A few weeks ago, a family friend called our house very distraught to tell us that she had been diagnosed with stage four ovarian cancer.
This revelation had been quite shocking for a fit and healthy woman, but her anxiety was increased by the fact that it took her several weeks to make her first doctor’s appointment and this was followed by another delay before she managed to get a consultation with a doctor. specialist. .
Now, compounding her distress was the news that, after receiving the verdict she feared, she would have to wait six weeks before her first chemotherapy session that would hopefully eliminate the disease.
Aside from the fact that he was in pain, this delay was agonizing in itself, as it played – as it did – on his understandable fears that the longer he waited before treatment, the more likely the disease would progress and negatively affect his long life. life. long-term results.
Around 375,000 people are diagnosed with cancer each year in Britain, which equates to around 1,000 a day or one person every two minutes.
Their fears are well founded: extensive research in recent years has shown that there is a significant impact on a person’s mortality if cancer treatment, whether surgical, systemic therapy (such as chemotherapy) or radiotherapy, is delayed.
People whose treatment is delayed by even a month have a 6 to 13 percent increased risk of dying, a figure that continues to increase with each day that passes without receiving treatment.
No wonder my wife’s friend was scared.
Fortunately for her, in this case I was able to plead with an oncologist to move her treatment forward and she had her first chemotherapy session within a week.
Of course, that privilege is not available to the majority of the 375,000 people who are diagnosed with cancer each year in the UK (around 1,000 each day) – that’s someone roughly every two minutes.
This is a huge number and I fear that many of them will face the same problems as our friend in the form of hugely unacceptable delays in diagnosis and treatment.
The delays are so long that, in some cases, oncologists are giving patients appointments desperately knowing they won’t live long enough to keep them.
That is why today, in the wake of my friend’s experience, I do not hesitate to express my deeply held – and I fear quite grim – belief that cancer care in this country is in a state of monumental crisis.
I do not write this lightly and I understand that it may surprise some of you who understandably cling to the idea that, no matter how serious the well-documented crisis in our health service, an exception will be made for the provision of oncology care.
This notion is supported by the glowing press releases issued by NHS England on an almost weekly basis announcing new developments in this field, all underlining the sense that patients are being prioritized and fast-tracked.
The NHS also needs to turn to the private sector, writes Professor Karol Sikora. It already does when it comes to surgical procedures, so why not cancer?
In 2000, the government introduced a two-week wait for cancer treatment to deal with a backlog. But last October, Health Secretary Steve Barclay (pictured) announced that he would abolish it because it was no longer sustainable.
Just two weeks ago it announced the launch of a new form of immunotherapy for advanced endometrial cancer, which could offer women in advanced stages of the disease significant additional time before it progresses compared to standard chemotherapy alone.
I also particularly remember an announcement from April 2021 in which NHS England stated that it was “mandating” faster diagnosis by March 2024, meaning that at least 75 percent of patients would receive a diagnosis of cancer or they would rule it out within four weeks of an emergency. Referral to GP.
Well, we are already in March 2024 and, as a friend of my wife can attest, reality is well short of this goal. No wonder the UK has one of the worst cancer survival rates in the developed world, ranking 28th out of 33 countries for five-year survival rates for common cancers such as stomach and lung cancers.
Our pancreatic, liver and esophageal cancer rates are slightly better, ranking 26th, 21st and 16th, respectively.
On average, only 16 per cent of UK patients live five years with these cancers, despite us spending as much per capita on cancer treatment as other developed countries.
Shocking, right? You might think it’s shocking enough to provoke some soul-searching among NHS panjandrums about where, exactly, they are going wrong.
Far from there. As I discovered during frequent attempts to try to reform our cancer care system from within (failed attempts that would eventually lead to me resigning from the NHS in 2004), they cling to an almost militant refusal to admit that only radical reform will solve our problems. problem with cancer diagnosis and treatment.
Maybe they’re too busy worrying about meeting diversity goals and touting their commitment to using proper pronouns.
Their refusal to engage in debate is all the more frustrating because they have all the skills and technology they need at their disposal. We have wonderful medical staff, effective drug regimens, and constantly evolving treatments.
As I wrote in The Mail on Sunday over the weekend, I have spent almost 50 years in the field of oncology and have witnessed first-hand the extraordinary changes that have seen universal chemotherapy treatments replaced by tailor-made programmes. tailored to individual diagnoses, helped by the exciting advances we have made in DNA detection and risk prediction.
But all this amounts to a mountain of beans if there are serious (and serial) delays in both diagnosis and treatment. Because delay means the cancer is at a more advanced stage when it is treated and, in turn, that means worse outcomes.
It’s not rocket science, but the people in charge seem unable to recognize this central truth, even when faced with those grim five-year survival statistics.
As I outlined in a five-point plan I presented to the Conservative government last October at its annual conference, the first thing that needs to happen is for the people in charge to recognize that change is needed.
After that, they need to use existing staff more efficiently, paying them overtime to ensure that hospital parking lots are as full of cancer patients in the evenings and weekends as they are from nine to five, Monday through Friday. Friday.
The same goes for GP surgeries as they are on the front line of diagnosis and too many people wait a month for an appointment.
The NHS also needs to turn to the private sector – it already does this when it comes to surgical procedures, so why not cancer? I know of at least one network of private cancer care clinics that is currently operating at only 30 percent capacity.
If this sounds like an overly ambitious transformation, then consider this: over the past four years, this Government implemented a huge national Covid vaccination program almost overnight. He also oversaw the creation of a vaccine and a vast network of efficiently organized pop-up centres, backed by brilliant technology and supported by volunteers.
If they can do it with Covid, they can do it with cancer; It just requires commitment. Otherwise, I fear those already grim statistics will only get worse.
Let’s not forget that back in 2000, the government introduced the concept of a two-week wait for cancer treatment in a bid to speed up cases through the system and tackle delays.
It was considered an interim rule that would no longer be needed in 2005. Eighteen years later, in October last year, then Health Secretary Steve Barclay announced he would abolish it because it was no longer sustainable.
This alone tells us all we need to know about the state of cancer care in modern Britain and why nothing less than major reform is needed to ensure thousands of lives are not lost unnecessarily.
- Professor Karol Sikora is former Director of the WHO Cancer Program and Medical Director of Rutherford Cancer Centres.