Health & Lifestyle

There is a NHS cancer care crisis in this country and it’s killing people, but there IS a cure writes PROFESSOR KAROL SIKORA

A few weeks ago, a family friend telephoned our home in great distress to tell us she had been diagnosed with stage four ovarian cancer.

This revelation had been shocking enough for an otherwise fit and healthy lady but her anxiety was heightened by the fact it had taken several weeks to make her first doctor’s appointment and this had been followed by another delay before she succeeded in securing a consultation with a specialist.

Now, compounding her anguish was the news that, after being given the verdict she had dreaded, she would have to wait six weeks before her first session of the chemotherapy that would, hopefully, eliminate the disease.

Aside from the fact she was in pain, this delay was agonising in itself, playing – as it did – to her understandable fears that the longer the wait before treatment, the more chance there would be of the disease advancing and adversely affecting her long-term outcomes.

Some 375,000 people are diagnosed with cancer in Britain every year, which equates to around 1,000 a day or someone every two minutes

Some 375,000 people are diagnosed with cancer in Britain every year, which equates to around 1,000 a day or someone every two minutes

Her fears are well grounded: extensive research in recent years has shown there is a significant impact on a person’s mortality if cancer treatment is delayed, whether it be surgical, systemic therapy (such as chemotherapy) or radiotherapy.

People whose treatment is delayed by even one month have a 6 to 13 per cent higher risk of dying – a number that keeps rising with every subsequent day their treatment does not take place.

Little wonder my wife’s friend was frightened.

Happily for her, in this instance I was able to plead with an oncologist to bring her treatment forward and she underwent her first chemotherapy session within a week.

Of course, that privilege is not available to most of the 375,000 people who are diagnosed with cancer in the UK every year – around 1,000 every day – meaning someone roughly every two minutes.

It’s a vast number and I am afraid that many of them will face the same issues as our friend in the form of hugely unacceptable delays in diagnosis and treatment.

Delays so lengthy that, in some cases, oncologists are giving patients appointments in the desperate knowledge that they won’t live long enough to fulfil them.

It’s why today, in the wake of my friend’s experience, I have no hesitation in stating my deeply held – and I’m afraid rather bleak – belief that cancer care in this country is in a state of monumental crisis.

I do not write this lightly, and I appreciate this may come as a shock to some of you who – understandably – cling onto the notion that, however grave the well-documented crisis in our health service may be, an exception will be made for the provision of cancer care.

This notion is underpinned by the glossy press releases put out by NHS England on an almost weekly basis that trumpet new developments in this arena, all underlining the sense that patients are prioritised and fast-tracked.

The NHS also needs to call on the private sector, writes Professor Karol Sikora. It does so already when it comes to surgical procedures, so why not cancer?

The NHS also needs to call on the private sector, writes Professor Karol Sikora. It does so already when it comes to surgical procedures, so why not cancer?

In 2000 the government introduced the two-week wait for cancer treatment to deal with a backlog. But last October then health secretary Steve Barclay, pictured, announced he would be abolishing it as it was no longer tenable

In 2000 the government introduced the two-week wait for cancer treatment to deal with a backlog. But last October then health secretary Steve Barclay, pictured, announced he would be abolishing it as it was no longer tenable

Only two weeks ago it announced the rollout of a new form of immunotherapy for advanced endometrial cancer, which could offer women in advanced stages of the disease significant extra time before it progresses compared with standard chemotherapy alone.

I also particularly recall an April 2021 announcement in which NHS England stated it was ‘mandating’ faster diagnosis by March 2024, meaning that at least 75 per cent of patients would either receive a cancer diagnosis or have it ruled out within four weeks of an urgent GP referral.

Well it’s March 2024 now and, as my wife’s friend can testify, the reality falls some way short of this target. No wonder the UK has some of the worst cancer survival rates in the developed world, ranking as low as 28th out of 33 countries for five-year survival rates in common cancers such as those of the stomach and the lung.

Our rates for pancreatic, liver and oesophageal cancers are little better at, respectively, 26th, 21st and 16th place.

On average, just 16 per cent of UK patients live for five years with these cancers – despite the fact we spend as much per head on cancer treatment as other developed nations.

Shocking isn’t it? Shocking enough, you might think, to prompt some heart-searching among NHS panjandrums about where, exactly, they are going wrong.

Far from it. As I discovered during frequent attempts to try to reform our cancer care system from within – failed attempts that would ultimately lead me to resign from the NHS in 2004 – they cling to an almost militant refusal to admit that only root and branch reform will solve our problem with cancer diagnosis and treatment.

Perhaps they are too busy worrying about meeting diversity targets and trumpeting their commitment to using the proper pronouns.

Their refusal to engage in discussion is all the more frustrating given that they have all the skills and technology they need at their disposal. We have wonderful medical staff, effective drug regimens and ever-evolving treatments.

As I wrote in The Mail on Sunday at the weekend, I have spent nearly 50 years in the oncology field and have witnessed first-hand the extraordinary changes which have seen one-size-fits-all chemotherapy treatments replaced by tailor-made programmes to fit individual diagnoses, aided by the exciting leaps we have made in DNA screening and risk prediction.

But all of this amounts to a hill of beans if you have serious – and serial – delays in both diagnosis and treatment. Because delay means cancer is at a more advanced phase when treated and in turn that means outcomes are poorer.

It’s not rocket science, but the people in charge nonetheless appear unable to acknowledge this central truth, even when confronted with those grim five-year survival statistics.

As I pointed out in a five-point plan I presented to the Conservative Government last October at their annual conference, the first thing that needs to happen is for the people in charge to acknowledge that change is needed.

After that, they need to use existing staff more efficiently, paying them overtime to ensure that hospital car parks are as full of cancer care patients in the evenings and weekends as they are from nine to five, Monday to Friday.

The same goes for GP surgeries, for they are at the frontline of diagnosis and too many people are waiting a month for an appointment.

The NHS also needs to call on the private sector: it does so already 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 running at just 30 per cent capacity.

If this sounds like an over-ambitious transformation, then consider this: within the last four years, this Government rolled out an enormous nationwide Covid vaccination programme almost overnight. It also oversaw the creation of a vaccine and a vast network of efficiently organised pop-up centres, underpinned by brilliant technology and supported by volunteers.

If they can do it for Covid they can do it for cancer – it just requires commitment. Otherwise, I’m afraid, those already grim statistics are only going to get worse.

Let us not forget that back in 2000, the government introduced the concept of the two-week wait for cancer treatment in a bid to speed cases through the system and deal with the backlog.

It was seen as a stopgap rule that would no longer be required by 2005. Eighteen years later, in October last year, the then health secretary Steve Barclay announced he would be abolishing it as it was no longer tenable.

That alone tells us everything we need to know about the state of cancer care in modern Britain – and why nothing less than major reform is needed in order to ensure that thousands of lives are not needlessly lost.

  • Professor Karol Sikora is a former director of the WHO Cancer Programme and medical director of Rutherford Cancer Centres


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