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Macmillan Cancer Support study : Cancer THEN and NOW

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    Sophia Courtaux considers a recent study by Macmillan Cancer Support which highlights the major changes in diagnosis, treatment and aftercare of cancer from 1970-2016.

    By Sophia Courtaux

We all know someone who has suffered from cancer and know the devastating effects this can have not just on that individual, but the whole family. I have been reading a recent study published by Macmillan Cancer Support and Public Health England – ‘Cancer: Then and Now’ – which suggests that at least 170,000 people are living with cancer who were diagnosed in the 1970’s and 1980’s.

This of course is positive news as it suggests our survival rates are increasing. Macmillan predicts that, over the coming years, the 2.5 million people currently living with cancer is due to increase to at least 4 million by 2030.

What has changed?

Forty years ago a cancer diagnosis was not only considered as a taboo, but was immediately associated with dying. There was no such thing as an urgent referral from your GP, people were left waiting months for treatment. Now the Government have set waiting time targets in England and Wales for treating cancer patients. The current targets are:

  • No more than 2 months wait between the date the hospital receives an urgent GP referral for suspected cancer and starting treatment.
  • Starting treatment no more than 31 days after the meeting at which you and your doctor agree the treatment plan.

The study also talks about the screening programmes and scientific technological advances in areas such as genetics and medical imaging which means that cancer is more likely to be diagnosed at a much earlier stage than in the 1970 and 1980’s. Although this is a significant improvement the report highlights that too many people are still only diagnosed with cancer after an emergency hospital visit.

Electronic referral software for GP’s

MacMillan has developed the electronic cancer decision support tool to “help GPs think of cancer” and support them in deciding whether to make a referral. The system was piloted in 2013 and, of patients who were referred for further investigation, 20% of these would have been sent home with no further action without the software. From May 2014, GP surgeries have been able to register to have the software installed for free, but sadly this is not compulsory.

Side effects of cancer treatment and long term impact

The report emphasises that cancer treatment has significantly improved over time and that there are more refined techniques in surgery, radiotherapy and chemotherapy, resulting in fewer side effects than those in the 1970’s and 1980’s. We do now, however, unfortunately see different side effects emerge from newer treatments.

Whilst the initial focus is always on surviving cancer, once treatment has been successful, an increasing number of people are coping with long term side effects including incontinence, fatigue, depression, heart damage and lymphoedema. Research suggests that around 625,000 people in the UK are estimated to be facing poor health or disability after treatment for cancer. This of course has a profound impact on someone’s quality of life.

Our experience

My colleagues and I often see cases where our clients have suffered a delayed diagnosis of cancer due to negligent failings in their medical treatment, for example where the patient’s GP fails to consider the possibility of cancer diagnosis and does not make the required referral. Delayed diagnosis can lead to the cancer advancing, requiring more extensive treatment and a worse prognosis for the patient.  As with the findings of this report, depending on the treatment that is required, our clients can suffer a range of side effects from the treatment which can be long-lasting and affect them on a daily basis and well beyond the end of their treatment.

It is really positive to read of the great progress that has been made in the treatment of cancer. It is no longer deemed a certain death sentence and in many cases patients are being given a second chance at life. The interesting challenge that this report discusses is how we seek to further our ability to combat this life changing illness at the initial stages while treating current and future patients suffering from the treatments of the past.

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