥檚 doing.

Claire

She takes her blades to school, like other people take their gym kit 鈥 huge bag 鈥 to change into her blades.

Porter

So, you literally take off your normal prostheses, put on your blades when you鈥檙e doing sports.听 How did you feel the first time you put on your blades?

Sasha

Springy.

Claire

She loved it, absolutely, she was bouncing around in here, in this gym, yeah.

Porter

Were they difficult to master 鈥 because they鈥檙e quite different from a normal ankle and foot aren鈥檛 they?

Sasha

They were 鈥 at the start they were a tiny bit hard but they just got easier and easier to walk on them.

Porter

Practise makes perfect.

Sasha

Yeah.

Sedki

It was very difficult for me, as a clinician, because I know that for children running and walking fast is actually a need rather than a luxury.

Porter

Until the fund for these special prostheses was set up, it was hard for clinicians like Dr Sedki, restricted to fitting only the most basic of artificial limbs for his patients.

Sedki

And we were forcing them to walk slower than they could do with substandard feet.听 Also, we were denying them from experiencing their interests in doing hobbies.听 So, there was dancing, there was archery, there was swimming 鈥 there are so many other things that prosthetics can facilitate that these children were not able to do.

Porter

Are people surprised when they find out that you haven鈥檛 got your feet?

Sasha

Quite surprised because they don鈥檛 really realise when I have trousers on.

Porter

I can understand that, I mean you move completely normally, I mean watching you kick the football 鈥 I think you鈥檙e a better football player than Dr Sedki.听 Don鈥檛 tell him that will you.

Sedki

The smile on the face is enough, when you see them in the fitting room jumping and running around.听 And it doesn鈥檛 take long for a child to utilise it, it takes minutes sometimes.听 You see them walking into the clinic and then they run out of the clinic straight ahead.听 It鈥檚 remarkable.

Porter

It鈥檚 hard to grasp just how agile and mobile Sasha is after such a devastating illness.

Sasha

I had a cold on my birthday and then I had a cough and then I 鈥 I think it was a couple of days later I was in bed and then I went downstairs and I couldn鈥檛 breathe very easily.

Porter

So, you were in hospital with sepsis and what happened to your legs?

Sasha

They went black because they lost their circulation.

Porter

Her very survival was hanging in the balance.

Claire

Well actually she did have a heart attack and they did eight CPR and got her back with defibrillation.

Porter

You鈥檙e tough aren鈥檛 you.

Claire

She is, that鈥檚 what the nurses said, she鈥檚 a tough old thing and actually was blue/black up to the 鈥 to here.

Porter

Sasha lost both of her鈥

Claire

Feet.

Porter

鈥eet, she鈥檚 coped remarkably hasn鈥檛 she.听 I mean are you surprised, I know mothers are biased?

Claire

Yes, we are surprised and her consultant at King鈥檚 College Hospital was surprised.听 Sasha used to ask her how she was.

Sedki

Right, so as you can see Soffyan has a prosthesis on the right side, he has an amputation above the knee and it鈥檚 usually quite hard to play football with these types of prosthesis but he鈥檚 quite skilled and he鈥檚 able even to stand on his prosthetic side, balance himself on one leg and then kick the ball with the other leg.听 And he can kick it very accurately and very strong as well.

Porter

Soffyan is another of Dr Sedki鈥檚 patients, here to get his prosthetic limb upgraded. 听He鈥檚 10 years old, a fanatical Arsenal supporter and a brilliant footballer.听 But his life changed last June when he was diagnosed with a rare cancer, synovial sarcoma.

Soffyan

I used to play a lot of football, I used to be really good.听 I used to go out every day after school to a pitch right next to my school and one day, having cancer, is not nice and you have to go through a lot and actually the first thing that I thought was 鈥 was I鈥檓 going to die, that鈥檚 what I thought first because people die from cancer.听 And I thought I was going to die.

Porter

The decision was taken to amputate Soffyan鈥檚 leg, it was devastating news for him and his family but of according to his mother, Raoda, it was his future on the pitch that worried him most.

Raoda

His main concern, before he had his amputation, was whether he鈥檇 ever be able to play football again.听 He wasn鈥檛 bothered about anything else, it was just 鈥 will I be able to kick a ball, will I be able to get on the pitch.

Porter

Soffyan had his amputation last September and just a month later, Dr Sedki and his team at Stanmore, were able to access the activity blades fund and fit him with a prosthesis that meant he could play football again.

Sedki

These things when they鈥檙e provided as early as possible they reduce the psychological suffering and you can see he became confident, he鈥檚 very outspoken.听 It makes a huge difference.听 So, I would think of it mainly actually for psychology and secondly for physical.听 For children the physical activity is a need, it鈥檚 not a luxury.

Soffyan

When I started to walk and started to do really well and I didn鈥檛 believe what could happen with it and it worked. 听Now I鈥檓 walking really fluidly, I [indistinct word] very quick.听 I鈥檝e been trying my best [indistinct words], I鈥檓 a lot stronger than I used to be with two legs, my upper body strength is really strong.听 I鈥檓 stronger than the year sixes in my school.听 I beat all of them in a plank 鈥 four minutes.

Raoda

This funding is just life changing.听 His whole life is sport and I think it鈥檚 a big thing that he鈥檚 able to do something that he was able to do before.

Soffyan

I could do a bit more if I鈥檓 honest because the past year 鈥 because of what I went through inside you become a stronger person.

Raoda

The most important thing in his recovery is the fact that he鈥檚 had access to these prosthetics.听 For him, his confidence is a lot to do with sport because that鈥檚 what he was known before, Soffyan the striker, the boy that can play football.听 So, for him, his mobility is everything.

Porter

Soffyan鈥檚 proud mum Raoda, who鈥檚 all too aware of the difference his blades have made.听 But there鈥檚 a fly in the ointment.听 As children grow they need new blades and ongoing funding is currently subject to annual review and even if it does continue it stops when they reach 18.

This is the last in the current series of Inside Health. 听Claudia Hammond will be taking over this chair next month for another run of All in The Mind, during which the team investigate loneliness. 听Many thousands of you have already completed the online survey 鈥 The 成人快手 Loneliness Experiment 鈥 making it one of the world鈥檚 largest ever surveys on the topic but there are still two weeks left if you want to contribute.听

Working with psychologists from three British universities, All in The Mind want to find out more about what causes loneliness and crucially, what propels people out of it. 听Anyone over the age of 16 can take part, whether or not they feel lonely at the moment.听 There's a link on our website or you can go straight to thelonelinessexperiment.com.

Inside Health will be back in July. 听Until then goodbye.

ENDS

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