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The Sunday Times Cancer Campaign

I count myself lucky to live near Cambridge. If I ever need treatment for cancer, I feel confident that I would be given the best care by oncologists at Addenbrooke’s Hospital. I certainly wouldn’t want to go to the Queen Elizabeth Hospital in King’s Lynn which is on special measures and failed my father.

The challenge for cancer patients is to have a doctors to correctly identify their symptoms which are often misdiagnosed and refer them swiftly to a consultant. Speed is of the essence for early diagnosis and treatment options before the cancer advances and spreads throughout the body.

Take ovarian cancer, the UK survival rates for this disease is amongst the lowest in Europe, with the Department of Health estimating 500 lives could be saved each year if the UK were to match the best European standards. Ovarian cancer is the UK’s biggest gynaecological killer. A woman dies every two hours in the UK from the disease and 7,000 women are diagnosed each year. 75% of women are diagnosed only once the cancer has spread, with 32% of all ovarian cancer patients presenting as emergency cases. Ovarian cancer is dubbed the “silent killer” because women are not aware they have the disease until it is too late.

It is inhumane and very unfair that some cancer patients are denied drugs in parts of the country which are readily available elsewhere, like Avastin. As the ST says:

“The Sunday Times believes everyone should have an equal right to life. That is why today we are launching our campaign to beat cancer.

 
“The campaign has three aims. The first is to speed up diagnosis. Treatment is much more likely to be successful when a cancer is diagnosed at an early state. Medical advances mean a patient diagnosed early enough is twice as likely to survive compared with 40 years ago.

 
“The average GP will see only seven or eight cancers in a year and not all are easy to spot. But some GPs seem to be more adept than others at identifying symptoms and are more willing to refer patients for tests. Too many patients have to trudge back to the GP again and again before they get a referral. The case studies we publish today demonstrate just how fatal this kind of delay can be.”

“Our second aim is to achieve faster, more consistent treatment throughout Britain. Too many trusts miss targets for the time between referral and diagnosis. A disjoined system – a gulf between GPs, consultants and radiotherapists – wastes resources and endangers patients.

“The third aim is to give patients access to more advanced radiotherapy. Of the 269 NHS radiotherapy machines in use in England, more than half are outdated or are near to the age which they should be taken out of service. About 52% of cancer patients are thought to benefit from some form of radiotherapy, but only 38% of NHS patients are getting it.”

The editorial acknowledges that while the government does not have millions of pounds to meet these costs, their manifesto demands smarter use of resources.

“Last year the Safe Weekend Care campaign convinced the NHS that patients deserve the same high quality treatment seven days a week. The petition signed by Sunday Times readers played a vital role in putting Safe Weekend care on the agenda. Now, with readers’ help, we hope to save more cancer patients from delays that can prove fatal.”

To pledge your support, as I have, go to thetim.es/nhsreform (correct spelling)

 Update 30 March: Harpal Kumar,  chief executive of Cancer Research UK, highlights the challenges of early cancer diagnosis for the Sunday Times Beat Cancer campaign.

EARLY diagnosis is key in beating cancer. The earlier cancer is treated, the better the chances of long-term survival for almost all types of the disease.

But too many barriers stand in the way of an efficient process that rapidly moves a patient with suspected cancer through the tests and treatment they may need.

First, patients sometimes don’t recognise signs that might be cancer and are often reluctant to visit the doctor or unable to get an appointment even when they do.

Second, GPs need better training to spot cancer symptoms and better access to relatively simple, inexpensive tests that might rule out cancer.

Third, GPs are not always able to get diagnostic tests done quickly when there is a reasonable suspicion of cancer. Fourth, financial constraints may stop them from referring patients to specialists.

Finally, GPs may be reluctant to refer patients with a low risk because of feedback from hospital consultants who feel they have been sent too many cases that turned out not to be cancer.

These problems are much worse in some areas of the country than in others. We need to tackle the huge national variation in how likely it is that a GP will send patients for chest x-rays for lung cancer, ultrasound for gynaecological cancers, endoscopy for bowel cancers or MRI scans for brain tumours.

The time between patients having tests and receiving results is often too long and alarmingly varied between hospitals.

We are the only country in Europe to have so many barriers to rapid cancer diagnosis — even our two-week “urgent referrals” compare unfavourably with many other European countries where a suspicion of cancer leads to investigative tests within a few days or even hours.

Historically in the UK, GPs have been trained and incentivised to be the gatekeepers to specialist care, with the emphasis on limiting the number of referrals. This attitude needs to change.

While not wanting to refer every patient with a stomach ache to a cancer specialist, we do need to encourage GPs to act on a lower threshold of suspicion. We also want to see co-ordination improved to reduce the growing chasm between GPs and hospital care.

Decades ago, the manufacturing industry realised the benefits of designing delay out of its systems. Not only did agility improve, but costs decreased markedly and quality improved. Healthcare is not manufacturing, but that does not mean the principles are irrelevant.

We need to see patients diagnosed as quickly as possible and to relieve patients without cancer of the anxiety of not knowing.

We also need new approaches that send many more people for investigative tests, even if the possibility of cancer is slight. This will be expensive but it should save money in the long run. The majority of people tested won’t have cancer, but that’s OK — we must find a better balance between sending too many for tests and missing vital diagnoses.

 

 


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