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Cancer survival rates lag behind other countries

5 Aug 2015 11:01

Did you read the news this morning about cancer survival in England? While it is improving, it’s still lagging behind other countries with similar healthcare systems. The study published today, by Cancer Research UK-funded scientists, shows that cancer survival in England remains lower than in other similar countries – something first identified back in the late 1980s.

But it’s not all doom and gloom. Read our blog post to find out more.

Cancer survival rates lag behind other countries

5 Aug 2015 14:43 in response to Moderator Sarah

Hi Sarah,

I think part of the problem is down to education. When we suspect we may have cancer, we often delay in going to see our G.P. (and men in particular) as cancer has always had a reputation as a killer disease. And yes it is but we havent updated our thinking to the new survival rates. As you and Cancer Research have stated, only 25% of people used to survive cancer just a few years ago, but now 50% of people survive, which is a very big increase. I feel quite confident, Cancer Research's aim of incressing this to 75% in the next ten years is attainable. I feel that if people feel there is a good chance of surving cancer, maybe more people would present themselves to their GP earlier. My grandmother admited she knew she had a lump in her breast for months before she told anyone because she was so scared she wouldnt survive. My mother was much the same. Somehow a way needs to be found that encourages people to seek help as soon as they suspect something is wrong. That is why I feel all the advertising being done by the variose cancer charities is a good thing for it needs to be drummed home that the earlier we seek help, the better the chance of beating cancer, Brian

Cancer survival rates lag behind other countries

5 Aug 2015 17:55 in response to Moderator Sarah

 

Hi Sarah. Just out of interest, do you know if there has ever been any research comparing survival rates of private and NHS cancer patients?  I only wonder because I realise that private patients can often access procedures and drugs which are not NICE approved and which are not declined because of cost issues.  Also diagnosis is normally much quicker, as is the start of treatment.  It would be very thought provoking if there is a difference in favour of the private sector as it would identify that we have the means to achieve better results but are unable to access them.  It would be an interesting study x

Cancer survival rates lag behind other countries

5 Aug 2015 19:26 in response to max56

I think as others say its down to education for many cases.

A lot of people only know about the main cancers, and might not even think its possible to get cancer in other places, as I thought before diagnoses.

That being said, I think its also the fact that many people don't want to get diagnosed and will perhaps ignore any symptoms they have until they can no longer.

You also have some doctors that seem to make assumptions, perhaps because some patients are not old enough (or too young), that it cannot/or is hihgly unlikely, going to be cancer. When in fact it is. Its a difficult one, doctors must face so many people a day fearing they have cancer because of a symptom, and most of them won't, its just finding the ones that do.

I have family members who have been treated by private healthcare (not for cancer), the only difference I could notice was how long it took for treatment to begin. You have to wait longer on the NHS, but apart from that many NHS consultants also do private work, as mine do, so even if you were private you may still get the same consultant, its just how fast you get access to the treatment. Facility wise the private hospitals are nice, much like a hotel, but all that matters is the health care to me. Even if I had all the money in the world, I would have still had the same treatment.

 

Cancer survival rates lag behind other countries

5 Aug 2015 19:54 in response to Space_1999

 

Hi Space and thanks for your input.  You are right that many consultants do private work but with some diseases, including cancer, doctors are able to prescribe different drugs and refer for procedures that are not NICE approved to their private patients. A couple of examples are - nanoknife to remove tumours attached to the vascular system, cyberknife for tumours deep in the brain where it is not effective to use conventional radiotherapy and effective drugs such as TDM-1 which is being withdrawn from the NHS because of cost but benefits many breast cancer patients and prolongs their prognosis.  Also as we all realise diagnosis and the start of treatment is much quicker. 

I agree that with standard operations/treatments such as your family members had timing is probably the only difference, but that does not apply to all patients - particularly those suffering from a disease which doesnt always have a 'one size fits all' standard treatment.

It is also a misconception that private patients are high-earners or rich.  Most I have met have health insurance policies attached to their employment or chose to pay monthly for a policy themselves.  Those who self-fund are probably in the minority and tend to be from overseas.  As for hotel-like facilities, I havent noticed that either - facilities at all hospitals/clinics/surgeries differ, whether NHS or privately owned - some are tatty and others newly-decorated and well-equipped. Our local NHS chemo unit has a fabulous lounge, kitchen, landscaped gardens and small comfortable rooms for infusions - a far cry from the private clinic's basement room where I have had treatmenr which accommodates around 40 patients on uncomfy 'dentist-like' chairs with a curtain divide. We have staff on duty that can answer our queries but no assigned nurses we can turn to for the emotional support when needed. Or a day centre we can visit if needed to take part in informative classes or socialise with others going through a similar journey. good and bad in all things I guess x

All the best and I am so happy to see you are keeping well x

Cancer survival rates lag behind other countries

6 Aug 2015 11:11 in response to max56

Interesting comment Max. I'm going to speak to our experts here and get a response for you

Thanks for flagging it!

Cancer survival rates lag behind other countries

6 Aug 2015 20:29 in response to Moderator Sarah

I think the lower survival rates here in UK are just down to lack of funding for the NHS. Great play is made about getting a quicker diagnosis, but even if a GP quickly suspects cancer and makes an urgent referal, 2 weeks pass before you are seen by a specialist, then another week or two pass before scans and biopsies are performed, then another 2 weeks before diagnosis is confirmed. Then 30 days pass before treatment begins, sometimes longer. That is two to three months the cancer has to grow and spread. A fast growing cancer can cause a lot of damage in this timeframe. Advancing from curable to incurable. This is what reduces the chance of survival.

This is not the fault of the hard working, professional health care staff, but due to lack of resources. 2p on income tax all of which would be allocated to the NHS would solve this, but there is no political will to do so, however it is a price that I and many others would be glad to pay. There is no one in the UK who does not have a friend or relative who has cancer and the chance of getting cancer is now approaching one in every two people.
 

Cancer survival rates lag behind other countries

6 Aug 2015 22:15 in response to Moderator Sarah

Thanks Sarah x

Cancer survival rates lag behind other countries

7 Aug 2015 18:50 in response to max56

Hi Max, 

Sarah asked me to forward this reply to you that we had back from our experts in response to your comments. 

 

"Hi Max. This is a tricky question – we don’t know of any studies or sets of data that directly compare private and NHS patients. It would be difficult to make this comparison because people don’t always stick to one system. Generally in the UK, treatments for cancer are the same whether a patient is treated privately or on the NHS. There are always improvements to be made but this doesn’t necessarily mean that newer, more expensive treatments and tests are automatically better or more informative. It’s also important to say that the advantage of a national healthcare system is that new techniques can be more easily tested and assessed through clinical trials to see if they’re the most effective way to help save lives. You can read more about private and NHS cancer treatment here:http://www.cancerresearchuk.org/about-cancer/cancers-in-general/cancer-q... "

Best wishes, 
Jenn
Cancer Chat moderator

Cancer survival rates lag behind other countries

7 Aug 2015 20:24 in response to Moderator Sarah

Hi Sarah,

Does this refer to just England or to the whole of the UK? I live in Scotland and wondered if this was just England what the rates were for other parts of the UK. We don't have NICE but we do have the Scottish Consortium which doe the same job.

I do think that a lot of people still have ideas stuck in the past. I always remember when I told an old friend about my NHL she replied that her cousen had that in the 60's and "she didn't last long"!! I think a lot people still have that attitude so would rather not know.

Cancer survival rates lag behind other countries

8 Aug 2015 00:02 in response to Moderator Jenn

Thanks Jenn for taking the time to answer.  I will read thru and give some thought to what has been said and get back to you.  Love to you and the team. 

Cancer survival rates lag behind other countries

8 Aug 2015 08:25 in response to Wolfhound

Hi Wolfhound. 

We've checked with the experts as this question has been raised by quite a few people and the the study only looked data from the NHS in England, as that’s the only UK data that they had access to at the time.

Best wishes, 
Jenn
Cancer Chat moderator

Cancer survival rates lag behind other countries

8 Aug 2015 13:18 in response to Moderator Sarah

That's a very complicated question to answer. There are probably a number of factors at play.

I was lucky enough to be invited to the National Cancer Information Network Conference in Belfast earlier this Summer as a patient representative. There was a very interesting presentation on GP behaviour. GPs from several countries were given different scenarios to deal with and their responses varied significantly by country. For example the majority of GPs from continental Europe referred the same patients for endoscopic and other tests on their first visit to the GP. The majority of English NHS GPs waited until the third presentation. The conclusion was that this was because they were following NICE guidance on only referring when the probability of cancer was high due to lifestyle, age and other factors. So the younger and fitter you were, the less chance of being put on a cancer pathway because your chances of having cancer was below a threshold (from memory this was about 5% - which is one in twenty). There was a consensus in the audience that this needed to change and NICE was lobbied successfully to do exactly that a few weeks later. 

Max asked about private patients. This was raised from the floor at the conference on several occasions and the answer seemed to be that only NHS statistics were being collected - which may well skew the figures as many people go private to get access to diagnostic services more quickly.

Time and again at the conference we were presented with evidence that the UK has the second highest levels of obesity in the World, one of the highest levels of alcohol consumption in the World and a general lack of awareness about the symptoms of cancer. Not surprising that we have higher rates of cancer prevalence nor that we tend to visit our GPs later than most. Couple this with GPs generally referring people onto a cancer pathway later than their peers on the continnent and there's no surprise that we are lagging behind on survival rates.

 

Best wishes
Dave

 

 

Cancer survival rates lag behind other countries

8 Aug 2015 13:47 in response to kimchoson

Hi Kim,

Your observations are spot on. Another factor is that every year more and more people are being diagnosed with cancer, so demand is increasing but local NHS resources are (at best) frozen. In reality resources at local level are being reduced year on year by about 3% as the government continues to "uplift" local budgets by a negative percentage to enforce "efficiency savings" - something started by Labour pre-2010.

In theory this is a good thing as it encourages NHS organisations to do more for less. The savings should be being used as capital to fund new hospitals and other innovations at National and Regional level. In practice, there are always many millions of pounds clawed back by the Treasury as the NHS as a whole is unable to spend the capital allocation for a variety of reasons. Capital money used for new hospitals etc. used to come out of a different central budget. So when government ministers (of whichever party) say that NHS "budgets"  aren't or "spending on the NHS" isn't being cut they are sort of telling the truth but the money actually available and spent locally has been reducing year on year for about 7 years now.

Smoke and mirrors plays a huge part in politics.

Add to this poor workforce planning since 2010 - there is a National shortage of Radiologists and Radiographers as so many leave through retirement or for other reasons - and it is no wonder things are only slowly improving.

Sorry for the rant - I could have gone on for hours!
Dave

 

Cancer survival rates lag behind other countries

8 Aug 2015 14:16 in response to davek

Another factor is the type of cancers that people are being diagnosed with, some are easier to treat etc.

I recently found out that my area has one of the highest rates of oral cancer in the whole of the UK.

I wonder if the UK has higher rates of certain cancers, which could explain why survival rates are different.