Cancer is brutal and it’s relentless. There are no waves or peaks, just thousands of deaths every week, many of which are unnecessary and entirely avoidable.
Survival rates in the UK are poor considering our wealth. The list of countries performing better than us (Australia, France, Canada, Norway to name a few) is long and depressing. If there were a league table for economically developed countries, we would be stuck in the relegation zone.
As someone who has spent my entire working life treating cancer, I have been delighted to hear recently both the Prime Minister and the Secretary of State for Health spell out the Government’s commitment to tackling waiting times for cancer diagnosis and treatments, which have been horrendously aggravated by the pandemic.
On a visit to Rutherford Diagnostic Centre Somerset in Taunton last week, the Prime Minister outlined what he thought was the “number one issue” for the British people. Not the Covid pandemic, but clearing the Covid backlogs. Earlier in the week, Sajid Javid vowed to “launch a war on cancer”, the rhetoric is changing and it’s changing for the better.
Cancer patients certainly need action. So, what can we do not just to tackle the backlog, but to transform cancer services in our country for good? How can we win the “war”?
Awareness is vital. Seriously ill people were told to stay home and protect the NHS. Many did just that and it has already or will cost them their lives. Even before the omicron wave, Macmillan estimated that there are roughly 50,000 “missing” cancer patients (those who should have been diagnosed, but haven’t) and 24,000 who have had their treatment significantly delayed. Those numbers are utterly hideous, and I suspect the situation is far worse than we realise.
Finding those people and getting them into the system should be a national priority. A delay of days and weeks is not terminal, but weeks and months will be. If people are more concerned about potentially catching the virus following three vaccinations than they are about untreated cancer, then public health messaging has been grotesquely warped out of reality.
And yes, it’s a fact that many people have been unable to access their GPs, despite the best efforts of staff. These surgeries should be relieved of their vaccination duties and allowed to focus on seeing patients face to face. Give them the funding and support they need to get people back into the surgery when it’s needed – a virtual consultation will suffice in a limited number of cases mainly to follow up on tests, but doctors need to see their patients when they have new symptoms.
Once cancer is suspected, we need to get the diagnosis finalised as soon as feasibly possible. Two things are needed – a biopsy when a sample from the cancer is removed and examined in the laboratory and some sort of imaging – CT or MRI – to understand its location and how it is spreading. Introducing diagnostic centres across the country has been innovative, pragmatic and it’s a policy I fully support. Nervous patients are more comfortable visiting a facility which is away from the perceived contagion zone of a hospital and bringing these hubs right into communities is such a fantastic tool – the more, the better.
Without prompt diagnosis, survival rates plummet. For early-stage cancer patients we expect approximately 90% to survive, that drops to around 10% for more advanced cases.
Knowing the location and detail of the cancer is half the battle. For a country of the wealth and stature of ours, money should be almost no object in delivering state-of-the-art treatment technology. Yet again though, we are lagging behind our neighbours. Take radiotherapy, in the UK roughly 27% of patients receive this treatment compared to international standards which are far higher. Campaigners estimate that a one-off investment of £250 million would transform radiotherapy services for a decade, with smaller ongoing funding required, I say that would be money well spent.
At Rutherford, we are in the process of offering our services to the NHS for three years on a not-for-profit basis to assist them more than we already are in clearing the backlog. I can only speak for our network, but the independent sector has the staff, infrastructure and capabilities to help.
We also need to face up to some ugly truths in our country. Anybody can develop cancer, but there are clear and obvious risk factors which we have huge control over. It’s a topic which is ignored for fearing of causing offence, but we are not a healthy nation – it’s pointless to argue otherwise. Obesity is rife and alcohol consumption is off the charts. Solving it is not a simple question, however I am sure that people need to take far more responsibility for their health.
As the devastating consequences of the pandemic on non-Covid healthcare are becoming clearer, so too will the public’s expectation for it to be tackled with the same vigour as our response to the virus. With tens of thousands of mothers, fathers, sons, daughters, friends and colleagues unknowingly developing advanced cancer, there really is no time to waste.
Professor Karol Sikora is a consultant oncologist and Medical Director of Rutherford Cancer Centres