Senior doctors responsible for monitoring cancer care in England and Wales are concerned that failings in NHS services are contributing to up to half of patients not getting the right treatment for some cancers. In evidence provided to the BBC, the National Cancer Audit Collaborating Centre (NatCan) highlighted particular problems with prostate, kidney, and colon cancers. The expert group said it had found significant variation between hospitals and warned that problems accessing nationally-recommended treatments were putting lives at risk. It carries out audits across nine major cancers, responsible for 80% of cases, and has found shortfalls across a range of different cancer types and stages.
Figures shared with the BBC show: 30% of patients with high-risk prostate cancer do not get curative treatment with either surgery or radiotherapy, with performance varying between 20% and 43% across different services. 34% of stage three colon cancer cases do not get chemotherapy within three months of surgery – at some hospitals the numbers exceed 60%. 50% of stage four renal cell carcinoma patients, a type of kidney cancer that has spread to other parts of the body, do not get drug treatment – with performance varying between 20% and 85%.
NatCan said while a minority of patients would be choosing not to have treatment themselves and others may not be well enough, that could not fully explain the scale of the shortfall or variation between hospitals. Governments in both nations say improving services is a key priority and England is in the process of drawing up a new cancer strategy, which ministers say will revolutionise services.
Ian Pattison, who is in remission after being diagnosed with high-risk prostate cancer in 2020, said he was lucky he lived close to a specialist cancer centre and was able to get the best treatment. He said the treatment was brutal but he is now fully recovered and is enjoying life.
Prof Ajay Aggarwal, clinical director at NatCan, said it was concerning so many patients were not getting the recommended treatment, adding that the variation was hard to understand. “We need to do better,” he said. “With cancer, we often hear people talking about what the next breakthrough is but, the fact remains, using what we have better could make a huge difference. It would extend and save lives.”
RCS president Tim Mitchell said the NHS has access to world-class cancer treatments and care, but inconsistent delivery means far too many patients miss out. “At worst, this may mean some patients are needlessly dying or in unnecessary pain.”
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