A postcode lottery in kidney cancer care is costing hundreds of lives every year, an NHS report has revealed.
In some rural parts of England, patients with the disease are almost half as likely to receive life-saving drugs as those in more developed areas such as London.
Those who received drugs were three times more likely to be alive two years after their diagnosis than patients who did not, according to NHS documents seen by The Mail on Sunday.
Shadow health secretary Wes Streeting, a kidney cancer survivor, called the findings “inexcusable”. The Labor MP, who was diagnosed with the disease in 2021, said: “I was lucky my kidney cancer was detected early and treated quickly.” It is inexcusable that patients cannot receive life-saving treatments because of where they live. The NHS should be there for all of us when we need it.’
Experts believe the disparity in access to these drugs is because there are no guidelines on what treatment to offer kidney cancer patients.
SURVIVOR: Labor MP Wes Streeting was treated for kidney cancer in 2021
These guidelines, created by the NHS spending watchdog, the National Institute for Health and Care Excellence (NICE), are for each of the ten most common types of cancer in the UK, except kidney cancer.
The disease affects 13,000 Britons every year, making it the seventh most common cancer. It usually occurs when people are between the ages of 60 and 70 and is very rare in people under 45, although Wes Streeting was diagnosed at 38.
The first signs are usually blood in the urine, back pain, and lumps or swelling in the back, under the ribs, or in the neck. Obesity, smoking, high blood pressure and late-stage chronic kidney disease, which affects almost 70,000 people in the UK, are thought to increase the risk. Genetics also play a role.
This year, NICE agreed to draw up its first guidelines for kidney cancer, but these are not expected to be published for years.
“Our work has shown that the treatment kidney cancer patients are likely to receive varies depending on where they live in England,” says Malcolm Packer, chief executive of the charity Kidney Care UK, which carried out the Kidney Cancer UK Accord report.
‘We are now working with NICE and participating in the development of the guidelines, but this will take two years. We are also asking doctors to look at how they can better diagnose and treat patients.”
If kidney cancer is found early, it can be cured by removing the affected section of the kidney through surgery. Until recently, there were very few effective treatments for the disease if it spreads outside the kidney.
However, in the past five years, a number of new immune-boosting drugs, collectively known as immunotherapy, have become available to these patients with advanced kidney cancer that can significantly extend their lives and even cure them. However, training is needed to administer the complex treatment, which experts say many consultants do not have.
“This report is deeply concerning,” says an oncologist, who asked to remain anonymous. ‘Cancer consultants in some parts of the country clearly do not have the time or expertise to administer complex, life-saving drug treatments. [such as those needed for kidney cancer]. I don’t think the new NICE guidelines are enough to solve this problem.’
The new report compared the provision of drug treatments across the 21 Alliances Against Cancer, the NHS districts for cancer care in England. It looked specifically at patients with advanced kidney cancer and whether they were offered the new drugs within the first 12 months of diagnosis.
He doesn’t name the specific alliances, but says that in three, less than 40 percent of this group of patients received new cancer-fighting drugs. The lowest-performing district offered these drug therapies to only 36 percent of patients. The highest rate of access to drugs was only 69%.
According to Dr. Kate Fife, a consultant oncologist at the University of Cambridge and lead author of the report, on average only about half of patients with advanced kidney cancer were receiving these treatments.
“While the figures vary by Alliance, it is clear that there are NHS patients who are not receiving drugs that could extend or even save their lives,” says Dr Fife.
Kidney cancer affects 13,000 Britons each year, making it the seventh most common cancer (file photo of the treatment)
The report also found that only 11 percent of patients who did not receive the drugs survived two years or more after diagnosis, compared with almost 40 percent of those who received the treatments.
“Not all patients can take these drugs,” says Dr. Fife. ‘About 15 per cent are too old or sick to start treatment safely. But that still leaves us with a lot of patients who should be treated.’
While the report does not name and shame specific areas of the country, experts say it is obvious where underperforming alliances are based.
“The data clearly shows that kidney cancer patients in London are much more likely to receive quality care than those in rural parts of the country,” said one oncologist.