While cancer incidence has been rising and the impact of the COVID pandemic on cancer care and cancer patients has been disastrous, the lack of a national cancer plan, despite the overwhelming evidence for one and the disconnect in appropriate investment in cancer services has left the UK lagging behind. For example, we rank 28 out of 33 countries for five year lung and stomach cancer survival, compared to other nations of similar wealth and income levels, an unacceptable situation for a nation that prides itself on its cancer research and innovation.
While we need consistency of cancer policy, a research and data informed national cancer plan and significant and sustained investment across the cancer continuum to improve our survival rates, Wednesday’s budget gives us an unrivalled opportunity to start making inroads on delays in treatment and more critically helping to save people’s lives. Surgery and radiotherapy represent two treatments that are effective in over 50% of cancer patients, while chemotherapy and targeted therapy can also be very effective. But if we look at the data, we see that, incredibly, we have not achieved the 62 day target for referral to first treatment since 2015, a shocking indictment of a system that is simply not serving our cancer patients adequately. Over a third of our patients are waiting longer than the specified 31 days for radical radiotherapy, another unwanted statistic, while two recent International Cancer Benchmarking Partnership studies highlighted how UK cancer patients receive less chemotherapy and less radiotherapy than comparable nations.
While we urgently need a total recalibration of the cancer health system, a reinstatement of the national cancer plan that the last government inexplicably consigned to the NHS dustbin, and sustained but appropriate investment, we nevertheless have a real opportunity to kick start the road to recovery now. Based on recent data from a number of reports, including the Lancet Oncology Commission on Global Cancer Surgery and the recent Radiotherapy Productivity report, an initial investment in the region of £850M (£350M on radiotherapy, £400M on surgery and £100M on chemotherapy) in Wednesday’s budget, would be a positive start, ensuring that thousands more patients would achieve the 62 day target for cancer treatment, thus improving our cancer outcomes.
Investing €350M in radiotherapy, by replacing out of date machines, alongside new technologies could free up 87,000 cancer appointments and boost the capacity of our workforce. Ensuring sufficient surgical capacity to allow treatment to be provided on time is urgently required and should be prioritized, e.g. through the provision of surgical cancer hubs. From a systemic chemotherapy perspective, enhancing community oncology so that we can move away from a model of delivery which is purely hospital-centric is required, allowing patients to have routine assessment, blood testing and dispensing of oral or subcutaneous chemotherapy safely and in a timely fashion in the community. Developing innovation partnerships to test and embed innovations with meaningful impacts should also be supported
These measures will not, on their own solve the cancer problem that the current government have inherited, but they will help deliver tangible outcomes in the short term and position the UK to significantly move up the cancer league table in the next 5-10 years.
Saving people’s lives and in many cases reintegrating them back into society where they can contribute to the nation’s prosperity is surely worth the relatively modest investment of £850M, a tiny fraction of the overall NHS budget.
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