01.05.10
Advancing the battle
Much progress has been made in the NHS's approach to the treatment of cancer in the last decade but there is still much more than can be done. National Health Executive asked Professor Sir Michael Richards how that approach will continue to evolve through the use of increasingly sophisticated technology and treatments
Statistics show that one in three people will be directly affected by cancer in their life time. Although there is controversy over the methods used to determinee the allocation of cancer treatments, one thing that cannot be questioned is the passion of clinicians battling a disease which is likely to many of us, directly or indirectly.
Professor Sir Michael Richards has been National Clinical Director for Cancer for the last ten years. He believes there is a great deal more that could be done to improve services and ensure that they are amongst the best in the world.
“When dealing with cancer it is important for the health service to ensure that cancer patients are diagnosed as quickly as possible. We have many priorities in dealing with cancer, but this is one of the most prominent. We have calculated that we could save almost ten thousand lives a year if we were to identify all cases at an earlier stage – as is achieved in some other countries.”
The Department of Health is now engaged in a major awareness programme whereby every PCT is being asked to raise public awareness about the importance of checking for the symptoms of cancer and then acting upon them.
“We want patients to feel encouraged to go to their GP if they do identify anything as being wrong and equally we will be supporting those GPs by giving them access to better diagnostic tests and aiding them in identifying which patients should be investigated further.”
This issue of patients being willing to convey their symptoms to a doctor at an early stage was hampered for years by an understandable reservation that many people have in acknowledging their symptoms. Recently, however, the level of awareness has been raised by a number of campaigns on television and radio, internet based campaigns and, most recently, social networking sites.
Does Professor Richards believe that this has helped improve the situation?
“The public are talking about cancer more, there is no doubt about that. Although when it comes down to a person actually going to see a doctor, we know that things still could be better.”
Professor Richards believes that sometimes a straightforward approach is all that is needed.
“A recent NHS campaign in Doncaster simply involved putting posters up in places like bus shelters, informing people that if they had been suffering from a cough for more three weeks, then they should ask their GP for a chest x-ray. This single campaign led to a number of people being diagnosed with early stage lung cancer.”
Another area of concern for the health service has been around the care which people receive once they have been successfully treated for cancer.
“We have launched a major programme called the National Cancer Survivorship Initiative which is a major drive to help people who have had cancer return to normal life as soon as possible afterwards.”
The emphasis for this drive is on recovery and well being and aims to help people take part in as many normal activities as they can.
“We know that the number of people who are surviving cancer is going up year on year by about three per cent. That is partly due to the overall number of new cancer patients rising every year but is also attributable to survival rates going up. We know that for many years the focus has largely been on detecting a recurrence of the cancer rather than looking at the person as a whole.”
Both of these initiatives are being delivered in partnership with third sector bodies, the early diagnosis campaign with Cancer Research UK and the survivorship initiative with Macmillan Cancer Support.
Another important part of cancer pathways are the treatments themselves which have the power to captivate the public's imagination through the use of increasingly sophisticated technology and medication.
“We are currently working to ensure that the very best technology is available throughout the country with a prime example being the new cancer treatment centre at North Staffordshire Hospital Trust, where there has been a complete new build and there is a very pleasant environment for patients to be treated.
There is also state-of-the-art radio therapy equipment and a very pleasant chemotherapy area, but this is not the only new centre. There are similar facilities in other parts of the country such as Leeds, Taunton and Hull, which is very good news.
“We know that technology doesn't stand still. There are new diagnostic technologies, such as PET CT scans, along with new surgical processes. We are now carrying out far more surgical procedures using sophisticated laparoscopic or keyhole methods. There are now more sophisticated forms of radiotherapy treatment such as intensity modulated radiotherapy and then there are new drug treatments as well. Over my time in my current role there have been some extremely significant breakthroughs in drug treatments.”
Is Professor Richards concerned that the progress of cancer treatment could suffer as a result of cutbacks?
“Although we all know that right across the public sector we face major financial restraint for the next few years, our focus must remain on improving the quality of care, but at a reduced cost. Some people will say that it is impossible; but they are not right.
“In many cases, it is possible to improve both quality and productivity, such as the Enhanced Recovery Programme, which is an innovation from Denmark and is allowing patients to leave hospital four days after bowel cancer treatment, instead of the usual ten to fourteen. This better for patients who become well earlier and also better for the NHS which saves on costs.”
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