Retiring breast cancer surgeon Mike Dixon has held the lives of up to 40,000 women in his hands, writes Sandra Dick

Of all the things for one of Scotland’s leading breast cancer experts to recall from a career spanning four decades and tens of thousands of patients, a 49p Harry Secombe record may seem the strangest.

Not that consultant breast surgeon Professor Mike Dixon does not recall with crystal clarity the faces, names and medical details of an astonishing number of women treated at his Edinburgh clinics.

Totting them up is harder:

There are women who dragged themselves through the doors of the UK’s busiest breast unit fearing a death sentence.

Ones who dreaded breast removal – and in the early days when battling cancer could be a brutal affair, they may have been right to.

The stoic families who threw a consoling arm around him at deeply moving funerals.

Dying young mums with tiny children in tow, the bright-eyed teenagers, worried grandmothers, frightened sisters and the many, with worrisome but benign lumps and bumps that turned out to be easier to fix than they feared.

“We see 10,000 patients in our clinics every year – around 200 a week,” he says, trying to figure out just how many lives he has touched since arriving in Edinburgh in the early 1980s to his recent plans for retirement and dramatic reduction in his hours at the Western General Hospital’s breast care clinic.

He eventually plumps for a figure of somewhere between 30,000 and 40,000 breast care patients.

At least 5000, he guesses, would be in the grip of breast cancer.

Of them, there have been many who, having poured out their fears, thanked him for being the only doctor who actually listened.

That they landed on the books of a surgeon and consultant with a reputation for a mellow bedside manner appears to be at least partly down to that 49p Harry Secombe record.

The son of a Sheffield steelworker and shopkeeper, Dixon grew up in one of the steel town’s poorer areas, walking out of school at 16 with four A levels and an interest in medicine.

But rather than plunge into university, he opted to learn the very basics of patient care, first as a porter in the physiotherapy department at Sheffield Northern General and then as an auxiliary nurse in an old people’s home.

To break the monotony of the hospital waiting room, he’d bring the portable record player he used for his other job as a DJ, and entertained the patients.

“It was the most valuable time for me,” says Dixon, a natural born communicator. “There was an old guy I used to see, he was always grumpy as a lot of old people can be.

“One day I made him tea in a huge mug and spoke to him about music. I asked what he liked, and he said ‘Harry Secombe’.”

Within days Dixon found a Harry Secombe record in a box on the pavement outside a record shop.

He paid 49p for it and then played it while grateful tears rolled down the elderly man’s cheeks.

“I realised it’s the little things you do with patients, the time you spend talking to them, getting to know what will make a difference for them, that matters,” Dixon says.

“You also discover that a good health system is built from the bottom up, not the top down, and that the most important thing you can do, is listen to people.”

He planned to become a pathologist until a meeting with an ebullient American with a passion for breast disease swept him in a wave of enthusiasm and convinced the Edinburgh University graduate to shift focus.

It set in motion a chain of events that would not only touch the lives of his patients, but others up and down the country.

Maggie Keswick Jencks was a charismatic writer, artist and garden designer whose breast cancer had metastasized to her liver and lymph nodes.

By the time she reached the Western General’s care, her condition was dire.

“She said when she was diagnosed, the doctor told her that he had more patients to see, and could she leave the room,” he says.

“She was told to make the most of the two or three months she had left.

“She was harshly treated,” he adds. “We gave her chemotherapy and stem cell rescue and repopulated her bone marrow from her own blood.

“For three and a half years she was fantastic, no breast cancer, we got rid of it from her liver, she did great.”

She told Dixon and her care team of her hope that all breast cancer patients could have the support to help them through. The blueprint they drafted drew on her feelings of vulnerability and fear, her theory that beautiful design and art could comfort and raise spirits and explored therapies and care that could ease women through the difficulties of their diagnosis.

The first Maggie’s Centre opened a stone’s throw from Dixon’s clinic in Western General Hospital grounds in 2006, a few months after her death. Today there are 19 Maggie’s Centres with more planned for the future.

Between the innovative force of Maggie’s and the expertise of the Western General breast unit – the UK’s busiest of its kind – Edinburgh has grown as a focal point for pioneering breast care.

As well as leading the way in the introduction of specialist breast care nurses, it is a centre for research. Dixon is clinical lead of Breast Cancer Now Edinburgh Research Team, which is currently focusing on why some patients fail to respond to certain commonly used cancer treatments.

Clinical trials are on the horizon, Dixon, however, has other plans.

Full retirement is coming, and he is now extrapolating himself, working reduced hours which, nevertheless, saw the 65-year-old surgeon rattle through six operations one day last week.

Within 18 months he plans to be permanently at his new home in Sussex where he’s just "Mike with the two dogs" and not Professor Dixon, the breast cancer surgeon and consultant.

He’ll spend precious time with his wife, Pam, who throughout his career has shared him with thousands of women, accepting the intrusions their care could make on family life.

For those early patients Dixon was the champion helping in their fight for life. Now, however, survival rates have improved dramatically, there are better reconstruction outcomes and less invasive treatment for conditions such as abscesses. Once gouged out in theatre and left to heal for weeks, Dixon’s innovative work means they are treated using just a thin needle.

“When I started, everyone who had breast cancer had to have their breast removed,” he reflects. “The aim was to get the cancer out, it didn’t matter what it looked like.

“We now do a lumpectomy and they don’t have to be mutilated.

“Breast cancer is no longer a disease that women need to fear; most who get breast cancer will not die of it.”

But sometimes things do not go well. The women who didn’t make it keep him awake at night, and he holds their memory close.

One, he remembers, gave him a pair of quirky Lion King socks as a thank you for her care. In his despair at her loss, he wore them until they were threadbare.

And then there are the funerals of women he cared for and, pained by their loss, how he found their loved ones offering him their sympathies.

“Do I remember all my successes? No I don’t,” he says quietly. “I remember the people who didn't make it, or who had complications.

“It has to be like that. The reality is you have to be good every day, and you’re only good by not thinking you know everything.

“You have to fear complications so much that you want to escape the risk of ever having that horrible feeling.

“And you’ll do everything you can to get it right.”