From The Times Saturday 22nd 2020
More than 100 MPs have written to Boris Johnson after the coronavirus lockdown caused severe disruption to cancer diagnoses and treatments. They have called on him to deliver an emergency boost to treatment capacity.
One senior oncologist has claimed that in a worst-case scenario the effects of the pandemic could result in 30,000 excess cancer deaths over the next decade.
In the letter, seen by The Times, the MPs write: “We urge you to work with your ministers to ensure that the NHS reacts more quickly to restore cancer services that have been badly disrupted due to the response to Covid.
“We are particularly concerned that the NHS’s plan appears to be limited to getting cancer services back to normal by the end of the year [but] this timescale is far too long. Many cancers can become untreatable in a matter of weeks.”
The signatories include Dan Poulter, a former health minister, Sir Ed Davey, a former energy secretary, and Sir Oliver Heald, a former solicitor-general.
Research predicts that people are more likely to die from cancer now than 15 years ago due to the effects of the pandemic. The Institute for Public Policy Research estimates that for lung cancer, five-year survival rates stand to drop from 16.2 per cent to 15.4 per cent, breast cancer from 85 per cent to 83.5 per cent, and colorectal cancer from 58.4 per cent to 56.1 per cent.
Separate figures from the Cancer Research UK charity indicate that in the 18 weeks since March 23 about three million people missed out on vital screenings for bowel, breast and cervical cancer. In the same period about 315,000 fewer people than normal received an urgent suspected cancer referral and overall there were 38,000 fewer treatments.
Karol Sikora, a senior oncologist and co-founder of Rutherford Health, a private cancer treatment company, suggested that there could be up to 30,000 excess cancer deaths in the next ten years. He cited a study published last month in the journal Lancet Oncology, looking at the decline during lockdown in urgent cancer referrals by GPs. It calculated a worst-case scenario where an average six-month delay in these referrals would lead to nearly 9,300 excess deaths in the next decade.
He conceded that his estimate was high compared with others. However, according to the study, if every urgent GP referral was delayed by just one month about 1,400 extra deaths would result. “Some estimates say a few thousand cancer patient lives could be lost. I think you can easily multiply that by ten,” Professor Sikora said. “It’s far worse than people appreciate.”
Mark Lawler, a cancer specialist at Queen’s University Belfast tracking the impact of Covid-19 disruptions, predicts between about 7,000 and 18,000 early deaths in the next ten years as a “reasonable scenario”. A worst-case scenario estimated about 35,000.
“I don’t think just returning to pre-Covid levels is sufficient, I think we need to be operating at at least 130 per cent rather than getting back to 100 per cent,” he said.
Cancer Research UK presented the government with a recovery plan in June but has not received any feedback.
The most recent letter to the prime minister, co-ordinated by the charity Action Radiotherapy, argues that smart and cost-effective solutions should be adopted to quickly respond to the crisis. Pat Price, the charity chairwoman, said: “This is the biggest crisis in cancer services in my lifetime. We need a dramatic intervention from the government, or we will lose thousands of lives unnecessarily.”
The all-party parliamentary group for radiotherapy has produced a plan to tackle the cancer backlog, that includes access to vital machinery, creating a national taskforce and increasing the radiotherapy workforce. Tim Farron, the former leader of the Liberal Democrats and chairman of the APPG, said: “A catastrophic cancer crisis is unfolding right now. It is not enough to get services back up and running by the end of the year.”
The most recent NHS data from June shows that urgent cancer referrals dropped by a fifth compared with June last year; breast cancer referrals dropped by 43 per cent.
Sarah Woolnough, Cancer Research UK’s executive director of policy and information, said: “The government must ensure that the NHS gets the investment it needs.”
This month Mr Johnson announced that NHS trusts across England would receive £300 million to upgrade A&E facilities as part of £1.5 billion capital building allocation set out in June.
Beth Purvis, 41, had surgery cancelled and has been told she is incurable
Beth Purvis will never know if surgery scheduled for March would have stopped her cancer from reaching her brain (Katie Gibbons writes).
Ms Purvis, 41, of Essex, was diagnosed with bowel cancer in October 2016 but it spread to her lungs. She was due to have surgery to remove a lung nodule when the country locked down. The operation was cancelled and Ms Purvis did not learn until May that the cancer had reached her brain. It is incurable.
“I completely understand why it was cancelled. When I found out it had spread to my brain I was devastated,” she said. “I have two children, Joseph aged ten and Abigail who is 12. We tell them everything, so that was a difficult conversation. There will always be a big ‘what if’ about whether that cancelled surgery could have given me more time.”
John Anderson has watched with frustration as his brother Alan’s condition worsens due to a lack of proper treatment. “He has battled bladder cancer for the past 18 months or so and was well into his treatment,” Mr Anderson, 72, said. His programme fell apart when lockdown started.
Alan went into a hospice in Luton eight weeks ago. “Of course he was very ill but we know he would have had a chance — now he is under palliative care and very, very ill,” his brother said. “He is in excruciating pain as the cancer is now in his spine. The doctors have told him there’s nothing more they can do.
“We think if he’d got the treatment when he should have then it might have extended his life. My view of the NHS is, at this time, not the same as all the ‘clappers’. I am watching my brother in pain.”
Beth Pattison, 27, died in June, leaving behind her five-year-old son Finn, after her cancer was dismissed as coronavirus by a GP. Ms Pattison had already beaten breast cancer twice but when she developed a cough and fever she had concerns. She called her GP in March and was told it was probably Covid-19.
Beth Pattison, 27, died after her cancer was dismissed as Covid-19; she left behind her five-year-old son, Finn
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In May she was taken to A&E by her father but was assessed only for Covid-19, tested negative and was sent home.
A month later she died; her cancer had returned and spread to her ovaries.
Her father, Craig, hopes others will avoid her fate. “They weren’t looking for anything else; they were focused on Covid and pneumonia,” he said. “Beth asked repeatedly whether the cancer could be back and each time they decided not to test her. She’s left behind a five-year-old boy and our lives are going to be devoted to him now.”
The Times: Coronavirus: Extend therapies to ease cancer backlog, doctors tell Hancock
Friday 5th June 2020 - Featured in The Times (print) and The Times Online https://www.thetimes.co.uk/edition/news/coronavirus-extend-therapies-to-ease-cancer-backlog-doctors-tell-hancock-7z2kd63s8
Cancer patients are travelling miles for radiotherapy as advanced equipment sits unused in half of NHS trusts because of bureaucratic delays, health professionals say.
They have written to the health secretary calling for an end to the “absurd situation” in which patients cannot access vital equipment at local cancer centres because staff are prevented from using it.
Stereotactic Ablative Radiotherapy (SABR) is limited to half of NHS trusts at present despite its huge potential for dealing with the cancer care backlog.
During the pandemic chemotherapy treatment has been delayed owing to immune system suppression risks and cancer surgeries cancelled because of demands on intensive care units.
An open letter to Matt Hancock and NHS England co-ordinated by the charity Action Radiotherapy has been signed by 235 healthcare professionals. They have accused the government of rationing the innovative treatment that could help to deal with an expected surge in cases and save lives.
Cancer Research UK has said that as many as 2.4 million people in Britain have been affected by the backlog in cancer care, waiting for screening, further tests or treatment. During the pandemic 12,750 fewer patients have had surgery, 6,000 fewer have had chemotherapy and 2,800 fewer have had radiotherapy — a treatment needed in half of cancer cases and used in a quarter of cases in which it is cured.
Every UK cancer centre can provide SABR but only 26 out of England’s 52 centres are permitted to offer it, according to letters and parliamentary questions. The treatment has been recommended by the National Institute for Health and Care Excellence but NHS England had indicated that the national expansion would not be completed until 2022. The Times can reveal that the NHS now plans to bring this forward so that all hospitals can carry out SABR by April but meanwhile the machines sit in hospitals unused.
Clive Peedell, a consultant clinical oncologist and signatory of the letter, says that SABR is an effective alternative to surgery in many cases. Radiotherapy professionals say that SABR can massively shorten treatment schedules and reduce the number of hospital visits needed from as many as 30 down to five.
Professor Karol Sikora, an oncologist and medical director of Rutherford Health, said: “We’ve simply got to start up again with precision radiotherapy techniques to replace surgery. SABR, MRI-guided radiotherapy and proton beam therapy all have their roles. Of all the good things to emerge post-Covid, an upgrade of our radiotherapy services would be a welcome boost.”
Professor Pat Price, chairman of Action Radiotherapy, said: “We have been warning of the groundswell of frustration among professionals for some time and it is understandable that professionals want to use the equipment within their hospitals to the fullest. We simply can’t let a bureaucratic decision made before this crisis stand in the way of an opportunity to deal with the cancer backlog caused by Covid.”
Professor Peter Johnson, national clinical director for cancer at NHS England, said: “Cancer treatment remains a priority for the NHS, and this hasn’t changed, even when we are responding to this unprecedented global pandemic. Radiotherapy is a critical part of NHS cancer services, and staff have worked hard to ensure that vital cancer treatment, such as this, continues to be safe and available for those who would benefit safely from it during the outbreak.”
Since all non-urgent medical treatments were cancelled in March, doctors across all specialities have warned of future health problems and deaths.
The British Heart Foundation is to publish data showing that 28,000 heart procedures have been delayed during the pandemic. A survey shows that 47 per cent of patients have found it harder to get treatment and 32 per cent cannot access medicines. The foundation wants the NHS to increase procedures, such as for pacemakers. Dr Sonya Babu-Narayan, associate medical director, said: “We must continue to provide care for people with heart and circulatory conditions in a safe way.”
The times: Coronavirus: Cancer patients at risk as radiotherapy machines stand idle
30th April 2020 Featured on The Times online - https://www.thetimes.co.uk/edition/news/coronavirus-cancer-patients-at-risk-as-radiotherapy-machines-stand-idle-f5smbjmmr
Cancer patients are facing up to six months in treatment delays as vital radiotherapy is cancelled despite some hospital machines sitting unused for hours each day.
Results from a rapid inquiry into radiotherapy cancer treatment during the Covid-19 pandemic reveals that half of all clinicians have had to delay treatment but have the capacity to carry out vital care.
It is predicted that the outbreak could result in 18,000 extra cancer deaths due to treatment delays and experts argue that an opportunity is being missed to avoid “collateral cancer deaths” by not prioritising radiotherapy.
Results of the inquiry will be presented to ministers tomorrow.
Radiotherapy treatment is needed in half of all cancer cases and is used in a quarter of cases where cancer is cured. It leaves patients less vulnerable to Covid-19 than chemotherapy and surgery. However, it is often seen as a Cinderella service and was suffering from financial and technological underinvestment before the pandemic.
A survey of clinicians carried out by the all-party parliamentary group (APPG) of MPs for radiotherapy and the charity Action Radiotherapy found that 50 per cent reported that two thirds of patients had had their radiotherapy treatment disrupted because of the coronavirus crisis.
Unused machine capacity has increased five fold with some centres now reporting six hours of spare machine time a day. Prostate cancer treatment makes up about a third of the workload of most radiotherapy departments. Now 56 per cent of these patients have seen their treatment delayed by up to six months.
The survey of 341 radiotherapy professionals also uncovered huge concerns in the lack of personal protective equipment for frontline staff and 76 per cent felt they would contract or pass on Covid-19 because of this.
An anonymous clinician said: “We are a highly at-risk group. Our faces are super close to the patient’s. We have to lean our entire body into them to move them contaminating our uniform, yet we’ve been told we are not allowed long-sleeve gowns."
Another added: “The street cleaners in China, who are spraying the streets with disinfectant have better PPE than I do.”
On March 28 the National Institute of Clinical Excellence issued rapid guidelines on how radiotherapy should be delivered during the pandemic. It ranked patients in a priority of 1 to 5 and many treatments were stopped, leaving radiotherapy departments empty and machines unused.
Tim Farron, the Liberal Democrat MP and chairman of the APPG, said, “A double disaster is looming in which we stand to lose as many to cancer as we save from Covid and I fear the secretary of state does not realise there is something he can do about it.
“By boosting radiotherapy, we can massively reduce the number of patients experiencing cancelled, delayed and deferred treatments, and ultimately save lives that would otherwise be lost unnecessarily. The evidence submitted by ourselves to the [health and social care] select committee clearly sets out the problem, and crucially, the solution. I urge him to meet with us to discuss how we can prevent this double tragedy.”
Pat Price, chairwoman of Action Radiotherapy, said: “There are going to be so many extra deaths from conditions other than Covid-19. But it doesn’t have to be as bad as it is on track to be. We need to boost radiotherapy as it can treat patients where other methods are currently high risk.”
Press release: UK charity leads the charge on global response to COVID-19 with launch of international radiotherapy treatment resource
Date : Immediate Release 21st April 2020
0203 051 5671
A new international cancer fighting resource has been launched by a UK charity to ensure cancer treatments can continue amid the COVID-19 pandemic. Whilst healthcare services wrestle with the possibility of deferring, delaying or cancelling cancer treatments, the tool provides a valuable source of short and long term solutions. Action Radiotherapy, who are playing a key role in the Coalition for Global Radiotherapy’s response to the global emergency, have published the tool which will allow international radiotherapy teams to develop the best and most life-saving approaches to keeping cancer treatments going during the pandemic.
The resource provides an opportunity for international healthcare professionals to learn from one another, rapidly share data, disseminate best practise and provide valuable global learning opportunities for healthcare professionals and governments.
Professor Pat Price, Chair of Action Radiotherapy said: “The resource is a call to action from the radiotherapy community to produce a multidisciplinary voice and demonstrate what a global coalition can achieve in advocating for best practice in radiotherapy services, which at this difficult time, will ultimately, save lives.”
“Unfortunately, the information we have so far does show that the UK is lagging behind in its response and there is a very real risk that the lives saved from COVID-19 will be outstripped by those we lose to cancer. It is therefore vital we learn from our global colleagues. And most importantly, act immediately.”
“The Coalition for Global Radiotherapy creates an international stakeholder network bringing together healthcare professionals, charities and industry. The resource provides the go-to information source that will help healthcare providers and policy makers ensure the best treatments for cancer patients during the current situation”.
Radiotherapy is one of the most important cancer treatments needed by 1 in 4 people and is vital in 40 percent of cancer cures. The treatment has quickly become the most important and safest cancer treatment option during COVID-19, largely because it does not require an ICU (Intensive Care Unit) facility like surgery and does not supress the immune system like chemotherapy.
Notes to the editor
Global Coalition For Radiotherapy COVID-19 response website: (https://www.actionradiotherapy.org/global-coalition)
The site was launched on the 8th of April 2020. Action Radiotherapy are continuing to populate the page on a daily basis with the latest information.
The international tool provides opportunities for professionals taking responsibility for finding short and long term solutions for cancer patients during this Covid-19 emergency. It will achieve this by:
Leveraging all organisations work and experiences – a global Radiotherapy (RT) stakeholder coalition for all parties
Rapid collection and dissemination of data from international experience to be shared in one place
Learning from Global experience through sharing what is or is not working in various countries
Linking with industry to find technical solutions
Thinking at an advocacy and policy level for what is needed for RT in short, medium and long term
The Coalition initially comprises of the following groups, others are of course welcome to join:
Union for International Cancer Control (UICC)
International Atomic Energy Agency (IAEA)
The Radiation Therapy Advisory Group (RTAG)
The Independent Clinical Oncology Network (ICON)
European Coordination Committee of the Radiological Electromedical and Healthcare IT Industry (COCIR)
The American Association of Physicists in Medicine (AAPM)
City Cancer Challenge
The Civic Group
Zhongnan Hospital of Wuhan University
National Cancer Centre Singapore
King's College London
This piece first appeared in the Times Red Box of 16th April 2020. Click here to download the original article in.pdf
The response to the coronavirus is already having a severe impact on patients with a range of other health issues as operations are deferred and treatments reprioritised. And in particular for cancer patients, this impact will be an issue long after the imminent expected “peak virus” has passed.
Until a vaccine is generally available special measures will continue to be needed for cancer patients as their condition often reduces immunity and so increases the risk of coronavirus complications. The inescapable consequence of the recent NHS guidelines on cancer prioritisation is that some cancer patients who would have survived without the pandemic will be lost.
Despite the heroic efforts of all concerned, these disruptions to treatment pathways mean that this is perhaps the most worrying period in our lifetimes to be given a cancer diagnosis. It’s vital that the NHS reconfiguration of all cancer treatments, but particularly radiotherapy, is supported, well funded, and flexible and innovative enough to save as many lives as possible.
Radiotherapy is already one of the major weapons against cancer. One in four of us will need it at some point in our lives and it is already needed in four out of ten cancer cures. The number of people receiving radiotherapy is as high as the number receiving chemotherapy. It is delivered by a community of around 5,000 dedicated, highly trained professionals. They are already performing heroically in the face of the Covid-19 challenge.
But its role is about to become even more crucial as clinicians judge it to be most appropriate treatment option in even more cancer cases for two main reasons. First, surgery as a treatment option will become more difficult as surgical resource (and the associated intensive care resource) is redeployed to combat Covid-19. Second, clinicians are aware that chemotherapy tends to reduce immunity so will judge radiotherapy to be, on balance, the better and safer option for more patients.
In this most concerning of times, the need to take every possible step to unleash the full capability and capacity of the radiotherapy service, to play its part in making sure that as many cancer patients are saved as possible, has never been greater. And some of those steps are eminently achievable at pace. First, the radiotherapy professionals need to be a priority case for the supply of PPE. It is outrageous that some centres appear to have no PPE at all, and many others limited supplies of only partially effective items.
Secondly, the bureaucratic restriction that only half of the centres in England can offer the more advanced and faster radiotherapy techniques, even though their machines are capable of delivering it, needs to be swept aside. Thirdly, there is an urgent need to boost IT connectivity between and within radiotherapy centres to maximise treatment capacity, and fourthly, the government should harness the significant spare radiotherapy capacity that exists in the private sector.
These are eminently achievable steps that can, and should, be taken. Cancer patients, and not just those of today, but of the next many months deserve the very best we can do despite the unavoidable pressures of this pandemic.
Professor Pat Price is a visiting professor in surgery at Imperial College, London, and chairwoman of the charity Action Radiotherapy
Press release: Henry Smith supports global manufacturer of innovative cancer technologies in Crawley
Date : Immediate Release 13th March 2020
Peter Carroll 07866 800 755
Daniel Laing 07983 472 541
Henry Smith MP visited Varian Medical Systems today, Friday 13th March 2020, to see the world-leading cancer care technologies manufactured in Crawley. As a supporter of the Radiotherapy4Life campaign, Action Radiotherapy and an active member of the All-Party Parliamentary Group for Radiotherapy (APPG RT), Henry met with representatives and local constituents who contribute to these innovative cancer care technologies.
“I was proud to visit Varian Medical Systems who have been creating jobs and opportunities in Crawley for over 35 years. Having access to the most advanced radiotherapy treatments is vital for fighting cancer and a staggering 1 in 4 of us will need it at some point in our lives.”
“On my visit I was delighted to see the work of local manufacturers in Crawley contributing to innovative technologies driving new wins in cancer care. As a member of the APPG for Radiotherapy, I know the life-saving impacts of radiotherapy and was grateful for the chance to see these innovations being produced first hand”.
Adele Lyons, Head Sales and Service UK and Ireland for Varian Medical Systems, said:
“We are very pleased to welcome Henry Smith, Crawley MP, to our UK and Ireland headquarters. We are particularly excited to share with him the manufacture of our latest technology platform, Halcyon. At Varian, we are committed to supporting the UK economy for more than 35 years, as well as the APPG RT, to enable the right access to radiotherapy for all patients who need it, by focusing on innovation through a strong investment in R&D.”
With 250 employees in the UK and Ireland and 10,000 worldwide, Varian Medical Systems hold a shared vision of a world without fear of cancer. Providing important tools for fighting cancer used across private, NHS, and veterinary sectors, Varian has the stated aim of providing simpler, more efficient, and more effective technologies to power new victories in cancer care.
Varian provides comprehensive solutions for radiotherapy, radiosurgery, proton therapy, and brachytherapy, as well as software systems for planning treatments, managing cancer clinics, sharing knowledge, coordinating care, and using data to deliver evidence-based medicine. With an Intelligent Cancer Care approach, the company is harnessing advanced technologies like artificial intelligence, machine learning and data analytics to enhance cancer treatment and expand access to care.
Radiotherapy4life world cancer day event 4th february 2020
Yesterday, the Radiotherapy4Life campaign, in association with Action Radiotherapy and the All-Party Parliamentary Group for Radiotherapy (APPGRT), hosted an event for MPs and Peers in the House of Commons for World Cancer Day to raise awareness about the need for improved radiotherapy provision in the NHS. We were supported by the UK Radiotherapy Board (SOR, IPEM and RCR) as well as industry and individual professionals. We had a great turn out of MPs interested to hear about radiotherapy. We discussed our recent report, covered this week by the Daily Express, showing that 3.5 million people in England live further than the 45 minute recommended travel time to their nearest radiotherapy centre. Investment in infrastructure, workforce and IT is desperately needed - half of NHS Trusts have machines that need replacing and advanced treatments are being restricted. Following this, a signed letter was delivered to No 10 Downing Street. The next step is for MPs to visit their local radiotherapy department and learn what a fantastic job the professionals do. To see more, please visit the Radiotherapy4Life website or the Twitter page, and follow the hashtag #Radiotherapy4Life
petition and government response
On the 26th of November 2018 Action Radiotherapy lodged a petition on the Governments petition website.
The petition was titled "We want a world class radiotherapy service accessible for all cancer patients"
Action Radiotherapy want the best radiotherapy treatment for cancer as close to home as possible. 1 in 2 of us will at some point develop cancer, meaning 1 in 4 of us need radiotherapy at some point in our lifetime. More investment is critical; despite the need, radiotherapy only receives 5% of the UK cancer budget.
The petition asked for an increase the NHS Cancer budget dedicated to radiotherapy from 5% to 6.5%, and a one-off £250 million investment to modernise existing machines and build satellite radiotherapy centres to ensure accessible service nationwide. UK cancer survival rates are well below European average.
If the UK achieved best European levels, 10k more patients would survive per year. Radiotherapy has a huge part to play in giving the people of the UK the cancer treatment service they deserve.
The petition achieved 10,610 signatures within the 3 month window prompting a response from The Government.
The response from The Government can be read HERE
Launch of APPGRT
On the 22nd of May 2018, in Westminster Tim Farron MP launched the APPG (All Party Parliamentary Group) on Radiotherapy with cross party support with an aim to develop a new patient manifesto for radiotherapy treatment in the UK. Action Radiotherapy was confirmed as the secretariat. With adequate resources we have the capability of providing a world leading high quality cost effective nationally consistent innovative radiotherapy service.
Parliamentary Reception: Radiotherapy
On Tuesday, November 14, Tim Farron MP in partnership with AdvaMed, the United States Trade Association for Advanced Medical Technologies, held a briefing to shine a light on radiotherapy and the benefits that it can bring to patients and in improving cancer outcomes. The event took place in the Strangers’ Dining Room, House of Commons, and featured Steve Brine, Parliamentary Under Secretary of State for Health, the lead Minister for cancer services.
In addition to Mr. Brine, the event brought together stakeholders from the local and national NHS, patient and professional groups, MPs and Peers to consider the benefits of radiotherapy and next steps across the UK. Participants recognised the welcome progress made to improve the provision of radiotherapy in the UK, raised awareness of the benefits of radiotherapy and considered how we can ensure equal access for all patients to the latest techniques.
Action Radiotherapy worked with Map Medtech in highlighting the parliamentary event to patients and professionals in the UK. Map Medtech confirmed that in large part to us, we have been successful in generating a large interest by both patients and professionals, enabling the event to be fully registered.
Action Radiotherapy was well represented at the event with attendance by Professor Pat Price, Chairman, Judith Potts, Trustee, Dr Christy Goldsmith, Trustee and Peter Zarko-Flynn, Trustee. We were also pleased to attain a new friend of Action Radiotherapy at the event, Rachel Bland, who presented her patient experience at the event with a round of applause from the audience.
Sky news: 'Life-saving' cancer treatment to be made available at all cancer centres in England
Thursday 11th June 2020 - Featured on Sky News online
Experts say the innovative treatment will help to deal with an expected backlog of cancer cases.
A key cancer treatment which could save lives is going to be made available to all cancer centres in England in the next year.
The NHS announcement is in response to an open letter signed by more than 200 cancer experts warning the treatment was being “rationed”, as reported exclusively by Sky News last month.
The experts had said failure to act would be a “tragic lost opportunity”.
The stereotactic ablative radiotherapy (SABR) treatment is more precise and uses a higher dose than standard radiotherapy - cutting down the number of hospital visits vulnerable cancer patients will need to make.
NHS chief executive Sir Simon Stevens says the innovative treatment will be “potentially life-saving”.
The treatment is currently used by around half of cancer centres and was going to be fully rolled out by 2022, but experts warned urgent action needed to be taken to help deal with a backlog of cancer cases as a result of the coronavirus pandemic.
Thousands of cancer patients have had treatments cancelled or postponed, while fewer cancers are currently being diagnosed.
A study by the University of Birmingham estimates 36,000 cancer procedures have been cancelled in the UK.
Cancer sufferers who face delays to their treatment are more likely to suffer complications and are more at risk of dying.
Dr Clive Peedell, a consultant clinical oncologist who wrote the open letter along with Action Radiotherapy, said he applauded the decision.
“I think it’s really important during this time because we know there’s going to be a really big cancer backlog and anything we can do to increase our capacity to treat cancer patients during this time will help,” he said.
“There will certainly be patients who can have stereotactic radiotherapy instead of surgery because there’s going to be big surgical waiting lists.”
William Robinson, 83, was diagnosed with a tumour on his lung after having a stent put in his heart in March.
The great-grandfather, from Middlesbrough, received one round of the SABR treatment and said: “It was excellent. It went great and I’ve been alright since.”
He said it was a “big surprise” he had been treated so quickly and praised the staff who looked after him.
SABR will initially be used to treat some tumours in the lungs, lymph nodes and bones, but will later be expanded to treat other cancers.
It will not be suitable for everyone, but the experts are clear it will save lives - and say they already have the capacity to provide the treatment.
Professor Pat Price, chair of Action Radiotherapy, said she was “delighted” with the decision but warned April is “still an awfully long time away”.
“The trouble is, the backlog is going to start coming in the autumn so April’s going to be too late for some places,” she said.
Professor Price said there are still a number of things which will need to be done to help with the backlog - including updating the IT and machines used to carry out radiotherapy.
“We’re heading for such a problem,” she said.
“Everybody’s quite positive at the moment thinking lockdown is nearly over, but the health problems are just starting.”
Published by CapX on 27th August 2020.
We are facing the very real possibility that 2020 will be remembered as the year of not one health crisis, but two. The loss and heartache caused by coronavirus itself is well known. But what is still dawning on many is the growing, catastrophic cancer crisis that the virus has precipitated – and may well end up killing more cancer patients unnecessarily than we will lose to the virus itself.
As the pandemic swept in, cancer screening services across the country were halted; scans, surgery and outpatient appointments were cancelled or delayed in the rush to make capacity for Covid; people were told to ‘stay at home, protect the NHS’ and became frightened to come into hospital, while some GPs started redirecting patients to call NHS 111. All this has led to delays in treatment, with a quarter of a million people who would normally have been urgently referred by their GP to a cancer specialist ‘missing from the diagnostic pipeline’ – and delays in diagnosing cancer can mean treatment comes too late to save lives. One estimate puts the cost of the cancer care backlog at 30,000 lives.
This is certainly the greatest crisis in cancer care in my 30-year career. What I find utterly frustrating is that it simply doesn’t have to be this way. There is time, just, to put in place solutions to avoid this cancer catastrophe – but only if the Government and senior NHS leaders act now. And when they act, it needs to be with same speed, energy and will that they mustered to tackle the virus itself. Slowly getting cancer treatments ‘back to normal’ won’t cut it. Addressing the problem will require a significant boost to services to tackle it and will require the healthcare establishment to make best use of advanced and innovative techniques. Be in no doubt, if this crisis isn’t dealt with it will be a horrendous policy failure – made all the more difficult to bear as we and others have been ringing the alarm bell now for months, since April! This is a crisis that the authorities know is coming. There will be nowhere to hide if it isn’t addressed.
Chief amongst those advanced technology solutions should be a transformational boost to radiotherapy services. Why? Because it is a treatment option that is particularly well suited for use when surgery and chemotherapy are riskier than normal due to possible Covid infection risks. And although radiotherapy already plays a significant role in 50% of cancer patients’ treatment – and is now seen as a safe substitute for surgery in many cases – years of under investment have held it back from reaching its full potential.
Radiotherapy is quick and incredibly cost effective. Typically, a cancer patient for whom radiotherapy is clinically appropriate can be cured for around £6,000. That is up to 40 times more cost effective than some chemotherapy treatments. What’s more, it is safe and already plays a part in 40% of cancer cures. Startling advances in the last decade mean that it is now possible to treat a lung cancer patient in one single 20-minute outpatient session. With all this going for it, you might think that policy makers would be beating a path to the sector’s door in an effort to find out how government can do more for more patients. Sadly, that is not the case.
For a variety of reasons radiotherapy has been treated as something of a Cinderella Service. In the UK, just 5% of the overall cancer budget is spent on radiotherapy. In Australia it’s 9%, and in many European countries it’s around 11%. But the problems are organisational too. The responsibility for radiotherapy in England is spread across 3 ministerial briefs and multiple NHS agencies. This lack of a co-ordinated approach has inevitably led to sub optimal commissioning.
The problems arising from this lack of investment and the lack of coherent commissioning are many and varied. For example, we simply don’t have enough radiotherapy centres and machines. Recent analysis estimates that 3.5 million people in England live further away than the recommended 45-minute travel time to their nearest centre. Added to the shortage of machines is their age. 50% of Trusts are using machines over their recommended 10-year life with all the associated risks to treatment schedules from breakdowns and increased maintenance. But most shockingly, the internal tariff used to remunerate Trusts for delivering radiotherapy incentivises Trusts to treat patients with less effective sessions, meaning patients are treated more times over a longer period than otherwise necessary. That is simply crazy, and a damning indictment of the dead-hand of bureaucracy that is holding this sector back.
The only good news in this worrying scenario is that the crisis can be averted. The All Party Parliamentary Group (APPG) for Radiotherapy has worked long and hard on this issue. With the help of the charity Action Radiotherapy as their secretariat, the APPG has produced a comprehensive 6-point plan to transform the radiotherapy sector and set the 5,000 dedicated professionals delivering it free to treat even more patients, even more quickly. Costing £280 million per annum over 3 years, a modest figure relative to other treatment options, this plan will help tackle both the Covid induced backlog and leave the UK with the world class radiotherapy sector that it deserves.
The Covid cancer clock is ticking. The solutions are at hand. Pounds spent on radiotherapy are amongst the most cost effective ‘health pounds’ the Chancellor could ever spend and we will be making that case in the run up to his Comprehensive Spending Review. It’s simple: curing cancer with radiotherapy saves the UK money. Before Covid the UK sat at the bottom of the cancer league of high-income countries. Now, with the delays due to Covid, it’s estimated that cancer survival has been set back 15 years. We can change this at the stroke of a pen by investing in radiotherapy.
My closing plea to the Prime Minister, the Chancellor, the DH&SC and the NHS is this: none of us involved in cancer care and cure want to be by the bedside of a patient telling them the worst news of all, knowing that they could have, and should have, been saved – so act now, not only to #CatchUpWithCancer, but boost radiotherapy. Let’s beat this crisis.
Professor Pat Price is a visiting professor at Imperial College London, advisor to the APPG for radiotherapy, Chair of the charity Action Radiotherapy and founder of the Radiotherapy4Life and #CatchUpWithCancer campaigns