Unless cancer services are properly protected and prioritised, we could see cancer survival worsening for the first time in decades. Michelle Mitchell OBE explains more.
For the last 18 months, the focus of the public, politicians and health services across the UK has been squarely on COVID-19.
This national effort against COVID-19 is essential. So too is a resolute focus on cancer.
A looming cancer crisis
The current situation for cancer is really tough.
This isn’t anything new – workforce shortages and shortages of essential diagnostic equipment have slowed progress for years. In England, the important 62-day measure from urgent cancer referral to beginning treatment hasn’t been met nationally since December 2015. In Northern Ireland, the 62-day target has never been met.
The pandemic has only worsened the situation, but thanks to the hard work of NHS staff across the country we saw tentative signs of recovery.
Now though, the Omicron variant threatens to throw this completely off track.
Action is needed now to stop us spiralling into a cancer crisis
With primary care being redirected to ramping up the booster campaign, there’s a risk people may be put off from coming forward with potential cancer symptoms. And while in England urgent cancer surgeries have been prioritised in new guidance, non-urgent appointments and elective surgeries may be postponed.
The pandemic has already had a devastating impact on cancer patients. Cancer Research UK's patient survey resulted in almost a third experiencing delays, cancellations or changes to treatment this year. The pandemic has also had an unequal impact on different patient groups, with the number of people diagnosed with prostate, lung and bowel cancer particularly impacted.
Action is needed now to stop us spiralling into a cancer crisis. Without it, an untold number of cancer patients, families, friends and loved ones will suffer.
Doing what works, driving innovation
Last week, Chris Whitty, England’s chief medical officer, addressing a Select Committee question on cancer and COVID-19, was clear: “Finding a way to manage covid in a way that it minimises the impact on everything else is absolutely central to what we’re trying to do.” This followed assurances from the Health Secretary Sajid Javid that cancer services will be protected – and here, as across the UK, political leaders must stand by their word.
We also need to double down on what we’ve learned works through the pandemic
Right now, that means making sure that ramped up efforts on vaccines don’t inadvertently make people think the NHS is closed for business. The government and health services must continue to encourage people who notice something unusual or who are worried that they might have cancer to seek help, such as through England’s Help Us Help You campaign. These efforts must in particular be targeted at the underserved communities who already bear the greatest cancer burden.
We also need to double down on what we’ve learned works through the pandemic. For example, the surgical hub model has allowed NHS providers to set up COVID-19-safe sites for cancer surgery. But it also supported service optimisation through sharing stretched capacity and supporting clinical prioritisation. Embedding collaboration through these effective new service models going forwards will be vital.
Moreover, the pace and scale of innovation we have seen in the last 18 month would have been unimaginable before the pandemic.
From deploying triage tools such as Cytosponge and colon capsule endoscopy, to the roll-out of the first community diagnostic centres, we have seen changes that have not only kept cancer services running but have the potential to transform patient experience and outcomes for people with cancer.
As we look forward, we must nurture this spirit of innovation, recognising its role not only in keeping services running, but to get us back on the road to ambitions to transform cancer outcomes.
Building a better future
Crucially, we cannot let ambitions for cancer slip further back – cancer won't wait.
And we are rightly ambitious across the UK in our efforts to improve outcomes for cancer patients.
England’s long-term plan ambition are to see 75 per cent of cancers diagnosed at an early stage; the aim to build world class cancer services at the heart of Northern Ireland’s new cancer strategy; delivering on ambitions for cancer in Wales’ Cancer Quality Statement.
The challenge is great, but we must act. The price of inaction is too high
To get back on track and drive forward progress will require us to act boldly and think differently. This will mean accelerating measures already set out in national plans, but also go further to close the gap between ambition and reality by learning the lessons of the pandemic and continuing to foster innovation. In this, the cancer community are primed to support.
These efforts must tackle cancer inequalities. It is unacceptable that people from more deprived areas in all parts of the UK are experiencing higher cancer incidence, higher mortality rates, and poorer survival outcomes.
We know that a key limiting factor is chronic shortages in key cancer professions. The 2021 Spending Review set out budgets for the next three years – now we urgently need clarity from governments on how this investment will grow an over-burdened and under-staffed NHS workforce in each part of the country.
The challenge is great, but we must act. The price of inaction is too high.
Michelle Mitchell OBE is chief executive officer of Cancer Research UK. You can follow her on Twitter @Michelle_CRUK