It is good to see recognition that this harm is sometimes caused by medical interventions. As a cancer patient I was subjected to an intrusive procedure without warning or consent. Since I was already raw inside and out, the event caused extreme pain, made worse by my attempts (clenched muscles) to prevent entry. Perhaps worse was the shock and trauma that a seemingly kindly, softly spoken clinician on whom I was totally dependent to 'save my life' should be doing this to me - while another doctor stood by grinning and he and a nurse did nothing to protect me. Nothing was said and no-one acknowledged that what took place was unacceptable.

I had years of playback, in every quiet moment re-living the pain and trauma - even speaking aloud as if trying to prevent it happening. The conflict between the former apparently caring attitude and such barbarity was enough to blow my mind. I discovered later that the clinical trial protocol by which I was treated (although I had not been told about this) allowed a 6-8 week delay before examination and assessment to allow the area to heal. I was given no time. And according to my medical notes no information was gained from the examination. I had suffered unnecessarily.

This experience had a greater impact on me than later when I was given no pain relief while the rectal muscle with 6 wires implanted (up to 6cm long and involving three quarters of the anal canal) went into repeated spasm for about three quarters of an hour.

Lack of acknowledgement of this harmful practice is what drove me to become a patient advocate and medical writer. I wrote in medical journals, gave presentations and one thing led to another. My book not only details the cumulative psychological effects of my experience, but provides discussion sections after each event, with references to good practice/evidence based practice, so can be useful in medical education.

Competing interests: Author, Nothing Personal, disturbing undercurrents in cancer care. Radcliffe Publishing.